WorldWideScience

Sample records for health board community

  1. A Twenty-Two-Year-Old Community Advisory Board: Health Research as an Opportunity for Social Change

    Science.gov (United States)

    Silvestre, Anthony J.; Quinn, Sandra J.; Rinaldo, Charles R.

    2010-01-01

    Conducting health research often requires a partnership between marginalized communities and researchers. Community organizers can broker this partnership in a way that not only produces important scientific discoveries but also brings needed resources to the communities. This article is a description of a community advisory board established in 1984 to advise researchers on a longitudinal study of the natural history of AIDS among gay men. The Board successfully guided the recruitment of more than 3,000 gay and bisexual male volunteers and, at the same time worked as a powerful change agent. An analysis of minutes from all Board meetings between 1984-2006 indicates that significant social change as well as important research findings resulted from Board actions. Community organizers who work to create a mutually beneficial partnership between communities and researchers may find new opportunities to support community growth and social justice. PMID:20523763

  2. Board self-evaluation: the Bayside Health experience.

    Science.gov (United States)

    Duncan-Marr, Alison; Duckett, Stephen J

    2005-08-01

    Board evaluation is a critical component of good governance in any organisation. This paper describes the board self-evaluation process used by Bayside Health, a public health service in Melbourne. The question of how governing boards can assess their performance has received increasing attention over the past decade. In particular, the increasing demand for accountability to shareholders and regulators experienced by corporate sector Boards has resulted in greater scrutiny of board performance, with the market and the balance sheet providing some basis for assessment. Performance evaluation of governing boards in the public sector has been more challenging. Performance evaluation is complex in a sector that is not simply driven by the bottom line, where the stakeholders involve both government and the broader community, and where access to, and the quality and safety of the services provided, are often the major public criteria by which performance may be judged. While some practices from the corporate sector can be applied successfully in the public sector, this is not always the case, and public sector boards such as the Board of Directors of Bayside Health have been developing ways to evaluate and improve their performance.

  3. Health-related hot topic detection in online communities using text clustering.

    Directory of Open Access Journals (Sweden)

    Yingjie Lu

    Full Text Available Recently, health-related social media services, especially online health communities, have rapidly emerged. Patients with various health conditions participate in online health communities to share their experiences and exchange healthcare knowledge. Exploring hot topics in online health communities helps us better understand patients' needs and interest in health-related knowledge. However, the statistical topic analysis employed in previous studies is becoming impractical for processing the rapidly increasing amount of online data. Automatic topic detection based on document clustering is an alternative approach for extracting health-related hot topics in online communities. In addition to the keyword-based features used in traditional text clustering, we integrate medical domain-specific features to represent the messages posted in online health communities. Three disease discussion boards, including boards devoted to lung cancer, breast cancer and diabetes, from an online health community are used to test the effectiveness of topic detection. Experiment results demonstrate that health-related hot topics primarily include symptoms, examinations, drugs, procedures and complications. Further analysis reveals that there also exist some significant differences among the hot topics discussed on different types of disease discussion boards.

  4. Patient Engagement in Community Health Center Leadership: How Does it Happen?

    Science.gov (United States)

    Sharma, Anjana E; Huang, Beatrice; Knox, Margae; Willard-Grace, Rachel; Potter, Michael B

    2018-05-18

    Patient engagement in primary care leadership is an important means to involve community voices at community health centers. Federally qualified health centers (FQHCs) are mandated to have patient representation within their governing boards, while practices seeking patient-centered medical home certification receive credit for implementing patient advisory councils (PACs). Our objective was to compare and contrast how community health centers engage patients in clinic management, decision-making and planning within governing boards versus PACs. Qualitative study conducted from August 2016 to June 2017 at community health centers in California, Arizona and Hawaii. We interviewed practice leaders of patient engagement programs at their site. Eligible clinics had patient representatives within their governing board, PAC, or both. We assessed patient demographics, roles and responsibilities of patients participating, and extent of involvement in quality improvement among governing boards versus PACs. We interviewed 19 sites, of which 17 were FQHCs that had governing boards. Of the 17 FQHCs, 11 had also implemented PACs. Two non-FQHC safety-net sites had PACs but did not have governing boards. Governing board members had formal, structured membership responsibilities such as finances and hiring personnel. PAC roles were more flexible, focusing on day-to-day clinic operations. Clinics tended to recruit governing board patient members for their skill set and professional experience; PAC member recruitment focused more on demographic representation of the clinic's patient population. Both groups worked on quality improvement, but governing boards tended to review clinic performance metrics, while PAC members were involved in specific project planning and implementation to improve clinical outcomes and patient experience. Patient involvement in clinic improvement in CHCs includes higher-level decision-making and governance through mechanisms such as governing boards, as

  5. Ethical dilemmas in community-based participatory research: recommendations for institutional review boards.

    Science.gov (United States)

    Flicker, Sarah; Travers, Robb; Guta, Adrian; McDonald, Sean; Meagher, Aileen

    2007-07-01

    National and international codes of research conduct have been established in most industrialized nations to ensure greater adherence to ethical research practices. Despite these safeguards, however, traditional research approaches often continue to stigmatize marginalized and vulnerable communities. Community-based participatory research (CBPR) has evolved as an effective new research paradigm that attempts to make research a more inclusive and democratic process by fostering the development of partnerships between communities and academics to address community-relevant research priorities. As such, it attempts to redress ethical concerns that have emerged out of more traditional paradigms. Nevertheless, new and emerging ethical dilemmas are commonly associated with CBPR and are rarely addressed in traditional ethical reviews. We conducted a content analysis of forms and guidelines commonly used by institutional review boards (IRBs) in the USA and research ethics boards (REBs) in Canada. Our intent was to see if the forms used by boards reflected common CBPR experience. We drew our sample from affiliated members of the US-based Association of Schools of Public Health and from Canadian universities that offered graduate public health training. This convenience sample (n = 30) was garnered from programs where application forms were available online for download between July and August, 2004. Results show that ethical review forms and guidelines overwhelmingly operate within a biomedical framework that rarely takes into account common CBPR experience. They are primarily focused on the principle of assessing risk to individuals and not to communities and continue to perpetuate the notion that the domain of "knowledge production" is the sole right of academic researchers. Consequently, IRBs and REBs may be unintentionally placing communities at risk by continuing to use procedures inappropriate or unsuitable for CBPR. IRB/REB procedures require a new framework more

  6. National survey and community advisory board development for a bipolar disorder biobank.

    Science.gov (United States)

    Frye, Mark A; Doederlein, Allen; Koenig, Barbara; McElroy, Susan L; Nassan, Malik; Seymour, Lisa R; Biernacka, Joanna M; Daniels, Allen S

    2015-09-01

    The aim of the present study was to engage a national advocacy group and local stakeholders for guidance in developing a bipolar disorder biobank through a web-based survey and a community advisory board. The Depression and Bipolar Support Alliance and the Mayo Clinic Bipolar Biobank conducted a national web-based survey inquiring about interest in participating in a biobank (i.e., giving DNA and clinical information). A community advisory board was convened to guide establishment of the biobank and identify key deliverables from the research project and for the community. Among 385 survey respondents, funding source (87%), professional opinion (76%), mental health consumer opinion (79%), and return of research results (91%) were believed to be important for considering study participation. Significantly more patients were willing to participate in a biobank managed by a university or clinic (78.2%) than one managed by government (63.4%) or industry (58.2%; both p bipolar disorder developing in a child of an affected parent and which medications to avoid. The advisory board endorsed the use of a comprehension questionnaire to evaluate participants' understanding of the study (e.g., longevity of DNA specimens, right to remove samples, accessing medical records) as a means to strengthen the informed consent process. These national survey and community advisory data support the merit of establishing a biobank to enable studies of disease risk, provided that health records and research results are adequately protected. The goals of earlier diagnosis and individualized treatment of bipolar disorder were endorsed. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  7. Public health accreditation and metrics for ethics: a case study on environmental health and community engagement.

    Science.gov (United States)

    Bernheim, Ruth Gaare; Stefanak, Matthew; Brandenburg, Terry; Pannone, Aaron; Melnick, Alan

    2013-01-01

    As public health departments around the country undergo accreditation using the Public Health Accreditation Board standards, the process provides a new opportunity to integrate ethics metrics into day-to-day public health practice. While the accreditation standards do not explicitly address ethics, ethical tools and considerations can enrich the accreditation process by helping health departments and their communities understand what ethical principles underlie the accreditation standards and how to use metrics based on these ethical principles to support decision making in public health practice. We provide a crosswalk between a public health essential service, Public Health Accreditation Board community engagement domain standards, and the relevant ethical principles in the Public Health Code of Ethics (Code). A case study illustrates how the accreditation standards and the ethical principles in the Code together can enhance the practice of engaging the community in decision making in the local health department.

  8. Ethical Dilemmas in Community-Based Participatory Research: Recommendations for Institutional Review Boards

    Science.gov (United States)

    Travers, Robb; Guta, Adrian; McDonald, Sean; Meagher, Aileen

    2007-01-01

    National and international codes of research conduct have been established in most industrialized nations to ensure greater adherence to ethical research practices. Despite these safeguards, however, traditional research approaches often continue to stigmatize marginalized and vulnerable communities. Community-based participatory research (CBPR) has evolved as an effective new research paradigm that attempts to make research a more inclusive and democratic process by fostering the development of partnerships between communities and academics to address community-relevant research priorities. As such, it attempts to redress ethical concerns that have emerged out of more traditional paradigms. Nevertheless, new and emerging ethical dilemmas are commonly associated with CBPR and are rarely addressed in traditional ethical reviews. We conducted a content analysis of forms and guidelines commonly used by institutional review boards (IRBs) in the USA and research ethics boards (REBs) in Canada. Our intent was to see if the forms used by boards reflected common CBPR experience. We drew our sample from affiliated members of the US-based Association of Schools of Public Health and from Canadian universities that offered graduate public health training. This convenience sample (n = 30) was garnered from programs where application forms were available online for download between July and August, 2004. Results show that ethical review forms and guidelines overwhelmingly operate within a biomedical framework that rarely takes into account common CBPR experience. They are primarily focused on the principle of assessing risk to individuals and not to communities and continue to perpetuate the notion that the domain of “knowledge production” is the sole right of academic researchers. Consequently, IRBs and REBs may be unintentionally placing communities at risk by continuing to use procedures inappropriate or unsuitable for CBPR. IRB/REB procedures require a new framework

  9. Building research infrastructure in community health centers: a Community Health Applied Research Network (CHARN) report.

    Science.gov (United States)

    Likumahuwa, Sonja; Song, Hui; Singal, Robbie; Weir, Rosy Chang; Crane, Heidi; Muench, John; Sim, Shao-Chee; DeVoe, Jennifer E

    2013-01-01

    This article introduces the Community Health Applied Research Network (CHARN), a practice-based research network of community health centers (CHCs). Established by the Health Resources and Services Administration in 2010, CHARN is a network of 4 community research nodes, each with multiple affiliated CHCs and an academic center. The four nodes (18 individual CHCs and 4 academic partners in 9 states) are supported by a data coordinating center. Here we provide case studies detailing how CHARN is building research infrastructure and capacity in CHCs, with a particular focus on how community practice-academic partnerships were facilitated by the CHARN structure. The examples provided by the CHARN nodes include many of the building blocks of research capacity: communication capacity and "matchmaking" between providers and researchers; technology transfer; research methods tailored to community practice settings; and community institutional review board infrastructure to enable community oversight. We draw lessons learned from these case studies that we hope will serve as examples for other networks, with special relevance for community-based networks seeking to build research infrastructure in primary care settings.

  10. Indian boarding school experience, substance use, and mental health among urban two-spirit American Indian/Alaska natives.

    Science.gov (United States)

    Evans-Campbell, Teresa; Walters, Karina L; Pearson, Cynthia R; Campbell, Christopher D

    2012-09-01

    Systematic efforts of assimilation removed many Native children from their tribal communities and placed in non-Indian-run residential schools. To explore substance use and mental health concerns among a community-based sample of 447 urban two-spirit American Indian/Alaska Native adults who had attended boarding school as children and/or who were raised by someone who attended boarding school. Eighty-two respondents who had attended Indian boarding school as children were compared to respondents with no history of boarding school with respect to mental health and substance use. Former boarding school attendees reported higher rates of current illicit drug use and living with alcohol use disorder, and were significantly more likely to have attempted suicide and experienced suicidal thoughts in their lifetime compared to non-attendees. About 39% of the sample had been raised by someone who attended boarding school. People raised by boarding school attendees were significantly more likely to have a general anxiety disorder, experience posttraumatic stress disorder symptoms, and have suicidal thoughts in their lifetime compared to others.

  11. Eastern Health Board Regional Orthodontic Service: an initial audit.

    LENUS (Irish Health Repository)

    Dowling, P A

    1997-01-01

    This initial audit of 600 recently assessed Eastern Health Board orthodontic patients suggests that a large number of them (47 per cent) requires referral for routine restorative and preventive dental care. Closer links are needed with general dental practitioners and community dental surgeons to resolve these needs. The trend for a high referral of females and Class 11 Division 1 malocclusion type correlated well with studies in other countries.

  12. IDENTIFYING COMPETENCIES OF VOLUNTEER BOARD MEMBERS OF COMMUNITY SPORTS CLUBS

    OpenAIRE

    A. BALDUCK; A. VAN ROSSEM; M. BUELENS

    2009-01-01

    This study contributes to the emerging empirical studies on roles and responsibilities of boards in nonprofit organizations by identifying competencies of volunteer board members. We identified how two types of constituents—volunteer board members and sports members—perceived competencies of volunteer board members in community sports clubs. We used the repertory grid technique to draw cognitive maps and to reveal the perceived reality of these constituents. Our results suggest that constitue...

  13. "Psychological Boarding" and Community-Based Behavioral Health Crisis Stabilization.

    Science.gov (United States)

    Mukherjee, Dhrubodhi; Saxon, Verletta

    2018-01-27

    This exploratory paper presents a case study where a community based mental health organization forging a partnership with a local hospital system to establish a crisis stabilization unit (CSU) to address behavioral health emergency care. The study takes a mixed methods case study approach to address two research questions; (a) did this approach reduce the overall length of stay in the hospital emergency departments? (b) What challenges did the taskforce face in implementing this CSU model? The paper shares recommendation from the findings.

  14. Psychiatric Boarding in Washington State and the Inadequacy of Mental Health Resources.

    Science.gov (United States)

    Bloom, Joseph D

    2015-06-01

    Psychiatric boarding is a term derived from emergency medicine that describes the holding of patients deemed in need of hospitalization in emergency departments for extended periods because psychiatric beds are not available. Such boarding has occurred for many years in the shadows of mental health care as both inpatient beds and community services have decreased. This article focuses on a 2014 Washington State Supreme Court decision that examined the interpretation of certain sections of the Washington state civil commitment statute that had been used to justify the extended boarding of detained psychiatric patients in general hospital emergency departments. The impact of this decision on the state of Washington should be significant and could spark a national debate about the negative impacts of psychiatric boarding on patients and on the nation's general hospital emergency services. © 2015 American Academy of Psychiatry and the Law.

  15. The Electronic Health Literacy and Utilization of Technology for Health in a Remote Hawaiian Community: Lana'i.

    Science.gov (United States)

    Witten, Nash Ak; Humphry, Joseph

    2018-03-01

    The Lana'i Community Health Center (LCHC) like other health care organizations, is striving to implement technology-enabled care (TEC) in the clinical setting. TEC includes such technological innovations as patient portals, mobile phone applications, wearable health sensors, and telehealth. This study examines the utilization of communication technology by members of the Lana'i community and LCHC staff and board members in the home and in their daily lives and evaluates the community's electronic health literacy. Quantitative surveys and qualitative focus groups were utilized. These revealed that members of the Lana'i community and LCHC staff and board members regularly utilize technology, in the form of smart cell phones, WiFi, and internet texting. This community has integrated technology into their daily lives, even though they live on an isolated island with 3,102 people; however, despite this integration, the electronic health literacy of this population appears insufficient for proper understanding and utilization of TEC, limiting the potential of patient portals or remote monitoring of patient generated data for chronic disease prevention and management without additional education and mentoring. It is therefore in the best interest of the LCHC and other health organizations wishing to implement TEC in a rural community such as Lana'i to include a strong educational component with use of TEC, and perhaps establish a mentor/partnership program for the highly-challenged patient.

  16. The WAMI Rural Hospital Project. Part 3: Building health care leadership in rural communities.

    Science.gov (United States)

    Elder, W G; Amundson, B A

    1991-01-01

    The WAMI Rural Hospital Project (RHP) intervention combined aspects of community development, strategic planning and organizational development to address the leadership issues in six Northwest rural hospitals. Hospitals and physicians, other community health care providers and local townspeople were involved in this intervention, which was accomplished in three phases. In the first phase, extensive information about organizational effectiveness was collected at each site. Phase two consisted of 30 hours of education for the physician, board, and hospital administrator community representatives covering management, hospital board governance, and scope of service planning. In the third phase, each community worked with a facilitator to complete a strategic plan and to resolve conflicts addressed in the management analyses. The results of the evaluation demonstrated that the greatest change noted among RHP hospitals was improvement in the effectiveness of their governing boards. All boards adopted some or all of the project's model governance plan and had successfully completed considerable portions of their strategic plans by 1989. Teamwork among the management triad (hospital, board, and medical staff) was also substantially improved. Other improvements included the development of marketing plans for the three hospitals that did not initially have them and more effective use of outside consultants. The project had less impact on improving the functioning of the medical chief of staff, although this was not a primary target of the intervention. There was also relatively less community interest in joining regional health care associations. The authors conclude that an intervention program tailored to address specific community needs and clearly identified leadership deficiencies can have a positive effect on rural health care systems.

  17. [Community health in primary health care teams: a management objective].

    Science.gov (United States)

    Nebot Adell, Carme; Pasarin Rua, Maribel; Canela Soler, Jaume; Sala Alvarez, Clara; Escosa Farga, Alex

    2016-12-01

    To describe the process of development of community health in a territory where the Primary Health Care board decided to include it in its roadmap as a strategic line. Evaluative research using qualitative techniques, including SWOT analysis on community health. Two-steps study. Primary care teams (PCT) of the Catalan Health Institute in Barcelona city. The 24 PCT belonging to the Muntanya-Dreta Primary Care Service in Barcelona city, with 904 professionals serving 557,430 inhabitants. Application of qualitative methodology using SWOT analysis in two steps (two-step study). Step 1: Setting up a core group consisting of local PCT professionals; collecting the community projects across the territory; SWOT analysis. Step 2: From the needs identified in the previous phase, a plan was developed, including a set of training activities in community health: basic, advanced, and a workshop to exchange experiences from the PCTs. A total of 80 team professionals received specific training in the 4 workshops held, one of them an advanced level. Two workshops were held to exchange experiences with 165 representatives from the local teams, and 22 PCTs presenting their practices. In 2013, 6 out of 24 PCTs have had a community diagnosis performed. Community health has achieved a good level of development in some areas, but this is not the general situation in the health care system. Its progression depends on the management support they have, the local community dynamics, and the scope of the Primary Health Care. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  18. Accelerated Adoption of Advanced Health Information Technology in Beacon Community Health Centers.

    Science.gov (United States)

    Jones, Emily; Wittie, Michael

    2015-01-01

    To complement national and state-level HITECH Act programs, 17 Beacon communities were funded to fuel community-wide use of health information technology to improve quality. Health centers in Beacon communities received supplemental funding. This article explores the association between participation in the Beacon program and the adoption of electronic health records. Using the 2010-2012 Uniform Data System, trends in health information technology adoption among health centers located within and outside of Beacon communities were explored using differences in mean t tests and multivariate logistic regression. Electronic health record adoption was widespread and rapidly growing in all health centers, especially quality improvement functionalities: structured data capture, order and results management, and clinical decision support. Adoption lagged for functionalities supporting patient engagement, performance measurement, care coordination, and public health. The use of advanced functionalities such as care coordination grew faster in Beacon health centers, and Beacon health centers had 1.7 times higher odds of adopting health records with basic safety and quality functionalities in 2010-2012. Three factors likely underlie these findings: technical assistance, community-wide activation supporting health information exchange, and the layering of financial incentives. Additional technical assistance and community-wide activation is needed to support the use of functionalities that are currently lagging. © Copyright 2015 by the American Board of Family Medicine.

  19. National Differences in Regional Emergency Department Boarding Times: Are US Emergency Departments Prepared for a Public Health Emergency?

    Science.gov (United States)

    Love, Jennifer S; Karp, David; Delgado, M Kit; Margolis, Gregg; Wiebe, Douglas J; Carr, Brendan G

    2016-08-01

    Boarding admitted patients decreases emergency department (ED) capacity to accommodate daily patient surge. Boarding in regional hospitals may decrease the ability to meet community needs during a public health emergency. This study examined differences in regional patient boarding times across the United States and in regions at risk for public health emergencies. A retrospective cross-sectional analysis was performed by using 2012 ED visit data from the American Hospital Association (AHA) database and 2012 hospital ED boarding data from the Centers for Medicare and Medicaid Services Hospital Compare database. Hospitals were grouped into hospital referral regions (HRRs). The primary outcome was mean ED boarding time per HRR. Spatial hot spot analysis examined boarding time spatial clustering. A total of 3317 of 4671 (71%) hospitals were included in the study cohort. A total of 45 high-boarding-time HRRs clustered along the East/West coasts and 67 low-boarding-time HRRs clustered in the Midwest/Northern Plains regions. A total of 86% of HRRs at risk for a terrorist event had high boarding times and 36% of HRRs with frequent natural disasters had high boarding times. Urban, coastal areas have the longest boarding times and are clustered with other high-boarding-time HRRs. Longer boarding times suggest a heightened level of vulnerability and a need to enhance surge capacity because these regions have difficulty meeting daily emergency care demands and are at increased risk for disasters. (Disaster Med Public Health Preparedness. 2016;10:576-582).

  20. Health and wellbeing boards: public health decision making bodies or political pawns?

    Science.gov (United States)

    Greaves, Z; McCafferty, S

    2017-02-01

    Health and Wellbeing boards in England are uniquely constituted; embedded in the local authorities with membership drawn from a range of stakeholders and partner organizations. This raises the question of how decision making functions of the boards reflects wider public health decision making, if criteria are applied to decision making, and what prioritization processes, if any, are used. Qualitative research methods were employed and five local boards were approached, interview dyads were conducted with the boards Chair and Director of Public Health across four of these (n = 4). Three questions were addressed: how are decisions made? What are the criteria applied to decision making? And how are criteria then prioritized? A thematic approach was used to analyse data identifying codes and extracting key themes. Equity, effectiveness and consistency with strategies of board and partners were most consistently identified by participants as criteria influencing decisions. Prioritization was described as an engaged and collaborative process, but criteria were not explicitly referenced in the decision making of the boards which instead made unstructured prioritization of population sub-groups or interventions agreed by consensus. Criteria identified are broadly consistent with those used in wider public health practice but additionally incorporated criteria which recognizes the political siting of the boards. The study explored the variety in different board's approaches to prioritization and identified a lack of clarity and rigour in the identification and use of criteria in prioritization processes. Decision making may benefit from the explicit inclusion of criteria in the prioritization process. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  1. Impact of board independence on the quality of community disclosures in annual reports

    OpenAIRE

    Yekini, Cecilia Olukemi; Adelopo, Ismail; Andrikopoulos, Panagiotis; Yekini, Sina

    2015-01-01

    This study investigates the link between board independence and the quality of community disclosures in annual reports. Using content analysis and a panel dataset from UK FTSE 350 companies the results indicate a statistically significant relationship between board independence, as measured by the proportion of non-executive directors, and the quality of community disclosures, while holding constant other corporate governance and firm specific variables. The study indicates tha...

  2. Aligning the goals of community-engaged research: why and how academic health centers can successfully engage with communities to improve health.

    Science.gov (United States)

    Michener, Lloyd; Cook, Jennifer; Ahmed, Syed M; Yonas, Michael A; Coyne-Beasley, Tamera; Aguilar-Gaxiola, Sergio

    2012-03-01

    Community engagement (CE) and community-engaged research (CEnR) are increasingly viewed as the keystone to translational medicine and improving the health of the nation. In this article, the authors seek to assist academic health centers (AHCs) in learning how to better engage with their communities and build a CEnR agenda by suggesting five steps: defining community and identifying partners, learning the etiquette of CE, building a sustainable network of CEnR researchers, recognizing that CEnR will require the development of new methodologies, and improving translation and dissemination plans. Health disparities that lead to uneven access to and quality of care as well as high costs will persist without a CEnR agenda that finds answers to both medical and public health questions. One of the biggest barriers toward a national CEnR agenda, however, are the historical structures and processes of an AHC-including the complexities of how institutional review boards operate, accounting practices and indirect funding policies, and tenure and promotion paths. Changing institutional culture starts with the leadership and commitment of top decision makers in an institution. By aligning the motivations and goals of their researchers, clinicians, and community members into a vision of a healthier population, AHC leadership will not just improve their own institutions but also improve the health of the nation-starting with improving the health of their local communities, one community at a time.

  3. Engaging Institutional Review Boards in Developing a Brief, Community-Responsive Human Subjects Training for Community Partners

    Science.gov (United States)

    Calzo, Jerel P.; Bogart, Laura M.; Francis, Evelyn; Kornetsky, Susan Z.; Winkler, Sabune J.; Kaberry, Julie M.

    2017-01-01

    BACKGROUND Engaging community partners as co-investigators in community-based participatory research (CBPR) requires certification in the rules, ethics, and principles governing research. Despite developments in making human research protection trainings more convenient and standardized (e.g., self-paced Internet modules), time constraints and the structure of the content (which may favor academic audiences) may hinder the training of community partners. OBJECTIVES This paper is motivated by a case example in which academic and community partners, and stakeholders of a community-based organization actively engaged the leadership of a pediatric hospital-based Institutional Review Board (IRB) in implementing a brief, community-responsive human subjects training session. METHODS A two hour, discussion-based human subjects training was developed via collaborations between the IRB and the community and academic partners. Interviews with trainees and facilitators after the training were used to evaluate its acceptability and possible future applications. CONCLUSIONS Local Institutional Review Boards have the potential to assist community partners in building sufficient knowledge of human subjects research protections to engage in specific projects, thereby expediting the progress of vital research to address community needs. We propose the need for developing truncated human subjects education materials to train and certify community partners, and creating formally organized entities within academic and medical institutions that specialize in community-based research to guide the development and implementation of alternative human subjects training certification opportunities for community partners. PMID:28230554

  4. Accredited Health Department Partnerships to Improve Health: An Analysis of Community Health Assessments and Improvement Plans.

    Science.gov (United States)

    Kronstadt, Jessica; Chime, Chinecherem; Bhattacharya, Bulbul; Pettenati, Nicole

    The Public Health Accreditation Board (PHAB) Standards & Measures require the development and updating of collaborative community health assessments (CHAs) and community health improvement plans (CHIPs). The goal of this study was to analyze the CHAs and CHIPs of PHAB-accredited health departments to identify the types of partners engaged, as well as the objectives selected to measure progress toward improving community health. The study team extracted and coded data from documents from 158 CHA/CHIP processes submitted as part of the accreditation process. Extracted data included population size, health department type, data sources, and types of partner organizations. Health outcome objectives were categorized by Healthy People 2020 Leading Health Indicator (LHI), as well as by the 7 broad areas in the PHAB reaccreditation framework for population health outcomes reporting. Participants included health departments accredited between 2013 and 2016 that submitted CHAs and CHIPs to PHAB, including 138 CHAs/CHIPs from local health departments and 20 from state health departments. All the CHAs/CHIPs documented collaboration with a broad array of partners, with hospitals and health care cited most frequently (99.0%). Other common partners included nonprofit service organizations, education, business, and faith-based organizations. Small health departments more frequently listed many partner types, including law enforcement and education, compared with large health departments. The majority of documents (88.6%) explicitly reference Healthy People 2020 goals, with most addressing the LHIs nutrition/obesity/physical activity and access to health services. The most common broad areas from PHAB's reaccreditation framework were preventive health care and individual behavior. This study demonstrates the range of partners accredited health departments engage with to collaborate on improving their communities' health as well as the objectives used to measure community health

  5. Disaster Mental Health and Community-Based Psychological First Aid: Concepts and Education/Training.

    Science.gov (United States)

    Jacobs, Gerard A; Gray, Brandon L; Erickson, Sara E; Gonzalez, Elvira D; Quevillon, Randal P

    2016-12-01

    Any community can experience a disaster, and many traumatic events occur without warning. Psychologists can be an important resource assisting in psychological support for individuals and communities, in preparation for and in response to traumatic events. Disaster mental health and the community-based model of psychological first aid are described. The National Preparedness and Response Science Board has recommended that all mental health professionals be trained in disaster mental health, and that first responders, civic officials, emergency managers, and the general public be trained in community-based psychological first aid. Education and training resources in these two fields are described to assist psychologists and others in preparing themselves to assist their communities in difficult times and to help their communities learn to support one another. © 2016 Wiley Periodicals, Inc.

  6. The representation of health professionals on governing boards of health care organizations in New York City.

    Science.gov (United States)

    Mason, Diana J; Keepnews, David; Holmberg, Jessica; Murray, Ellen

    2013-10-01

    The Representation of Health Professionals on Governing Boards of Health Care Organizations in New York City. The heightened importance of processes and outcomes of care-including their impact on health care organizations' (HCOs) financial health-translate into greater accountability for clinical performance on the part of HCO leaders, including their boards, during an era of health care reform. Quality and safety of care are now fiduciary responsibilities of HCO board members. The participation of health professionals on HCO governing bodies may be an asset to HCO governing boards because of their deep knowledge of clinical problems, best practices, quality indicators, and other issues related to the safety and quality of care. And yet, the sparse data that exist indicate that physicians comprise more than 20 % of the governing board members of hospitals while less than 5 % are nurses and no data exist on other health professionals. The purpose of this two-phased study is to examine health professionals' representations on HCOs-specifically hospitals, home care agencies, nursing homes, and federally qualified health centers-in New York City. Through a survey of these organizations, phase 1 of the study found that 93 % of hospitals had physicians on their governing boards, compared with 26 % with nurses, 7 % with dentists, and 4 % with social workers or psychologists. The overrepresentation of physicians declined with the other HCOs. Only 38 % of home care agencies had physicians on their governing boards, 29 % had nurses, and 24 % had social workers. Phase 2 focused on the barriers to the appointment of health professionals to governing boards of HCOs and the strategies to address these barriers. Sixteen health care leaders in the region were interviewed in this qualitative study. Barriers included invisibility of health professionals other than physicians; concerns about "special interests"; lack of financial resources for donations to the organization

  7. Extent and patterns of community collaboration in local health departments: An exploratory survey

    Directory of Open Access Journals (Sweden)

    Fisher John W

    2011-10-01

    Full Text Available Abstract Background Local public health departments (LHDs in the United States have been encouraged to collaborate with various other community organizations and individuals. Current research suggests that many forms of active partnering are ongoing, and there are numerous examples of LHD collaboration with a specific organization for a specific purpose or program. However, no existing research has attempted to characterize collaboration, for the defined purpose of setting community health status priorities, between a defined population of local officials and a defined group of alternative partnering organizations. The specific aims of this study were to 1 determine the range of collaborative involvement exhibited by a study population of local public health officials, and, 2 characterize the patterns of the selection of organizations/individuals involved with LHDs in the process of setting community health status priorities. Methods Local health department officials in North Carolina (n = 53 responded to an exploratory survey about their levels of involvement with eight types of possible collaborator organizations and individuals. Descriptive statistics and the stochastic clustering technique of Self-Organizing Maps (SOM were used to characterize their collaboration. Results Local health officials vary extensively in their level of collaboration with external collaborators. While the range of total involvement varies, the patterns of involvement for this specific function are relatively uniform. That is, regardless of the total level of involvement (low, medium or high, officials maintain similar hierarchical preference rankings with Community Advisory Boards and Local Boards of Health most involved and Experts and Elected Officials least involved. Conclusion The extent and patterns of collaboration among LHDs with other community stakeholders for a specific function can be described and ultimately related to outcome measures of LHD performance.

  8. Democratising health care governance? New Zealand's inaugural district health board elections, 2001.

    Science.gov (United States)

    Gauld, Robin

    2002-01-01

    New Zealand's 'district health board' (DHB) system has been under implementation since the 1999 general election. A key factor motivating the change to DHBs is the democratisation of health care governance. A majority of the new DHB members are popularly elected. Previously, hospital board members were government appointees. Inaugural DHB elections were held in October 2001. This article reports on the election results and the wider operating context for DHBs. It notes organisational issues to be considered for the next DHB elections in 2004, and questions the extent to which the elections and DHB governance structure will enhance health care democratisation in New Zealand.

  9. Refinement of boards' role required.

    Science.gov (United States)

    Umbdenstock, R J

    1987-01-01

    The governing board's role in health care is not changing, but new competitive forces necessitate a refinement of the board's approach to fulfilling its role. In a free-standing, community, not-for-profit hospital, the board functions as though it were the "owner." Although it does not truly own the facility in the legal sense, the board does have legal, fiduciary, and financial responsibilities conferred on it by the state. In a religious-sponsored facility, the board fulfills these same obligations on behalf of the sponsoring institute, subject to the institute's reserved powers. In multi-institutional systems, the hospital board's power and authority depend on the role granted it by the system. Boards in all types of facilities are currently faced with the following challenges: Fulfilling their basic responsibilities, such as legal requirements, financial duties, and obligations for the quality of care. Encouraging management and the board itself to "think strategically" in attacking new competitive market forces while protecting the organization's traditional mission and values. Assessing recommended strategies in light of consequences if constituencies think the organization is abandoning its commitments. Boards can take several steps to match their mode of operation with the challenges of the new environment. Boards must rededicate themselves to the hospital's mission. Trustees must expand their understanding of health care trends and issues and their effect on the organization. Boards must evaluate and help strengthen management's performance, rather than acting as a "watchdog" in an adversarial position. Boards must think strategically, rather than focusing solely on operational details. Boards must evaluate the methods they use for conducting business.

  10. Health Extension and Clinical and Translational Science: An Innovative Strategy for Community Engagement.

    Science.gov (United States)

    Kaufman, Arthur; Rhyne, Robert L; Anastasoff, Juliana; Ronquillo, Francisco; Nixon, Marnie; Mishra, Shiraz; Poola, Charlene; Page-Reeves, Janet; Nkouaga, Carolina; Cordova, Carla; Larson, Richard S

    Health Extension Regional Officers (HEROs) through the University of New Mexico Health Sciences Center (UNMHSC) help to facilitate university-community engagement throughout New Mexico. HEROs, based in communities across the state, link priority community health needs with university resources in education, service, and research. Researchers' studies are usually aligned with federal funding priorities rather than with health priorities expressed by communities. To help overcome this misalignment, the UNM Clinical and Translational Science Center (CTSC) provides partial funding for HEROs to bridge the divide between research priorities of UNMHSC and health priorities of the state's communities. A bidirectional partnership between HEROs and CTSC researchers was established, which led to: 1) increased community engaged studies through the CTSC, 2) the HERO model itself as a subject of research, 3) a HERO-driven increase in local capacity in scholarship and grant writing, and 4) development of training modules for investigators and community stakeholders on community-engaged research. As a result, 5 grants were submitted, 4 of which were funded, totaling $7,409,002.00, and 3 research articles were published. Health extension can serve as a university-funded, community-based bridge between community health needs and Clinical and Translational Science Award (CTSA) research capacity, opening avenues for translational research. © Copyright 2017 by the American Board of Family Medicine.

  11. Up dating Islamic Boarding School Santri and Reproductive Health Information

    Directory of Open Access Journals (Sweden)

    Made Asri Budisuari

    2016-06-01

    Full Text Available Background: Islamic boarding school system has long story in indonesia, they covered as much 14.798 student whoare teenager between 9–15 year old. Problems encountered with adolescent sexuality and reproductive health. Methods:An explorative research implemented in 3 provinces ie East Java, Nusa Tenggara Barat (NTB, East Kalimantan and sixIslamic boarding schools. Data were collected through questionnaires about reproductive health. Results: It showed 48,5%of respondents didn’t have enough knowledge, attitudes and behavior about reproductive health, 40% of respondents knewvery little about puberty, menstruation and wet dream, 71% of respondents had little knowledge about the risk of pregnancy;49% of respondents had not enough knowledge about sexually transmited diseases. 88% respondents said that they hadfall in love, 76% of respondents had positive courtship behavior. Conclusion: The information about reproductive healthin islamic boarding school for adolescents is still in adequate and only refer to yellow book. Health worker did not provideadequqte information. We still found student who have sex while when they were engaged still datting. Suggestion: Theneed of additional and up to date reproductive health information and the risks of sexual intercourse marriage it maybedelivery on interesting media, such as one social networking. A health reproductive modules consist of scientic materialand some knowledge has to be developed and should be delivery health worker. Reproductive health syllabus and trainingfor trainers for teachers of boarding school is needed.

  12. New Zealand evidence for the impact of primary healthcare investment in Capital and Coast District Health Board.

    Science.gov (United States)

    Tan, Lee; Carr, Julia; Reidy, Johanna

    2012-03-30

    This paper provides New Zealand evidence on the effectiveness of primary care investment, measured through the Capital and Coast District Health Board's (DHB) Primary Health Care Framework. The Framework was developed in 2002/2003 to guide funding decisions at a DHB level, and to provide a transparent basis for evaluation of the implementation of the Primary Health Care Strategy in this district. The Framework used a mixed method approach; analysis was based on quantitative and qualitative data. This article demonstrates the link between investment in primary health care, increased access to primary care for high-need populations, workforce redistribution, and improved health outcomes. Over the study period, ambulatory sensitive hospitalisations and emergency department use reduced for enrolled populations and the District's immunisation coverage improved markedly. Funding and contracting which enhanced both 'mainstream' and 'niche' providers combined with community-based health initiatives resulted in a measurable impact on a range of health indicators and inequalities. Maori primary care providers improved access for Maori but also for their enrolled populations of Pacific and Other ethnicity. Growth and redistribution of primary care workforce was observed, improving the availability of general practitioners, nurses, and community workers in poorer communities.

  13. 76 FR 5340 - Federal Advisory Committee; Defense Health Board (DHB) Meeting

    Science.gov (United States)

    2011-01-31

    ... Hilton Washington Dulles Hotel, 13869 Park Center Road, Herndon, Virginia, 20171 FOR FURTHER INFORMATION... meeting registration are available online at the Defense Health Board (DHB) Web site: http://www.ha.osd... the Defense Health Board until the next open meeting. The Designated Federal Officer will review all...

  14. Institutional review board challenges related to community-based participatory research on human exposure to environmental toxins: A case study

    Directory of Open Access Journals (Sweden)

    Rudel Ruthann A

    2010-07-01

    Full Text Available Abstract Background We report on the challenges of obtaining Institutional Review Board (IRB coverage for a community-based participatory research (CBPR environmental justice project, which involved reporting biomonitoring and household exposure results to participants, and included lay participation in research. Methods We draw on our experiences guiding a multi-partner CBPR project through university and state Institutional Review Board reviews, and other CBPR colleagues' written accounts and conference presentations and discussions. We also interviewed academics involved in CBPR to learn of their challenges with Institutional Review Boards. Results We found that Institutional Review Boards are generally unfamiliar with CBPR, reluctant to oversee community partners, and resistant to ongoing researcher-participant interaction. Institutional Review Boards sometimes unintentionally violate the very principles of beneficence and justice which they are supposed to uphold. For example, some Institutional Review Boards refuse to allow report-back of individual data to participants, which contradicts the CBPR principles that guide a growing number of projects. This causes significant delays and may divert research and dissemination efforts. Our extensive education of our university Institutional Review Board convinced them to provide human subjects protection coverage for two community-based organizations in our partnership. Conclusions IRBs and funders should develop clear, routine review guidelines that respect the unique qualities of CBPR, while researchers and community partners can educate IRB staff and board members about the objectives, ethical frameworks, and research methods of CBPR. These strategies can better protect research participants from the harm of unnecessary delays and exclusion from the research process, while facilitating the ethical communication of study results to participants and communities.

  15. Novel use of the Wii Balance Board to prospectively predict falls in community-dwelling older adults.

    Science.gov (United States)

    Kwok, Boon-Chong; Clark, Ross A; Pua, Yong-Hao

    2015-06-01

    The Wii Balance Board has received increasing attention as a balance measurement tool; however its ability to prospectively predict falls is unknown. This exploratory study investigated the use of the Wii Balance Board and other clinical-based measures for prospectively predicting falls among community-dwelling older adults. Seventy-three community-dwelling men and women, aged 60-85years were followed-up over a year for falls. Standing balance was indexed by sway velocities measured using the Wii Balance Board interfaced with a laptop. Clinical-based measures included Short Physical Performance Battery, gait speed and Timed-Up-and-Go test. Multivariable regression analyses were used to assess the ability of the Wii Balance Board measure to complement the TUG test in fall screening. Individually, the study found Wii Balance Board anteroposterior (odds ratio 1.98, 95% CI 1.16 to 3.40, P=0.01) and mediolateral (odds ratio 2.80, 95% CI 1.10 to 7.13, p=0.03) sway velocity measures predictive of prospective falls. However, when each velocity measure was adjusted with body mass index and Timed-Up-and-Go, only anteroposterior sway velocity was predictive of prospective falls (odds ratio 2.21, 95% CI 1.18 to 4.14). A faster anteroposterior velocity was associated with increased odds of falling. Area-under-the-curves for Wii Balance Board sway velocities were 0.67 and 0.71 for anteroposterior and mediolateral respectively. The Wii Balance Board-derived anteroposterior sway velocity measure could complement existing clinical-based measures in predicting future falls among community-dwelling older adults. Australian New Zealand Clinical Trials Registry number: ACTRN12610001099011. Copyright © 2015 Elsevier Ltd. All rights reserved.

  16. Board on chemical sciences and technology

    International Nuclear Information System (INIS)

    1991-01-01

    The Board on Chemical Sciences and Technology organizes and provides direction for standing and ad-hoc committees charged with addressing specific issues relevant to the continued health of the chemical sciences and technology community. Studies currently under the oversight of the BCST include a major survey of the chemical sciences, a complementary survey of chemical engineering, an examination of the problems of biohazards in the laboratory, and an analysis of the roots and magnitude of the problem of obsolescent facilities for research and teaching in departments in the chemical sciences and engineering. The Board continues to respond to specific agency requests for program assessments and advice. BCST members are designated to serve as liaison with major federal agencies or departments that support research in order to help identify ways for the Board to assist these organizations. The BCST maintains close contact with professional societies and non-governmental organizations that share the Board's concern for the health of chemical sciences and technology. Individual Board members are assigned responsibility for liaison with the American Chemical Society, the American Institute of Chemical Engineers, the American Society of Biological Chemists, the Council for Chemical Research, the NAS Chemistry and Biochemistry Sections, and the National Academy of Engineering. In the past few years, the Board has served as a focus and a forum for a variety of issues that relate specifically to the health of chemistry

  17. Community of solution for the U.S. health care system: lessons from the U.S. educational system.

    Science.gov (United States)

    Devoe, Jennifer E; Gold, Rachel

    2013-01-01

    The Folsom Group asserts that radical changes are needed to fix the health care system in the United States. The U.S. education system is one potential model to emulate. Could a future health care system-level community of solution be modeled after the U.S. education system? Could community health care services be planned, organized, and delivered at the neighborhood level by district, similar to the structure for delivering public education? Could community health centers, governed by community boards, serve every neighborhood? This essay imagines how U.S. health care system reforms could be designed using our public school system as a roadmap. Our intention is to challenge readers to recognize the urgent need for radical reform in the U.S. health care system, to introduce one potential model for reform, and to encourage creative thinking about other system-level communities of solution that could lead to profound change and improvements in the U.S. health care system.

  18. Health care policy and community pharmacy: implications for the New Zealand primary health care sector.

    Science.gov (United States)

    Scahill, Shane; Harrison, Jeff; Carswell, Peter; Shaw, John

    2010-06-25

    The aim of our paper is to expose the challenges primary health care reform is exerting on community pharmacy and other groups. Our paper is underpinned by the notion that a broad understanding of the issues facing pharmacy will help facilitate engagement by pharmacy and stakeholders in primary care. New models of remuneration are required to deliver policy expectations. Equally important is redefining the place of community pharmacy, outlining the roles that are mooted and contributions that can be made by community pharmacy. Consistent with international policy shifts, New Zealand primary health care policy outlines broad directives which community pharmacy must respond to. Policymakers are calling for greater integration and collaboration, a shift from product to patient-centred care; a greater population health focus and the provision of enhanced cognitive services. To successfully implement policy, community pharmacists must change the way they think and act. Community pharmacy must improve relationships with other primary care providers, District Health Boards (DHBs) and Primary Health Organisations (PHOs). There is a requirement for DHBs to realign funding models which increase integration and remove the requirement to sell products in pharmacy in order to deliver services. There needs to be a willingness for pharmacy to adopt a user pays policy. General practitioners (GPs) and practice nurses (PNs) need to be aware of the training and skills that pharmacists have, and to understand what pharmacists can offer that benefits their patients and ultimately general practice. There is also a need for GPs and PNs to realise the fiscal and professional challenges community pharmacy is facing in its attempt to improve pharmacy services and in working more collaboratively within primary care. Meanwhile, community pharmacists need to embrace new approaches to practice and drive a clearly defined agenda of renewal in order to meet the needs of health funders, patients

  19. Federal Board of Health - annual report 1981

    International Nuclear Information System (INIS)

    1981-01-01

    The emphases of the work of the Federal Board of Health is on drug control, consumer protection with regard to health, environmental hygiene, radiation hygiene, preventation and intervention as well as on special subjects, as for instance the control of animal experiments and the supervision of biological safety of genetic engineering. In addition, central services, systems of information and documentation, publications and courses for professional and advanced training are offered. (DG) [de

  20. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    user

    2Department of Community Health, University of Benin, Benin City, Nigeria. ... Mental morbidity is a public health problem that can lead to a great burden of disability in the community. ..... community study in Sao Paulo, Brazil where.

  1. Building relationships with Aboriginal Communities and the Energy and Utilities Board

    Energy Technology Data Exchange (ETDEWEB)

    Barber, R.; Handel, J.; Healy, D. [Alberta Energy and Utilities Board, Calgary, AB (Canada)

    2004-07-01

    One of the challenges facing the oil and gas industry in Alberta is building a relationship between industry, government and Aboriginal people. The Alberta Energy and Utilities Board (EUB) is promoting and developing positive relationships with Aboriginal communities in terms of land-use issues and land claim agreements. A study was commissioned in 2000 by the EUB to identify concerns to communities affected by sour gas development. The study identified the need to improve working relations with Aboriginal communities. This paper describes the experience of the Field Surveillance Branch of the EUB over the past few years in building such relationships. Historical information provides insight that helps in establishing effective working relationships with Aboriginal communities. An important ingredient is appreciation of the perspective of these communities, which is achieved through awareness training. The use of local Aboriginal resource people as part of the training is recommended in order to address local issues. 1 ref.

  2. Partnering with American Indian communities in health using methods of strategic collaboration.

    Science.gov (United States)

    Rajaram, Shireen S; Grimm, Brandon; Giroux, Jennifer; Peck, Magda; Ramos, Athena

    2014-01-01

    The Association for Prevention Teaching and Research (APTR) sponsored six regional workshops in 2010 on community engagement and community-engaged research. One of the six workshops was a collaborative effort between the Great Plains Tribal Chairman's Health Board (GPTCHB)-Northern Plains Tribal Epidemiology Center and the College of Public Health at the University of Nebraska Medical Center (UNMC-COPH). To create a meaningful and dynamic forum for the exchange of ideas and co-learning between researchers from urban, tribal and nontribal communities and to build the groundwork for development of sustainable partnerships between researchers and American Indian (AI) communities to eliminate health disparities. To enhance meaningful community engagement, we utilized methods of Strategic Collaboration using the Appreciative Inquiry, 4D Change Process Model and designed several interactive group activities including Collaborative Learning and Understanding Exercises (CLUE) and the Research Café. The key themes that emerged from the interactive sessions stressed the importance of building relationships and trust; mutual use and sharing of data; and acquiring knowledge, skills, and abilities to enable sustainable research partnerships with AI communitiesConclusions: Innovative, dynamic, and strategic collaborative methods of Appreciative Inquiry and the World Café can served to engage people in a constructive dialogue to create a shared vision and plan for more meaningful research partnerships based on principles of equity and social justice, essential for the elimination of health disparities. These collaborative methods can be replicated and adapted in diverse communities, locally, nationally, and globally.

  3. 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.

  4. Engaging Institutional Review Boards in Developing a Brief, Community-Responsive Human Subjects Training for Community Partners.

    Science.gov (United States)

    Calzo, Jerel P; Bogart, Laura M; Francis, Evelyn; Kornetsky, Susan Z; Winkler, Sabune J; Kaberry, Julie

    2016-01-01

    Engaging community partners as co-investigators in community-based participatory research (CBPR) requires certification in the rules, ethics, and principles governing research. Despite developments in making human research protection trainings more convenient and standardized (eg, self-paced Internet modules), time constraints and the structure of the content (which may favor academic audiences) may hinder the training of community partners. This paper is motivated by a case example in which academic and community partners, and stakeholders of a community-based organization actively engaged the leadership of a pediatric hospital-based institutional review board (IRB) in implementing a brief, community-responsive human subjects training session. A 2-hour, discussion-based human subjects training was developed via collaborations between the IRB and the community and academic partners. Interviews with trainees and facilitators after the training were used to evaluate its acceptability and possible future applications. Local IRBs have the potential to assist community partners in building sufficient knowledge of human subjects research protections to engage in specific projects, thereby expediting the progress of vital research to address community needs. We propose the need for developing truncated human subjects education materials to train and certify community partners, and creating formally organized entities within academic and medical institutions that specialize in community-based research to guide the development and implementation of alternative human subjects training certification opportunities for community partners.

  5. Public/private partners. Key factors in creating a strategic alliance for community health.

    Science.gov (United States)

    Nelson, J C; Rashid, H; Galvin, V G; Essien, J D; Levine, L M

    1999-04-01

    The rapidly evolving American health system creates economic and societal incentives for public and private health organizations to collaborate. Despite the apparent benefits of collaboration, there is a paucity of information available to help local agencies develop partnerships. This study, itself a collaboration between a school of public health (SPH) and a Georgia health district, was undertaken to identify critical factors necessary to successfully initiate and sustain a public/private community health collaboration. Professional staff at the SPH conducted 26 standardized interviews involving participants from Cobb and Douglas counties Boards of Health; Promina Northwest (now known as Wellstar), a not-for-profit health system; and community stakeholders. Content analysis of each interview question was performed and comparisons were made both within each group and across groups. Trends were identified in the following key areas: vision of health care for Cobb and Douglas counties, forces driving collaboration, strengths of each organization, critical negotiating issues, and potential community gain resulting from the partnership. A shared vision between potential collaborators facilitates communication regarding strategies to achieve common goals. A previous history of working together in limited capacities allowed the partners to develop trust and respect for one another prior to entering negotiations. These factors, when taken in conjunction with each organization's strong leadership and knowledge of the community, build a strong foundation for a successful partnership.

  6. Lifestyle factors in Croatian seafarers as relating to health and stress on board.

    Science.gov (United States)

    Slišković, Ana; Penezić, Zvjezdan

    2017-01-01

    Seafaring is characterized by specific stressors and health risks. The purpose of this article was to compare the prevalence of various lifestyle factors between the shipping and home environments, and in addition to test the relations between lifestyle factors, perceived stress on board, and health in seafarers. A total of 530 Croatian seafarers participated in an on-line survey. The questionnaire contained requests for demographic data and a set of questions relating to lifestyle, stress on board, physical health symptoms, and mental health. The data showed higher sleep deprivation, higher levels of smoking and unhealthier diet at sea than at home, with prevalence of alcohol consumption and physical exercise being more favourable for the shipping environment. Sleep deprivation, unhealthy diet, lack of physical exercise, and smoking are shown as negative correlates of various measures of health. Stress on board was associated with sleep deprivation and unhealthy diet, and with more unfavourable physical and mental health. The results give practical implications for promoting health in seafarers. Some of the lifestyle factors tested, such as alcohol use, smoking and physical exercise, fall rather under individual control, but others, such as a healthy, balanced diet on board and sleeping hygiene at sea, should be improved by shipping management.

  7. A community based participatory approach to improving health in a Hispanic population

    Directory of Open Access Journals (Sweden)

    Urquieta de Hernandez Brisa

    2011-04-01

    Full Text Available Abstract Background The Charlotte-Mecklenburg region has one of the fastest growing Hispanic communities in the country. This population has experienced disparities in health outcomes and diminished ability to access healthcare services. This city is home to an established practice-based research network (PBRN that includes community representatives, health services researchers, and primary care providers. The aims of this project are: to use key principles of community-based participatory research (CBPR within a practice-based research network (PBRN to identify a single disease or condition that negatively affects the Charlotte Hispanic community; to develop a community-based intervention that positively impacts the chosen condition and improves overall community health; and to disseminate findings to all stakeholders. Methods/design This project is designed as CBPR. The CBPR process creates new social networks and connections between participants that can potentially alter patterns of healthcare utilization and other health-related behaviors. The first step is the development of equitable partnerships between community representatives, providers, and researchers. This process is central to the CBPR process and will occur at three levels -- community members trained as researchers and outreach workers, a community advisory board (CAB, and a community forum. Qualitative data on health issues facing the community -- and possible solutions -- will be collected at all three levels through focus groups, key informant interviews and surveys. The CAB will meet monthly to guide the project and oversee data collection, data analysis, participant recruitment, implementation of the community forum, and intervention deployment. The selection of the health condition and framework for the intervention will occur at the level of a community-wide forum. Outcomes of the study will be measured using indicators developed by the participants as well as geospatial

  8. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    adedamla

    compared the perceived availability of essential drugs and patronage of health facilities in a BI and non-BI Local government areas (LGA) of ... 2Medical Directorate, Hospitals Management Board, Uyo, Akwa Ibom State ... majority of the population in Malaysia had access to .... Ethical clearance for this study was obtained.

  9. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    care policy which was intended to make health care which of the two alternative methods of health care available to individuals and families in the financing options of free health or DRF was community at very little or no cost at all. However, preferred by the community members within most health facilities would appear to ...

  10. US DoE's Environmental Management Site-Specific Advisory Board 15 Years of Community Involvement

    International Nuclear Information System (INIS)

    Nielson, M.; Brennan, C.A.

    2009-01-01

    This paper provides an overview of the U.S. Department of Energy's Environmental Management Site-Specific Advisory Board (EM SSAB) from its roots in the early 1990's at the Keystone Center to its current activities. The EM SSAB has a unique mandate to provide input regarding the cleanup of nuclear legacy sites in the United States. Chartered under the Federal Advisory Committee Act, the EM SSAB today comprises eight local boards. The Office of Environmental Management has made public participation a fundamental component of its cleanup mission and has found that the EM SSAB has contributed greatly to bringing community values and priorities to the cleanup decision-making processes. Public participation that involves ongoing community engagement has inherent challenges; the EM SSAB has additional challenges that reflect the political and technical nature of the Agency's work. (authors)

  11. Board composition and firm reputation: The role of business experts, support specialists and community influentials

    Directory of Open Access Journals (Sweden)

    Emma García-Meca

    2018-04-01

    Full Text Available The objective of this paper is to analyze the influence of board resource diversity on firm reputation. We classify board members as business experts, support specialists, political directors and other community influentials, in an effort to address whether business, technical expertise or political ties in the boardroom affect stakeholders’ opinion and, therefore, firm reputation.This study confirms that not all outside directors are equally effective in improving firm reputation, and that certain kinds of outside directors, especially business experts, help increase it. However, the findings note an inverted U-shaped non-linear relationship with these directors, which means that the effect of business experts on reputation is positive up to a point, after which the relationship becomes negative. The findings also evidence that, contrary to popular beliefs, directors with previous experience as politicians are not negatively viewed by stakeholders. Moreover, this type of community influential directors has positive effects on firm reputation in regulated firms as well as in those of the public work sector. JEL classification: G30, Keywords: Reputation, Board, Expertise, Corporate governance, Directors

  12. 77 FR 12577 - Department of Defense (DoD) Medicare-Eligible Retiree Health Care Board of Actuaries; Federal...

    Science.gov (United States)

    2012-03-01

    ... Retiree Health Care Board of Actuaries; Federal Advisory Committee Meeting AGENCY: DoD. ACTION: Meeting... DoD Medicare-Eligible Retiree Health Care Board of Actuaries will take place. DATES: Friday, August 3... Contact: Persons desiring to attend the DoD Medicare- Eligible Retiree Health Care Board of Actuaries...

  13. Evaluation of the organizational cultural competence of a community health center: a multimethod approach.

    Science.gov (United States)

    Cherner, Rebecca; Olavarria, Marcela; Young, Marta; Aubry, Tim; Marchant, Christina

    2014-09-01

    Cultural competence is an important component of client-centered care in health promotion and community health services, especially considering the changing demographics of North America. Although a number of tools for evaluating cultural competence have been developed, few studies have reported on the results of organizational cultural competence evaluations in health care or social services settings. This article aims to fill this gap by providing a description of a cultural competence evaluation of a community health center serving a diverse population. Data collection included reviewing documents, and surveying staff, management, and the Board of Directors. The organization fully met 28 of 53 standards of cultural competence, partially met 21 standards, and did not meet 2 standards, and 2 standards could not be assessed due to missing information. The advantages and lessons learned from this organizational cultural competence evaluation are discussed. © 2014 Society for Public Health Education.

  14. The relationship of five boarding school experiences and physical health status among Northern Plains Tribes.

    Science.gov (United States)

    Running Bear, Ursula; Croy, Calvin D; Kaufman, Carol E; Thayer, Zaneta M; Manson, Spero M

    2018-01-01

    American Indian (AI) boarding school attendance is related to poor physical health status; however, little is known about how specific aspects of this experience contribute to poor health. Five experiences (age of first attendance, limited family visits, forced church attendance, prohibition on practicing AI culture and traditions, and punishment for use of AI language) may be independently associated with physical health status in adulthood. We expected the effect to be greater for those who began boarding school at older ages. Data on AI boarding school attenders (n = 771) came from the AI-Service Utilization, Psychiatric Epidemiology, Risk and Protective Factors Project. Multiple linear regression models examined the association of these five experiences with physical health status. Additionally, we conducted a separate set of regressions to test for an interaction effect of age of first attendance. Each of the five experiences noted above were independently associated with poorer physical health status compared to those who did not have these experiences. An interaction effect for those punished for use of AI language and who were aged 8 or older was confirmed. Findings are consistent with reports that boarding school attendance is related to poor AI adult health. To inform AI health programs, the relationship of specific diseases and boarding school attendance should be considered.

  15. Next level of board accountability in health care quality.

    Science.gov (United States)

    Pronovost, Peter J; Armstrong, C Michael; Demski, Renee; Peterson, Ronald R; Rothman, Paul B

    2018-03-19

    Purpose The purpose of this paper is to offer six principles that health system leaders can apply to establish a governance and management system for the quality of care and patient safety. Design/methodology/approach Leaders of a large academic health system set a goal of high reliability and formed a quality board committee in 2011 to oversee quality and patient safety everywhere care was delivered. Leaders of the health system and every entity, including inpatient hospitals, home care companies, and ambulatory services staff the committee. The committee works with the management for each entity to set and achieve quality goals. Through this work, the six principles emerged to address management structures and processes. Findings The principles are: ensure there is oversight for quality everywhere care is delivered under the health system; create a framework to organize and report the work; identify care areas where quality is ambiguous or underdeveloped (i.e. islands of quality) and work to ensure there is reporting and accountability for quality measures; create a consolidated quality statement similar to a financial statement; ensure the integrity of the data used to measure and report quality and safety performance; and transparently report performance and create an explicit accountability model. Originality/value This governance and management system for quality and safety functions similar to a finance system, with quality performance documented and reported, data integrity monitored, and accountability for performance from board to bedside. To the authors' knowledge, this is the first description of how a board has taken this type of systematic approach to oversee the quality of care.

  16. The Board of Governors Fee Waiver, Financial Aid, and Community College Student Success

    Science.gov (United States)

    Coria, Elizabeth F.

    2013-01-01

    California established the Board of Governors (BOG) fee waiver in 1984 to maintain educational access after the implementation of the state's first ever unit-based fees for community college attendance. Although it was not designed as an incentive to stimulate higher levels of academic achievement or student success, recent accountability policy…

  17. The meaning of community involvement in health: the perspective of primary health care communities

    Directory of Open Access Journals (Sweden)

    GG Mchunu

    2005-09-01

    Full Text Available The goal of this study was to establish the understanding and appreciation of the essence of PHC principles in the two Primary Health Care (PHC communities. The PHC communities in this study referred to the people who were involved in the operation of the phenomenon, that is health professionals working in the health care centers and the communities served by these health care centers. It was hoped that the study would enhance the understanding of the importance of community involvement in health (CIH in health care delivery, for both community members and health professionals. A case study method was used to conduct the study. Two community health centers in the Ethekwini health district, in Kwa Zulu Natal, were studied. One health center was urban based, the other was rural based. A sample of 31 participants participated in the study. The sample comprised of 8 registered nurses, 2 enrolled nurses, 13 community members and 8 community health workers. Data was collected using individual interviews and focus groups, and was guided by the case study protocol. The findings of the study revealed that in both communities, participants had different, albeit complementary, understanding of the term ‘Community Involvement in Health’ (CIH. Essentially, for these participants, CIH meant collaboration, co-operation and involvement in decision-making.

  18. Community Health Warriors: Marshallese Community Health Workers' Perceptions and Experiences with CBPR and Community Engagement.

    Science.gov (United States)

    Purvis, Rachel S; Bing, Williamina Ioanna; Jacob, Christopher J; Lang, Sharlynn; Mamis, Sammie; Ritok, Mandy; Rubon-Chutaro, Jellesen; McElfish, Pearl Anna

    2017-01-01

    Our manuscript highlights the viewpoints and reflections of the native Marshallese community health workers (CHWs) engaged in research with the local Marshallese community in Northwest Arkansas. In particular, this paper documents the vital role Marshallese CHWs play in the success of programs and research efforts. The negative health effects of nuclear testing in the Marshall Islands has been passed down through many generations, along with unfavorable attitudes toward the U.S. government and researchers. However, the community-based participatory research (CBPR) approach used by the University of Arkansas for Medical Sciences (UAMS) has allowed the native Marshallese CHWs to become advocates for the Marshallese community. The use of native CHWs has also leveled the power dynamics that can be a barrier to community-based research, and has strengthened trust with community stakeholders. Our paper shows how using Marshallese CHWs can produce positive health outcomes for the Marshallese community.

  19. Promoting Community Health and Eliminating Health Disparities Through Community-Based Participatory Research.

    Science.gov (United States)

    Xia, Ruiping; Stone, John R; Hoffman, Julie E; Klappa, Susan G

    2016-03-01

    In physical therapy, there is increasing focus on the need at the community level to promote health, eliminate disparities in health status, and ameliorate risk factors among underserved minorities. Community-based participatory research (CBPR) is the most promising paradigm for pursuing these goals. Community-based participatory research stresses equitable partnering of the community and investigators in light of local social, structural, and cultural elements. Throughout the research process, the CBPR model emphasizes coalition and team building that joins partners with diverse skills/expertise, knowledge, and sensitivities. This article presents core concepts and principles of CBPR and the rationale for its application in the management of health issues at the community level. Community-based participatory research is now commonly used to address public health issues. A literature review identified limited reports of its use in physical therapy research and services. A published study is used to illustrate features of CBPR for physical therapy. The purpose of this article is to promote an understanding of how physical therapists could use CBPR as a promising way to advance the profession's goals of community health and elimination of health care disparities, and social responsibility. Funding opportunities for the support of CBPR are noted. © 2016 American Physical Therapy Association.

  20. Board on chemical sciences and technology

    International Nuclear Information System (INIS)

    1991-01-01

    The Board on Chemical Sciences and Technology organizes and provides direction for standing and ad hoc committees charged with addressing specific issues relevant to the continued health of the chemical sciences and technology community. Studies currently under the oversight of the BCST include a major survey of chemical engineering, an examination of the problems of biohazards in the laboratory, and an analysis of the roots and magnitude of the problem of obsolescent facilities for research and teaching in departments in the chemical sciences and engineering. The Board continues to respond to specific agency requests for program assessments and advice. BCST members are designated to serve as liaison with major federal agencies or departments that support research in order to help identify ways for the board to assist the these organizations. The BCST also maintains close contact with professional societies and nongovernmental organizations that share the Board's concern for the health of chemical sciences and technology. Individual Board members are assigned responsibility for liaison with the American Chemical Society, the American Institute of Chemical Engineers, the American Society of Biological Chemists, the Council for Chemical Research, the Chemistry and Biochemistry Sections of the National Academy of Sciences (NAS), and the National Academy of Engineering (NAE). In the past few years, the Board has served as a focus and a forum for a variety of issues that relate specifically to the health of chemistry. A sampling of these concerns include: industry-university cooperation; basic research funding in DOD, DOE, NIH, and NSF; basic research in the chemistry of life processes; basic research in biochemical engineering; basic research in the science and technology of new materials; and undergraduate education in chemistry and chemical engineering

  1. Service utilization in community health centers in China: a comparison analysis with local hospitals

    Directory of Open Access Journals (Sweden)

    Wang Xiaohang

    2006-08-01

    Full Text Available Abstract Background Being an important part of China's Urban Health Care Reform System, Community Health Centers (CHCs have been established throughout the entire country and are presently undergoing substantial reconstruction. However, the services being delivered by the CHCs are far from reaching their performance targets. In order to assess the role of the CHCs, we examined their performance in six cities located in regions of South-East China. The purpose of this investigation was to identify the utilization and the efficiency of community health resources that are able to provide basic medical and public health services. Methods The study was approved by Peking University Health Science Center Institutional Reviewing Board (NO: IRB00001052-T1. Data were collected from all the local health bureaux and processed using SPSS software. Methods of analysis mainly included: descriptive analysis, paired T-test and one-way ANOVA. Results The six main functions of the CHCs were not fully exploited and the surveys that were collected on their efficiency and utilization of resources indicate that they have a low level of performance and lack the trust of local communities. Furthermore, the CHCs seriously lack funding support and operate under difficult circumstances, and residents have less positive attitudes towards them. Conclusion The community health service must be adjusted according to the requirements of urban medical and health reform, taking into account communities' health needs. More research is required on the living standards and health needs of residents living within the CHC's range, taking into consideration the users' needs in expanding the newly implemented service, and at the same time revising the old service system so as to make the development of CHCs realistic and capable of providing a better service to patients. Several suggestions are put forward for an attainable scheme for developing a community health service.

  2. Community Bioethics: The Health Decisions Community Council.

    Science.gov (United States)

    Gallegos, Tom; Mrgudic, Kate

    1993-01-01

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

  3. Factors that hinder community participation in developing and implementing comprehensive council health plans in Manyoni District, Tanzania

    Directory of Open Access Journals (Sweden)

    Emmanuel G. Kilewo

    2015-06-01

    Full Text Available Background: Decentralization of public health planning is proposed to facilitate public participation in health issues. Health Sector Reform in Tanzania places emphasis on the participation of lower level health facilities and community in health planning process. Despite availability of policies, guidelines, and community representative organs, actual implementation of decentralization strategies is poorly achieved. This study intended to find out factors that hinder community participation in developing and implementing Comprehensive Council Health Plan (CCHP. Materials and methods: A qualitative approach was conducted in this study with key informants from Health Facility Governing Committees (HFGC, Council Health Service Board (CHSB, and Council Health Management Team (CHMT. Data were collected using in-depth interviews. Data generated were analyzed for themes and patterns. Results: Factors that hindered community participation included lack of awareness on the CCHP among HFGC members, poor communication and information sharing between CHMT and HFGC, unstipulated roles and responsibilities of HFGC, lack of management capacity among HFGC members, and lack of financial resources for implementing HFGC activities. Conclusions: The identified challenges call for policy makers to revisit the decentralization by devolution policy by ensuring that local governance structures have adequate resources as well as autonomy to participate in planning and managing CCHP in general and health facility plans in particular.

  4. From Community to Meta-Community Mental Health Care

    Directory of Open Access Journals (Sweden)

    Nick Bouras

    2018-04-01

    Full Text Available Since the 1960s, we have witnessed the development and growth of community mental health care that continues to dominate mental health policy and practice. Several high-income countries have implemented community mental health care programmes but for many others, including mostly low- and middle-income countries, it remains an aspiration. Although community mental health care has been positive for many service users, it has also had severe shortcomings. Expectations that it would lead to fuller social integration have not been fulfilled and many service users remain secluded in sheltered or custodial environments with limited social contacts and no prospect of work. Others receive little or no service at all. In today’s complex landscape of increasingly specialised services for people with mental health problems, the number of possible interfaces between services is increasing. Together with existing uneven financing systems and a context of constant change, these interfaces are challenging us to develop effective care pathways adjusted to the needs of service users and their carers. This discussion paper reviews the developments in community mental health care over the recent years and puts forward the concept of “Meta-Community Mental Health Care”. “Meta-Community Mental Health Care” embraces pluralism in understanding and treating psychiatric disorders, acknowledges the complexities of community provision, and reflects the realities and needs of the current era of care.

  5. Common and Critical Components Among Community Health Assessment and Community Health Improvement Planning Models.

    Science.gov (United States)

    Pennel, Cara L; Burdine, James N; Prochaska, John D; McLeroy, Kenneth R

    Community health assessment and community health improvement planning are continuous, systematic processes for assessing and addressing health needs in a community. Since there are different models to guide assessment and planning, as well as a variety of organizations and agencies that carry out these activities, there may be confusion in choosing among approaches. By examining the various components of the different assessment and planning models, we are able to identify areas for coordination, ways to maximize collaboration, and strategies to further improve community health. We identified 11 common assessment and planning components across 18 models and requirements, with a particular focus on health department, health system, and hospital models and requirements. These common components included preplanning; developing partnerships; developing vision and scope; collecting, analyzing, and interpreting data; identifying community assets; identifying priorities; developing and implementing an intervention plan; developing and implementing an evaluation plan; communicating and receiving feedback on the assessment findings and/or the plan; planning for sustainability; and celebrating success. Within several of these components, we discuss characteristics that are critical to improving community health. Practice implications include better understanding of different models and requirements by health departments, hospitals, and others involved in assessment and planning to improve cross-sector collaboration, collective impact, and community health. In addition, federal and state policy and accreditation requirements may be revised or implemented to better facilitate assessment and planning collaboration between health departments, hospitals, and others for the purpose of improving community health.

  6. 78 FR 48151 - Defense Health Board; Notice of Federal Advisory Committee Meeting

    Science.gov (United States)

    2013-08-07

    ... implications of trends in overweight and obesity in America for the DoD and the report on the Deployment Health... by the subcommittees on the sustainment and advancement of amputee care, deployment pulmonary health... DEPARTMENT OF DEFENSE Office of the Secretary Defense Health Board; Notice of Federal Advisory...

  7. Community Psychology and Community Mental Health: A Call for Reengagement.

    Science.gov (United States)

    Townley, Greg; Brown, Molly; Sylvestre, John

    2018-03-01

    Community psychology is rooted in community mental health research and practice and has made important contributions to this field. Yet, in the decades since its inception, community psychology has reduced its focus on promoting mental health, well-being, and liberation of individuals with serious mental illnesses. This special issue endeavors to highlight current efforts in community mental health from our field and related disciplines and point to future directions for reengagement in this area. The issue includes 12 articles authored by diverse stakeholder groups. Following a review of the state of community mental health scholarship in the field's two primary journals since 1973, the remaining articles center on four thematic areas: (a) the community experience of individuals with serious mental illness; (b) the utility of a participatory and cross-cultural lens in our engagement with community mental health; (c) Housing First implementation, evaluation, and dissemination; and (d) emerging or under-examined topics. In reflection, we conclude with a series of challenges for community psychologists involved in future, transformative, movements in community mental health. © Society for Community Research and Action 2018.

  8. Nurses on health care governing boards: An integrative review.

    Science.gov (United States)

    Sundean, Lisa J; Polifroni, E Carol; Libal, Kathryn; McGrath, Jacqueline M

    Nurses are key change agents in health care; yet, nurses have not been sufficiently engaged on boards to shape decision making. Without an equal voice in the boardroom, nurses cannot fulfill their professional obligation to society. The purpose of this study was to understand the progression in research focus and recommendations over time about nurses on boards (NOB), identify research gaps, and make research/practice recommendations. An integrative review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines (2009) for data evaluation and analysis. Eleven studies (six quantitative, three qualitative, and two quasi-mixed methods) were included in the review. The focus/recommendations of research about NOB have changed from passive observation to action-oriented inquiry that considers nurse expertise and value but lacks a coordinated approach to advance board appointments for nurses. A systematic approach to the research is needed to advance NOB as key agents in health care transformation and social justice. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Place, health, and community attachment: Is community capacity associated with self-rated health at the individual level?

    Science.gov (United States)

    Lovell, Sarah A; Gray, Andrew R; Boucher, Sara E

    2017-12-01

    Community-level interventions dominate contemporary public health responses to health inequalities as a lack of political will has discouraged action at a structural level. Health promoters commonly leverage community capacity to achieve programme goals, yet the health implications of low community capacity are unknown. In this study, we analyse perceptions of community capacity at the individual-level to explore how place-based understandings of identity and connectedness are associated with self-rated health. We examine associations between individual community capacity, self-rated health and income using a cross-sectional survey that was disseminated to 303 residents of four small (populations 1500-2000) New Zealand towns. Evidence indicating a relationship between individual community capacity and self-reported health was unconvincing once the effects of income were incorporated. That is, people who rated their community's capacity higher did not have better self-rated health. Much stronger evidence supported the relationship between income and both higher individual community capacity and higher self-rated health. We conclude that individual community capacity may mediate the positive association between income and health, however, overall we find no evidence suggesting that intervening to enhance individual community capacity is likely to improve health outcomes.

  10. Community health centers and community development financial institutions: joining forces to address determinants of health.

    Science.gov (United States)

    Kotelchuck, Ronda; Lowenstein, Daniel; Tobin, Jonathan N

    2011-11-01

    Community health centers and community development financial institutions share similar origins and missions and are increasingly working together to meet community needs. Addressing the social and economic determinants of health is a common focus. The availability of new federal grants and tax credits has led these financial institutions to invest in the creation and expansion of community health centers. This article reviews the most recent trends in these two sectors and explores opportunities for further collaboration to transform the health and well-being of the nation's low-income communities.

  11. Community views and public health priority setting: how do health department priorities, community views, and health indicator data compare?

    Science.gov (United States)

    Earle-Richardson, Giulia; Scribani, Melissa; Wyckoff, Lynae; Strogatz, David; May, John; Jenkins, Paul

    2015-01-01

    New York, like many other states, provides county-level health statistics for use in local priority settings but does not provide any data on public views about priority health issues. This study assessed whether health department priorities are notably different from community concerns about health, and how both groups' priorities compare with local health statistics. Data from a 2009 rural survey on community health concerns were compared to priorities named by the seven area county health departments, and to local health indicator data. Health care/insurance cost (60%), obesity (53%), and prescription cost (41%) were leading community concerns, regardless of age, education, sex, or Internet in the home. Six of seven county health departments selected access to quality health care (which includes health care/insurance cost) as a leading public health priority, but only three identified obesity. The following leading local health issues were suggested by health indicators: Physical activity and nutrition, Smoking, and Unintentional injury. Health departments diverged from community priorities, from health indicator data, and from one another in choosing priorities. Adding a question about community health priorities to existing state telephone surveys on health behavior and lifestyle would provide an important tool to local health departments. © 2014 Society for Public Health Education.

  12. Place, health, and community attachment: Is community capacity associated with self-rated health at the individual level?

    Directory of Open Access Journals (Sweden)

    Sarah A. Lovell

    2017-12-01

    Full Text Available Community-level interventions dominate contemporary public health responses to health inequalities as a lack of political will has discouraged action at a structural level. Health promoters commonly leverage community capacity to achieve programme goals, yet the health implications of low community capacity are unknown. In this study, we analyse perceptions of community capacity at the individual-level to explore how place-based understandings of identity and connectedness are associated with self-rated health. We examine associations between individual community capacity, self-rated health and income using a cross-sectional survey that was disseminated to 303 residents of four small (populations 1500–2000 New Zealand towns. Evidence indicating a relationship between individual community capacity and self-reported health was unconvincing once the effects of income were incorporated. That is, people who rated their community's capacity higher did not have better self-rated health. Much stronger evidence supported the relationship between income and both higher individual community capacity and higher self-rated health. We conclude that individual community capacity may mediate the positive association between income and health, however, overall we find no evidence suggesting that intervening to enhance individual community capacity is likely to improve health outcomes.

  13. Corporate Philanthropy Toward Community Health Improvement in Manufacturing Communities.

    Science.gov (United States)

    McHugh, Megan; Farley, Diane; Maechling, Claude R; Dunlop, Dorothy D; French, Dustin D; Holl, Jane L

    2018-06-01

    Virtually all large employers engage in corporate philanthropy, but little is known about the extent to which it is directed toward improving community health. We conducted in-depth interviews with leaders of corporate philanthropy from 13 of the largest manufacturing companies in the US to understand how giving decisions were made, the extent to which funding was directed towards improving community health, and whether companies coordinate with local public health agencies. We found that corporate giving was sizable and directed towards communities in which the manufacturers have a large presence. Giving was aligned with the social determinants of health (i.e., aimed at improving economic stability, the neighborhood and physical environment, education, food security and nutrition, the community and social context, and the health care system). However, improving public health was not often cited as a goal of corporate giving, and coordination with public health agencies was limited. Our results suggest that there may be opportunities for public health agencies to help guide corporate philanthropy, particularly by sharing community-level data and offering their measurement and evaluation expertise.

  14. Nurse leadership: making the most of community service.

    Science.gov (United States)

    Dawson, Susan; Freed, Patricia E

    2008-06-01

    Nurses are expected to demonstrate professionalism through service leadership, but it is unlikely they have been prepared to understand the responsibilities associated with taking leadership roles in the community. The authors have had a variety of experiences serving on nonprofit health care boards and have obtained information about board roles and responsibilities that would be helpful for practicing nurses who want to be board members. Nurses can make vital contributions to the nonprofit sector of the nation's health care, but must know how to make wise choices to maintain their commitments. This article provides nurses with basic information about the roles and responsibilities of nonprofit board members and some lessons about board service from the authors' experiences.

  15. Joint Community Health Needs Assessments as a Path for Coordinating Community-Wide Health Improvement Efforts Between Hospitals and Local Health Departments.

    Science.gov (United States)

    Carlton, Erik L; Singh, Simone Rauscher

    2018-05-01

    To examine the association between hospital-local health department (LHD) collaboration around community health needs assessments (CHNAs) and hospital investment in community health. We combined 2015 National Association of County and City Health Officials (NACCHO) Forces of Change, 2013 NACCHO Profile, and 2014-2015 Area Health Resource File data to identify a sample of LHDs (n = 439) across the United States. We included data on hospitals' community benefit from their 2014 tax filings (Internal Revenue Service Form 990, Schedule H). We used bivariate and multivariate regression analyses to examine LHDs' involvement in hospitals' CHNAs and implementation strategies and the relationship with hospital investment in community health. The LHDs that collaborated with hospitals around CHNAs were significantly more likely to be involved in joint implementation planning activities than were those that did not. Importantly, LHD involvement in hospitals' implementation strategies was associated with greater hospital investment in community health improvement initiatives. Joint CHNAs may improve coordination of community-wide health improvement efforts between hospitals and LHDs and encourage hospital investment in community health improvement activities. Public Health Implications. Policies that strengthen LHD-hospital collaboration around the CHNA may enhance hospital investments in community health.

  16. [Community mental health networks and doors at a Health and Community Center (CeSAC No 24) in the south of the Autonomous City of Buenos Aires (CABA)].

    Science.gov (United States)

    Corin, Marcela

    2013-01-01

    The history of the Health and Community Center (CeSAC) No 24 began 21 years ago in the Ramón Carrillo district, in Villa Soldati neighborhood. This is a marginal urban area in the south of the CABA with a population with urgent needs. The work started with a group of professionals dealing with primary care practices, and it continues up to the present. The goal of our community mental health project is the creation of spaces for prevention and well-being including art in all its expressions, with the active participation of neighbors in the coordination of many activities. Through the symbolic opening of doors and making networks visible, we opened the CeSAC to universities, scientific societies, foundations, NGOs, neighbor committees, neighborhood boards, human rights organizations, formal and informal education centers, cultural centers, churches, community radios, in order to show the vital movements of the community, as we -as a team- are an integral part of it. Our spaces, workshops and programs are a collective socio-historical construction that achieves milestones such as thinking, thinking of us, getting together and achieving the participation from the community and the continuous training for everybody working and living in Soldati. The decentralization and democratization trend, and the heterarchical management of our organization favors the possibility of catalyzing the wishes, motivations and efforts of the healthcare team, neighbors and network nodes, thus benefiting the creative work that turns a dream into a hopeful reality.

  17. Agreement Between the Faculty Council of Alpena Community College and the Alpena Board of Education, August 19, 1973 - August 18, 1974.

    Science.gov (United States)

    Alpena Community Coll., MI.

    This agreement between the Faculty Council of Alpena Community College and the Alpena Board of Education covers the period of August 19, 1973 to August 18, 1974. Articles of the agreement cover the preamble; agreement; recognition; instructor's rights; board rights; employment practices; instructor's work load; holidays, vacations, leaves of…

  18. Delivering democracy? An analysis of New Zealand's District Health Board elections, 2001 and 2004.

    Science.gov (United States)

    Gauld, Robin

    2005-08-01

    The district health board (DHB) system is New Zealand's present structure for the governance and delivery of publicly-funded health care. An aim of the DHB system is to democratise health care governance, and a key element of DHBs is elected membership of their governing boards. This article focuses on the electoral component of DHBs. It reports on the first DHB elections of 2001 and recent 2004 elections. The article presents and discusses data regarding candidates, the electoral process, voter behaviour and election results. It suggests that the extent to which the DHB elections are contributing to aims of democratisation is questionable.

  19. Using Storytelling to Address Oral Health Knowledge in American Indian and Alaska Native Communities.

    Science.gov (United States)

    Heaton, Brenda; Gebel, Christina; Crawford, Andrew; Barker, Judith C; Henshaw, Michelle; Garcia, Raul I; Riedy, Christine; Wimsatt, Maureen A

    2018-05-24

    We conducted a qualitative analysis to evaluate the acceptability of using storytelling as a way to communicate oral health messages regarding early childhood caries (ECC) prevention in the American Indian and Alaska Native (AIAN) population. A traditional story was developed and pilot tested among AIAN mothers residing in 3 tribal locations in northern California. Evaluations of the story content and acceptability followed a multistep process consisting of initial feedback from 4 key informants, a focus group of 7 AIAN mothers, and feedback from the Community Advisory Board. Upon story approval, 9 additional focus group sessions (N = 53 participants) were held with AIAN mothers following an oral telling of the story. Participants reported that the story was culturally appropriate and used relatable characters. Messages about oral health were considered to be valuable. Concerns arose about the oral-only delivery of the story, story content, length, story messages that conflicted with normative community values, and the intent to target audiences. Feedback by focus group participants raised some doubts about the relevance and frequency of storytelling in AIAN communities today. AIAN communities value the need for oral health messaging for community members. However, the acceptability of storytelling as a method for the messaging raises concerns, because the influence of modern technology and digital communications may weaken the acceptability of the oral tradition. Careful attention must be made to the delivery mode, content, and targeting with continual iterative feedback from community members to make these messages engaging, appropriate, relatable, and inclusive.

  20. Recruiting community health centers into pragmatic research: Findings from STOP CRC.

    Science.gov (United States)

    Coronado, Gloria D; Retecki, Sally; Schneider, Jennifer; Taplin, Stephen H; Burdick, Tim; Green, Beverly B

    2016-04-01

    Challenges of recruiting participants into pragmatic trials, particularly at the level of the health system, remain largely unexplored. As part of Strategies and Opportunities to STOP Colon Cancer in Priority Populations (STOP CRC), we recruited eight separate community health centers (consisting of 26 individual safety net clinics) into a large comparative effectiveness pragmatic study to evaluate methods of raising the rates of colorectal cancer screening. In partnership with STOP CRC's advisory board, we defined criteria to identify eligible health centers and applied these criteria to a list of health centers in Washington, Oregon, and California affiliated with Oregon Community Health Information Network, a 16-state practice-based research network of federally sponsored health centers. Project staff contacted centers that met eligibility criteria and arranged in-person meetings of key study investigators with health center leadership teams. We used the Consolidated Framework for Implementation Research to thematically analyze the content of discussions during these meetings to identify major facilitators of and barriers to health center participation. From an initial list of 41 health centers, 11 met the initial inclusion criteria. Of these, leaders at three centers declined and at eight centers (26 clinic sites) agreed to participate (73%). Participating and nonparticipating health centers were similar with respect to clinic size, percent Hispanic patients, and percent uninsured patients. Participating health centers had higher proportions of Medicaid patients and higher baseline colorectal cancer screening rates. Common facilitators of participation were perception by center leadership that the project was an opportunity to increase colorectal cancer screening rates and to use electronic health record tools for population management. Barriers to participation were concerns of center leaders about ability to provide fecal testing to and assure follow-up of

  1. [Community health course--student's evaluation].

    Science.gov (United States)

    Juresa, Vesna; Musil, Vera; Sosić, Zvonko; Majer, Marjeta; Pavleković, Gordana

    2010-12-01

    Since 1952, Andrija Stampar School of Public Health, School of Medicine, University of Zagreb, has provided a community health course, based on the medical education approach that the main fields of physicians' action are human settlements and not only consulting rooms and clinics. The aim of the study was to compare community health course students' evaluations immediately after attending the course at the 4th and 6th study years. The survey included 224 4th year medical students attending the community course during the academic year 2007-2008 and 192 same-generation 6th year students (85.7%) during the academic year 2009-2010. Students were required to fill out an evaluation questionnaire about the activities during the community health course using grades from 1-poor to 5-excellent, and to write personal remarks and essay. The academic year 2007-2008 students (n=224) were very satisfied (grades 5 and 4) with preparatory seminar (98% of students), final seminar (97%), course organization (90%) and course contents (89%). The same grades were allocated by 98% of students to public health field research, 94% to work in community nurse service, 93% to work in family practice and health promotion in school and kindergarten, and 87% to water sampling. Satisfaction with the community health course was very emotionally described in final essays: "... work with community nurse service in the poorest part of Croatia has changed my life. I have learned in only few hours to wish less and to give more. Every physician should experience it, because that is real life". Results of the same-generation students (n=192) in the academic year 2009-2010, now at 6th study year, showed them to be still very satisfied (grades 5 and 4) with the activities in the community health course: 94% with health promotion, 92% with work in the community nurse service and family medicine, 86% with course contents, 82% with course organization, 78% with final seminar, 64% with preparatory seminar

  2. Listening to community health workers: how ethnographic research can inform positive relationships among community health workers, health institutions, and communities.

    Science.gov (United States)

    Maes, Kenneth; Closser, Svea; Kalofonos, Ippolytos

    2014-05-01

    Many actors in global health are concerned with improving community health worker (CHW) policy and practice to achieve universal health care. Ethnographic research can play an important role in providing information critical to the formation of effective CHW programs, by elucidating the life histories that shape CHWs' desires for alleviation of their own and others' economic and health challenges, and by addressing the working relationships that exist among CHWs, intended beneficiaries, and health officials. We briefly discuss ethnographic research with 3 groups of CHWs: volunteers involved in HIV/AIDS care and treatment support in Ethiopia and Mozambique and Lady Health Workers in Pakistan. We call for a broader application of ethnographic research to inform working relationships among CHWs, communities, and health institutions.

  3. infant mortality and the Kimberley Board of Health, 1898-1977

    African Journals Online (AJOL)

    Leonard B. Lerer. Annual reports of the Kimberley Board of Health, established in 1883. provide rich insight into public hearth discourse on infant mortality. Commentaries on the determinants of infant mortality, especially prior to 1950, largely focus on poverty and interracial disparities, issues relevant to current heatth policy.

  4. Describing the continuum of collaboration among local health departments with hospitals around the community health assessments.

    Science.gov (United States)

    Wilson, Kristin D; Mohr, Lisa Buettner; Beatty, Kate E; Ciecior, Amanda

    2014-01-01

    Hospitals and local health departments (LHDs) are under policy requirements from the Affordable Care Act and accreditation standards through the Public Health Accreditation Board. Tax exempt hospitals must perform a community health needs assessment (CHNA), similar to the community health assessment (CHA) required for LHDs. These efforts have led to a renewed interest in hospitals and LHDs working together to achieve common goals. The purpose of this study is to gain a better understanding of levels of joint action leading toward collaboration between LHDs and hospitals and describe collaboration around CHAs. Local health departments were selected on the basis of reporting collaboration (n = 26) or unsure about collaboration (n = 29) with local hospitals. Local health departments were surveyed regarding their relationship with local hospitals. For LHDs currently collaborating with a hospital, a collaboration continuum scale was calculated. Appropriate nonparametric tests, chi-squares, and Spearman's rank correlations were conducted to determine differences between groups. A total of 44 LHDs responded to the survey (80.0%). Currently collaborating LHDs were more likely to be interested in accreditation and to refer to their CHA 5 or more times a year compared to the unsure LHDs. In the analysis, a collaboration continuum was created and is positively correlated with aspects of the CHA and CHA process. This study is the first attempt to quantify the level of collaboration between LHDs and hospitals around CHAs. Better understanding of the levels of joint action required may assist LHDs in making informed decisions regarding deployment of resources on the path to accreditation.

  5. Do Management and Leadership Practices in the Context of Decentralisation Influence Performance of Community Health Fund? Evidence From Iramba and Iringa Districts in Tanzania.

    Science.gov (United States)

    Joseph, Chakupewa; Maluka, Stephen Oswald

    2016-09-26

    In early 1990s, Tanzania like other African countries, adopted health sector reform (HSR). The most strongly held centralisation system that informed the nature of services provision including health was, thus, disintegrated giving rise to decentralisation system. It was within the realm of HSR process, user fees were introduced in the health sector. Along with user fees, various types of health insurances, including the Community Health Fund (CHF), were introduced. While the country's level of enrolment in the CHF is low, there are marked variations among districts. This paper highlights the role of decentralised health management and leadership practices in the uptake of the CHF in Tanzania. A comparative exploratory case study of high and low performing districts was carried out. In-depth interviews were conducted with the members of the Council Health Service Board (CHSB), Council Health Management Team (CHMT), Health Facility Committees (HFCs), in-charges of health facilities, healthcare providers, and Community Development Officers (CDOs). Minutes of the meetings of the committees and district annual health plans and district annual implementation reports were also used to verify and triangulate the data. Thematic analysis was adopted to analyse the collected data. We employed both inductive and deductive (mixed coding) to arrive to the themes. There were no differences in the level of education and experience of the district health managers in the two study districts. Almost all district health managers responsible for the management of the CHF had attended some training on management and leadership. However, there were variations in the personal initiatives of the top-district health leaders, particularly the district health managers, the council health services board and local government officials. Similarly, there were differences in the supervision mechanisms, and incentives available for the health providers, HFCs and board members in the two study

  6. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    the_monk

    Journal of Community Medicine and Primary Health Care. 26 (1) 12-20 .... large proportions of the population work in the poor people use health care services far less than. 19 ... hypertension, cancers and road traffic accidents) below 1 dollar ...

  7. Commentary: linking health equity with economic development: insights from my year as Chairman of the Board of the Chamber of Commerce.

    Science.gov (United States)

    Clancy, Gerard P

    2012-12-01

    Many urban areas struggle with significant health disparities. In Tulsa, Oklahoma, there is a 14-year difference in life expectancy between the predominantly African American population in north Tulsa and the predominantly Caucasian population in south Tulsa. The roots of Tulsa's health disparities can be linked, in part, to a long history of racial mistrust stemming from the 1921 Tulsa Race Riot, arguably one of the worst race riots in U.S. history. In 2011, the author served as both a university campus president and chairman of the board of the Tulsa region's chamber of commerce. Through his work with the chamber, he discovered the business community's substantial resources and advocacy abilities. He also found that regional business leaders strongly supported health equity, diversity, and inclusion initiatives, both as moral obligations and regional economic development imperatives. After sharing the lessons he learned from working closely with business leaders, the author encourages other academic health centers (AHCs) to reach out to their business communities, which are likely willing and able to help them undertake similar initiatives. In doing so, AHCs and businesses can work together to improve the economic vitality of their regions.

  8. Metabolic monitoring in New Zealand district health board mental health services.

    Science.gov (United States)

    Staveley, Aimee; Soosay, Ian; O'Brien, Anthony J

    2017-11-10

    To audit New Zealand district health boards' (DHBs) metabolic monitoring policies in relation to consumers prescribed second-generation antipsychotic medications using a best practice guideline. Metabolic monitoring policies from DHBs and one private clinic were analysed in relation to a best practice standard developed from the current literature and published guidelines relevant to metabolic syndrome. Fourteen of New Zealand's 20 DHBs currently have metabolic monitoring policies for consumers prescribed antipsychotic medication. Two of those policies are consistent with the literature-based guideline. Eight policies include actions to be taken when consumers meet criteria for metabolic syndrome. Four DHBs have systems for measuring their rates of metabolic monitoring. There is no consensus on who is clinically responsible for metabolic monitoring. Metabolic monitoring by mental health services in New Zealand reflects international experience that current levels of monitoring are low and policies are not always in place. Collaboration across the mental health and primary care sectors together with the adoption of a consensus guideline is needed to improve rates of monitoring and reduce current rates of physical health morbidities.

  9. Trialing the Community-Based Collaborative Action Research Framework: Supporting Rural Health Through a Community Health Needs Assessment.

    Science.gov (United States)

    Van Gelderen, Stacey A; Krumwiede, Kelly A; Krumwiede, Norma K; Fenske, Candace

    2018-01-01

    To describe the application of the Community-Based Collaborative Action Research (CBCAR) framework to uplift rural community voices while conducting a community health needs assessment (CHNA) by formulating a partnership between a critical access hospital, public health agency, school of nursing, and community members to improve societal health of this rural community. This prospective explorative study used the CBCAR framework in the design, collection, and analysis of the data. The framework phases include: Partnership, dialogue, pattern recognition, dialogue on meaning of pattern, insight into action, and reflecting on evolving pattern. Hospital and public health agency leaders learned how to use the CBCAR framework when conducting a CHNA to meet Affordable Care Act federal requirements. Closing the community engagement gap helped ensure all voices were heard, maximized intellectual capital, synergized efforts, improved communication by establishing trust, aligned resources with initiatives, and diminished power struggles regarding rural health. The CBCAR framework facilitated community engagement and promoted critical dialogue where community voices were heard. A sustainable community-based collaborative was formed. The project increased the critical access hospital's capacity to conduct a CHNA. The collaborative's decision-making capacity was challenged and ultimately strengthened as efforts continue to be made to address rural health.

  10. 76 FR 41221 - Federal Advisory Committee; Defense Health Board (DHB) Meeting

    Science.gov (United States)

    2011-07-13

    ... August 8, 2011, the DHB will receive briefings regarding military health needs and priorities. The DHB... briefings about the DoD Institutional Review Board, the Military Infectious Diseases Research Program, and... (sign language, wheelchair accessibility) please contact Ms. Lisa Jarrett at (703) 681- 8448 Ext. 1280...

  11. 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.

  12. Interprofessional student experiences on the HAVEN free clinic leadership board.

    Science.gov (United States)

    Scott, Elizabeth Anne; Swartz, Martha K

    2015-01-01

    In this study, we examined the experiences of students serving on the leadership board of HAVEN - the student-run free clinic of the Yale University health professional schools. Open-ended responses were collected from 18 of the 28 members of the 2011-2012 leadership board through an online survey. Students reported an overall positive experience participating on the board and valued the opportunity to be part of a committed community creating change. The majority of students reported that their time as a board member had improved their attitude towards interprofessional collaboration (78%) and had also fostered their leadership skills (67%). Around two thirds (67%) reported that their experience had positively impacted their future career plans, either reinforcing their desire to work with underserved populations or encouraging them to pursue leadership roles. Based on these data, it is suggested that the HAVEN Free Clinic offers a useful opportunity for students to experience the demands of clinical care leadership while working together in an interprofessional context.

  13. COMMUNITY MEDICINE & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    Background:Community Based Health Insurance Scheme is a social service organized at community level. It is a mutual health ... As part of her corporate social responsibility. Shell in .... Schmidt J. The benefits and challenges of shows the ...

  14. Engaging with Community Advisory Boards (CABs) in Lusaka Zambia: perspectives from the research team and CAB members.

    Science.gov (United States)

    Mwinga, Alwyn; Moodley, Keymanthri

    2015-06-03

    The use of a Community Advisory Board (CAB) is one method of ensuring community engagement in community based research. To identify the process used to constitute CABs in Zambia, this paper draws on the perspectives of both research team members and CAB members from research groups who used CABs in Lusaka. Enabling and restricting factors impacting on the functioning of the CAB were identified. All studies approved by the University of Zambia Bioethics Research Committee (UBNZABREC) from 2008 - 2012 were reviewed to identify those studies that were likely to include a CAB. Eight teams with studies that included a CAB were identified. For each of these studies, consent was obtained to conduct an informal interview with a research team member and to obtain contact details for one CAB member. In total 14 interviews were conducted with 8 research team members and 6 CAB members from 12-30 August 2013. Identification of potential CAB members from the community and their participation in developing the terms of reference for CABs was perceived to have contributed to the success of the CAB. Due to the trust that the community had in members of their community the CABs were then in a stronger position to influence community participation in the research. Training of CAB members was identified as a factor that enhanced the functioning of a CAB. Lack of commitment and low literacy levels of CAB members posed a threat to the role of the CAB. Although compensation in the form of a stipend was not provided, CAB members were provided with transport reimbursements for attending meetings. Selection of CAB members from within the community contributed to community confidence in the CAB, enhancing its ability to act as an effective link between study team and community. This contributed positively to the conduct of the study and enhanced community awareness and acceptance of the research. However, establishment of study specific CABs has the potential to compromise CAB independence

  15. From Help-Seekers to Influential Users: A Systematic Review of Participation Styles in Online Health Communities.

    Science.gov (United States)

    Carron-Arthur, Bradley; Ali, Kathina; Cunningham, John Alastair; Griffiths, Kathleen Margaret

    2015-12-01

    Understanding how people participate in and contribute to online health communities (OHCs) is useful knowledge in multiple domains. It is helpful for community managers in developing strategies for building community, for organizations in disseminating information about health interventions, and for researchers in understanding the social dynamics of peer support. We sought to determine if any patterns were apparent in the nature of user participation across online health communities. The current study involved a systematic review of all studies that have investigated the nature of participation in an online health community and have provided a quantifiable method for categorizing a person based on their participation style. A systematic search yielded 20 papers. Participatory styles were classified as either multidimensional (based on multiple metrics) or unidimensional (based on one metric). With respect to the multidimensional category, a total of 41 different participation styles were identified ranging from Influential Users who were leaders on the board to Topic-Focused Responders who focused on a specific topic and tended to respond to rather than initiate posts. However, there was little overlap in participation styles identified both across OHCs for different health conditions and within OHCs for specific health conditions. Five of the 41 styles emerged in more than one study (Hubs, Authorities, Facilitators, Prime Givers, and Discussants), but the remainder were reported in only one study. The focus of the unidimensional studies was on level of engagement and particularly on high-engaged users. Eight different metrics were used to evaluate level of engagement with the greatest focus on frequency of posts. With the exception of high-engaged users based on high post frequency, the current review found little evidence for consistent participatory styles across different health communities. However, this area of research is in its infancy, with most of the

  16. A Longitudinal Study into Indicators of Mental Health, Strengths and Difficulties Reported by Boarding Students as They Transition from Primary School to Secondary Boarding Schools in Perth, Western Australia

    Science.gov (United States)

    Mander, David J.; Lester, Leanne

    2017-01-01

    This study examined indicators of mental health, as well as strengths and difficulties, as reported by same-age boarding and non-boarding students spanning four time points over a 2-year period as they transitioned from primary to boarding school in Western Australia (i.e., at the end of Grade 7, beginning of Grade 8, end of Grade 8, and end of…

  17. Service functions of private community health stations in China: A comparison analysis with government-sponsored community health stations.

    Science.gov (United States)

    Hou, Wanli; Fan, Hong; Xu, Jing; Wang, Fang; Chai, Yun; Xu, Hancheng; Li, Yongbin; Liu, Liqun; Wang, Bin; Jin, Jianqiang; Lu, Zuxun

    2012-04-01

    In China, with the restructuring of health care system moving forward, private community health facilities have been playing a complementary but increasingly important role in providing public health and basic medical care services in urban areas. However, only limited evidence is available concerning the service functions of private community health facilities in China. The aim of this study was to explore the functions of private community health stations (PCHSs) to provide evidence-based recommendations for policy-making and practice in the development of urban community health services systems. A total of 818 PCHSs and 4320 government-sponsored community health stations (GCHSs) located in 28 cities of China were investigated in 2008. The percentages of stations that provided health services and the annual workload per community health worker (CHW) were compared between the two types of institutions. The results showed that the percentages of PCHSs providing public health services were significantly higher than those of GCHSs (P0.05). The annual workloads of all the public health services and basic medical services per CHW in PCHSs were lighter than those in GCHSs (P0.05). At present, the GCHSs are still the mainstream in urban China, which will last for a long period in future. However, our findings showed that the annual workloads of CHWs in PCHSs were no heavier than those in GCHSs, and the PCHSs were willing to provide public health services. In view of current inadequacy of health resources in China, it is feasible to further develop PCHSs under the guidance of the government, given that PCHSs can perform the basic functions of community health services, which is useful for the formation of public-private partnerships (PPP) and the improvement of community health services.

  18. Do Management and Leadership Practices in the Context of Decentralisation Influence Performance of Community Health Fund? Evidence From Iramba and Iringa Districts in Tanzania

    Directory of Open Access Journals (Sweden)

    Chakupewa Joseph

    2017-05-01

    Full Text Available Background In early 1990s, Tanzania like other African countries, adopted health sector reform (HSR. The most strongly held centralisation system that informed the nature of services provision including health was, thus, disintegrated giving rise to decentralisation system. It was within the realm of HSR process, user fees were introduced in the health sector. Along with user fees, various types of health insurances, including the Community Health Fund (CHF, were introduced. While the country’s level of enrolment in the CHF is low, there are marked variations among districts. This paper highlights the role of decentralised health management and leadership practices in the uptake of the CHF in Tanzania. Methods A comparative exploratory case study of high and low performing districts was carried out. In-depth interviews were conducted with the members of the Council Health Service Board (CHSB, Council Health Management Team (CHMT, Health Facility Committees (HFCs, in-charges of health facilities, healthcare providers, and Community Development Officers (CDOs. Minutes of the meetings of the committees and district annual health plans and district annual implementation reports were also used to verify and triangulate the data. Thematic analysis was adopted to analyse the collected data. We employed both inductive and deductive (mixed coding to arrive to the themes. Results There were no differences in the level of education and experience of the district health managers in the two study districts. Almost all district health managers responsible for the management of the CHF had attended some training on management and leadership. However, there were variations in the personal initiatives of the top-district health leaders, particularly the district health managers, the council health services board and local government officials. Similarly, there were differences in the supervision mechanisms, and incentives available for the health providers

  19. Co-creation by the ABIM Geriatric Medicine Board and the AGS - Helping Move Geriatrics Forward.

    Science.gov (United States)

    Leff, Bruce; Lundjeberg, Nancy E; Brangman, Sharon A; Dubow, Joyce; Levine, Sharon; Morgan-Gouveia, Melissa; Schlaudecker, Jeffrey; Lynn, Lorna; McDonald, Furman S

    2017-10-01

    The American board of internal medicine (ABIM) establishes standards for physicians. The American geriatrics society (AGS) is a not-for-profit membership organization of nearly 6,000 health professionals devoted to improving the health, independence, and quality of life of all older people. Beginning in 2013, ABIM redesigned its governance structure, including the role of the specialty boards. Specialty boards are charged with responsibilities for oversight in four main areas: (1) the assessments used in initial certification and maintenance of certification (MOC); (2) medical knowledge self-assessment and practice assessment in the specialty; (3) building relationships with relevant professional societies and other organizational stakeholders; and (4) issues related to training requirements for initial certification eligibility within the specialty. The aim of this paper is to inform the geriatrics community regarding the function of geriatric medicine board (GMB) of the ABIM, and to invite the geriatrics community to fully engage with and leverage the GMB as a partner to: (1) develop better certification examinations and processes, identifying better knowledge and practice assessments, and in establishing appropriate training and MOC requirements for geriatric medicine; (2) leverage ABIM assets to conduct applied research to guide the field in the areas of training and certification and workforce development in geriatric medicine; (3) make MOC relevant for practicing geriatricians. Active engagement of the geriatrics community with ABIM and the GMB will ensure that certification in geriatric medicine provides the greatest possible value and meaning to physicians, patients, and the public. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  20. Facilitating communities in designing and using their own community health impact assessment tool

    International Nuclear Information System (INIS)

    Cameron, Colleen; Ghosh, Sebanti; Eaton, Susan L.

    2011-01-01

    Reducing health inequities and improving the health of communities require an informed public that is aware of the social determinants of health and how policies and programs have an impact on the health of their communities. People Assessing Their Health (PATH) is a process that uses community-driven health impact assessment to build the capacity of people to become active participants in the decisions that affect the well-being of their community. The PATH process is both a health promotion and a community development approach that builds people's ability to bring critical analysis to a situation and to engage in effective social action to bring about desired change. Because it increases analytical skills and provides communities with their own unique tool to assess the potential impact of projects, programs or policies on the health and well-being of their community it is an empowering process. PATH was originally used in three communities in northeastern Nova Scotia, Canada in 1996 when the Canadian health care system was being restructured to a more decentralized system. Since then it has been used in other communities in Nova Scotia and India. This paper will describe the PATH process and the use of the community health impact assessment as well as the methodology used in the PATH process. The lessons learned from PATH's experiences of building capacity among the community in Canada and India will be presented.

  1. 76 FR 28790 - Board of Scientific Counselors, National Institute for Occupational Safety and Health (BSC, NIOSH)

    Science.gov (United States)

    2011-05-18

    ... Hearing Loss Prevention; Personal Protective Technologies; Health Hazard Evaluations; Construction Safety... Scientific Counselors, National Institute for Occupational Safety and Health (BSC, NIOSH) In accordance with... relating to occupational safety and health and to mine health. The Board of Scientific Counselors shall...

  2. 76 FR 65729 - Board of Scientific Counselors, National Institute for Occupational Safety and Health (BSC, NIOSH)

    Science.gov (United States)

    2011-10-24

    ... Recommendations for Respiratory Diseases, Hearing Loss Prevention, Personal Protective Technologies, and Health... Scientific Counselors, National Institute for Occupational Safety and Health (BSC, NIOSH) In accordance with..., and demonstrations relating to occupational safety and health and to mine health. The Board of...

  3. Implementing Community-based Health Planning and Services in impoverished urban communities: health workers' perspective.

    Science.gov (United States)

    Nwameme, Adanna Uloaku; Tabong, Philip Teg-Nefaah; Adongo, Philip Baba

    2018-03-20

    Three-quarters of sub-Saharan Africa's urban population currently live under slum conditions making them susceptible to ill health and diseases. Ghana characterizes the situation in many developing countries where the urban poor have become a group much afflicted by complex health problems associated with their living conditions, and the intra-city inequity between them and the more privileged urban dwellers with respect to health care accessibility. Adopting Ghana's rural Community-Based Health Planning and Service (CHPS) programme in urban areas is challenging due to the differences in social networks and health challenges thus making modifications necessary. The Community Health Officers (CHOs) and their supervisors are the frontline providers of health in the community and there is a need to analyze and document the health sector response to urban CHPS. The study was solely qualitative and 19 in-depth interviews were conducted with all the CHOs and key health sector individuals in supervisory/coordinating positions working in urban CHPS zones to elicit relevant issues concerning urban CHPS implementation. Thematic content data analysis was done using the NVivo 7 software. Findings from this appraisal suggest that the implementation of this urban concept of the CHPS programme has been well undertaken by the health personnel involved in the process despite the challenges that they face in executing their duties. Several issues came to light including the lack of first aid drugs, as well as the need for the Integrated Management of Neonatal and Childhood Illnesses (IMNCI) programme and more indepth training for CHOs. In addition, the need to provide incentives for the volunteers and Community Health Committee members to sustain their motivation and the CHOs' apprehensions with regards to furthering their education and progression in their careers were key concerns raised. The establishment of the CHPS concept in the urban environment albeit challenging has been

  4. Community desires for an online health information strategy.

    Science.gov (United States)

    Dart, Jared M; Gallois, Cindy

    2010-11-01

    To determine whether the community's attitudes to components of a community eHealth strategy differ across three different socioeconomic groups. A survey questionnaire was designed and implemented across three different communities. Paper-based surveys were left in community organisations and local health practices in a low socioeconomic community on the outskirts of Ipswich, Queensland (n = 262), a mid-high socioeconomic community in the western suburbs of Brisbane (n = 256) and at a local university (n = 200). Ascribed importance and comfort with proposed components of a community eHealth strategy. A community-oriented health website was perceived as useful in getting access to relevant health information. Those who were most comfortable with accessing online health information were those who were: experienced, had home internet access and were frequent internet users. The most important types of health information for the website were: information about the treatment of conditions, how to manage a chronic illness, how to stay healthy and patient clinical pathways. The low socioeconomic community had different information priorities – all categories were considered more important, particularly information about how the public system operates, local health support groups, and the roles of health professionals. Different communities have different information demands but there is a strong demand for information which empowers community members to take control of their own health and become active participants in their health care. Tools such as a community health portal and patient clinical pathways should become more available.

  5. The community health worker cultural mentoring project: preparing professional students for team work with health workers from urban communities.

    Science.gov (United States)

    Sherwen, Laurie N; Schwolsky-Fitch, Elena; Rodriquez, Romelia; Horta, Greg; Lopez, Ivanna

    2007-01-01

    Community Health Workers or CHWs (also known by a variety of alternative titles) are health workers drawn from communities to provide access to care for members of their communities. CHWs have been documented as effective in delivering a variety of services in a culturally-sensitive manner, and in providing a bridge between health professionals and underserved or minority communities. Yet, CHWs have not been well incorporated into interdisciplinary health care teams. The majority of health professionals are not even aware of the possible role and skills of CHWs. Believing that the best time to educate professionals about this valuable health worker and ensure that CHWs become part of interdisciplinary health care teams is during the student years, the Hunter College Schools of the Health Professions, and the Community Health Worker Network of New York City developed a pilot project, the Community Health Worker Cultural Mentoring Project. Community Health Workers, who were members of the Network, served as "community mentors" for health professions students drawn from the programs of community health education, nursing, and nutrition. CHWs worked with faculty of selected courses in each of the professional programs, and served as panelists in these courses, presenting information about health beliefs and alternative health practices of diverse cultural groups in communities of New York City. Class sessions were first held in the fall of 2004; subsequent sessions were held in following semesters. Approximately 40 students participated in 7 classes, with 6 CHWs serving as mentors - two per class. At the end of the classroom presentations, students wrote reflections relating to their understanding of the CHW role and relevance for their future interdisciplinary practice. The majority of reflections met the goal of increasing professional students' understanding of the CHW role and skills. At this point, quantitative and qualitative data will need to be collected to

  6. Communities defining environmental health: examples from the Colorado (U.S.A.) Healthy Communities Initiative.

    Science.gov (United States)

    Conner, R F; Tanjasiri, S P

    2000-01-01

    Communities are increasingly defining 'health' for themselves, then becoming the main actors in actions to improve their health and well being. These community members work from a broad and inclusive definition of 'health' that often incorporates environmental health as a key aspect. They also assume an ecological, or systems, viewpoint that integrates many aspects of the community that affect health and well being, including housing, health, economy, education, transportation, youth and family issues, as well as health and illness care. This paper describes a program that involves 28 large and small, urban and rural communities in the United States state of Colorado that undertook this type of community-based health improvement project. The Colorado Healthy Communities Initiative (CHCI) was designed to bring together citizens in Colorado to work collaboratively to make their communities healthier. This paper describes the program's background, including its principles, processes, and participants, then focuses on the particular aspects of environmental health that communities included in their definitions of a 'healthy community'.

  7. 78 FR 38346 - Subcommittee on Procedures Review, Advisory Board on Radiation and Worker Health (ABRWH...

    Science.gov (United States)

    2013-06-26

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Subcommittee on Procedures Review, Advisory Board on Radiation and Worker Health (ABRWH), National Institute for Occupational Safety and Health (NIOSH) In accordance with section 10(a)(2) of the Federal Advisory Committee Act...

  8. Keys to Successful Community Health Worker Supervision

    Science.gov (United States)

    Duthie, Patricia; Hahn, Janet S.; Philippi, Evelyn; Sanchez, Celeste

    2012-01-01

    For many years community health workers (CHW) have been important to the implementation of many of our health system's community health interventions. Through this experience, we have recognized some unique challenges in community health worker supervision and have highlighted what we have learned in order to help other organizations effectively…

  9. Consumer attitudes toward health policy and knowledge about health legislation.

    Science.gov (United States)

    Riska, E; Taylor, J A

    1978-01-01

    Consumer attitudes toward key issues affecting health policy decisions in the local community have been ignored both by local health policy makers and by medical sociologists. The authors report an empirical analysis of: (1) consumer attitudes towards federal intervention in health care; (2) consumer perceptions of the free market philosophy of health providers; (3) consumer perceptions of their involvement in health policy making; (4) consumer confidence in present systems of health services delivery; and (5) consumer awareness of recent major health legislation. It was found that consumers are poorly informed about recent health care legislation. The authors compared the attitudes of consumers with those held by local hospital board members toward health policy issues. The differences for all comparisons were statistically significant. The authors argue that hospital board members attribute problems in health services delivery to demand dysfunctions while consumers perceive the problems to be a result of supply dysfunctions. Thus, failure to include consumers on health policy boards guarantees the absence of a solution-oriented dialogue and promotes the continuing predominance of a provider-biased ideology.

  10. 75 FR 42448 - Board of Scientific Counselors (BSC), Coordinating Center for Health Promotion (CCHP): Notice of...

    Science.gov (United States)

    2010-07-21

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention (CDC) Board of Scientific Counselors (BSC), Coordinating Center for Health Promotion (CCHP): Notice of Charter Amendment... Disease Prevention and Health Promotion (NCCDPHP). [[Page 42449

  11. 78 FR 11651 - Board of Scientific Counselors, National Institute for Occupational Safety and Health (BSC, NIOSH)

    Science.gov (United States)

    2013-02-19

    ... Scientific Counselors, National Institute for Occupational Safety and Health (BSC, NIOSH) In accordance with..., research, experiments, and demonstrations relating to occupational safety and health and to mine health... Occupational Safety and Health on research and prevention programs. Specifically, the Board shall provide...

  12. 77 FR 47850 - Board of Scientific Counselors, National Institute for Occupational Safety and Health (BSC, NIOSH)

    Science.gov (United States)

    2012-08-10

    ... Scientific Counselors, National Institute for Occupational Safety and Health (BSC, NIOSH) In accordance with..., research, experiments, and demonstrations relating to occupational safety and health and to mine health... Occupational Safety and Health on research and prevention programs. Specifically, the Board shall provide...

  13. Unlicensed Boarding House Managers' Experiences and Perceptions of Need in Residents with Mental Health and Substance Use Problems

    Science.gov (United States)

    Deane, Frank P.; Tweedie, Rosemarie; van der Weyden, Chantelle; Cowlin, Feona

    2012-01-01

    Unlicensed boarding houses provide low cost accommodation for many people who have mental health and/or alcohol or other drug problems. The present study explored the needs and experiences of owners and managers of unlicensed boarding houses who have residents with MH and AOD problems. Twenty-three boarding house managers (BHMs) from Illawarra and…

  14. Your health is your wealth: faith-based community action on the health of African migrant communities in Amsterdam

    NARCIS (Netherlands)

    Agyemang, Charles; Meeks, Karlijn; Boateng, Reynolds; Beune, Erik

    2018-01-01

    The African migrant communities in Europe face many challenges including poor health outcomes. Migrant community leaders can play a crucial role in addressing the health needs of their community members. In this paper, we described Sub-Saharan African migrant community leaders' action to improve the

  15. 76 FR 38183 - Subcommittee on Procedures Review, Advisory Board on Radiation and Worker Health (ABRWH...

    Science.gov (United States)

    2011-06-29

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Subcommittee on Procedures Review, Advisory Board on Radiation and Worker Health (ABRWH), National Institute for Occupational Safety and Health (NIOSH) In accordance with section 10(a)(2) of the Federal Advisory Committee Act (Pub...

  16. 76 FR 11483 - Subcommittee on Procedures Review, Advisory Board on Radiation and Worker Health (ABRWH...

    Science.gov (United States)

    2011-03-02

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Subcommittee on Procedures Review, Advisory Board on Radiation and Worker Health (ABRWH), National Institute for Occupational Safety and Health (NIOSH) In accordance with section 10(a)(2) of the Federal Advisory Committee Act (Pub...

  17. 78 FR 19268 - Subcommittee on Procedures Review, Advisory Board on Radiation and Worker Health (ABRWH...

    Science.gov (United States)

    2013-03-29

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Subcommittee on Procedures Review, Advisory Board on Radiation and Worker Health (ABRWH), National Institute for Occupational Safety and Health (NIOSH) In accordance with section 10(a)(2) of the Federal Advisory Committee Act (Pub...

  18. 75 FR 78998 - Subcommittee on Procedures Review, Advisory Board on Radiation and Worker Health (ABRWH...

    Science.gov (United States)

    2010-12-17

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Subcommittee on Procedures Review, Advisory Board on Radiation and Worker Health (ABRWH), National Institute for Occupational Safety and Health (NIOSH) In accordance with section 10(a)(2) of the Federal Advisory Committee Act (Pub...

  19. 78 FR 78965 - Subcommittee on Procedures Review, Advisory Board on Radiation and Worker Health (ABRWH...

    Science.gov (United States)

    2013-12-27

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Subcommittee on Procedures Review, Advisory Board on Radiation and Worker Health (ABRWH), National Institute for Occupational Safety and Health (NIOSH) In accordance with section 10(a)(2) of the Federal Advisory Committee Act (Pub...

  20. 77 FR 40890 - Subcommittee on Procedures Review, Advisory Board on Radiation and Worker Health (ABRWH...

    Science.gov (United States)

    2012-07-11

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Subcommittee on Procedures Review, Advisory Board on Radiation and Worker Health (ABRWH), National Institute for Occupational Safety and Health (NIOSH) In accordance with section 10(a)(2) of the Federal Advisory Committee Act (Pub...

  1. 77 FR 15761 - Subcommittee on Procedures Review, Advisory Board on Radiation and Worker Health (ABRWH...

    Science.gov (United States)

    2012-03-16

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Subcommittee on Procedures Review, Advisory Board on Radiation and Worker Health (ABRWH), National Institute for Occupational Safety and Health (NIOSH) In accordance with section 10(a)(2) of the Federal Advisory Committee Act (Pub...

  2. 78 FR 732 - Subcommittee on Procedures Review, Advisory Board on Radiation and Worker Health (ABRWH...

    Science.gov (United States)

    2013-01-04

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Subcommittee on Procedures Review, Advisory Board on Radiation and Worker Health (ABRWH), National Institute for Occupational Safety and Health (NIOSH) In accordance with section 10(a)(2) of the Federal Advisory Committee Act (Pub...

  3. 78 FR 78963 - Subcommittee on Procedures Review, Advisory Board on Radiation and Worker Health (ABRWH...

    Science.gov (United States)

    2013-12-27

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Subcommittee on Procedures Review, Advisory Board on Radiation and Worker Health (ABRWH), National Institute for Occupational Safety and Health (NIOSH) In accordance with section 10(a)(2) of the Federal Advisory Committee Act (Pub...

  4. 78 FR 62635 - Subcommittee on Procedures Review, Advisory Board on Radiation and Worker Health (ABRWH...

    Science.gov (United States)

    2013-10-22

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Subcommittee on Procedures Review, Advisory Board on Radiation and Worker Health (ABRWH), National Institute for Occupational Safety and Health (NIOSH) In accordance with section 10(a)(2) of the Federal Advisory Committee Act (Pub...

  5. 75 FR 39029 - Subcommittee on Procedures Review, Advisory Board on Radiation and Worker Health (ABRWH...

    Science.gov (United States)

    2010-07-07

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Subcommittee on Procedures Review, Advisory Board on Radiation and Worker Health (ABRWH), National Institute for Occupational Safety and Health (NIOSH) In accordance with section 10(a)(2) of the Federal Advisory Committee Act (Pub...

  6. 76 FR 77235 - Subcommittee on Procedures Review, Advisory Board on Radiation and Worker Health (ABRWH...

    Science.gov (United States)

    2011-12-12

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Subcommittee on Procedures Review, Advisory Board on Radiation and Worker Health (ABRWH), National Institute for Occupational Safety and Health (NIOSH) In accordance with section 10(a)(2) of the Federal Advisory Committee Act (Pub...

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

    Science.gov (United States)

    Brown, Angela; Malca, Rosa; Zumaran, Adriana; Miranda, J Jaime

    2006-05-17

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

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

    Science.gov (United States)

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

    2013-01-01

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

  9. 78 FR 48163 - Board of Scientific Counselors, National Center for Health Statistics

    Science.gov (United States)

    2013-08-07

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Board of... Federal Advisory Committee Act (Pub. L. 92-463), the Centers for Disease Control and Prevention (CDC... listed below. All requests must contain the name, address, telephone number, and organizational...

  10. 78 FR 17411 - Board of Scientific Counselors, National Center for Health Statistics

    Science.gov (United States)

    2013-03-21

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Board of... Federal Advisory Committee Act (Pub. L. 92-463), the Centers for Disease Control and Prevention (CDC... contain the name, address, telephone number, and organizational affiliation of the presenter. Written...

  11. 78 FR 48438 - Board of Scientific Counselors, National Center for Health Statistics

    Science.gov (United States)

    2013-08-08

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Board of... Federal Advisory Committee Act (Pub. L. 92-463), the Centers for Disease Control and Prevention (CDC... listed below. All requests must contain the name, address, telephone number, and organizational...

  12. A New Arduino Datalogger Board for Simple, Low Cost Environmental Monitoring and the EnviroDIY Web Community

    Science.gov (United States)

    Hicks, S. D.; Aufdenkampe, A. K.; Montgomery, D. S.; Damiano, S. G.; Brooks, H. P.

    2015-12-01

    Scientists and educators around the world have been building their own dataloggers and devices using a variety of boards based on the Arduino open source electronics platform. While there have been several useful boards on the market in the past few years, they still required significant modification or additional components in order to use them with various sensors or deploy them in remote areas. Here we introduce our new custom datalogger board that makes it very easy to build a rugged environmental monitoring system. These custom boards contain all of the essential features of a solar-powered datalogger with radio telemetry, plus they have a very convenient and modular method for attaching a wide variety of sensors and devices. Various deployment options and installations are shown, as well as the online database that is used for capturing the live streaming data from the loggers and displaying graphs on custom web pages. Following the introduction last year of the EnviroDIY online community (http://enviroDIY.org), it continues to gain new members and share new ideas about open-source hardware and software solutions for observing our environment. EnviroDIY members can showcase their gadgets or describe their projects, ask questions, or follow along with helpful tutorials. Our new datalogger board, together with the EnviroDIY website, will make it easy for anyone to build and deploy their own environmental monitoring stations.

  13. Departmental Appeals Board Decisions

    Data.gov (United States)

    U.S. Department of Health & Human Services — Decisions issued by the Chair and Board Members of the Departmental Appeals Board concerning determinations in discretionary, project grant programs, including...

  14. 78 FR 51729 - Board of Scientific Counselors, National Institute for Occupational Safety and Health (BSC, NIOSH)

    Science.gov (United States)

    2013-08-21

    ... Scientific Counselors, National Institute for Occupational Safety and Health (BSC, NIOSH) In accordance with... demonstrations relating to occupational safety and health and to mine health. The Board of Scientific Counselors shall provide guidance to the Director, National Institute for Occupational Safety and Health on...

  15. The board's role in organizational finance.

    Science.gov (United States)

    Curran, Connie R

    2010-01-01

    Health care reform will result in significant changes in reimbursement with much greater emphasis put on primary care, home care, and other types of non-acute care. The changes in reimbursement will necessitate significant changes in organizational structure and operations. It is essential board members keep current in their knowledge of health care finance so they can execute their responsibilities for the financial health of the organization. The board must ensure that the budget is aligned with the organization's financial objectives and monitor the financial performance. It is essential the chief nursing officer (CNO) contributes to the board's understanding of the financial health of the organization. The board of trustees will more effectively execute their financial responsibilities with the input of nurse trustees and the CNO.

  16. Investigation of medical board reports of disability due to mental health problems

    Directory of Open Access Journals (Sweden)

    Mesut Yildiz

    2016-06-01

    Conclusion: We think that this report might be helpful for regulations related to disabled people, and might guide adult psychiatric services for patients who present to medical boards for disability due to mental health problems. [Cukurova Med J 2016; 41(2.000: 253-258

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

    Science.gov (United States)

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

    2014-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Zumaran Adriana

    2006-05-01

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

  19. Training community health students to develop community-requested social marketing campaigns: an innovative partnership.

    Science.gov (United States)

    Lindsey, Billie J; Hawk, Carol Wetherill

    2013-01-01

    This paper describes a sustained partnership between a university community health program and local and regional community health agencies. As a key component of the Health Communication and Social Marketing course, the partnership involves undergraduate community health students working for and with community agencies and community members to design social marketing campaigns based on community-identified health needs. The goals of the course are to (1) provide students with the opportunity to work within the community to apply their skills in program planning, evaluation, and communication and (2) provide community agencies with a tailored campaign that can be implemented in their communities. Throughout the 10-week quarter, teams of students follow the principles of community participation in planning a social marketing campaign. These include (1) audience segmentation and formative assessment with the intended audience to determine campaign content and strategies and (2) pretesting and revisions of campaign messages and materials based on community feedback. This partnership contributes to the promotion of health in the local community and it builds the skills and competencies of future health educators. It demonstrates a successful and sustainable combination of community-based participatory research and experiential learning. From 2005 to 2011, 35 campaigns have been developed, many which have been implemented.

  20. A Feminist Framework for Nurses on Boards.

    Science.gov (United States)

    Sundean, Lisa J; Polifroni, E Carol

    Nurses' knowledge, skills, and expertise uniquely situate them to contribute to health care transformation as equal partners in organizational board governance. The Institute of Medicine, the 10,000 Nurses on Boards Coalition, and a growing number of nurse and health care scholars advocate nurse board leadership; however, nurses are rarely appointed as voting board members. When no room is made for nurses to take a seat at the table, the opportunity is lost to harness the power of nursing knowledge for health care transformation and social justice. No philosophical framework underpins the emerging focus on nurse board leadership. The purpose of this article is to add to the extant nursing literature by suggesting feminism as a philosophical framework for nurses on boards. Feminism contributes to the knowledge base of nursing as it relates to the expanding roles of nurses in health care transformation, policy, and social justice. Furthermore, a feminist philosophical framework for nurses on boards sets the foundation for new theory development and validates ongoing advancement of the nursing profession. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Using health information technology to engage communities in health, education, and research.

    Science.gov (United States)

    Marriott, Lisa K; Nelson, David A; Allen, Shauntice; Calhoun, Karen; Eldredge, Christina E; Kimminau, Kim S; Lucero, Robert J; Pineda-Reyes, Fernando; Rumala, Bernice B; Varanasi, Arti P; Wasser, June S; Shannon, Jackilen

    2012-02-01

    The August 2011 Clinical and Translational Science Awards conference "Using IT to Improve Community Health: How Health Care Reform Supports Innovation" convened four "Think Tank" sessions. Thirty individuals, representing various perspectives on community engagement, attended the "Health information technology (HIT) as a resource to improve community health and education" session, which focused on using HIT to improve patient health, education, and research involvement. Participants discussed a range of topics using a semistructured format. This article describes themes and lessons that emerged from that session, with a particular focus on using HIT to engage communities to improve health and reduce health disparities in populations.

  2. Training of Community Health Agents in health hearing children: current perspectives.

    Science.gov (United States)

    Castro, Taís Teixeira de Oliveira; Zucki, Fernanda

    2015-01-01

    To characterize the training of Community Health Workers in the field of child hearing health. A systematic literature review on Biblioteca Virtual em Saúde (BVS) and Biblioteca Digital de Teses e Dissertações of USP databases was performed. The search strategy was oriented by the specific question: "How have the Community Health Workers been trained to work in the field of child hearing health?" The study selection criteria involved consistency with the proposed theme, belonging to the category of scientific papers, dissertation or thesis, and publication in Brazilian Portuguese. A total of 2,687 studies were found. After analyzing the title and abstract, eight studies were chosen for full reading, however, only four of them met the proposed criteria and were included in the review. The studies indicated live and virtual classes with the use of video conferencing or CD-ROM as training strategies for Community Health Workers. Trainings were effective. Only one questionnaire about hearing and language monitoring was described. Different possibilities for the activities of Community Health Workers were identified. Different learning methodologies have been used for training the Community Health Worker in the field of child hearing health, and all of have proven effective for knowledge acquisition. Community Health Workers play an important role in promoting and monitoring child hearing health.

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

    Directory of Open Access Journals (Sweden)

    Vivi Maketa

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

  4. Testing the associations between different aspects of seafarers' employment contract and on-board internet access and their job and life satisfaction and health.

    Science.gov (United States)

    Slišković, Ana; Penezić, Zvjezdan

    2016-12-01

    The aim of this study was to test for associations between different aspects of contract and on-board internet access and seafarers' satisfaction and health. Altogether 298 Croatian seafarers, all officers, employed on cargo ships, with a minimum work experience of two years with their current shipping company, participated in an online survey. The questionnaire included sociodemographic items, questions relating to their employment contract and internet access, and measures of job satisfaction, life satisfaction, mental health, and gastrointestinal and cardiovascular symptoms. Their job- and lifesatisfaction levels were higher for shorter duration on board, favourable ratio of work to non-work days, and compliance with the employment contract regarding the changes to work and non-work days. Mental health differed likewise but only in relation to two aspects of the contract: on-board duration and compliance with the contract. The level of gastrointestinal symptoms was lower in cases of shorter on-board duration and compliance with the contract, and in seafarers who have free, unlimited internet access on board. Lower level of cardiovascular symptoms was found in seafarers with free, unlimited internet access on board. Our findings suggest that in promoting satisfaction and health in seafaring, attention should be given to reducing on-board duration, compliance with the contract, and internet accessibility on board.

  5. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    adedamla

    Quarry industry has become a major means of livelihood in Ebonyi state, but insufficient data exists on their operations ... of Dust Mask among Crushers of Selected Quarry (Crushed ... Journal of Community Medicine and Primary Health Care.

  6. Community mental health care in India.

    Science.gov (United States)

    Padmavati, R

    2005-04-01

    Recent times are witnessing methods in the various forms of community care for the mentally ill in India. Non-governmental organizations (NGO) play a pivotal role in filling the gap in the existing mental health services in India and the substantial need for these services. Various strategies that have been employed in community care have attempted to utilize existing community resources for implementation. Informal manpower resources incorporated with specialist psychiatric care and integrated with existing health care facilities have been general strategies. While the feasibility and cost-effectiveness of the NGO operated community outreach programs for the mentally ill have been demonstrated, various factors are seen to influence the planning and execution of such programs. This paper elucidates some critical factors that would need to be considered in community mental health care in India.

  7. Community health nursing vision for 2020: shaping the future.

    Science.gov (United States)

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

    2011-12-01

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

  8. Assessment of oral health needs and barriers to care in a Gullah community: Hollywood smiles.

    Science.gov (United States)

    Leite, Renata; Hudson, Christine; West, Lynn; Carpenter, Elizabeth; Andrews, Jeannette O

    2013-01-01

    To assess the oral health (OH) needs and barriers to OH care in Gullah African American communities. A community advisory board (CAB) was formed to guide the research study. Five focus groups (n = 27 participants) were conducted to explore the OH needs/barriers. Participants completed demographic surveys and participated in discussions facilitated by open-ended questions. All sessions were audio-recorded, transcribed and analyzed using NVivo8. Facilitators of OH included positive experiences and modeling. Fear and access to care were the most cited barriers. Tooth extraction was the dental treatment of choice. Intervention recommendations included improving clinic access, using the churches to socially influence receipt of OH care, providing group educational sessions with OH specialists, and having local "lay people" to provide support and help to navigate OH care systems. The design of a multilevel, culturally and locally relevant intervention may lead to a decrease in OH disparities in Gullah communities.

  9. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    Department of Epidemiology and Community Health, University of Ilorin, Ilorin, Nigeria .... exercise. All pupils in the selected school later done under the light ..... increased the likelihood of intestinal parasitic of Ilechukwu et al in which a ...

  10. Perceptions of the community on the pricing of community mental health services.

    Science.gov (United States)

    Ogden, J R; Ogden, D T

    1992-01-01

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

  11. Community Health Workers as Support for Sickle Cell Care

    Science.gov (United States)

    Hsu, Lewis L.; Green, Nancy S.; Ivy, E. Donnell; Neunert, Cindy; Smaldone, Arlene; Johnson, Shirley; Castillo, Sheila; Castillo, Amparo; Thompson, Trevor; Hampton, Kisha; Strouse, John J.; Stewart, Rosalyn; Hughes, TaLana; Banks, Sonja; Smith-Whitley, Kim; King, Allison; Brown, Mary; Ohene-Frempong, Kwaku; Smith, Wally R.; Martin, Molly

    2016-01-01

    Community health workers are increasingly recognized as useful for improving health care and health outcomes for a variety of chronic conditions. Community health workers can provide social support, navigation of health systems and resources, and lay counseling. Social and cultural alignment of community health workers with the population they serve is an important aspect of community health worker intervention. Although community health worker interventions have been shown to improve patient-centered outcomes in underserved communities, these interventions have not been evaluated with sickle cell disease. Evidence from other disease areas suggests that community health worker intervention also would be effective for these patients. Sickle cell disease is complex, with a range of barriers to multifaceted care needs at the individual, family/friend, clinical organization, and community levels. Care delivery is complicated by disparities in health care: access, delivery, services, and cultural mismatches between providers and families. Current practices inadequately address or provide incomplete control of symptoms, especially pain, resulting in decreased quality of life and high medical expense. The authors propose that care and care outcomes for people with sickle cell disease could be improved through community health worker case management, social support, and health system navigation. This report outlines implementation strategies in current use to test community health workers for sickle cell disease management in a variety of settings. National medical and advocacy efforts to develop the community health workforce for sickle cell disease management may enhance the progress and development of “best practices” for this area of community-based care. PMID:27320471

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

    Directory of Open Access Journals (Sweden)

    Merridy Grant

    2017-05-01

    Conclusion: Understanding the complex contextual challenges faced by CHWs and community members can strengthen community-based interventions. CHWs require training, support and supervision to develop competencies navigating complex relationships within the community and the health system to provide effective care in communities.

  13. Changes to the law on consent following Montgomery vs Lanarkshire Health Board.

    Science.gov (United States)

    Clearkin, Louis

    2016-06-01

    The Supreme Court's determination on Montgomery (AP) (Appellant) v Lanarkshire Health Board (Respondent) (Scotland) [2015] clarified UK law on consent. It is for the informed patient to determine which intervention, if any, they will undergo. All doctors must meet this standard and may need to reassess their practice to do so.

  14. Community-Based Nursing versus Community Health Nursing: What Does It All Mean?

    Science.gov (United States)

    Zotti, Marianne E.; And Others

    1996-01-01

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

  15. Improving local health through community health workers in Cambodia: challenges and solutions.

    Science.gov (United States)

    Ozano, Kim; Simkhada, Padam; Thann, Khem; Khatri, Rose

    2018-01-06

    Volunteer community health workers (CHWs) are an important link between the public health system and the community. The 'Community Participation Policy for Health' in Cambodia identifies CHWs as key to local health promotion and as a critical link between district health centres and the community. However, research on the challenges CHWs face and identifying what is required to optimise their performance is limited in the Cambodian context. This research explores the views of CHWs in rural Cambodia, on the challenges they face when implementing health initiatives. Qualitative methodology was used to capture the experiences of CHWs in Kratie and Mondulkiri provinces. Two participatory focus groups with CHWs in Mondulkiri and ten semi-structured interviews in Kratie were conducted. Results from both studies were used to identify common themes. Participants were CHWs, male and female, from rural Khmer and Muslim communities and linked with seven different district health centres. Findings identify that CHWs regularly deliver health promotion to communities. However, systemic, personal and community engagement challenges hinder their ability to function effectively. These include minimal leadership and support from local government, irregular training which focuses on verticalised health programmes, inadequate resources, a lack of professional identity and challenges to achieving behaviour change of community members. In addition, the CHW programme is delivered in a fragmented way that is largely influenced by external aid objectives. When consulted, however, CHWs demonstrate their ability to develop realistic practical solutions to challenges and barriers. The fragmented delivery of the CHW programme in Cambodia means that government ownership is minimal. This, coupled with the lack of defined core training programme or adequate resources, prevents CHWs from reaching their potential. CHWs have positive and realistic ideas on how to improve their role and, subsequently

  16. Towards a Conceptualization of Online Community Health

    DEFF Research Database (Denmark)

    Wagner, David; Richter, Alexander; Trier, Matthias

    2014-01-01

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

  17. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    A nation's disease control effort is often as good as the surveillance and notification system put in place, .... Department. Community Health. 11. 4.9. Dentistry. 28. 12.5. Family Medicine. 14 .... formal training and a posting in the Infection control.

  18. Art and community health: lessons from an urban health center.

    Science.gov (United States)

    Siegel, Wilma Bulkin; Bartley, Mary Anne

    2004-01-01

    Staff at a nurse-managed urban health center conducted a series of art sessions to benefit the community. The authors believe the program's success clearly communicated the relationship between art and community health. As a result of the success of the sessions, plans are in the works to make art a permanent part of the health center's services.

  19. Community Members Draw the Line

    Directory of Open Access Journals (Sweden)

    Gregory Freeland

    2014-06-01

    Full Text Available This study investigates whether a community-based task force’s redistricting plan in Ventura County, California, positively affected fair representation, social equity issues, community interests, and the electoral process. Examination and evaluation of the organizational strategies and collaborations involved in the task force’s redistricting process find that the Board of Supervisors districts that members of the community drew were successful in improving and maintaining fair representation. This finding is based on comparing supervisorial votes and policies with community members’ votes on state propositions and local measures, in addition to conducting interviews with task force members, politicians, and community activists. This study finds that citizen participation in governmental processes improves overall community health and political participation.

  20. 78 FR 12422 - Health Services Research and Development Service Scientific Merit Review Board, Notice of Meeting

    Science.gov (United States)

    2013-02-22

    ... DEPARTMENT OF VETERANS AFFAIRS Health Services Research and Development Service Scientific Merit... nursing research. Applications are reviewed for scientific and technical merit, mission relevance, and the... Program Manager, Scientific Merit Review Board, Department of Veterans Affairs, Health Services Research...

  1. Developing a virtual community for health sciences library book selection: Doody's Core Titles.

    Science.gov (United States)

    Shedlock, James; Walton, Linda J

    2006-01-01

    The purpose of this article is to describe Doody's Core Titles in the Health Sciences as a new selection guide and a virtual community based on an effective use of online systems and to describe its potential impact on library collection development. The setting is the availability of health sciences selection guides. Participants include Doody Enterprise staff, Doody's Library Board of Advisors, content specialists, and library selectors. Resources include the online system used to create Doody's Core Titles along with references to complementary databases. Doody's Core Titles is described and discussed in relation to the literature of selection guides, especially in comparison to the Brandon/Hill selected lists that were published from 1965 to 2003. Doody's Core Titles seeks to fill the vacuum created when the Brandon/Hill lists ceased publication. Doody's Core Titles is a unique selection guide based on its method of creating an online community of experts to identify and score a core list of titles in 119 health sciences specialties and disciplines. The result is a new selection guide, now available annually, that will aid health sciences librarians in identifying core titles for local collections. Doody's Core Titles organizes the evaluation of core titles that are identified and recommended by content specialists associated with Doody's Book Review Service and library selectors. A scoring mechanism is used to create the selection of core titles, similar to the star rating system employed in other Doody Enterprise products and services.

  2. Community College Student Mental Health: A Comparative Analysis

    Science.gov (United States)

    Katz, Daniel Seth; Davison, Karen

    2014-01-01

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

  3. Developing Community Health Worker Diabetes Training

    Science.gov (United States)

    Ferguson, W. J.; Lemay, C. A.; Hargraves, J. L.; Gorodetsky, T.; Calista, J.

    2012-01-01

    We designed, implemented and evaluated a 48-hour training program for community health workers (CHWs) deployed to diabetes care teams in community health centers (CHCs). The curriculum included core knowledge/skills with diabetes content to assist CHWs in developing patient self-management goals. Our qualitative evaluation included…

  4. An evaluation of Health of the Nation Outcome Scales data to inform psychiatric morbidity following the Canterbury earthquakes.

    Science.gov (United States)

    Beaglehole, Ben; Frampton, Chris M; Boden, Joseph M; Mulder, Roger T; Bell, Caroline J

    2017-11-01

    Following the onset of the Canterbury, New Zealand earthquakes, there were widespread concerns that mental health services were under severe strain as a result of adverse consequences on mental health. We therefore examined Health of the Nation Outcome Scales data to see whether this could inform our understanding of the impact of the Canterbury earthquakes on patients attending local specialist mental health services. Health of the Nation Outcome Scales admission data were analysed for Canterbury mental health services prior to and following the Canterbury earthquakes. These findings were compared to Health of the Nation Outcome Scales admission data from seven other large District Health Boards to delineate local from national trends. Percentage changes in admission numbers were also calculated before and after the earthquakes for Canterbury and the seven other large district health boards. Admission Health of the Nation Outcome Scales scores in Canterbury increased after the earthquakes for adult inpatient and community services, old age inpatient and community services, and Child and Adolescent inpatient services compared to the seven other large district health boards. Admission Health of the Nation Outcome Scales scores for Child and Adolescent community services did not change significantly, while admission Health of the Nation Outcome Scales scores for Alcohol and Drug services in Canterbury fell compared to other large district health boards. Subscale analysis showed that the majority of Health of the Nation Outcome Scales subscales contributed to the overall increases found. Percentage changes in admission numbers for the Canterbury District Health Board and the seven other large district health boards before and after the earthquakes were largely comparable with the exception of admissions to inpatient services for the group aged 4-17 years which showed a large increase. The Canterbury earthquakes were followed by an increase in Health of the Nation

  5. Privatizing community animal health worker based veterinary ...

    African Journals Online (AJOL)

    Privatizing community animal health worker based veterinary services delivery system in West Kordofan, Southern Sudan; The needed roles of community animal health assistant (CAHA) and Pastoral unions.

  6. COMMUNITY HEALTH & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    the_monk

    VPDs, this represents 17% of global total. 1 ... Knowledge, Attitude and Practice of Childhood Immunization ... Department of Community Health & Primary Care, College of Medicine, University of Lagos, Idi-Araba, P.M.B. 12003, ... include access to services, parental (maternal) ... Calmette Guerin (BCG) vaccine Oral Polio.

  7. Work of community health agents in the Family Health Strategy: meta-synthesis

    Directory of Open Access Journals (Sweden)

    Carolina Maria do Carmo Alonso

    2018-02-01

    Full Text Available ABSTRACT OBJECTIVE To systematize and analyze the evidence from qualitative studies that address the perception of Brazilian Community Health Agents about their work. METHODS This is a systematic review of the meta-synthesis type on the work of community health agents, carried out from the Virtual Health Library using the descriptors “Agente Comunitário de Saúde” and “Trabalho”, in Portuguese. The strategy was constructed by crossing descriptors, using the Boolean operator “AND”, and filtering Brazilian articles, published from 2004 to 2014, which resulted in 129 identified articles. We removed quantitative or quanti-qualitative research articles, essays, debates, literature reviews, reports of experiences, and research that did not include Brazilian Community Health Agents as subjects. Using these criteria, we selected and analyzed 33 studies that allowed us to identify common subjects and differences between them, to group the main conclusions, to classify subjects, and to interpret the content. RESULTS The analysis resulted in three thematic units: characteristics of the work of community health agents, problems related to the work of community health agents, and positive aspects of the work of community health agents. On the characteristics, we could see that the work of the community health agents is permeated by the political and social dimensions of the health work with predominant use of light technologies. The main input is the knowledge that this professional obtains with the contact with families, which is developed with home visits. On the problems in the work of community health agents, we could identify the lack of limits in their attributions, poor conditions, obstacles in the relationship with the community and teams, weak professional training, and bureaucracy. The positive aspects we identified were the recognition of the work by families, resolution, bonding, work with peers, and work close to home. CONCLUSIONS

  8. [Development of the community mental health system and activities of the community mental health team in Kawasaki City].

    Science.gov (United States)

    Ito, Masato

    2012-01-01

    Since the 1960s, Kawasaki City has been leading the nation in its efforts regarding community mental health practices. Public institutions such as the Psychiatric Rehabilitation Center in the central area of the city and the Mental Health and Welfare Center in the southern area have mainly developed the psychiatric rehabilitation system. However, since 2000, new mental health needs have emerged, as the target of mental health and welfare services has been diversified to include people with developmental disorders, higher brain dysfunction, or social withdrawal, in addition to those with schizophrenia. Therefore, Kawasaki City's plan for community-based rehabilitation was drawn up, which makes professional support available for individuals with physical, intellectual, and mental disabilities. As the plan was being implemented, in 2008, the Northern Community Rehabilitation Center was established by both the public and private sectors in partnership. After the community mental health teams were assigned to both southern and northern areas of the city, the community partnership has been developed not only for individual support but also for other objectives that required the partnership. Takeshima pointed out that the local community should be inclusive of the psychiatric care in the final stage of community mental health care in Japan. Because of the major policies regarding people with disabilities, the final stage has been reached in the northern area of Kawasaki City. This also leads to improvement in measures for major issues in psychiatry, such as suicide prevention and intervention in psychiatric disease at an early stage.

  9. Marketing and Community Mental Health Centers.

    Science.gov (United States)

    Ferniany, Isaac W.; Garove, William E.

    1983-01-01

    Suggests that a marketing approach can be applied to community mental health centers. Marketing is a management orientation of providing services for, not to, patients in a systematic manner, which can help mental health centers improve services, strengthen community image, achieve financial independence and aid in staff recruitment. (Author)

  10. Community factors supporting child mental Health.

    Science.gov (United States)

    Earls, F

    2001-10-01

    A principal purpose of this article has been to examine the gap between research and practice in relation to community factors in child mental health. Two caveats were introduced in preparation for this assessment. First, it was pointed out that the definition of communities has been expanded by considering the organizing properties of social aggregates that are not simply a function of the race, ethnicity, or social class of individuals who compose them. Having these definitions grounded in theory substantially advances the needs of research and the design and goals of community-level interventions. The second caveat relates to the boundaries of the disciplines that cater to the needs of children. During the same era when child psychiatry is largely occupied with placing psychotropic medications at the center of clinical approaches, there is an important effort in child psychology and sociology to cut across their disciplinary confines to form more comprehensive designs that are sensitive to experiences and circumstances that emerge from specific aspects of community context. Research from the PHDCN was used as an example of this new interdisciplinary approach. Several community-based research projects were selected for review based on their clear implications to improve context-sensitive assessment of child mental health and design effective community-based interventions to improve child mental health. The Healthy Start and CATCH programs indicate that involving child professionals at the grassroots of community life requires skill and patience but that the effort is satisfying and potentially effective. Other examples, exemplified by North Carolina's Smart Start initiative and the program of developmental assets from the Search Institute, demonstrate coherent approaches that provide a foundation for long-term capacity building in assessment, local decision making, and the design and evaluation of interventions. Three conclusions are warranted from this

  11. A community approach to health.

    Science.gov (United States)

    Hagland, M

    1997-01-01

    Improving the health and well-being of a community may seem like a daunting task-particularly when you consider the vast number of factors that can influence the quality of life of a neighborhood or a region. It's not impossible, however, as six widely different communities across the U.S. are discovering. The Accelerating Community Transformation (ACT) project--now underway by The Healthcare Forum through a five-year, $5 million grant from pharmaceutical joint venture Astra Merck Inc.--is an innovative attempt to create real-life learning laboratories in communities as diverse as an inner-city neighborhood on the west side of Chicago; the small southern town of Aiken, S.C.: the semi-desert city of San Bernardino, Calif.; a corner of America's heartland where Missouri, Kansas. Nebraska and Iowa meet; the new town of Celebration, Fla.; and St. Louis, Mo. The goals: to evaluate and accelerate community-wide efforts that result in healthier, more desirable places for people to live, work and play; to build community capacity; and to achieve measurable improved health and quality of life outcomes.

  12. Under-reporting of notifiable infectious disease hospitalizations in a health board region in Ireland: room for improvement?

    LENUS (Irish Health Repository)

    Brabazon, E D

    2008-02-01

    Rapid notification of infectious diseases is essential for prompt public health action and for monitoring of these diseases in the Irish population at both a local and national level. Anecdotal evidence suggests, however, that the occurrence of notifiable infectious diseases is seriously underestimated. This study aims to assess the level of hospitalization for notifiable infectious diseases for a 6-year period in one health board region in Ireland and to assess whether or not there was any under-reporting during this period. All hospital in-patient admissions from 1997 to 2002 inclusive with a principal diagnosis relating to \\'infectious and parasitic diseases\\' (ICD codes 001-139) of residents from a health board region in Ireland were extracted from the Hospital In-Patient Enquiry System (HIPE). All notifiable infectious diseases were identified based on the 1981 Irish Infectious Disease Regulations and the data were analysed in the statistical package, JMP. These data were compared with the corresponding notification data. Analysis of the hospital in-patient admission data revealed a substantial burden associated with notifiable infectious diseases in this health board region: there were 2758 hospitalizations by 2454 residents, 17,034 bed days and 33 deaths. The statutory notification data comprises both general practitioner and hospital clinician reports of infectious disease. Therefore, only in cases where there are more hospitalizations than notifications can under-reporting be demonstrated. This occurred in nine out of 22 notifiable diseases and amounted to an additional 18% of notifications (or 572 cases) which were \\'missed\\' due to hospital clinician under-reporting. The majority of these under-reported cases were for viral meningitis (45%), infectious mononucleosis (27%), viral hepatitis C unspecified (15%) and acute encephalitis (5.8%). This study has highlighted the extent of under-reporting of hospitalized notifiable infectious diseases, in a

  13. Community Capacity Building for Health

    Directory of Open Access Journals (Sweden)

    Martha Traverso-Yepez

    2012-05-01

    Full Text Available There is a great deal of literature examining the benefits and relevance of community participation and community capacity building in health promotion and disease prevention endeavors. Academic literature embracing principles and commitment to community participation in health promotion practices often neglects the complexities involved and the flexibility required to work within this approach. This article addresses some of these challenges through a case study of two projects funded by Provincial Wellness Grants in Newfoundland and Labrador, a province in Canada with a strong tradition of community ties and support systems. In addition to addressing the unique circumstances of the community groups, this research allowed the authors to examine the situational context and power relations involved in the provision of services as well as the particular forms of subjectivity and citizenship that the institutional practices support. Recognizing this complex interdependency is an important step in creating more effective intervention practices.

  14. Determinants of puberty health among female adolescents residing in boarding welfare centers in Tehran: An application of health belief model.

    Science.gov (United States)

    Shirzadi, Shayesteh; Asghari Jafarabadi, Mohammad; Nadrian, Haidar; Mahmoodi, Hassan

    2016-01-01

    Background: Adolescence is a critical stage of growth and development. That is associated with changes in body shape and appearance. Issues such as irregular menstrual periods, amenorrhea, and menstrual cycle are major issues in women's health. The purpose of this study was to examine the determinants of physical puberty health based on the Health Belief Model (HBM) among female adolescents. Methods: This analytical cross sectional study was conducted in welfare boarding centers in Tehran, Iran. Data were collected in 2011 by a structured and valid questionnaire. Total 61 female adolescents (age range: 12-19 yrs) participated in this study from welfare boarding centers in Iran, Tehran, by using convenience sampling method. The questionnaire consisted of demographic characteristics, health belief model constructs and physical puberty health behaviors gathered by using interview. A series of univariate general linear models were used to assess the relationship between puberty health and health belief model constructs. Results: According to the results of this study there were positive significant relationships between perceived susceptibility, perceived benefits, perceived barriers, cues to action and increased puberty health in female adolescents (p<0.05). Perceived benefits, perceived barriers and cues to action were predictors of physical puberty health behaviors. Conclusion: Based on the results of the study to improve the physical Puberty health behaviors of female adolescents should make them aware of the benefits of health behaviors, and remove or reform the perceived barriers of health behaviors. Also, the appropriate information resources should be introduced for obtaining information about puberty health.

  15. Trust the process: community health psychology after Occupy.

    Science.gov (United States)

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

    2014-01-01

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

  16. 77 FR 52025 - Notification of a Public Teleconference of the Science Advisory Board; Exposure and Human Health...

    Science.gov (United States)

    2012-08-28

    ... Science Advisory Board; Exposure and Human Health Committee AGENCY: Environmental Protection Agency (EPA... Office announces a public teleconference of the SAB Exposure and Human Health Committee to discuss its... hereby given that the SAB Exposure and Human Health Committee (EHHC) will hold a public teleconference to...

  17. 77 FR 42365 - Health Services Research and Development Service Scientific Merit Review Board, Notice of Meeting

    Science.gov (United States)

    2012-07-18

    ... DEPARTMENT OF VETERANS AFFAIRS Health Services Research and Development Service Scientific Merit...-463 (Federal Advisory Committee Act) that various subcommittees of the Health Services Research and Development Service Scientific Merit Review Board will meet on August 28-30, 2012, at the Boston Omni Parker...

  18. [Community health agents: profile and education].

    Science.gov (United States)

    Marzari, Carla Kowalski; Junges, José Roque; Selli, Lucilda

    2011-01-01

    This research discusses the profile and education of the community health agents. There is no clarity about the kind of professional needed and the appropriate training to the fulfillment of the function. The research is a case study with exploratory methodology and qualitative approach. The data was collected with a focused group, formed by ten agents, intentional selected from those with more time in service in Family Health Strategy teams from the municipality of Santa Maria, Rio Grande do Sul State. The discussions were recorded and transcribed by the researcher. The data was interpreted by content analysis. The results pointed to some important questions concerning the identity of the community health agents: integration on the health team, insertion in the community, profile and education. The profile which emerges from the research, is not different from the one proposed by the Ministry of Health. However, the difference is the professionalization, an initiative assumed by the agent, guided by reality, which he faces in his activity. The gaps, perceived in his formation, cause the agent to construct his professional identity, determined more by the technical aspect of the scientific knowledge than by his social competence as a community agent.

  19. Health literacy of an urban business community.

    Science.gov (United States)

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

    2012-02-01

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

  20. 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.

  1. 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

  2. Is the value of Community Healthcare Agents in Brazil's Family Health Strategy receiving full recognition?

    Science.gov (United States)

    Guanaes-Lorenzi, Carla; Pinheiro, Ricardo Lana

    2016-08-01

    This paper discusses meanings produced by Community Healthcare Agents (ACSs) on whether or not they feel that ACSs in Brazil's Family Health Strategy are receiving the recognition they deserve, considering their work with social networks. Discussion groups with 28 agents of six Health Units were held, sound-recorded and transcribed. Qualitative analysis of the material enables us to identify, in the discursive practices of ACSs, a tension on whether proper value is attributed to their work, or not. There was attribution of value when they talk of their activity in close proximity with the community, and their potential for construction of human connections; but there was non-attribution of value when they talk of the system's macro-structural aspects, such as low salaries, and low recognition of their function, in comparison to higher-level professionals. We conclude that the view of their work - still involving fragmented work processes, and expectation by the population that they will be able to provide immediate solutions to demands - might be preventing them from taking on board a more wide-ranging concept of primary healthcare, as a structuring and communication agent of the Healthcare Network, and as an organizing agent of Brazil's Unified Health System.

  3. Community mental health nursing: keeping pace with care delivery?

    Science.gov (United States)

    Henderson, Julie; Willis, Eileen; Walter, Bonnie; Toffoli, Luisa

    2008-06-01

    The National Mental Health Strategy has been associated with the movement of service delivery into the community, creating greater demand for community services. The literature suggests that the closure of psychiatric beds and earlier discharge from inpatient services, have contributed to an intensification of the workload of community mental health nurses. This paper reports findings from the first stage of an action research project to develop a workload equalization tool for community mental health nurses. The study presents data from focus groups conducted with South Australian community mental health nurses to identify issues that impact upon their workload. Four themes were identified, relating to staffing and workforce issues, clients' characteristics or needs, regional issues, and the impact of the health-care system. The data show that the workload of community mental health nurses is increased by the greater complexity of needs of community mental health clients. Service change has also resulted in poor integration between inpatient and community services and tension between generic case management and specialist roles resulting in nurses undertaking tasks for other case managers. These issues, along with difficulties in recruiting and retaining staff, have led to the intensification of community mental health work and a crisis response to care with less time for targeted interventions.

  4. Health politics meets post-modernism: its meaning and implications for community health organizing.

    Science.gov (United States)

    Rosenau, P V

    1994-01-01

    In this article, post-modern theory is described and applied to health politics with examples from community health organizing, social movements, and health promotion. Post-modernism questions conventional assumptions about concepts such as representation, participation, empowerment, community, identity, causality, accountability, responsibility, authority, and roles in community health promotion (those of expert, leader, and organizer). I compare post-modern social movements with their modern counterparts: the organizational forms, leadership styles, and substantive intellectual orientations of the two differ. I explain the social planning, community development, and social action models of community health organizing, comparing them with the priorities of post-modern social movements, and show the similarities and differences between them as to structural preferences, process, and strategies. Finally, and most importantly, I present the implicit lessons that post-modernism offers to health politics and outline the strengths and weaknesses of this approach to health politics.

  5. Women's Health Leadership to Enhance Community Health Workers as Change Agents.

    Science.gov (United States)

    Ingram, Maia; Chang, Jean; Kunz, Susan; Piper, Rosie; de Zapien, Jill Guernsey; Strawder, Kay

    2016-05-01

    Objectives A community health worker (CHW) is a frontline public health worker who is a trusted member of and/or has an unusually close understanding of the community served. While natural leadership may incline individuals to the CHW profession, they do not always have skills to address broad social issues. We describe evaluation of the Women's Health Leadership Institute (WHLI), a 3-year training initiative to increase the capacity of CHWs as change agents. Methods Pre-/postquestionnaires measured the confidence of 254 participants in mastering WHLI leadership competencies. In-depth interviews with CHW participants 6 to 9 months after the training documented application of WHLI competencies in the community. A national CHW survey measured the extent to which WHLI graduates used leadership skills that resulted in concrete changes to benefit community members. Multivariate logistic regressions controlling for covariates compared WHLI graduates' leadership skills to the national sample. Results Participants reported statistically significant pre-/postimprovements in all competencies. Interviewees credited WHLI with increasing their capacity to listen to others, create partnerships, and initiate efforts to address community needs. Compared to a national CHW sample, WHLI participants were more likely to engage community members in attending public meetings and organizing events. These activities led to community members taking action on an issue and a concrete policy change. Conclusions Leadership training can increase the ability of experienced CHWs to address underlying issues related to community health across different types of organizational affiliations and job responsibilities. © 2016 Society for Public Health Education.

  6. Evaluating Community-Based Participatory Research to Improve Community-Partnered Science and Community Health

    Science.gov (United States)

    Hicks, Sarah; Duran, Bonnie; Wallerstein, Nina; Avila, Magdalena; Belone, Lorenda; Lucero, Julie; Magarati, Maya; Mainer, Elana; Martin, Diane; Muhammad, Michael; Oetzel, John; Pearson, Cynthia; Sahota, Puneet; Simonds, Vanessa; Sussman, Andrew; Tafoya, Greg; Hat, Emily White

    2013-01-01

    Background Since 2007, the National Congress of American Indians (NCAI) Policy Research Center (PRC) has partnered with the Universities of New Mexico and Washington to study the science of community-based participatory research (CBPR). Our goal is to identify facilitators and barriers to effective community–academic partnerships in American Indian and other communities, which face health disparities. Objectives We have described herein the scientific design of our National Institutes of Health (NIH)-funded study (2009–2013) and lessons learned by having a strong community partner leading the research efforts. Methods The research team is implementing a mixed-methods study involving a survey of principal investigators (PIs) and partners across the nation and in-depth case studies of CBPR projects. Results We present preliminary findings on methods and measures for community-engaged research and eight lessons learned thus far regarding partnership evaluation, advisory councils, historical trust, research capacity development of community partner, advocacy, honoring each other, messaging, and funding. Conclusions Study methodologies and lessons learned can help community–academic research partnerships translate research in communities. PMID:22982842

  7. Community-centered family health history: a customized approach to increased health communication and awareness.

    Science.gov (United States)

    O'Leary, James; Edelson, Vaughn; Gardner, Nicora; Gepp, Alejandra; Kyler, Panelpha; Moore, Penelope; Petruccio, Claudia; Williams, Marc; Terry, Sharon; Bowen, Deborah

    2011-01-01

    There has been little study of whether family health history (FHH) tools used by individuals, families, and communities inspire measurable changes in communication and behavior. The Community-Centered Family Health History (CCFHH) project was a collaborative endeavor among national and community-based organizations with an interest in genetics education and health. Using community- based participatory research principles as a foundation, CCFHH examined whether the Does It Run In the Family? toolkit, a set of two customizable booklets on health and genetics, encourages discussion and collection of FHH information across diverse communities. Five communities across the country measured the utility of customized versions of the Does It Run In the Family? toolkit. Each community partner recruited families, consisting of two or more blood relatives, to use the toolkit for 3 months, discuss it among their family members, and consider the implications of the health information. Pre- and postintervention surveys measured family communication about family history and disease risk and the use of FHH information in health care provider interactions. After aggregate, cross-community analysis of individual responses, from pre- to post-toolkit use family members showed increases in communication about family history of disease risk (p < .05) and in awareness about FHH (p < .05). These findings indicate that diverse communities are receptive to FHH intervention, and tailored health educational materials can lead to increased conversations and awareness about health issues across communities.

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

    Science.gov (United States)

    Shannon, Crystal

    2014-01-01

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

  9. 75 FR 17754 - Board of Scientific Counselors, National Center for Health Statistics, (BSC, NCHS)

    Science.gov (United States)

    2010-04-07

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Board of...) of the Federal Advisory Committee Act (Pub. L. 92-463), the Centers for Disease Control and... name, address, telephone number, and organizational affiliation of the presenter. Written comments...

  10. Institutional review board community members: who are they, what do they do, and whom do they represent?

    Science.gov (United States)

    Klitzman, Robert

    2012-07-01

    The roles of nonaffiliated and nonscientific institutional review board (IRB) members at academic medical centers have received some attention, but questions remain-Who are they, what do they do, and whom, if anyone, do they represent? The author interviewed 46 IRB chairs, directors, administrators, and members in 2007-2009. He contacted the leadership of 60 IRBs (every fourth one in the list of the top 240 institutions by National Institutes of Health funding), interviewed IRB leaders from 34 of these institutions, then recruited 7 additional members from these IRBs to interview. Regular IRB members often called these individuals community members and were confused as to who these members were, or should be, and whether they did, or should, represent anyone and, if so, whom. IRBs encountered challenges in finding, training, and retaining these community members. Tensions emerged because nonscientific members, by definition, have no scientific training, so they have difficulty understanding key aspects of protocols, making them feel unempowered to contribute to reviews. IRBs varied in how much they encouraged these members to participate, in what ways, and with what success. At academic medical centers, IRBs struggled with how to view, choose, employ, and retain nonaffiliated and nonscientific members, and they varied widely in these regards. Some IRBs had these members review entire protocols, others only limited parts (particularly reading consent forms for comprehension), pro forma. Yet, at times, these members' input proved very important. These findings have critical implications for policy, practice, and research.

  11. Design of an online health-promoting community: negotiating user community needs with public health goals and service capabilities.

    Science.gov (United States)

    Ekberg, Joakim; Timpka, Toomas; Angbratt, Marianne; Frank, Linda; Norén, Anna-Maria; Hedin, Lena; Andersen, Emelie; Gursky, Elin A; Gäre, Boel Andersson

    2013-07-04

    An online health-promoting community (OHPC) has the potential to promote health and advance new means of dialogue between public health representatives and the general public. The aim of this study was to examine what aspects of an OHPC that are critical for satisfying the needs of the user community and public health goals and service capabilities. Community-based participatory research methods were used for data collection and analysis, and participatory design principles to develop a case study OHPC for adolescents. Qualitative data from adolescents on health appraisals and perspectives on health information were collected in a Swedish health service region and classified into categories of user health information exchange needs. A composite design rationale for the OHPC was completed by linking the identified user needs, user-derived requirements, and technical and organizational systems solutions. Conflicts between end-user requirements and organizational goals and resources were identified. The most prominent health information needs were associated to food, exercise, and well-being. The assessment of the design rationale document and prototype in light of the regional public health goals and service capabilities showed that compromises were needed to resolve conflicts involving the management of organizational resources and responsibilities. The users wanted to discuss health issues with health experts having little time to set aside to the OHPC and it was unclear who should set the norms for the online discussions. OHPCs can be designed to satisfy both the needs of user communities and public health goals and service capabilities. Compromises are needed to resolve conflicts between users' needs to discuss health issues with domain experts and the management of resources and responsibilities in public health organizations.

  12. Increasing Community Research Capacity to Address Health Disparities.

    Science.gov (United States)

    Komaie, Goldie; Ekenga, Christine C; Sanders Thompson, Vetta L; Goodman, Melody S

    2017-02-01

    The Community Research Fellows Training program is designed to enhance capacity for community-based participatory research; program participants completed a 15-week, Master of Public Health curriculum. We conducted qualitative, semistructured interviews with 81 participants from two cohorts to evaluate the learning environment and how the program improved participants' knowledge of public health research. Key areas that provided a conducive learning environment included the once-a-week schedule, faculty and participant diversity, and community-focused homework assignments. Participants discussed how the program enhanced their understanding of the research process and raised awareness of public health-related issues for application in their personal lives, professional occupations, and in their communities. These findings highlight key programmatic elements of a successful public health training program for community residents.

  13. Enabling nurses to lead change: the orientation experiences of nurses to boards.

    Science.gov (United States)

    Walton, AnnMarie; Lake, Donna; Mullinix, Connie; Allen, Deborah; Mooney, Kathi

    2015-01-01

    Nurses need to be full partners in shaping health care and health care policy. One way to do this is to be present and active on boards at all levels. The purpose of this study is to examine the orientation experiences of nurses to boards and their preparation to influence health care and health care policy. A Web-based survey about the efficacy of board orientation was sent to members of three local boards made up exclusively of nurses. Liabilities and fiduciary duties were least likely to be addressed in board orientation for nurses. Board members requested more training in finance and a more formal/structured orientation process. Standardizing orientation elements for nurses serving on boards would best prepare them to serve on interprofessional hospital boards and work in the health policy arena. The orientation experience on local- and state-level nursing boards is fundamental to nurses beginning board service. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. Tax-Exempt Hospitals' Investments in Community Health and Local Public Health Spending: Patterns and Relationships.

    Science.gov (United States)

    Singh, Simone R; Young, Gary J

    2017-12-01

    To investigate whether tax-exempt hospitals' investments in community health are associated with patterns of governmental public health spending focusing specifically on the relationship between hospitals' community benefit expenditures and the spending patterns of local health departments (LHDs). We combined data on tax-exempt hospitals' community benefit spending with data on spending by the corresponding LHD that served the county in which a hospital was located. Data were available for 2 years, 2009 and 2013. Generalized linear regressions were estimated with indicators of hospital community benefit spending as the dependent variable and LHD spending as the key independent variable. Hospital community benefit spending was unrelated to how much local public health agencies spent, per capita, on public health in their communities. Patterns of local public health spending do not appear to impact the investments of tax-exempt hospitals in community health activities. Opportunities may, however, exist for a more active engagement between the public and private sector to ensure that the expenditures of all stakeholders involved in community health improvement efforts complement one another. © Health Research and Educational Trust.

  15. Towards a Unified Taxonomy of Health Indicators: Academic Health Centers and Communities Working Together to Improve Population Health

    Science.gov (United States)

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

    2014-01-01

    The Clinical and Translational Science Awards (CTSA) program represents a significant public investment. To realize its major goal of improving the public’s health and reducing health disparities, the CTSA Consortium’s Community Engagement Key Function Committee has undertaken the challenge of developing a taxonomy of community health indicators. The objective is to initiate a unified approach for monitoring progress in improving population health outcomes. Such outcomes include, importantly, the interests and priorities of community stakeholders, plus the multiple, overlapping interests of universities and of the public health and health care professions involved in the development and use of local health care indicators. The emerging taxonomy of community health indicators that the authors propose supports alignment of CTSA activities and facilitates comparative effectiveness research across CTSAs, thereby improving the health of communities and reducing health disparities. The proposed taxonomy starts at the broadest level, determinants of health; subsequently moves to more finite categories of community health indicators; and, finally, addresses specific quantifiable measures. To illustrate the taxonomy’s application, the authors have synthesized 21 health indicator projects from the literature and categorized them into international, national, or local/special jurisdictions. They furthered categorized the projects within the taxonomy by ranking indicators with the greatest representation among projects and by ranking the frequency of specific measures. They intend for the taxonomy to provide common metrics for measuring changes to population health and, thus, extend the utility of the CTSA Community Engagement Logic Model. The input of community partners will ultimately improve population health. PMID:24556775

  16. Promotion of oral health by community nurses.

    Science.gov (United States)

    Garry, Brendan; Boran, Sue

    2017-10-02

    To explore the enablers and barriers perceived by community nurses in the promotion of oral health in an adult community trust directorate. Oral health care promotion in community care settings is being neglected. England and Wales have witnessed marked improvements in periodontal disease; however, no improvements have been seen in older people. A qualitative methodology was employed, where eight nurses from Band 5 to 7 were interviewed using a semi-structured approach. The data was analysed thematically. Data analysis was organised into four themes: professional self-concept and the development of knowledge, skills and attitudes necessary in the promotion of oral health; the impact an organisation has on the promotion of oral health and an exploration of the enablers and barriers identified by the community nurses while delivering care; the relationships between the nurse and patient and the potential impact on oral health promotion; the concept of self-regard in relation to the promotion of oral health and its overall impact. A commitment to improving oral health and requests for additional educational input were apparent. Organisational enablers and barriers were identified, alongside the crucial role a positive self-regard for oral health care may play in the promotion of oral health. Nurses need relevant education, organisational support, adequate resources and support from a multidisciplinary team to deliver optimal oral health promotion.

  17. Smart health community: the hidden value of health information exchange.

    Science.gov (United States)

    Ciriello, James N; Kulatilaka, Nalin

    2010-12-01

    Investments in health information technology are accelerating the digitization of medicine. The value from these investments, however, can grow beyond efficiencies by filling the information gaps between the various stakeholders. New work processes, governance structures, and relationships are needed for the coevolution of healthcare markets and business models. But coevolution is slow, hindered by the scarcity of incentives for legacy delivery systems and constrained by the prevailing patient-healthcare paradigm. The greater opportunity lies in wellness for individuals, families, communities, and society at large: a consumer-community paradigm. Capturing new value from this opportunity can start with investment in health information exchange and the creation of Smart Health Communities. By shifting the focus of exchange from public servant to value-added service provider, these communities can serve as a platform for a wider array of wellness services from consumer care, traditional healthcare, and research.

  18. The Alberta Oil Sands Community Exposure and Health Effects Assessment Program : methods report

    International Nuclear Information System (INIS)

    2000-01-01

    The Alberta Oil Sands Community Exposure and Health Effects Assessment Program involved the development of a holistic approach to the study of personal exposure and the potential health impacts of airborne contaminants including volatile organic compounds (VOCs), sulphur dioxide (SO 2 ), nitrogen dioxide (NO 2 ), ozone (O 3 ) and particulates (both PM10 and PM2.5). Volunteer residents from Fort McMurray, Alberta were recruited to participate in neurocognitive tests and a health and nutrition survey. In addition, the local community identified several priority contaminants which were highlighted during a public hearing of the Alberta Energy and Utilities Board in relation to Syncrude's Mildred Lake Development Project. The approach to the study was based on the direct measurement of all routes of exposure to the contaminants (breathing, ingestion and skin contact), direct measurement of biomarkers, and daily logs of participant's activities. The choice of biomarkers was based on the ability of the laboratory to measure low levels of relevant biological markers, the most appropriate media for measuring the markers, and the burden placed on each volunteer. The final set of biological measures of exposure included trace metals (arsenic, cadmium, lead and uranium) nicotine, and metabolites of the BTEX compounds (benzene, toluene, ethylbenzene, and xylenes). The objective was to determine if chronic or occupational exposure to these contaminants cause structural alterations in the respiratory system that compromise oxygen absorption and lung elasticity. 82 refs., 14 tabs., 15 figs., 3 appendices

  19. Women's health is a community issue.

    Science.gov (United States)

    Irvin, A

    1997-01-01

    When a member of the Community Life Project in Nigeria led a group of women in a discussion about HIV/AIDS, the women reported that they understood that condom use is the best means of protection but that they were unable to negotiate condom use with their husbands. Even if the women were economically independent, they would rather face the risk of HIV/AIDS than divorce. Thus, efforts to improve women's health have not generated much change on the local level. This can also be seen by the facts that current programs have failed to reduce the numbers of women dying from pregnancy-related causes each year, nearly 3000 women die from tuberculosis each day, women suffer occupational health risks, and domestic violence is an important determinant of health problems for women. Because women lack power in many societies, efforts to effect individual change may be blocked by a woman's particular circumstances. Thus, the involvement of entire communities is necessary to improve the conditions affecting women's health. Community-level discussions may open the door for couples to discuss sexuality and gender-based issues as well as safer sex behavior. Despite the important role they can play, women's community health groups face stiff challenges because of a lack of knowledge or training and because of the difficulty in overcoming gender-based discrimination. The Hesperian Foundation's publication, "Where Women Have No Doctor," is an excellent resource for understanding how poverty and gender issues affect women's health. The book contains practical information, promotes a model of community-based responses to problems with social origins, and shares experiences of grassroots groups world-wide.

  20. 75 FR 82030 - Board of Scientific Counselors, National Center for Health Statistics (BSC, NCHS)

    Science.gov (United States)

    2010-12-29

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Board of...) of the Federal Advisory Committee Act (Pub. L. 92-463), the Centers for Disease Control and... below. All requests must contain the name, address, telephone number, and organizational affiliation of...

  1. 77 FR 22326 - Board of Scientific Counselors, National Center for Health Statistics, (BSC, NCHS)

    Science.gov (United States)

    2012-04-13

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Board of...) of the Federal Advisory Committee Act (Pub. L. 92-463), the Centers for Disease Control and..., and organizational affiliation of the presenter. Written comments should not exceed five single-spaced...

  2. New Developments in Mental Health and Community

    Directory of Open Access Journals (Sweden)

    Isabel Fazenda

    2014-06-01

    Full Text Available The community mental health model implies a bio‐psycho‐social perspective of mental health/illness issues, as well as a set of values that advocate equity in service access, community treatment, respect for human rights, a recovery vision, promotion of independent living, social integration and user and family participation. In accordance with the priorities set by the European Union, mental health services must guarantee that these principles are applied in the prevention, treatment, rehabilitation and promotion of mental health. Inter‐sector cooperation is an essential part of developing transversal policies that ensure society’s involvement in mental health promotion. Advances in community mental health in‐ dicate the relevance of considering human rights both in policy development and in practice, of the recovery perspective and of the need to promote the participation of user and carer organizations.

  3. Factors Associated with Review Board Dispositions following Re-hospitalization among Discharged Persons found Not Criminally Responsible.

    Science.gov (United States)

    Wilson, Catherine M; Nicholls, Tonia L; Charette, Yanick; Seto, Michael C; Crocker, Anne G

    2016-03-01

    In the Canadian forensic mental health system, a person found Not Criminally Responsible on account of Mental Disorder (NCRMD) and given a conditional discharge returns to the community while remaining under the jurisdiction of a provincial/territorial Review Board. However, the individual can be re-hospitalized while on conditional discharge, for reasons such as substance use, violation of conditions, or violence. We investigated whether being re-hospitalized has an impact on the factors associated with the subsequent Review Board disposition. Persons found NCRMD from the three largest Canadian provinces who were conditionally discharged at least once during the observation period were included in the sample (N = 1,367). These individuals were involved in 2,920 disposition hearings; nearly one-third of patients (30%) were re-hospitalized after having been conditionally discharged by the Review Board. The factors examined included the scales of the Historical Clinical Risk Management-20 and salient behavior that occurred since the previous hearing, such as substance use or violence. The greater presence of clinical items resulted in a greater likelihood of a hospital detention decision at the next hearing. The effect was larger for the re-hospitalized group than for the group who successfully remained in the community since the last hearing. The results suggest that dynamic factors, specifically indicators of mental health, are heavily weighted by the Review Boards, consistent with the literature on imminent risk and in line with the NCRMD legislation. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  4. DOE's Environmental Management Site-Specific Advisory Board: The Roles, Work, and Assessment of the Constituent Local Boards - 13587

    International Nuclear Information System (INIS)

    Alexander, Catherine; Freeman, Jenny; Cantrell, Yvette

    2013-01-01

    The charter for the Department of Energy's Environmental Management (EM) Site-Specific Advisory Board (SSAB) was approved under the Federal Advisory Committee Act (FACA) in 1994. With a unique mandate to provide public input on issues associated with the cleanup of nuclear legacy sites in the U.S., the EM SSAB comprises eight local boards, which are based at major EM sites. While each board is unique to the community in which it is located and reflects the diversity of the local population, the boards are governed by FACA, related regulations, and DOE policies that are intended to standardize agency advisory board operations. The EM SSAB local boards are made up of a diverse group of citizens who want to understand the mission and goals of the EM program and to help EM achieve those goals for the benefit of their communities. Some are quite passionate about their mission; others need to be coaxed into active participation. Maintaining productive relationships and a supportive environment for effective board operations is the challenge of board management for DOE EM and the board members themselves. DOE draws on research findings and best practices literature from academics and practitioners in the field of public involvement in its board management practices. The EM SSAB is also evaluated annually under the law to ensure that the investment of taxpayer dollars in the board is warranted in light of the contributions of the board. Further evaluation takes place at the agency and site levels in order to identify what aspects of board functioning the agency and board members find important to its success and to address areas where improvement is needed. Board contributions, compliance factors, and measurable outcomes related to board products and process areas are key to agency commitment to ongoing support of the boards and to participant satisfaction and thus continued member involvement. In addition to evaluation of these factors in improving board effectiveness

  5. Trialling a shaken baby syndrome prevention programme in the Auckland District Health Board.

    Science.gov (United States)

    Kelly, Patrick; Wilson, Kati; Mowjood, Aqeela; Friedman, Joshua; Reed, Peter

    2016-02-19

    To describe and evaluate a shaken baby prevention programme trialled in the Auckland District Health Board from January 2010, to December 2011. Development and implementation of the programme, telephone survey of a sample of caregivers and written survey of a sample of providers. At least 2,592 caregivers received the trial programme. 150 (6%) were surveyed by telephone a median of 6 weeks later. 128 (85%) remembered at least one key message, unprompted; most commonly "It's OK to walk away" (94/150, 63%). When asked, 92% had made a plan for what to do when frustrated and 63% had shared the information with others. Only 98/150 (65%) watched the programme DVD. Many said they already knew about the risks of shaking a baby, but still found the programme highly relevant. Thirty-one nurses were surveyed. There was a high degree of agreement that the programme was relevant. Barriers to programme delivery included time, workload and the documentation required. A shaken baby prevention programme adapted to New Zealand can be introduced in a District Health Board and is acceptable to caregivers and health professionals. Further research is needed to evaluate the content, mode of delivery and effectiveness of this programme.

  6. COMMUNITY MEDICINE & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    ajiboro

    Work Profile of Community Health Extension Workers in Cross. River State and ... reasons. In some countries they were to meet shortages in health manpower. In other ... Life expectancy is 51 years; maternal mortality and workers were ...

  7. The narrative psychology of community health workers.

    Science.gov (United States)

    Murray, Michael; Ziegler, Friederike

    2015-03-01

    Community health psychology is an approach which promotes community mobilisation as a means of enhancing community capacity and well-being and challenging health inequalities. Much of the research on this approach has been at the more strategic and policy level with less reference to the everyday experiences of community workers who are actively involved in promoting various forms of community change. This article considers the narrative accounts of a sample of 12 community workers who were interviewed about their lives. Their accounts were analysed in terms of narrative content. This revealed the tensions in their everyday practice as they attempted to overcome community divisions and management demands for evidence. Common to all accounts was a commitment to social justice. These findings are discussed with reference to opportunities and challenges in the practice of community work. © The Author(s) 2015.

  8. A Comparison of Student Test Results: Business and Marketing Education National Board Certified Teachers and Non-National Board Certified Teachers

    Science.gov (United States)

    Rouse, William Jr.; Hollomon, Harold L., Jr.

    2005-01-01

    The underlying question for the educational community is to determine the effect of the National Board for Professional Teaching Standards on creating a higher quality professional who, in turn, imparts knowledge so that their students are better educated to compete in a global economy. Thus, does the attainment of National Board Certification by…

  9. The Los Angeles County Community Disaster Resilience Project — A Community-Level, Public Health Initiative to Build Community Disaster Resilience

    Directory of Open Access Journals (Sweden)

    David Eisenman

    2014-08-01

    Full Text Available Public health officials need evidence-based methods for improving community disaster resilience and strategies for measuring results. This methods paper describes how one public health department is addressing this problem. This paper provides a detailed description of the theoretical rationale, intervention design and novel evaluation of the Los Angeles County Community Disaster Resilience Project (LACCDR, a public health program for increasing community disaster resilience. The LACCDR Project utilizes a pretest–posttest method with control group design. Sixteen communities in Los Angeles County were selected and randomly assigned to the experimental community resilience group or the comparison group. Community coalitions in the experimental group receive training from a public health nurse trained in community resilience in a toolkit developed for the project. The toolkit is grounded in theory and uses multiple components to address education, community engagement, community and individual self-sufficiency, and partnerships among community organizations and governmental agencies. The comparison communities receive training in traditional disaster preparedness topics of disaster supplies and emergency communication plans. Outcome indicators include longitudinal changes in inter-organizational linkages among community organizations, community member responses in table-top exercises, and changes in household level community resilience behaviors and attitudes. The LACCDR Project is a significant opportunity and effort to operationalize and meaningfully measure factors and strategies to increase community resilience. This paper is intended to provide public health and academic researchers with new tools to conduct their community resilience programs and evaluation research. Results are not yet available and will be presented in future reports.

  10. Website Sharing in Online Health Communities: A Descriptive Analysis.

    Science.gov (United States)

    Nath, Chinmoy; Huh, Jina; Adupa, Abhishek Kalyan; Jonnalagadda, Siddhartha R

    2016-01-13

    An increasing number of people visit online health communities to seek health information. In these communities, people share experiences and information with others, often complemented with links to different websites. Understanding how people share websites can help us understand patients' needs in online health communities and improve how peer patients share health information online. Our goal was to understand (1) what kinds of websites are shared, (2) information quality of the shared websites, (3) who shares websites, (4) community differences in website-sharing behavior, and (5) the contexts in which patients share websites. We aimed to find practical applications and implications of website-sharing practices in online health communities. We used regular expressions to extract URLs from 10 WebMD online health communities. We then categorized the URLs based on their top-level domains. We counted the number of trust codes (eg, accredited agencies' formal evaluation and PubMed authors' institutions) for each website to assess information quality. We used descriptive statistics to determine website-sharing activities. To understand the context of the URL being discussed, we conducted a simple random selection of 5 threads that contained at least one post with URLs from each community. Gathering all other posts in these threads resulted in 387 posts for open coding analysis with the goal of understanding motivations and situations in which website sharing occurred. We extracted a total of 25,448 websites. The majority of the shared websites were .com (59.16%, 15,056/25,448) and WebMD internal (23.2%, 5905/25,448) websites; the least shared websites were social media websites (0.15%, 39/25,448). High-posting community members and moderators posted more websites with trust codes than low-posting community members did. The heart disease community had the highest percentage of websites containing trust codes compared to other communities. Members used websites to

  11. 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.

  12. Access to health care and community social capital.

    Science.gov (United States)

    Hendryx, Michael S; Ahern, Melissa M; Lovrich, Nicholas P; McCurdy, Arthur H

    2002-02-01

    To test the hypothesis that variation in reported access to health care is positively related to the level of social capital present in a community. The 1996 Household Survey of the Community Tracking Study, drawn from 22 metropolitan statistical areas across the United States (n = 19,672). Additional data for the 22 communities are from a 1996 multicity broadcast media marketing database, including key social capital indicators, the 1997 National Profile of Local Health Departments survey, and Interstudy, American Hospital Association, and American Medical Association sources. The design is cross-sectional. Self-reported access to care problems is the dependent variable. Independent variables include individual sociodemographic variables, community-level health sector variables, and social capital variables. Data are merged from the various sources and weighted to be population representative and are analyzed using hierarchical categorical modeling. Persons who live in metropolitan statistical areas featuring higher levels of social capital report fewer problems accessing health care. A higher HMO penetration rate in a metropolitan statistical area was also associated with fewer access problems. Other health sector variables were not related to health care access. The results observed for 22 major U.S. cities are consistent with the hypothesis that community social capital enables better access to care, perhaps through improving community accountability mechanisms.

  13. Research on gender differences in online health communities.

    Science.gov (United States)

    Liu, Xuan; Sun, Min; Li, Jia

    2018-03-01

    With the growing concern about health issues and the emergence of online communities based on user-generated content (UGC), more and more people are participating in online health communities (OHCs) to exchange opinions and health information. This paper aims to examine whether and how male and female users behave differently in OHCs. Using data from a leading diabetes community in China (Tianmijiayuan), we incorporate three different techniques: topic modeling analysis, sentiment analysis and friendship network analysis to investigate gender differences in chronic online health communities. The results indicated that (1) Male users' posting content was usually more professional and included more medical terms. Comparatively speaking, female users were more inclined to seek emotional support in the health communities. (2) Female users expressed more negative emotions than male users did, especially anxiety and sadness. (3) In addition, male users were more centered and influential in the friendship network than were women. Through these analyses, our research revealed the behavioral characteristics and needs for different gender users in online health communities. Gaining a deeper understanding of gender differences in OHCs can serve as guidance to better meet the information needs, emotional needs and relationship needs of male and female patients. Copyright © 2018 Elsevier B.V. All rights reserved.

  14. The mission of the well-managed community hospital.

    Science.gov (United States)

    Griffith, J R

    1988-07-01

    The well-managed community hospital as an organization is in dynamic equilibrium with its geographic community and with other communities providing finance, physicians, nurses, other professionals and resources necessary to meet local health care needs. The hospital is "well-managed" when it develops an equilibrium that permits all of its various constituencies to be satisfied. Growth in market share results from good management. The hospital's ability to attract and satisfy the needs of health care professionals while simultaneously meeting the needs of patients and their families at competitive prices allows it to flourish. Its financial success allows it to reward its medical staff and employees in ways that attract the best of each work group. A central problem in achieving good management is communication. Hospitals must communicate their goals convincingly to a large number of doctors and employees. "The Well-Managed Community Hospital," winner of the James A. Hamilton Hospital Administration Book Award, argues that a well-structured mission statement is the essential first step in the communications process. According to the book, final responsibility for the mission statement lies with the governing board and is one of five non-delegable functions of the board. The nature of the mission setting function as described in the book follows.

  15. Community Health Workers in Health-Related Missouri Agencies: Role, Professional Development and Health Information Needs

    Science.gov (United States)

    Visker, Joseph; Rhodes, Darson; Cox, Carol

    2017-01-01

    Community Health Workers (CHWs) serve an indispensable but oftten misunderstood and unrecognized role in public health. These individuals constitute the frontline of health care in many communities and are relied upon to provide an assortment of services. Unfortunately, the full extent to which CHWs are utilized is unknown and there is little…

  16. A Measure of the Potential Impact of Hospital Community Health Activities on Population Health and Equity.

    Science.gov (United States)

    Begun, James W; Kahn, Linda M; Cunningham, Brooke A; Malcolm, Jan K; Potthoff, Sandra

    2017-12-13

    Many hospitals in the United States are exploring greater investment in community health activities that address upstream causes of poor health. Develop and apply a measure to categorize and estimate the potential impact of hospitals' community health activities on population health and equity. We propose a scale of potential impact on population health and equity, based on the cliff analogy developed by Jones and colleagues. The scale is applied to the 317 activities reported in the community health needs assessment implementation plan reports of 23 health care organizations in the Minneapolis-St Paul, Minnesota metropolitan area in 2015. Using a 5-point ordinal scale, we assigned a score of potential impact on population health and equity to each community health activity. A majority (50.2%) of health care organizations' community health activities are classified as addressing social determinants of health (level 4 on the 5-point scale), though very few (5.4%) address structural causes of health equity (level 5 on the 5-point scale). Activities that score highest on potential impact fall into the topic categories of "community health and connectedness" and "healthy lifestyles and wellness." Lower-scoring activities focus on sick or at-risk individuals, such as the topic category of "chronic disease prevention, management, and screening." Health care organizations in the Minneapolis-St Paul metropolitan area vary substantially in the potential impact of their aggregated community health activities. Hospitals can be significant contributors to investment in upstream community health programs. This article provides a scale that can be used not only by hospitals but by other health care and public health organizations to better align their community health strategies, investments, and partnerships with programming and policies that address the foundational causes of population health and equity within the communities they serve.

  17. Community perceptions and attitudes on malaria case management and the role of community health workers.

    Science.gov (United States)

    Owek, Collins J; Oluoch, Elizabeth; Wachira, Juddy; Estambale, Benson; Afrane, Yaw A

    2017-07-04

    Community Case Management of malaria (CCMm) is one of the new approaches adopted by the World Health Organization for malaria endemic countries to reduce the burden of malaria for vulnerable populations. It is based on the evidence that well-trained and supervised community health workers (CHWs) can provide prompt and adequate treatment to fever cases within 24 h to help reduce morbidity and mortality associated with malaria among under-five children. The perception and attitudes of the community members on the CHWs' role is of greater importance for acceptance of their services. The aim of the study was to assess community's perception and attitude towards CCMm and on CHWs who undertake it. This study was conducted in five districts in western Kenya where Community Case Management was being undertaken. This was a qualitative cross-sectional study in which in-depth interviews and focus group discussions were conducted with mothers of under-five children and key stakeholders. Overall, there were more positive expressions of perceptions and attitudes of the community members towards the CCMm programme and the role of CHWs. The positive perceptions included among others; recognition and appreciation of services of CHWs, bringing health services to close proximity to the community, avoiding long queues in the health facilities, provision of health education that encourages good health practices, and promotion of positive health-seeking behaviour from within the communities. This programme is not without challenges as some of the negative perceptions expressed by the community members included the fact that some clinicians doubt the capacity of CHWs on dispensing drugs in the community, some CHWs do not keep client's secrets and mistrust of CHWs due to conflicting information by government. It was evident that the community had more positive perceptions and attitudes towards the role of CHWs in CCMm than negative ones. There should however, be deliberate efforts

  18. Innovation in health service delivery: integrating community health assistants into the health system at district level in Zambia.

    Science.gov (United States)

    Zulu, Joseph Mumba; Hurtig, Anna-Karin; Kinsman, John; Michelo, Charles

    2015-01-28

    To address the huge human resources for health gap in Zambia, the Ministry of Health launched the National Community Health Assistant Strategy in 2010. The strategy aims to integrate community-based health workers into the health system by creating a new group of workers, called community health assistants (CHAs). However, literature suggests that the integration process of national community-based health worker programmes into health systems has not been optimal. Conceptually informed by the diffusion of innovations theory, this paper qualitatively aimed to explore the factors that shaped the acceptability and adoption of CHAs into the health system at district level in Zambia during the pilot phase. Data gathered through review of documents, 6 focus group discussions with community leaders, and 12 key informant interviews with CHA trainers, supervisors and members of the District Health Management Team were analysed using thematic analysis. The perceived relative advantage of CHAs over existing community-based health workers in terms of their quality of training and scope of responsibilities, and the perceived compatibility of CHAs with existing groups of health workers and community healthcare expectations positively facilitated the integration process. However, limited integration of CHAs in the district health governance system hindered effective programme trialability, simplicity and observability at district level. Specific challenges at this level included a limited information flow and sense of programme ownership, and insufficient documentation of outcomes. The district also had difficulties in responding to emergent challenges such as delayed or non-payment of CHA incentives, as well as inadequate supervision and involvement of CHAs in the health posts where they are supposed to be working. Furthermore, failure of the health system to secure regular drug supplies affected health service delivery and acceptability of CHA services at community level. The

  19. The interactions of Canadian ethics consultants with health care managers and governing boards during times of crisis.

    Science.gov (United States)

    Kaposy, Chris; Maddalena, Victor; Brunger, Fern; Pullman, Daryl; Singleton, Richard

    2017-01-01

    Health care organizations can be very complex, and are often the setting for crisis situations. In recent years, Canadian health care organizations have faced large-scale systemic medical errors, a nation-wide generic injectable drug shortage, iatrogenic infectious disease outbreaks, and myriad other crises. These situations often have an ethical component that ethics consultants may be able to address. Organizational leaders such as health care managers and governing boards have responsibilities to oversee and direct the response to crisis situations. This study investigates the nature and degree of involvement of Canadian ethics consultants in such situations. This qualitative study used semi-structured interviews with Canadian ethics consultants to investigate the nature of their interactions with upper-level managers and governing board members in health care organizations, particularly in times of organizational crisis. We used a purposive sampling technique to identify and recruit ethics consultants throughout Canada. We found variability in the interactions between ethics consultants and upper-level managers and governing boards. Some ethics consultants we interviewed did not participate in managing organizational crisis situations. Most ethics consultants reported that they had assisted in the management of some crises and that their participation was usually initiated by managers. Some ethics consultants reported the ability to bring issues to the attention of upper-level managers and indirectly to their governing boards. The interactions between managers and ethics consultants were characterized by varying degrees of collegiality. Ethics consultants reported participating in or chairing working groups, participating in incident management teams, and developing decision-making frameworks. Canadian ethics consultants tend to believe that they have valuable skills to offer in the management of organizational crisis situations. Most of the ethics consultants

  20. The urban and community health pathway: preparing socially responsive physicians through community-engaged learning.

    Science.gov (United States)

    Meurer, Linda N; Young, Staci A; Meurer, John R; Johnson, Sheri L; Gilbert, Ileen A; Diehr, Sabina

    2011-10-01

    One of five options for the new required Medical College of Wisconsin Pathways program, the Urban and Community Health Pathway (UCHP), links training with community needs and assets to prepare students with the knowledge, skills, and attitudes to provide effective care in urban, underserved settings; promote community health; and reduce health disparities. Students spend at least 10 hours per month on pathway activities: 4 hours of core material delivered through readings, didactics, case discussions, and site visits; and at least 6 hours of experiential noncore activities applying core competencies, guided by an Individualized Learning Plan and faculty advisor. Noncore activities include community-engaged research, service-learning activities or other relevant experiences, and submission of a synthesis paper addressing pathway competencies. The first cohort of students began their pathways in January 2010. Of 560 participating students, 95 (of which 48 were first-year, 21 second-year, and 26 third-year students) selected UCHP. Core sessions focused on public health, social determinants, cultural humility, poverty, the local healthcare system, and safety net. During noncore time, students engaged in projects addressing homelessness, obesity, advocacy, Hmong and Latino health, HIV, asthma, and violence prevention. Students enjoyed working with peers across classes and favored interactive, community-based sessions over didactics in the classroom. Students' papers reflected a range of service and scholarly activities and a deepened appreciation of social and economic influences on health. The UCHP enriches the traditional curriculum with individualized, community-based experiences to build knowledge about health determinants and skills in partnering with communities to improve health. Copyright © 2011 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  1. Community participation and mental health during retirement in community sample of Australians.

    Science.gov (United States)

    Olesen, Sarah C; Berry, Helen L

    2011-03-01

    This study considered whether community participation during later adulthood is more strongly associated with mental health during retirement than it is while in employment; i.e. in the absence of paid work. Participants were 322 men and 311 women aged 45 years and older, who were part of a random sample of an Australian coastal community. The frequency of participation across 14 types of community-based activities was assessed. Overall mental health was measured on a 10-item Kessler Psychological Distress Scale. Linear regression models tested the multivariate associations between distress and community participation, and whether this association differed for retired and working people. Retirees did not participate in their communities more than working people. The association between community participation and psychological distress did not differ by retirement status when people of all ages were considered together; however, stronger associations between several activities and (less) distress were found for retirees compared to their working peers in a younger cohort (aged 45 to 54). This cohort coincides with the average age of transition to retirement in Australia. These findings offer some support for the view that community participation may assist in managing the mental health implications of the transition from work to retirement.

  2. Health care waste management in community-based care: experiences of community health workers in low resource communities in South Africa

    Directory of Open Access Journals (Sweden)

    Lydia Hangulu

    2017-05-01

    Full Text Available Abstract Background In South Africa, community health workers (CHWs working in community-based care (CBC programmes provide care to patients most of whom are living with HIV/AIDS and tuberculosis (TB. Although studies have shown that the caregiving activities provided by the CHWs generate health care waste (HCW, there is limited information about the experiences of CHWs on health care waste management (HCWM in CBC. This study explored HCWM in CBC in Durban, South Africa from the perspectives CHWs. Methods We used three ethnographic approaches to collect data: focus group discussions, participant observations and informal discussions. Data was collected from 85 CHWs working in 29 communities in the Durban metropolis, South Africa. Data collection took place from July 2013 to August 2014. Results CHWs provided nursing care activities to patients many of whom were incontinent or bedridden. Some the patients were living with HIV/AIDS/TB, stroke, diabetes, asthma, arthritis and high blood pressure. These caregiving activities generate sharps and infectious waste but CHWs and family members did not segregate HCW according to the risk posed as stipulated by the HCWM policy. In addition, HCW was left with domestic waste. Major barriers to proper HCWM identified by CHWs include, lack of assistance from family members in assisting patients to use the toilet or change diapers and removing HCW from homes, irregular waste collection by waste collectors, inadequate water for practicing hygiene and sanitation, long distance between the house and the toilets and poor conditions of communal toilets and pit latrines. As a result of these barriers, HCW was illegally dumped along roads or in the bush, burnt openly and buried within the yards. Liquid HCW such as vomit, urine and sputum were disposed in open spaces near the homes. Conclusion Current policies on primary health care (PHC and HCWM in South Africa have not paid attention to HCWM. Findings suggest the

  3. DEFINING THE "COMMUNITY" FOR A COMMUNITY-BASED PUBLIC HEALTH INTERVENTION ADDRESSING LATINO IMMIGRANT HEALTH DISPARITIES: AN APPLICATION OF ETHNOGRAPHIC METHODS.

    Science.gov (United States)

    Edberg, Mark; Cleary, Sean; Simmons, Lauren B; Cubilla-Batista, Idalina; Andrade, Elizabeth L; Gudger, Glencora

    2015-01-01

    Although Latino and other immigrant populations are the driving force behind population increases in the U.S., there are significant gaps in knowledge and practice on addressing health disparities in these populations. The Avance Center for the Advancement of Immigrant/Refugee Health, a health disparities research center in the Washington, DC area, includes as part of its mission a multi-level, participatory community intervention (called Adelante) to address the co-occurrence of substance abuse, violence and sex risk among Latino immigrant youth and young adults. Research staff and community partners knew that the intervention community had grown beyond its Census-designated place (CDP) boundaries, and that connection and attachment to community were relevant to an intervention. Thus, in order to understand current geographic and social boundaries of the community for sampling, data collection, intervention design and implementation, the research team conducted an ethnographic study to identify self-defined community boundaries, both geographic and social. Beginning with preliminary data from a pilot intervention and the original CDP map, the research included: geo-mapping de-identified addresses of service clients from a major community organization; key informant interviews; and observation and intercept interviews in the community. The results provided an expanded community boundary profile and important information about community identity.

  4. Using Peace Corps volunteers in community eye health

    OpenAIRE

    Barnes, Shawn

    2009-01-01

    Initiating a community eye health programme in an unfamiliar culture and language can be a daunting task. This report focuses on an underutilised resource for community eye health: American Peace Corps volunteers.

  5. Program Spotlight: National Outreach Network's Community Health Educators

    Science.gov (United States)

    National Outreach Network of Community Health Educators located at Community Network Program Centers, Partnerships to Advance Cancer Health Equity, and NCI-designated cancer centers help patients and their families receive survivorship support.

  6. Objective community integration of mental health consumers living in supported housing and of others in the community.

    Science.gov (United States)

    Yanos, Philip T; Stefancic, Ana; Tsemberis, Sam

    2012-01-01

    Housing programs for people with severe mental illnesses aim to maximize community integration. However, little is known about how the community integration of mental health consumers living in supported housing compares with that of other community residents in the socially disadvantaged communities where supported housing is often located. The purpose of this study was to examine predictors of objective community integration of mental health consumers living in supported housing and of other persons living in the same communities. Participants were 124 adults (60 mental health consumers and 64 other community residents) residing in designated zip codes in the Bronx, New York. Participants were administered measures of psychiatric symptoms, substance use, physical community integration (participation in local activities), social integration (interactions with community members), and citizenship (political activism or volunteering). Mental health consumers living in supported independent housing had significantly lower scores on indicators of objective community integration than other community members. However, differences were relatively small. Among mental health consumers, African-American race, education, and length of time in current residence were associated with better community integration. Findings suggest that mental health consumers living in supported housing may not achieve levels of objective community integration that are comparable with other community members; however, psychiatric factors did not account for this difference. Length of time in neighborhoods appears to be an important factor in facilitating social integration.

  7. The Community Child Health Network Life Stress Interview: a brief chronic stress measure for community health research.

    Science.gov (United States)

    Tanner Stapleton, Lynlee R; Dunkel Schetter, Christine; Dooley, Larissa N; Guardino, Christine M; Huynh, Jan; Paek, Cynthia; Clark-Kauffman, Elizabeth; Schafer, Peter; Woolard, Richard; Lanzi, Robin Gaines

    2016-07-01

    Chronic stress is implicated in many theories as a contributor to a wide range of physical and mental health problems. The current study describes the development of a chronic stress measure that was based on the UCLA Life Stress Interview (LSI) and adapted in collaboration with community partners for use in a large community health study of low-income, ethnically diverse parents of infants in the USA (Community Child Health Network [CCHN]). We describe the instrument, its purpose and adaptations, implementation, and results of a reliability study in a subsample of the larger study cohort. Interviews with 272 mothers were included in the present study. Chronic stress was assessed using the CCHN LSI, an instrument designed for administration by trained community interviewers to assess four domains of chronic stress, each rated by interviewers. Significant correlations ranging from small to moderate in size between chronic stress scores on this measure, other measures of stress, biomarkers of allostatic load, and mental health provide initial evidence of construct and concurrent validity. Reliability data for interviewer ratings are also provided. This relatively brief interview (15 minutes) is available for use and may be a valuable tool for researchers seeking to measure chronic stress reliably and validly in future studies with time constraints.

  8. The Chinese community patient’s life satisfaction, assessment of community medical service, and trust in community health delivery system

    Science.gov (United States)

    2013-01-01

    Background Although the Chinese government put a lot of effort into promoting the community patient’s life satisfaction, there still lacked the holistic and systematic approaches to promote the community patient’s life satisfaction in various regions of China. On the basis of the literature, it was found that both the community patient’s assessment of community medical service and trust in community health delivery system were important considerations when the community patient comprehensively evaluated community medical service to generate life satisfaction. So this study was set up to test whether and to what extent the community patient’s assessments of various major aspects of community medical service/various major aspects of the community patient’s trust in community health delivery system influenced life satisfaction in whole China/in various regions of China. Methods In order to explore the situation of China’s community health delivery system before 2009 and provide a reference for China’s community health delivery system reform, the data that could comprehensively and accurately reflect the community patient’s life satisfaction, assessment of community medical service, and trust in community health delivery system in various regions of China was needed, so this study collaborated with the National Bureau of Statistics of China to carry out a large-scale 2008 national community resident household survey (N = 3,306) for the first time in China. And the specified ordered probit models were established to analyze the dataset from this household survey. Results Among major aspects of community medical service, the medical cost (particularly in developed regions), the doctor-patient communication (particularly in developed regions), the medical facility and hospital environment (particularly in developed regions), and the medical treatment process (particularly in underdeveloped regions) were all key considerations (ppatient’s life

  9. Medical Waste Management in Community Health Centers.

    Science.gov (United States)

    Tabrizi, Jafar Sadegh; Rezapour, Ramin; Saadati, Mohammad; Seifi, Samira; Amini, Behnam; Varmazyar, Farahnaz

    2018-02-01

    Non-standard management of medical waste leads to irreparable side effects. This issue is of double importance in health care centers in a city which are the most extensive system for providing Primary Health Care (PHC) across Iran cities. This study investigated the medical waste management standards observation in Tabriz community health care centers, northwestern Iran. In this triangulated cross-sectional study (qualitative-quantitative), data collecting tool was a valid checklist of waste management process developed based on Iranian medical waste management standards. The data were collected in 2015 through process observation and interviews with the health center's staff. The average rate of waste management standards observance in Tabriz community health centers, Tabriz, Iran was 29.8%. This case was 22.8% in dimension of management and training, 27.3% in separating and collecting, 31.2% in transport and temporary storage, and 42.9% in sterilization and disposal. Lack of principal separation of wastes, inappropriate collecting and disposal cycle of waste and disregarding safety tips (fertilizer device performance monitoring, microbial cultures and so on) were among the observed defects in health care centers supported by quantitative data. Medical waste management was not in a desirable situation in Tabriz community health centers. The expansion of community health centers in different regions and non-observance of standards could predispose to incidence the risks resulted from medical wastes. So it is necessary to adopt appropriate policies to promote waste management situation.

  10. Evaluation of a nursing student health fair program: Meeting curricular standards and improving community members' health.

    Science.gov (United States)

    Salerno, John P; McEwing, Evan; Matsuda, Yui; Gonzalez-Guarda, Rosa M; Ogunrinde, Olutola; Azaiza, Mona; Williams, Jessica R

    2018-04-17

    Public health nursing (PHN) is an essential component of baccalaureate nursing education. In order to build PHN competencies, universities must design and operationalize meaningful clinical activities addressing community and population health. Currently, there is a paucity of literature delineating best practices for promoting competency in PHN. The purpose of this manuscript is to describe a PHN-student health fair program as a means for meeting undergraduate PHN curricular standards, and to report results of an evaluation conducted examining its effectiveness in improving community member's health knowledge. Health fairs were held at community agencies that served the homeless or victims of intimate partner violence. A total of 113 community members that attended a health fair were assessed at baseline and immediate posttest using open-ended questionnaires. The design of the health fairs included a community assessment, intervention, and evaluation flow that followed the nursing process. We report that results from participants surveyed indicated that PHN-student delivered health fairs improved health knowledge among community members in this sample (p = .000). Health fairs conducted by PHN students appear to be promising community health promotion and disease prevention interventions that can serve as an effective strategy for teaching PHN student competencies and facilitating engagement with the community. © 2018 Wiley Periodicals, Inc.

  11. Water Science and Technology Board annual report, 1990

    Energy Technology Data Exchange (ETDEWEB)

    1990-01-01

    This report summarizes the activities of the Water Science and Technology Board (WSTB) during 1990, its eighth year of existence. It describes current and recently completed projects, new activities scheduled to begin in 1991, and plans for the future. The WSTB is intended to be a dynamic forum, a mechanism by which the board community of water science, technology, and policy professionals can help assure high-quality national water programs. As such, the Board considers out-reach and communications of much importance.

  12. Water Science and Technology Board annual report, 1990

    Energy Technology Data Exchange (ETDEWEB)

    1990-12-31

    This report summarizes the activities of the Water Science and Technology Board (WSTB) during 1990, its eighth year of existence. It describes current and recently completed projects, new activities scheduled to begin in 1991, and plans for the future. The WSTB is intended to be a dynamic forum, a mechanism by which the board community of water science, technology, and policy professionals can help assure high-quality national water programs. As such, the Board considers out-reach and communications of much importance.

  13. Promotores de salud and community health workers: an annotated bibliography.

    Science.gov (United States)

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

    2012-01-01

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

  14. Mobile health monitoring system for community health workers

    CSIR Research Space (South Africa)

    Sibiya, G

    2014-09-01

    Full Text Available of hypertension as it provides real time information and eliminates the need to visit a healthcare facility to take blood pressure readings. Our proposed mobile health monitoring system enables faster computerization of data that has been recorded... pressure, heart rate and glucose readings. These reading closely related to most common NCDs. D. Feedback to health worker and the subject of care Community health workers are often not professionally trained on health. As a result they are not expected...

  15. Our games our health: a cultural asset for promoting health in indigenous communities.

    Science.gov (United States)

    Parker, Elizabeth; Meiklejohn, Beryl; Patterson, Carla; Edwards, Ken; Preece, Cilia; Shuter, Patricia; Gould, Trish

    2006-08-01

    Indigenous Australians have higher morbidity and mortality rates than non-Indigenous Australians. Until recently, few health promotion interventions have had more than limited success in Indigenous populations. This community-based health promotion initiative introduced traditional Indigenous games into schools and community groups in Cherbourg and Stradbroke Island (Queensland, Australia). A joint community forum managed the project, and the Indigenous community-based project officers co-ordinated training in traditional games and undertook community asset audits and evaluations. The games have been included in the activities of a range of community organisations in Cherbourg and Stradbroke Island. Several other organisations and communities in Australia have included them in their projects. A games video and manual were produced to facilitate the initiative's transferability and sustainability. Conventional approaches to health promotion generally focus on individual risk factors and often ignore a more holistic perspective. This project adopted a culturally appropriate, holistic approach, embracing a paradigm that concentrated on the communities' cultural assets and contributed to sustainable and transferable outcomes. There is a need for appropriate evaluation tools for time-limited community engagement projects.

  16. Citizenship and Community Mental Health Care.

    Science.gov (United States)

    Ponce, Allison N; Rowe, Michael

    2018-03-01

    Citizenship is an approach to supporting the social inclusion and participation in society of people with mental illnesses. It is receiving greater attention in community mental health discourse and literature in parallel with increased awareness of social determinants of health and concern over the continued marginalization of persons with mental illness in the United States. In this article, we review the definition and principles of our citizenship framework with attention to social participation and access to resources as well as rights and responsibilities that society confers on its members. We then discuss our citizenship research at both individual and social-environmental levels, including previous, current, and planned efforts. We also discuss the role of community psychology and psychologists in advancing citizenship and other themes relevant to a citizenship perspective on mental health care and persons with mental illness. © Society for Community Research and Action 2018.

  17. Rural health care bypass behavior: how community and spatial characteristics affect primary health care selection.

    Science.gov (United States)

    Sanders, Scott R; Erickson, Lance D; Call, Vaughn R A; McKnight, Matthew L; Hedges, Dawson W

    2015-01-01

    (1) To assess the prevalence of rural primary care physician (PCP) bypass, a behavior in which residents travel farther than necessary to obtain health care, (2) To examine the role of community and non-health-care-related characteristics on bypass behavior, and (3) To analyze spatial bypass patterns to determine which rural communities are most affected by bypass. Data came from the Montana Health Matters survey, which gathered self-reported information from Montana residents on their health care utilization, satisfaction with health care services, and community and demographic characteristics. Logistic regression and spatial analysis were used to examine the probability and spatial patterns of bypass. Overall, 39% of respondents bypass local health care. Similar to previous studies, dissatisfaction with local health care was found to increase the likelihood of bypass. Dissatisfaction with local shopping also increases the likelihood of bypass, while the number of friends in a community, and commonality with community reduce the likelihood of bypass. Other significant factors associated with bypass include age, income, health, and living in a highly rural community or one with high commuting flows. Our results suggest that outshopping theory, in which patients bundle services and shopping for added convenience, extends to primary health care selection. This implies that rural health care selection is multifaceted, and that in addition to perceived satisfaction with local health care, the quality of local shopping and levels of community attachment also influence bypass behavior. © 2014 National Rural Health Association.

  18. Factors influencing motivation and job satisfaction among supervisors of community health workers in marginalized communities in South Africa

    OpenAIRE

    Akintola, Olagoke; Chikoko, Gamuchirai

    2016-01-01

    Background Management and supervision of community health workers are factors that are?critical to the success of community health worker programmes. Yet few studies have explored the perspectives of supervisors in these programmes. This study explored factors influencing motivations of supervisors in community health worker programmes. Methods We conducted qualitative interviews with 26 programme staff providing supervision to community health workers in eight community-based organizations i...

  19. 78 FR 32657 - Board of Scientific Counselors, National Center for Environmental Health/Agency for Toxic...

    Science.gov (United States)

    2013-05-31

    ..., diagnosis, treatment, control, and prevention of physical and mental diseases and other impairments; (2... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention (CDC) Board of.... L. 92-463), the Centers for Disease Control and Prevention (CDC), announces the following meeting of...

  20. Contribution of community health workers to surveillance of vaccine-preventable diseases in the Obala health district

    Science.gov (United States)

    Vouking, Marius Zambou; Binde, Thierry; Tadenfok, Carine Nouboudem; Ekani, Jean Marie Edengue; Ekra, Daniel

    2017-01-01

    Introduction The establishment of effective community-based surveillance is an essential objective of all disease surveillance systems. Several studies and reports have found that the situation is far from optimal in several developing countries such as Cameroon. Methods We conducted a cross-sectional descriptive study to assess the contribution of community health workers to surveillance of vaccine-preventable diseases in Obala health district. The performance of community health workers was measured using: the number of cases referred to the health center, the percentage of accomplished referrals, the percentage of cases referred by community health workers confirmed by the staff of health centers. A questionnaire containing forty-seven questions (open-ended and closed-ended) was used for interviews with community health workers. The data were analyzed using SPSS 21 and Excel 2007. Counts and percentages are reported. Results The study showed that the age ranged of community health workers was from 24 to 61 years with an average of 37.9 years ± 6.7 years. The most represented age group was between 40 and 50 with a percentage of 38.6%. The male sex was more represented than the female sex (61.4% vs 38.6%) or a sex ratio male man of 1.7. Forty-five percent of community health workers were selected at a village meeting, 93.1% of community health workers were involved in the surveillance of vaccine-preventable diseases and 87% experienced at least one preventable disease. Only 45.8% of them had the case definitions of the four diseases. Analysis of community health workers attendance at organized health committee meetings showed that 79% of community health workers attended at least one health committee meeting in 2015 and only 49% were monitored in 2015. Community health workers reported 42 suspected cases of measles, 37 of which actually went to the nearest Health Center, a baseline rate of 88%. Conclusion Community health workers play a key role in the control of

  1. Measuring progress of collaborative action in a community health effort

    Directory of Open Access Journals (Sweden)

    Vicki L. Collie-Akers

    2013-12-01

    Full Text Available OBJECTIVE: To measure the progress made by the collaborative actions of multisectorial partners in a community health effort using a systematic method to document and evaluate community/system changes over time. METHODS: This was a community-based participatory research project engaging community partners of the Latino Health for All Coalition, which based on the Health for All model, addresses health inequity in a low-income neighborhood in Kansas City, Kansas, United States of America. Guided by three research questions regarding the extent to which the Coalition catalyzed change, intensity of change, and how to visually display change, data were collected on community/system changes implemented by the community partners from 2009-2012. These changes were characterized and rated according to intensity (event duration, population reach, and strategy and by other categories, such as social determinant of health mechanism and sector. RESULTS: During the 4-year study period, the Coalition implemented 64 community/system changes. These changes were aligned with the Coalition's primary goals of healthy nutrition, physical activity, and access to health screenings. Community/system efforts improved over time, becoming longer in duration and reaching more of the population. CONCLUSIONS: Although evidence of its predictive validity awaits further research, this method for documenting and characterizing community/system changes enables community partners to see progress made by their health initiatives.

  2. Community Health Global Network and Sustainable Development

    Directory of Open Access Journals (Sweden)

    Rebekah Young

    2016-01-01

    Full Text Available With the achievements, failures and passing of the Millennium Development Goals (MDG, the world has turned its eyes to the Sustainable Development Goals (SDG, designed to foster sustainable social, economic and environmental development over the next 15 years.(1 Community-led initiatives are increasingly being recognised as playing a key role in realising sustainable community development and in the aspirations of universal healthcare.(2 In many parts of the world, faith-based organisations are some of the main players in community-led development and health care.(3 Community Health Global Network (CHGN creates links between organisations, with the purpose being to encourage communities to recognise their assets and abilities, identify shared concerns and discover solutions together, in order to define and lead their futures in sustainable ways.(4 CHGN has facilitated the development of collaborative groups of health and development initiatives called ‘Clusters’ in several countries including India, Bangladesh, Kenya, Tanzania, Zambia and Myanmar. In March 2016 these Clusters met together in an International Forum, to share learnings, experiences, challenges, achievements and to encourage one another. Discussions held throughout the forum suggest that the CHGN model is helping to promote effective, sustainable development and health care provision on both a local and a global scale.

  3. A Mobile-Based Community Health Management Information System for Community Health Workers and Their Supervisors in 2 Districts of Zambia.

    Science.gov (United States)

    Biemba, Godfrey; Chiluba, Boniface; Yeboah-Antwi, Kojo; Silavwe, Vichaels; Lunze, Karsten; Mwale, Rodgers K; Russpatrick, Scott; Hamer, Davidson H

    2017-09-27

    Effective community health management information systems (C-HMIS) are important in low-resource countries that rely heavily on community-based health care providers. Zambia currently lacks a functioning C-HMIS to provide real-time, community-based health information from community health workers (CHWs) to health center staff and higher levels of the health system. We developed a C-HMIS mobile platform for use by CHWs providing integrated community case management (iCCM) services and their supervisors to address challenges of frequent stock-outs and inadequate supportive supervision of iCCM-trained CHWs. The platform used simple feature mobile phones on which were loaded the District Health Information System version 2 (DHIS2) software and Java 2 platform micro edition (J2ME) aggregation and tracker applications. This project was implemented in Chipata and Chadiza districts, which supported previous mHealth programs and had cellular coverage from all 3 major network carriers in Zambia. A total of 40 CHWs and 20 CHW supervisors received mobile phones with data bundles and training in the mobile application, after which they implemented the program over a period of 5.5 months, from February to mid-July 2016. CHWs used the mobile phones to submit data on iCCM cases seen, managed, and referred, as well as iCCM medical and diagnostic supplies received and dispensed. Using their mobile phones, the supervisors tracked CHWs' reported cases with medicine consumption, sent CHWs feedback on their referrals, and received SMS reminders to set up mentorship sessions. CHWs were able to use the mobile application to send weekly reports to health center supervisors on disease caseloads and medical commodities consumed, to make drug and supply requisitions, and to send pre-referral notices to health centers. Health center staff used the mobile system to provide feedback to CHWs on the case outcomes of referred patients and to receive automated monthly SMS reminders to invite CHWs to

  4. Measuring progress of collaborative action in a community health effort

    OpenAIRE

    Vicki L. Collie-Akers; Stephen B. Fawcett; Jerry A. Schultz

    2013-01-01

    OBJECTIVE: To measure the progress made by the collaborative actions of multisectorial partners in a community health effort using a systematic method to document and evaluate community/system changes over time. METHODS: This was a community-based participatory research project engaging community partners of the Latino Health for All Coalition, which based on the Health for All model, addresses health inequity in a low-income neighborhood in Kansas City, Kansas, United States of America. Guid...

  5. Boarding school rules.

    Science.gov (United States)

    Griffiths, Matt

    2017-01-04

    Ofsted inspects and regulates services that care for children and young people, including boarding facilities. Medication management is an integral part of caring for children in boarding schools, and robust systems must be in place to pass inspection. These systems must cover how medicines are dispensed, administered and stored at the facility, risk assessments, identifying which pupils can manage their own medicines and the individual health needs of boarders, so that care plans can be put in place for children with specific needs.

  6. DOE's Environmental Management Site-Specific Advisory Board: The Roles, Work, and Assessment of the Constituent Local Boards - 13587

    Energy Technology Data Exchange (ETDEWEB)

    Alexander, Catherine [U.S. Dept. of Energy, Office of Environmental Management, Office of Intergovernmental and Community Activities, 1000 Independence Avenue, S.W.,Washington, D.C. 20585 (United States); Freeman, Jenny [Strata-G, LLC, 2027 Castaic Lane, Knoxville, TN 37932 (United States); Cantrell, Yvette [Restoration Services, Inc., 136 Mitchell Road, Oak Ridge, TN 37830 (United States)

    2013-07-01

    The charter for the Department of Energy's Environmental Management (EM) Site-Specific Advisory Board (SSAB) was approved under the Federal Advisory Committee Act (FACA) in 1994. With a unique mandate to provide public input on issues associated with the cleanup of nuclear legacy sites in the U.S., the EM SSAB comprises eight local boards, which are based at major EM sites. While each board is unique to the community in which it is located and reflects the diversity of the local population, the boards are governed by FACA, related regulations, and DOE policies that are intended to standardize agency advisory board operations. The EM SSAB local boards are made up of a diverse group of citizens who want to understand the mission and goals of the EM program and to help EM achieve those goals for the benefit of their communities. Some are quite passionate about their mission; others need to be coaxed into active participation. Maintaining productive relationships and a supportive environment for effective board operations is the challenge of board management for DOE EM and the board members themselves. DOE draws on research findings and best practices literature from academics and practitioners in the field of public involvement in its board management practices. The EM SSAB is also evaluated annually under the law to ensure that the investment of taxpayer dollars in the board is warranted in light of the contributions of the board. Further evaluation takes place at the agency and site levels in order to identify what aspects of board functioning the agency and board members find important to its success and to address areas where improvement is needed. Board contributions, compliance factors, and measurable outcomes related to board products and process areas are key to agency commitment to ongoing support of the boards and to participant satisfaction and thus continued member involvement. In addition to evaluation of these factors in improving board

  7. Finding Sustainability: University-community collaborations focused on arts in health

    Directory of Open Access Journals (Sweden)

    Mike White

    2011-11-01

    Full Text Available This article describes a number of community-based arts in health projects in schools and disadvantaged communities in Northern England that connect with the interdisciplinary research interests of the Centre for Medical Humanities at Durham University (www.dur.ac.uk/cmh. It examines issues about what makes for sustainability in both practice and research of arts in health when operating from a university base and stresses the importance of relationship-based work in health promotion interventions in communities. It attempts to set arts development work in the policy context of how community health has been addressed over the last decade. It provides both practical and metaphorical illustrations of how community cohesion and emotional literacy can be developed and recognised in schools and communities when supported by ethnographic research that is underpinned by theories of social capital, resilience and participatory arts practice. The significance that the artwork can attain as a social gift, with a special meaning for its creators, is examined from an anthropological perspective. Looking historically and comparatively at some longitudinal projects in community-based arts in health, the article assesses what makes for both success and failure in practice, and looks particularly at the significance of the arts in helping to deliver strategies for improving child health and education. In a strategic development context, explanation is given of several strands of university-community collaboration in arts in health, with interlinked project examples drawn from Tyneside and West Yorkshire. Finally, the article looks at the prospects for sustaining arts in health within the coming transfer of the public health function to local government. Keywords Sustainability, arts in community health, resilience, child mental health, social capital

  8. Assessment of health community at the level of Health center Rakovica: Goals and opportunities

    Directory of Open Access Journals (Sweden)

    Šćepanović Aleksandar

    2017-01-01

    Full Text Available Assessment of the health status of the population is the foundation for troubleshooting health of the community. For this first step in solving the problems of health need to have adequate data. The basis for the registration of medical information is medical documentation. The aim is to assess the role and place of assessment of the health status of the community according to the literature in this field. We analyzed the available literature in the field of social medicine and health statistics, enlightened assessment of health in the community. The data necessary for determining the state of health can be related to many characteristics. The data can be accessed: review of available medical records and life statistics. Data analysis is performed with respect to the individual, family, group or the entire community. Based on the analysis and evaluation of health status can begin activities in the planning of preventive measures that should be implemented. To evaluate prevention plan is necessary to select and collect the appropriate data for the evaluation. The analysis and evaluation of individuals involved in cooperation with a team of health care health center for the level of Rakovica. Based on the good judgment of health condition can make appropriate plans of action to protect the health of the community.

  9. Factors Affecting Patient Satisfaction with Community Health Service under the Gatekeeper System: A Cross-sectional Study in Nanjing, China.

    Science.gov (United States)

    Li, Wen Zhen; Gan, Yong; Zhou, Yan Feng; Chen, Ya Wen; Li, Jing; Kkandawire, Naomiem; Hu, Sai; Qiao, Yan; Lu, Zu Xun

    2017-09-01

    The gatekeeper policy has been implemented for approximately ten years on a pilot population in China. It is necessary to assess the satisfaction of patients utilizing community health service (CHS) under the gatekeeper system. Our study showed that the cognition of gatekeeper policy was associated with four dimensions including doctor-patient relationships, information and support, organization of care, and accessibility (P health scores also affected their satisfaction. General practitioners must be prepared to focus on these aspects of information and support, organization of care, and accessibility as indicators of potential opportunities for improvement. Additionally, policymakers can improve patients' satisfaction with CHS by strengthening their awareness of the gatekeeper policy. Copyright © 2017 The Editorial Board of Biomedical and Environmental Sciences. Published by China CDC. All rights reserved.

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

    Science.gov (United States)

    Borrow, Stephanie; Munns, Ailsa; Henderson, Saras

    2011-12-01

    The purpose of this research was to define, the practice domain of community-based child health nursing in light of widespread political, economic and social changes in Western Australia. The project was conducted by a group of nurse researchers with experience in child health nursing from the School of Nursing and Midwifery at Curtin University and the Child and Adolescent Community Health Division at the Department of Health, Western Australia. The overall aim of the project was to map the scope of nursing practice in the community child health setting in Western Australia and to identify the decision making framework that underpins this nursing specialty. Given the widespread social, economic and health service management changes, it was important for nurses involved with, or contemplating a career in, community-based child health to have the role accurately defined. In addition, consumer expectations of the service needed to be explored within the current climate. A descriptive qualitative study was used for this project. A purposive sample of 60 participants was drawn from the pool of child health nurses in the South Metropolitan Community Health Service, North Metropolitan Health Service and Western Australian Country Health Service. Following ethical approval data was collected via participants keeping a 2-week work diary. The data was coded and thematic analysis was applied. Several themes emerged from the analysis which were validated by follow up focus group interviews with participants. This clearly demonstrated common, recurring issues. The results identified that the community-based child health nurses are currently undertaking a more complex and expanded child health service role for an increasingly diverse client population, over their traditional practices which are still maintained. Excessive workloads and lack of human and non human resources also presented challenges. There are increasing requirements for child health nurses to engage in

  11. Moving health promotion communities online: a review of the literature.

    Science.gov (United States)

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

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

  12. Experiences of community service environmental health practitioners

    Directory of Open Access Journals (Sweden)

    Anusha Karamchand

    2017-11-01

    Full Text Available Orientation: The community service initiative, a 1-year placement of health graduates, significantly improved human resource availability in the South African public health sector, even though the process was fraught with challenges. Although experiences in the curative health sector were assessed, the experiences of environmental health practitioners were yet to be studied. Research purpose: This study assessed the experiences of environmental health practitioners during their community service year. Motivation for the study: Anecdotal evidence suggested problems with the process. This study endeavoured to identify the challenges whilst taking cognisance of its effectiveness. Method: A total of n = 40 environmental health graduates from the Durban University of Technology who had concluded community service completed questionnaires in this crosssectional quantitative study. Descriptive statistics, means and standard deviations were used to analyse the data. Main findings: The timing of community service placements was critical as 58% of respondents had to repay study loans. The placement of married respondents (10% outside KwaZuluNatal, however, could have had impacts on family structures. Only 68% felt stimulated by their job functions, and there arose challenges with accommodation and overtime duties. Respondents felt that their tertiary education did equip them and that engagement with senior personnel helped in their professional development. Even though most of the review of the community service year appeared to be positive, a majority of respondents did not intend to continue working or recommending their workplaces. Future career pathing showed that 79% would prefer to be employed outside the public sector. Practical and managerial implications: The process needs to be reviewed to strengthen human resource management and enhance retention in the often overloaded and under-resourced South African public health sector. Contribution

  13. Community Mental Health Clinic Cost Reports

    Data.gov (United States)

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

  14. Adolescent health: a rural community's approach.

    Science.gov (United States)

    Groft, Jean N; Hagen, Brad; Miller, Nancy K; Cooper, Natalie; Brown, Sharon

    2005-01-01

    Significant health problems encountered in adulthood often have their roots in health behaviours initiated during adolescence. In order to reverse this trend, school and health personnel, as well as parents and other community members working with high school students, need to be aware of the health-related beliefs and choices that guide the behaviours of teenagers. Although a wide variety of research has been conducted on this topic among urban adolescents, less is known about the health beliefs and behaviors of adolescents residing in rural areas, particularly in Canada. In general, rural Canadians are less healthy than their urban counterparts. Building on the knowledge and understanding of their own community, key stakeholders were invited to engage in the design and implementation of a participatory action research project aimed at understanding and improving the health of rural adolescents. A group of parents, teachers, students, school administrators and public health nurses engaged in a participatory action research project to better understand determinants of the health of rural adolescents at a high school in Western Canada. Group members developed and administered a health survey to 288 students from a small rural high school, in an effort to identify areas of concern and interest regarding health practices and beliefs of rural adolescents, and to take action on these identified concerns. Results indicated some interesting but potentially worrying trends in this population. For example, while frequent involvement in a physical activity was noted by 75.9% of participants, close to half of the females (48%) described their body image as 'a little overweight' or 'definitely overweight', and approximately 25.8% of respondents noted that they skipped meals most of the time. Differences between the genders were apparent in several categories. For example, more girls smoked (16.2%) than boys (12.3%), and more males (55.0%) than females (41%) had tried illegal

  15. Analysis of Hospital Community Benefit Expenditures’ Alignment With Community Health Needs: Evidence From a National Investigation of Tax-Exempt Hospitals

    Science.gov (United States)

    Young, Gary J.; Daniel Lee, Shoou-Yih; Song, Paula H.; Alexander, Jeffrey A.

    2015-01-01

    Objectives. We investigated whether federally tax-exempt hospitals consider community health needs when deciding how much and what types of community benefits to provide. Methods. Using 2009 data from hospital tax filings to the Internal Revenue Service and the 2010 County Health Rankings, we employed both univariate and multivariate analyses to examine the relationship between community health needs and the types and levels of hospitals’ community benefit expenditures. The study sample included 1522 private, tax-exempt hospitals throughout the United States. Results. We found some patterns between community health needs and hospitals’ expenditures on community benefits. Hospitals located in communities with greater health needs spent more as a percentage of their operating budgets on benefits directly related to patient care. By contrast, spending on community health improvement initiatives was unrelated to community health needs. Conclusions. Important opportunities exist for tax-exempt hospitals to improve the alignment between their community benefit activities and the health needs of the community they serve. The Affordable Care Act requirement that hospitals conduct periodic community health needs assessments may be a first step in this direction. PMID:25790412

  16. UNDER-UTILIZATION OF COMMUNITY HEALTH CENTERS IN PURWOREJO REGENCY, CENTRAL JAVA

    Directory of Open Access Journals (Sweden)

    Atik Triratnawati

    2006-06-01

    Full Text Available The basic strategy of the Ministry of Health to achieve Health For All In Indonesia 2010 is through health paradigm, decentralization, professionalism and health service management. Community health centers play an important role to achieve the goal. Unfortunately, underutilization of community health centers is still a problem in Purworejo. The purpose of this study was to know the utilization of community health centers using a sociological health approach. Qualitative research by observation, in-depth interview and focus group discussion were done among different types of group. The study was done in Purworejo District on February and March 2000. The main problems related to underutilization of community health centers are mostly on administration (less quality services, un-efficient, long hours waiting, strong bureaucratic system (physician has a dominant power, overlapping programs, poor coordination and integration with other divisions and cultural behavior of the community (labeling/stigma, self-care dominant, lack of community participation. To overcome under-utilization of community health centers the administration and bureaucracy should be changed into more efficient, not bureaucratic management. In addition social changes of the community culture is needed. As a consequence through these changes the staff of the health centers will be more efficient and effective.

  17. Community-based health insurance knowledge, concern ...

    African Journals Online (AJOL)

    Community-based health insurance knowledge, concern, preferences, and financial planning for health care among informal sector workers in a health district of Douala, Cameroon. ... This is mainly due to the lack of awareness and limited knowledge on the basic concepts of a CBHI by this target population. Solidarity ...

  18. 78 FR 6854 - Health Services Research and Development Service Scientific Merit Review Board; Notice of Meeting

    Science.gov (United States)

    2013-01-31

    ... DEPARTMENT OF VETERANS AFFAIRS Health Services Research and Development Service Scientific Merit... Research and Development Service Scientific Merit Review Board will meet on February 13-14, 2013, at the... research. Applications are reviewed for scientific and technical merit. Recommendations regarding funding...

  19. 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.

  20. Mental health status among Burmese adolescent students living in boarding houses in Thailand: a cross-sectional study.

    Science.gov (United States)

    Akiyama, Takeshi; Win, Thar; Maung, Cynthia; Ray, Paw; Sakisaka, Kayako; Tanabe, Aya; Kobayashi, Jun; Jimba, Masamine

    2013-04-12

    In Tak province of Thailand, a number of adolescent students who migrated from Burma have resided in the boarding houses of migrant schools. This study investigated mental health status and its relationship with perceived social support among such students. This cross-sectional study surveyed 428 students, aged 12-18 years, who lived in boarding houses. The Hopkins Symptom Checklist (HSCL)-37 A, Stressful Life Events (SLE) and Reactions of Adolescents to Traumatic Stress (RATS) questionnaires were used to assess participants' mental health status and experience of traumatic events. The Medical Outcome Study (MOS) Social Support Survey Scale was used to measure their perceived level of social support. Descriptive analysis was conducted to examine the distribution of sociodemographic characteristics, trauma experiences, and mental health status. Further, multivariate linear regression analysis was used to examine the association between such characteristics and participants' mental health status. In total, 771 students were invited to participate in the study and 428 students chose to take part. Of these students, 304 completed the questionnaire. A large proportion (62.8%) indicated that both of their parents lived in Myanmar, while only 11.8% answered that both of their parents lived in Thailand. The mean total number of traumatic events experienced was 5.7 (standard deviation [SD] 2.9), mean total score on the HSCL-37A was 63.1 (SD 11.4), and mean total score on the RATS was 41.4 (SD 9.9). Multivariate linear regression analysis revealed that higher number of traumatic events was associated with more mental health problems. Many students residing in boarding houses suffered from poor mental health in Thailand's Tak province. The number of traumatic experiences reported was higher than expected. Furthermore, these traumatic experiences were associated with poorer mental health status. Rather than making a generalized assumption on the mental health status of

  1. HEALTH INSURANCE SCHEME -- announcement from the CHIS Board

    CERN Document Server

    2005-01-01

    A number of members of our Health Insurance Scheme are currently experiencing difficulties getting reimbursement for consulting an acupuncture practitioner. The CHIS Board wishes to remind you that in order to be reimbursed, you must receive your acupuncture treatment from doctors recognised by the competent authorities of the country in which they have their medical practice. In Switzerland, these are people possessing the title of doctor of medicine recognised by the Swiss Medical Association (FMH). Treatment provided by medical auxiliaries must be prescribed beforehand by a recognised doctor. As the practitioner in question is currently not recognised as a doctor in Switzerland, his services are not reimbursed. In order to avoid any inconvenience, we advise you to contact uniqa before undergoing such treatment. You will find all details concerning reimbursement of complementary medicine (acupuncture, chiropractic, osteopathy and ethiopathy) in CHISbull’ No. 18 dated November 2004, which can ...

  2. HEALTH INSURANCE SCHEME - announcement from the CHIS Board

    CERN Multimedia

    2005-01-01

    A number of members of our Health Insurance Scheme are currently experiencing difficulties getting reimbursement for consulting an acupuncture practitioner. The CHIS Board wishes to remind you that in order to be reimbursed, you must receive your acupuncture treatment from doctors recognised by the competent authorities of the country in which they have their medical practice. In Switzerland, these are people possessing the title of doctor of medicine recognised by the Swiss Medical Association (FMH). Treatment provided by medical auxiliaries must be prescribed beforehand by a recognised doctor. As the practitioner in question is currently not recognised as a doctor in Switzerland, his services are not reimbursed. In order to avoid any inconvenience, we advise you to contact uniqa before undergoing such treatment. You will find all details concerning reimbursement of complementary medicine (acupuncture, chiropractic, osteopathy and ethiopathy) in CHISbull' No. 18 dated November 2004, which can also be co...

  3. Resources for Governing Board on Codes of Ethics

    Science.gov (United States)

    Community College League of California, 2009

    2009-01-01

    Reprinted herein is Chapter 14 of the "2007 Trustee Handbook," published by the Community College League of California. Contents include: (1) Ethics and Laws; (2) Sample Statements: Codes of Ethics and Standards for Practice; (3) Association of Community College Trustees Models; and (4) Upholding Board Ethics.

  4. Significance of mental health legislation for successful primary care for mental health and community mental health services: A review.

    Science.gov (United States)

    Ayano, Getinet

    2018-03-29

     Mental health legislation (MHL) is required to ensure a regulatory framework for mental health services and other providers of treatment and care, and to ensure that the public and people with a mental illness are afforded protection from the often-devastating consequences of mental illness.  To provide an overview of evidence on the significance of MHL for successful primary care for mental health and community mental health servicesMethod: A qualitative review of the literature on the significance of MHL for successful primary care for mental health and community mental health services was conducted.  In many countries, especially in those who have no MHL, people do not have access to basic mental health care and treatment they require. One of the major aims of MHL is that all people with mental disorders should be provided with treatment based on the integration of mental health care services into the primary healthcare (PHC). In addition, MHL plays a crucial role in community integration of persons with mental disorders, the provision of care of high quality, the improvement of access to care at community level. Community-based mental health care further improves access to mental healthcare within the city, to have better health and mental health outcomes, and better quality of life, increase acceptability, reduce associated social stigma and human rights abuse, prevent chronicity and physical health comorbidity will likely to be detected early and managed.  Mental health legislation plays a crucial role in community integration of persons with mental disorders, integration of mental health at primary health care, the provision of care of high quality and the improvement of access to care at community level. It is vital and essential to have MHL for every country.

  5. A survey of community child health audit.

    Science.gov (United States)

    Spencer, N J; Penlington, E

    1993-03-01

    Community child health medical audit is established in most districts surveyed. A minority have integrated audit with hospital paediatric units. Very few districts use an external auditor. Subject audit is preferred to individual performance audit and school health services were the most common services subjected to medical audit. The need for integrated audit and audit forms suitable for use in the community services is discussed.

  6. Case study in designing a research fundamentals curriculum for community health workers: a university-community clinic collaboration.

    Science.gov (United States)

    Dumbauld, Jill; Kalichman, Michael; Bell, Yvonne; Dagnino, Cynthia; Taras, Howard L

    2014-01-01

    Community health workers (CHWs) are increasingly incorporated into research teams. Training them in research methodology and ethics, while relating these themes to a community's characteristics, may help to better integrate these health promotion personnel into research teams. An interactive training course on research fundamentals for CHWs was designed and implemented jointly by a community agency serving a primarily Latino, rural population and an academic health center. A focus group of community members and input from community leaders comprised a community-based participatory research model to create three 3-hour interactive training sessions. The resulting curriculum was interactive and successfully stimulated dialogue between trainees and academic researchers. By choosing course activities that elicited community-specific responses into each session's discussion, researchers learned about the community as much as the training course educated CHWs about research. The approach is readily adaptable, making it useful to other communities where CHWs are part of the health system.

  7. Adult and adolescent livestock productive asset transfer programmes to improve mental health, economic stability and family and community relationships in rural South Kivu Province, Democratic Republic of Congo: a protocol of a randomised controlled trial.

    Science.gov (United States)

    Kohli, Anjalee; Perrin, Nancy A; Remy, Mitima Mpanano; Alfred, Mirindi Bacikenge; Arsene, Kajabika Binkurhorhwa; Nadine, Mwinja Bufole; Heri, Banyewesize Jean; Clovis, Mitima Murhula; Glass, Nancy

    2017-03-14

    People living in poverty have limited access to traditional financial institutions. Microfinance programmes are designed to meet this gap and show promise in improving income, economic productivity and health. Our Congolese-US community academic research partnership developed two livestock productive asset transfer programmes, Pigs for Peace (PFP) and Rabbits for Resilience (RFR), to address the interlinked health, social and economic well-being of individuals, their families and communities. The community-based randomised controlled trials examine the effectiveness of PFP and RFR to improve health, economic stability, and family and community relationships among male and female adults and adolescents living in 10 rural, postconflict villages of eastern Democratic Republic of Congo. PFP participants include adult permanent residents of rural villages; adolescent participants in RFR include male and female adolescents 10-15 years old living in the selected rural villages. Participants were randomised to intervention or delayed control group. Participants in PFP completed baseline interview prior to intervention and follow-up interview at 6, 12 and 18 months postintervention. In RFR, participants completed baseline interview prior to intervention and follow-up interview at 6, 12 and 18 months postbaseline. The primary outcome of both trials, the change in baseline mental health distress at 18 months in the intervention group (adults, adolescents) compared to control group, is used to calculate sample size. The Johns Hopkins Medical Institute Internal Review Board approved this protocol. A committee of respected Congolese educators and community members (due to lack of local ethics review board) approved the study. The findings will provide important information on the potential for community-led sustainable development initiatives to build on traditional livelihood (livestock raising, agriculture) to have a sustained health, economic and social impact on the

  8. The role of physicians in a community-wide program for prevention of cardiovascular disease: the Minnesota Heart Health Program.

    Science.gov (United States)

    Mittelmark, M B; Leupker, R V; Grimm, R; Kottke, T E; Blackburn, H

    1988-01-01

    The Minnesota Heart Health Program (MHHP) aims to reduce cardiovascular disease (CVD) morbidity and mortality by reducing risk factors among the mass of residents in three midwestern communities. A major aspect of the program is the involvement of community physicians because they have high credibility as citizen leaders, especially on health issues. In the MHHP, physicians contributed in a number of ways. The initial contacts with physicians resulted in their providing support and introductions to other community leaders, whose active support was also gained. Physicians sit as members of the central Community Advisory Borads of MHHP and serve on the executive committees of these boards. All MHHP issues related to medical practice are brought before Physicians' Advisory Groups in each community for resolution. Primary care physicians attend MHHP continuing education programs. In a survey of 109 physicians in one of the MHHP communities, 95 percent of respondents believed cigarette smoking to be an important risk factor for CVD, but only 15 percent judged themselves to be effective in dealing with patients who smoked. Forty-one percent of respondents said that elevated blood cholesterol is an important risk factor, but only 20 percent felt effective in treating the condition. Only 18 percent of the physicians in the sample believed that a poor eating pattern plays a substantial role in CVD, and 9 percent felt effective in counseling patients about eating habits. This pattern of results indicates the need not only for continuing education about risk factors for CVD, but also for training to improve patient counseling skills. PMID:3136495

  9. Social network fragmentation and community health.

    Science.gov (United States)

    Chami, Goylette F; Ahnert, Sebastian E; Kabatereine, Narcis B; Tukahebwa, Edridah M

    2017-09-05

    Community health interventions often seek to intentionally destroy paths between individuals to prevent the spread of infectious diseases. Immunizing individuals through direct vaccination or the provision of health education prevents pathogen transmission and the propagation of misinformation concerning medical treatments. However, it remains an open question whether network-based strategies should be used in place of conventional field approaches to target individuals for medical treatment in low-income countries. We collected complete friendship and health advice networks in 17 rural villages of Mayuge District, Uganda. Here we show that acquaintance algorithms, i.e., selecting neighbors of randomly selected nodes, were systematically more efficient in fragmenting all networks than targeting well-established community roles, i.e., health workers, village government members, and schoolteachers. Additionally, community roles were not good proxy indicators of physical proximity to other households or connections to many sick people. We also show that acquaintance algorithms were effective in offsetting potential noncompliance with deworming treatments for 16,357 individuals during mass drug administration (MDA). Health advice networks were destroyed more easily than friendship networks. Only an average of 32% of nodes were removed from health advice networks to reduce the percentage of nodes at risk for refusing treatment in MDA to below 25%. Treatment compliance of at least 75% is needed in MDA to control human morbidity attributable to parasitic worms and progress toward elimination. Our findings point toward the potential use of network-based approaches as an alternative to role-based strategies for targeting individuals in rural health interventions.

  10. 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.

  11. How to Keep Your Health Information Private and Secure

    Science.gov (United States)

    ... or on a mobile device, such as a smartphone or tablet. · Share over social media websites or health-related online communities, such as message boards. · Store in a personal health record (PHR) that ... are smartphone users. Source: Pew Research Center’s Internet and American ...

  12. Victoria's review of registration for health practitioners.

    Science.gov (United States)

    Scotts, H; Carter, M

    1988-01-01

    This article discusses some of the issues raised in the Interim Report of the current Review of Registration of Health Practitioners being conducted for the Victorian Health Department. The Report attempts to develop the framework in which the registration Boards will operate as part of a cohesive registration system. It proposed a mechanism and criteria for the registration of new groups as well as principles which can be applied to the ongoing review of each existing Board. The Review takes the perspective that registration of health practitioners carries with it both advantages and disadvantages for the general community. Under the proposed new system the controls exercised over health care providers by Registration Boards would be evaluated on the basis of to what extent the benefits to the public outweighed the potential costs. It is in this context that the Report addresses issues such as consumer complaints handling, registration of individual practitioners and controls over professional advertising and other business practices.

  13. The Nutrition Club Approach: Community Mobilization to Prevent Child Malnutrition

    International Nuclear Information System (INIS)

    Nugyen, Anh Vu

    2014-01-01

    Full text: Objective: To establish a scalable and sustainable, community led approach to prevent and manage child malnutrition, and increase vulnerable families’ access to food security. Methods: The establishment of the nutrition club is a participatory community mobilization process involving local leaders including the Women’s Union, Farmers Union and Youth Union, local health workers and caregivers of young children. The first step in the process is the formation of district and commune management boards and community development boards. This is followed by a training needs assessment and capacity strengthening of local partners. Nutrition club facilitators are selected by the community and are widely respected and committed to community service. Monthly nutrition club meetings are attended by pregnant women and caregivers of children under five years old. Activities during the nutrition club meeting includes: care and nutrition during pregnancy and the post partum period, complementary feeding, child care practices, development of home gardens and hygiene and sanitation; using interactive facilitation methods such as games, skills practice, role plays and competitions. Follow up home visits are conducted to reinforce positive practices and support vulnerable families. Caregivers who attend the nutrition club have access to community led interest groups such as: chicken raising, livelihoods, agriculture and micro-credit schemes. Nutrition club members pay a small monthly fee that covers cost of refreshments and utilities. Monitoring and supervision is conducted by a team of government district and health center staff. Sustainability of the approach is promoted by mobilizing and utilizing existing resources. An agreement is made between the community development board and World Vision that support for running costs will gradually be reduced and discontinued after four years. The alignment of the nutrition club approach with government policy and priorities

  14. Effect on postpartum hemorrhage of prophylactic oxytocin (10 IU by injection by community health officers in Ghana: a community-based, cluster-randomized trial.

    Directory of Open Access Journals (Sweden)

    Cynthia K Stanton

    2013-10-01

    Full Text Available BACKGROUND: Oxytocin (10 IU is the drug of choice for prevention of postpartum hemorrhage (PPH. Its use has generally been restricted to medically trained staff in health facilities. We assessed the effectiveness, safety, and feasibility of PPH prevention using oxytocin injected by peripheral health care providers without midwifery skills at home births. METHODS AND FINDINGS: This community-based, cluster-randomized trial was conducted in four rural districts in Ghana. We randomly allocated 54 community health officers (stratified on district and catchment area distance to a health facility: ≥10 km versus <10 km to intervention (one injection of oxytocin [10 IU] one minute after birth and control (no provision of prophylactic oxytocin arms. Births attended by a community health officer constituted a cluster. Our primary outcome was PPH, using multiple definitions; (PPH-1 blood loss ≥500 mL; (PPH-2 PPH-1 plus women who received early treatment for PPH; and (PPH-3 PPH-2 plus any other women referred to hospital for postpartum bleeding. Unsafe practice is defined as oxytocin use before delivery of the baby. We enrolled 689 and 897 women, respectively, into oxytocin and control arms of the trial from April 2011 to November 2012. In oxytocin and control arms, respectively, PPH-1 rates were 2.6% versus 5.5% (RR: 0.49; 95% CI: 0.27-0.88; PPH-2 rates were 3.8% versus 10.8% (RR: 0.35; 95% CI: 0.18-0.63, and PPH-3 rates were similar to those of PPH-2. Compared to women in control clusters, those in the intervention clusters lost 45.1 mL (17.7-72.6 less blood. There were no cases of oxytocin use before delivery of the baby and no major adverse events requiring notification of the institutional review boards. Limitations include an unblinded trial and imbalanced numbers of participants, favoring controls. CONCLUSION: Maternal health care planners can consider adapting this model to extend the use of oxytocin into peripheral settings including, in some

  15. The levels of Community Involvement in Health (CIH: a case of rural and urban communities in KwaZulu-Natal

    Directory of Open Access Journals (Sweden)

    G.G. Mchunu

    2009-09-01

    Full Text Available The study aimed to describe the practice of community involvement in health programmes.The study therefore explored the nature and practice of community involvementin health programmes in the two communities in KwaZulu Natal. Thestudy was guided by the conceptual framework adapted from Amstein’s,( 1969 Ladderof Citizen Participation. This framework shows different levels and steps in communityparticipation. A case study method was used to conduct the study. The twocases were one urban based and one rural based community health centers in theIlembe health district, in Kwa Zulu Natal. A sample of 31 persons participated in thestudy. The sample comprised 8 registered nurses, 2 enrolled nurses 13 communitymembers and 8 community health workers. Data was collected using structured individualinterviews and focus group interviews, and was guided by the case protocol.Community involvement in health largely depended on the type of community, withrural community members being in charge of their health projects and urban communitymembers helping each other as neighbours in times of need.

  16. Ethnic Differences for Public Health Knowledge, Health Advocacy Skills, and Health Information Seeking Among High School Students: Community Agents of Change.

    Science.gov (United States)

    Kratzke, Cynthia; Rao, Satya; Marquez, Ruben

    2018-03-06

    Although adult health advocacy programs have been examined in communities, little is known about integrated adolescent health advocacy programs in high schools. The purpose of this study was to examine the health advocacy program impact and ethnic differences among high school students. Using a cross-sectional study, high school students participating in the school-based program completed evaluation surveys. The program domains included upstream causes of health, community assets, and public health advocacy. Bivariate analyses were conducted to examine ethnic differences for public health knowledge, health advocacy skills, and health information seeking behaviors. Using thematic analysis, open-ended survey item responses were coded to identify themes for students' perceptions of community health. Non-Hispanic (n = 72) and Hispanic high school students (n = 182) in ten classes reported owning smartphones (95%) and laptops (76%). Most students (72%) reported seeking online health information. Non-Hispanic students reported significantly higher health advocacy skills for speaking with the class about health issues, identifying community services, or creating health awareness at school than Hispanic students. Non-Hispanic students were more likely to seek health information from fathers and television than Hispanic students. Hispanic students were more likely to seek health information from hospital or clinic staff than non-Hispanic students. Emergent themes included health advocacy skills, community awareness, and individual and community health changes. High schools benefit from integrating health advocacy programs into the core curriculum. Adolescents gain important skills to improve their individual health and engage in changing community health.

  17. Indigenous community health and climate change: integrating biophysical and social science indicators

    Science.gov (United States)

    Donatuto, Jamie; Grossman, Eric E.; Konovsky, John; Grossman, Sarah; Campbell, Larry W.

    2014-01-01

    This article describes a pilot study evaluating the sensitivity of Indigenous community health to climate change impacts on Salish Sea shorelines (Washington State, United States and British Columbia, Canada). Current climate change assessments omit key community health concerns, which are vital to successful adaptation plans, particularly for Indigenous communities. Descriptive scaling techniques, employed in facilitated workshops with two Indigenous communities, tested the efficacy of ranking six key indicators of community health in relation to projected impacts to shellfish habitat and shoreline archaeological sites stemming from changes in the biophysical environment. Findings demonstrate that: when shellfish habitat and archaeological resources are impacted, so is Indigenous community health; not all community health indicators are equally impacted; and, the community health indicators of highest concern are not necessarily the same indicators most likely to be impacted. Based on the findings and feedback from community participants, exploratory trials were successful; Indigenous-specific health indicators may be useful to Indigenous communities who are assessing climate change sensitivities and creating adaptation plans.

  18. Engaging Consumer Voices in Health Care Policy: Lessons for Social Work Practice.

    Science.gov (United States)

    Law, Kristi Lohmeier; Saunders, A

    2016-02-01

    Community health centers provide comprehensive public health care in some of the most disadvantaged communities in the United States. To ensure that health centers meet the needs of their consumers, they uniquely engage them in their organizational decision-making and policy-development processes by requiring that their boards of directors encompass a 51 percent consumer majority. To understand the quality of board members' experiences, a critical ethnography was conducted using Arnstein's ladder of citizen participation and the socioecological model as a framework. The analysis identified multiple influences on the quality of participation among consumer members. Findings also confirm other research that has found that knowledge of the economic, political, and cultural factors surrounding the context of the individual health center is important to understanding meaningful participation. The experience is important to understand given the shift driven by the Patient Protection and Affordable Care Act of 2010 in health care, which emphasizes a patient-entered model of care. Social work practitioners and others in the public health arena interested in empowering consumers to have a role in the provision of services need to understand the impact of each of these areas'and the experience of this unique sample of health center board members.

  19. Ten Best Readings on Community Participation and Health | Rifkin ...

    African Journals Online (AJOL)

    African Health Sciences ... This article reviews, in the opinion of the , the 10 most influential reading on community participation ... Key Words: community participation, health and development, participation as an intervention, empowerment

  20. UNDER-UTILIZATION OF COMMUNITY HEALTH CENTERS IN PURWOREJO REGENCY, CENTRAL JAVA

    OpenAIRE

    Atik Triratnawati

    2006-01-01

    The basic strategy of the Ministry of Health to achieve Health For All In Indonesia 2010 is through health paradigm, decentralization, professionalism and health service management. Community health centers play an important role to achieve the goal. Unfortunately, underutilization of community health centers is still a problem in Purworejo. The purpose of this study was to know the utilization of community health centers using a sociological health approach. Qualitative research by observati...

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

    Directory of Open Access Journals (Sweden)

    Fábio Alexandre Melo do Rego Sousa

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

  2. Forging successful academic-community partnerships with community health centers: the California statewide Area Health Education Center (AHEC) experience.

    Science.gov (United States)

    Fowkes, Virginia; Blossom, H John; Mitchell, Brenda; Herrera-Mata, Lydia

    2014-01-01

    Increased access to insurance under the Affordable Care Act will increase demands for clinical services in community health centers (CHCs). CHCs also have an increasingly important educational role to train clinicians who will remain to practice in community clinics. CHCs and Area Health Education Centers (AHECs) are logical partners to prepare the health workforce for the future. Both are sponsored by the Health Resources and Services Administration, and they share a mission to improve quality of care in medically underserved communities. AHECs emphasize the educational side of the mission, and CHCs the service side. Building stronger partnerships between them can facilitate a balance between education and service needs.From 2004 to 2011, the California Statewide AHEC program and its 12 community AHECs (centers) reorganized to align training with CHC workforce priorities. Eight centers merged into CHC consortia; others established close partnerships with CHCs in their respective regions. The authors discuss issues considered and approaches taken to make these changes. Collaborative innovative processes with program leadership, staff, and center directors revised the program mission, developed common training objectives with an evaluation plan, and defined organizational, functional, and impact characteristics for successful AHECs in California. During this planning, centers gained confidence as educational arms for the safety net and began collaborations with statewide programs as well as among themselves. The AHEC reorganization and the processes used to develop, strengthen, and identify standards for centers forged the development of new partnerships and established academic-community trust in planning and implementing programs with CHCs.

  3. Evaluation a Community Maternal Health Programme: Lessons Learnt

    OpenAIRE

    Sharma, Sheetal; Simkhada, Padam; Hundley, Vanora; Van Teijlingen, Edwin; Stephens, Jane; Silwal, R.C.; Angell, Catherine

    2017-01-01

    Abstract Using the example of a community-based health promotion intervention, this paper explores the important triangle between health promotion theory, intervention design, and evaluation research. This paper first outlines the intervention and then the mixed-method evaluation. In 2007, a non-governmental organisation (NGO) designed and implemented an intervention to improve the uptake of maternal health provision in rural Nepal. A community-based needs assessment preceded this novel healt...

  4. Ngoelmun Yawar, Our Journey: The Transition and The Challenges for Female Students Leaving Torres Strait Island Communities for Boarding Schools in Regional Queensland

    Science.gov (United States)

    Bobongie, Francis

    2017-01-01

    This paper explores the transitional experiences and challenges faced by girls from the Torres Strait Islands when they leave individual communities to attend boarding school in regional Queensland. The paper presents original ethnographic research using a narrative enquiry approach, capturing stories as narrated by a broad cohort of girls from…

  5. Beacon communities' public health initiatives: a case study analysis.

    Science.gov (United States)

    Massoudi, Barbara L; Marcial, Laura H; Haque, Saira; Bailey, Robert; Chester, Kelley; Cunningham, Shellery; Riley, Amanda; Soper, Paula

    2014-01-01

    The Beacon Communities for Public Health (BCPH) project was launched in 2011 to gain a better understanding of the range of activities currently being conducted in population- and public health by the Beacon Communities. The project highlighted the successes and challenges of these efforts with the aim of sharing this information broadly among the public health community. The Beacon Community Program, designed to showcase technology-enabled, community-based initiatives to improve outcomes, focused on: building and strengthening health information technology (IT) infrastructure and exchange capabilities; translating investments in health IT to measureable improvements in cost, quality, and population health; and, developing innovative approaches to performance measurement, technology, and care delivery. Four multimethod case studies were conducted based on a modified sociotechnical framework to learn more about public health initiative implementation and use in the Beacon Communities. Our methodological approach included using document review and semistructured key informant interviews. NACCHO Model Practice Program criteria were used to select the public health initiatives included in the case studies. Despite differences among the case studies, common barriers and facilitators were found to be present in all areas of the sociotechnical framework application including structure, people, technology, tasks, overarching considerations, and sustainability. Overall, there were many more facilitators (range = 7-14) present for each Beacon compared to barriers (range = 4-6). Four influential promising practices were identified through the work: forging strong and sustainable partnerships; ensuring a good task-technology fit and a flexible and iterative design; fostering technology acceptance; and, providing education and demonstrating value. A common weakness was the lack of a framework or model for the Beacon Communities evaluation work. Sharing a framework or approach

  6. 75 FR 60762 - Board of Scientific Counselors (BSC), National Center for Environmental Health/Agency for Toxic...

    Science.gov (United States)

    2010-10-01

    ... studies relating to the causes, diagnosis, treatment, control, and prevention of physical and mental... DEPARTMENT OF HEALTH AND HUMAN SERVICES (HHS) Centers for Disease Control and Prevention Board of... Climate Control; a discussion of ATSDR Funded State Reports; an update on Amyotrophic Lateral Sclerosis...

  7. Using Population Dose to Evaluate Community-level Health Initiatives.

    Science.gov (United States)

    Harner, Lisa T; Kuo, Elena S; Cheadle, Allen; Rauzon, Suzanne; Schwartz, Pamela M; Parnell, Barbara; Kelly, Cheryl; Solomon, Loel

    2018-05-01

    Successful community-level health initiatives require implementing an effective portfolio of strategies and understanding their impact on population health. These factors are complicated by the heterogeneity of overlapping multicomponent strategies and availability of population-level data that align with the initiatives. To address these complexities, the population dose methodology was developed for planning and evaluating multicomponent community initiatives. Building on the population dose methodology previously developed, this paper operationalizes dose estimates of one initiative targeting youth physical activity as part of the Kaiser Permanente Community Health Initiative, a multicomponent community-level obesity prevention initiative. The technical details needed to operationalize the population dose method are explained, and the use of population dose as an interim proxy for population-level survey data is introduced. The alignment of the estimated impact from strategy-level data analysis using the dose methodology and the data from the population-level survey suggest that dose is useful for conducting real-time evaluation of multiple heterogeneous strategies, and as a viable proxy for existing population-level surveys when robust strategy-level evaluation data are collected. This article is part of a supplement entitled Building Thriving Communities Through Comprehensive Community Health Initiatives, which is sponsored by Kaiser Permanente, Community Health. Copyright © 2018 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  8. Using a community advisory board to develop a serious game for older adults undergoing treatment for cancer.

    Science.gov (United States)

    Loerzel, Victoria; Clochesy, John; Geddie, Patricia

    2018-02-01

    Older adults undergoing treatment for cancer are at risk for serious complications such as chemotherapy-induced nausea and vomiting (CINV). Older adults are often overwhelmed by information and under-manage cancer treatment-related side effects. New educational strategies such as serious gaming may help teach or reinforce key symptom self-management strategies. This paper describes how a community advisory board of older adults, their caregivers, and oncology nurses were consulted to develop a serious game for CINV. A formative evaluation process using a community advisory board (CAB) and a series of three focus groups were used to develop this serious game about managing CINV at home. The formative evaluation process and involvement of the CAB allowed researchers to learn about the experience of having CINV from an older adult perspective. Common themes related to CINV onset, severity and self-management formed the basis for the serious games' script and scenarios. Themes were validated and CAB members provided feedback on a game prototype. Feedback from CAB members indicated that the serious game was realistic and reflective of their CINV experience. Including older adults in the development of a serious game was instrumental in creating a relevant educational opportunity. Serious gaming should be considered as a way to add to the educational experiences of older adults as generic teaching methods may not address the needs of all age groups. Exploring for new ways to emphasize key points related to symptom management and prioritize learning may impact outcomes for older adults. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. 78 FR 44954 - Advisory Board on Radiation and Worker Health (ABRWH or Advisory Board), National Institute for...

    Science.gov (United States)

    2013-07-25

    ... provided to the contact person below in advance of the meeting. Background: The Advisory Board was... President on a variety of policy and technical functions required to implement and effectively manage the new compensation program. Key functions of the Advisory Board include providing advice on the...

  10. Community as Teacher Model: Health Profession Students Learn Cultural Safety from an Aboriginal Community

    Science.gov (United States)

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

    2013-01-01

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

  11. 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.

  12. Preserving the Legitimacy of Board Certification.

    Science.gov (United States)

    Hanemann, Michael S; Wall, Holly C; Dean, John A

    2017-06-01

    The aims of this discussion were to inform the medical community about the American Board of Cosmetic Surgery's ongoing attempts in Louisiana to achieve equivalency to American Board of Medical Specialties (ABMS) member boards so that its diplomates may use the term "board certified" in advertising and to ensure public safety by upholding the standards for medical board certification. In 2011, Louisiana passed a truth in medical advertising law, which was intended to protect the public by prohibiting the use of the term "board certified" by improperly credentialed physicians. An American Board of Cosmetic Surgery diplomate petitioned the Louisiana State Board of Medical Examiners to approve a rule that would establish a pathway to equivalency for non-ABMS member boards, whose diplomates have not completed training approved by the Accreditation Council for Graduate Medical Education (ACGME) in the specialty they are certifying. Physicians and physician organizations representing multiple specialties (facial plastic and reconstructive surgery, otolaryngology [head and neck surgery], orthopedic spine surgery, pediatric neurosurgery, dermatology, and plastic surgery) urged the Louisiana State Board of Medical Examiners to clarify its advertising policy, limiting the use of the term "board certified" to physicians who have completed ACGME-approved training in the specialty or subspecialty named in the certificate. The public equates the term "board certified" with the highest level of expertise in a medical specialty. When a certifying board does not require completion of ACGME or American Osteopathic Association (AOA)-accredited training in the specialty it certifies, the result is an unacceptable degree of variability in the education and training standards applied to its diplomates. Independent, third-party oversight of certifying boards and training programs is necessary to ensure quality standards are upheld. Any system that assesses a non-ABMS member or non

  13. Factors influencing motivation and job satisfaction among supervisors of community health workers in marginalized communities in South Africa.

    Science.gov (United States)

    Akintola, Olagoke; Chikoko, Gamuchirai

    2016-09-06

    Management and supervision of community health workers are factors that are critical to the success of community health worker programmes. Yet few studies have explored the perspectives of supervisors in these programmes. This study explored factors influencing motivations of supervisors in community health worker programmes. We conducted qualitative interviews with 26 programme staff providing supervision to community health workers in eight community-based organizations in marginalized communities in the greater Durban area of South Africa from July 2010 to September 2011. Findings show that all the supervisors had previous experience working in the health or social services sectors and most started out as unpaid community health workers. Most of the participants were poor women from marginalized communities. Supervisors' activities include the management and supply of material resources, mentoring and training of community health workers, record keeping and report writing. Supervisors were motivated by intrinsic factors like making a difference and community appreciation and non-monetary incentives such as promotion to supervisory positions; acquisition of management skills; participation in capacity building and the development of programmes; and support for educational advancement like salary, bonuses and medical benefits. Hygiene factors that serve to prevent dissatisfaction are salaries and financial, medical and educational benefits attached to the supervisory position. Demotivating factors identified are patients' non-adherence to health advice and alienation from decision-making. Dissatisfiers include working in crime-prevalent communities, remuneration for community health workers (CHWs), problems with material and logistical resources, job insecurity, work-related stressors and navigating the interface between CHWs and management. While participants were dissatisfied with their low remuneration, they were not demotivated but continued to be motivated

  14. The role of community mental health services in supporting oral health outcomes among consumers.

    Science.gov (United States)

    Meldrum, Rebecca; Ho, Hillary; Satur, Julie

    2018-04-16

    People with a lived experience of mental illness are at a higher risk for developing oral diseases and having poorer oral health than the broader population. This paper explores the role of Australian community mental health services in supporting the prevention and management of poor oral health among people living with mental illness. Through focus groups and semi-structured interviews, participants identified the value of receiving oral health support within a community mental health setting, in particular the delivery of basic education, preventive strategies, assistance with making or attending appointments and obtaining priority access to oral health services. Engagement with Community Health Services and referrals generated through the priority access system were identified as key enablers to addressing oral health issues. This study provides new insight into the importance of undertaking an integrated approach to reducing the oral health disparities experienced by those living with mental illness.

  15. Workforce insights on how health promotion is practised in an Aboriginal Community Controlled Health Service.

    Science.gov (United States)

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

    2017-07-01

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

  16. Implementing and sustaining a hand hygiene culture change programme at Auckland District Health Board.

    Science.gov (United States)

    Roberts, Sally A; Sieczkowski, Christine; Campbell, Taima; Balla, Greg; Keenan, Andrew

    2012-05-11

    In January 2009 Auckland District Health Board commenced implementation of the Hand Hygiene New Zealand (HHNZ) programme to bring about a culture change and to improve hand hygiene compliance by healthcare workers. We describe the implementation process and assess the effectiveness of this programme 36 months after implementation. In keeping with the HHNZ guideline the implementation was divided into five steps: roll-out and facility preparation, baseline evaluation, implementation, follow-up evaluation and sustainability. The process measure was improvement in hand hygiene compliance and the outcome measure was Staphylococcus aureus clinical infection and bacteraemia rates. The mean (95% CI; range) baseline compliance rates for the national reporting wards was 35% (95% CI 24-46%, 25-61%). The overall compliance by the 7th audit period was 60% (95% CI 46-74; range 47-91). All healthcare worker groups had improvement in compliance. The reduction in healthcare-associated S. aureus bacteraemia rates following the implementation was statistically significant (p=0.027). Compliance with hand hygiene improved following implementation of a culture change programme. Sustaining this improvement requires commitment and strong leadership at a senior level both nationally and within each District Health Board.

  17. Community as classroom: teaching and learning public health in rural Appalachia.

    Science.gov (United States)

    Florence, James; Behringer, Bruce

    2011-01-01

    Traditional models for public health professional education tend to be didactic, with brief, discrete practica appended. National reports of both practitioners and academicians have called for more competency-driven, interdisciplinary-focused, community-based, service-oriented, and experientially-guided learning for students across the curriculum. East Tennessee State University began its own curricular revisioning in health professions education nearly 2 decades ago with a grant from the W.K. Kellogg Foundation, emphasizing competencies development through community-based learning in community-academic partnerships. This article describes 3 examples that grew from that initiative. In the first example, students in multiple classes delivered a longitudinal community-based employee wellness intervention for a rural county school district. BS public health students conducted needs assessments and prepared health education materials; MPH students conducted health assessments and worked with school wellness councils to deliver client-centered interventions; DrPH students supervised the project and provided feedback to the schools using participatory methods. In the second example, MPH students in a social-behavioral foundations course used experiential learning to investigate the region's elevated cancer mortality ranking. Following meetings with multiple community groups, students employed theoretical constructs to frame regional beliefs about cancer and presented findings to community leaders. One outcome was a 5-year community-based participatory research study of cancer in rural Appalachia. In the third example, MPH students in a health-consulting course assessed local African Americans' awareness of the university's health and education programs and perceptions of their community health issues. Students learned consultation methods by assisting at multiple regional African American community meetings to discover issues and interest that resulted in the

  18. Community organizing and community health: piloting an innovative approach to community engagement applied to an early intervention project in south London.

    Science.gov (United States)

    Bolton, Matthew; Moore, Imogen; Ferreira, Ana; Day, Crispin; Bolton, Derek

    2016-03-01

    The importance of community engagement in health is widely recognized, and key themes in UK National Institute for Health and Clinical Excellence (NICE) recommendations for enhancing community engagement are co-production and community control. This study reports an innovative approach to community engagement using the community-organizing methodology, applied in an intervention of social support to increase social capital, reduce stress and improve well-being in mothers who were pregnant and/or with infants aged 0-2 years. Professional community organizers in Citizens-UK worked with local member civic institutions in south London to facilitate social support to a group of 15 new mothers. Acceptability of the programme, adherence to principles of co-production and community control, and changes in the outcomes of interest were assessed quantitatively in a quasi-experimental design. The programme was found to be feasible and acceptable to participating mothers, and perceived by them to involve co-production and community control. There were no detected changes in subjective well-being, but there were important reductions in distress on a standard self-report measure (GHQ-12). There were increases in social capital of a circumscribed kind associated with the project. Community organizing provides a promising model and method of facilitating community engagement in health. © The Author 2015. Published by Oxford University Press on behalf of Faculty of Public Health.

  19. Community health workers and mobile technology: a systematic review of the literature.

    Science.gov (United States)

    Braun, Rebecca; Catalani, Caricia; Wimbush, Julian; Israelski, Dennis

    2013-01-01

    In low-resource settings, community health workers are frontline providers who shoulder the health service delivery burden. Increasingly, mobile technologies are developed, tested, and deployed with community health workers to facilitate tasks and improve outcomes. We reviewed the evidence for the use of mobile technology by community health workers to identify opportunities and challenges for strengthening health systems in resource-constrained settings. We conducted a systematic review of peer-reviewed literature from health, medical, social science, and engineering databases, using PRISMA guidelines. We identified a total of 25 unique full-text research articles on community health workers and their use of mobile technology for the delivery of health services. Community health workers have used mobile tools to advance a broad range of health aims throughout the globe, particularly maternal and child health, HIV/AIDS, and sexual and reproductive health. Most commonly, community health workers use mobile technology to collect field-based health data, receive alerts and reminders, facilitate health education sessions, and conduct person-to-person communication. Programmatic efforts to strengthen health service delivery focus on improving adherence to standards and guidelines, community education and training, and programmatic leadership and management practices. Those studies that evaluated program outcomes provided some evidence that mobile tools help community health workers to improve the quality of care provided, efficiency of services, and capacity for program monitoring. Evidence suggests mobile technology presents promising opportunities to improve the range and quality of services provided by community health workers. Small-scale efforts, pilot projects, and preliminary descriptive studies are increasing, and there is a trend toward using feasible and acceptable interventions that lead to positive program outcomes through operational improvements and

  20. Community health workers and mobile technology: a systematic review of the literature.

    Directory of Open Access Journals (Sweden)

    Rebecca Braun

    Full Text Available In low-resource settings, community health workers are frontline providers who shoulder the health service delivery burden. Increasingly, mobile technologies are developed, tested, and deployed with community health workers to facilitate tasks and improve outcomes. We reviewed the evidence for the use of mobile technology by community health workers to identify opportunities and challenges for strengthening health systems in resource-constrained settings.We conducted a systematic review of peer-reviewed literature from health, medical, social science, and engineering databases, using PRISMA guidelines. We identified a total of 25 unique full-text research articles on community health workers and their use of mobile technology for the delivery of health services.Community health workers have used mobile tools to advance a broad range of health aims throughout the globe, particularly maternal and child health, HIV/AIDS, and sexual and reproductive health. Most commonly, community health workers use mobile technology to collect field-based health data, receive alerts and reminders, facilitate health education sessions, and conduct person-to-person communication. Programmatic efforts to strengthen health service delivery focus on improving adherence to standards and guidelines, community education and training, and programmatic leadership and management practices. Those studies that evaluated program outcomes provided some evidence that mobile tools help community health workers to improve the quality of care provided, efficiency of services, and capacity for program monitoring.Evidence suggests mobile technology presents promising opportunities to improve the range and quality of services provided by community health workers. Small-scale efforts, pilot projects, and preliminary descriptive studies are increasing, and there is a trend toward using feasible and acceptable interventions that lead to positive program outcomes through operational

  1. Barriers to promote cardiovascular health in community pharmacies: a systematic review.

    Science.gov (United States)

    Alonso-Perales, María Del Mar; Lasheras, Berta; Beitia, Guadalupe; Beltrán, Idoia; Marcos, Beatriz; Núñez-Córdoba, Jorge M

    2017-06-01

    Community pharmacists play an important role in the provision of health promotion services, and community pharmacies are considered as a potentially ideal site for cardiovascular health promotion. Information based on a systematic review of barriers to promoting cardiovascular health in community pharmacy is currently lacking. We have sought to identify the most important barriers to cardiovascular health promotion in the community pharmacy. We have systematically searched PubMed and International Pharmaceutical Abstracts for a period of 15 years from 1 April 1998 to 1 April 2013, contacted subject experts and hand-searched bibliographies. We have included peer-reviewed articles, with English abstracts in the analysis, if they reported community pharmacists' perceptions of the barriers to cardiovascular health promotion activities in a community pharmacy setting. Two reviewers have independently extracted study characteristics and data. We identified 24 studies that satisfy the eligibility criteria. The main barriers to cardiovascular health promotion in the community pharmacy included pharmacist-related factors; practice site factors; financial factors; legal factors; and patient-related factors. This review will help to provide reliable evidence for health promotion practitioners of the barriers to promoting cardiovascular health in the community pharmacy setting. This knowledge is valuable for the improvement of cardiovascular health promotion in this setting and guiding future research. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  2. Creating A Sustainable Model of Spine Care in Underserved Communities

    DEFF Research Database (Denmark)

    Haldeman, Scott; Nordin, Margareta; Outerbridge, Geoff

    2015-01-01

    The world lacks sustainable models of care to manage spinal disorders in poor and underserved communities. The purpose of this article is to: (1) review the rationale and importance of developing a sustainable evidence-based model of care at low cost for people with spinal disorders in underserved...... adequate care, World Spine Care (WSC) was established to "improve lives in underserved communities through sustainable, integrated, evidence-based, spinal care." WSC is comprised of volunteers and institutions from 6 continents and several countries, and incorporates a Board of Directors, an executive...... are adapted to and integrated within each community in collaboration with local decision makers, existing health care workers and traditional healers. Cornerstones of WSC's emphasis on long-term sustainability are (1) education of community partners, governments and local health professionals, and (2...

  3. Guiding health promotion efforts with urban Inuit: a community-specific perspective on health information sources and dissemination strategies.

    Science.gov (United States)

    McShane, Kelly E; Smylie, Janet K; Hastings, Paul D; Martin, Carmel M

    2006-01-01

    To develop a community-specific perspective of health information sources and dissemination strategies of urban Inuit to better guide health promotion efforts. Through a collaborative partnership with the Tungasuvvingat Inuit Family Resource Centre, a series of key informant interviews and focus groups were conducted to gather information on specific sources of health information, strategies of health information dissemination, and overall themes in health information processes. Distinct patterns of health information sources and dissemination strategies emerged from the data. Major themes included: the importance of visual learning, community Elders, and cultural interpreters; community cohesion; and the Inuit and non-Inuit distinction. The core sources of health information are family members and sources from within the Inuit community. The principal dissemination strategy for health information was direct communication, either through one-on-one interactions or in groups. This community-specific perspective of health information sources and dissemination strategies shows substantial differences from current mainstream models of health promotion and knowledge translation. Health promotion efforts need to acknowledge the distinct health information processes of this community, and should strive to integrate existing health information sources and strategies of dissemination with those of the community.

  4. Performance of community health workers:situating their intermediary position within complex adaptive health systems

    OpenAIRE

    Kok, Maryse. C; Broerse, Jacqueline E.W; Theobald, Sally; Ormel, Hermen; Dieleman, Marjolein; Taegtmeyer, Miriam

    2017-01-01

    Health systems are social institutions, in which health worker performance is shaped by transactional processes between different actors. This analytical assessment unravels the complex web of factors that influence the performance of community health workers (CHWs) in low- and middle-income countries. It examines their unique intermediary position between the communities they serve and actors in the health sector, and the complexity of the health systems in which they operate. The assessment...

  5. Utilization of a Technical Peer Review to Support the Mission of the Nevada Test Site Community Advisory Board

    International Nuclear Information System (INIS)

    Dixon, Earle C.; Peterson, Kathleen

    2003-01-01

    The U. S. Department of Energy's (DOE) National Nuclear Security Administration Nevada Operations Office (NNSA/NV) Environmental Management (EM) Underground Test Area (UGTA) project addresses the characterization and needs for long-term monitoring of the subsurface contamination resulting from 828 underground nuclear weapon tests at the Nevada Test Site (NTS). EM promotes, and is required, to include stakeholders in its program. However, UGTA is a very complex program not easily understood by members of the public. The NTS Community Advisory Board (CAB), a federally chartered Site Specific Advisory Board (SSAB), has studied the UGTA project since 1996, and has found it a challenge to completely comprehend and provide NNSA/NV meaningful citizen input. The CAB realized the benefit of a technical peer review and in 2000 recommended to NNSA/NV that a peer review of the UGTA strategy would provide valuable feedback to the program to address underground contamination at the NTS. N NSA agreed to the CAB's recommendation, and moved forward with a scope of work to have the American Society of Mechanical Engineers (ASME) perform the peer review of the UGTA strategy. The ASME began the peer review in June 2001, and their final report was published in November 2001. In January 2002, the CAB devoted their monthly meeting in Las Vegas, Nevada to reporting the results of the peer review of the UGTA strategy to the public. Two public workshops were later held in the community of Amargosa, Nevada during the month of January to help educate and build interest in the CAB February 2002 monthly meeting which was also held in Amargosa. The CAB recommendation to NNSA to utilize a technical peer review has provided valuable information to NNSA, the State of Nevada, and the CAB. At other DOE sites SSABs are challenged by a number of complex, technical programs requiring considerable time and resources for the board to comprehend. It is worth considering the utilization of an independent

  6. Journal of Community Medicine and Primary Health Care

    African Journals Online (AJOL)

    Journal of Community Medicine and Primary Health Care. ... environmental health, clinical care, health planning and management, health policy, health ... non-communicable diseases within the Primary Health Care system in the Federal ... Assessment of occupational hazards, health problems and safety practices of petrol ...

  7. Workforce diversity and community-responsive health-care institutions.

    Science.gov (United States)

    Nivet, Marc A; Berlin, Anne

    2014-01-01

    While the levers for the social determinants of health reside largely outside institutional walls, this does not absolve health professional schools from exercising their influence to improve the communities in which they are located. Fulfilling this charge will require a departure from conventional thinking, particularly when it comes to educating future health professionals. We describe efforts within medical education to transform recruitment, admissions, and classroom environments to emphasize diversity and inclusion. The aim is to cultivate a workforce with the perspectives, aptitudes, and skills needed to fuel community-responsive health-care institutions.

  8. Keeping "Community" in a Community Land Trust

    Science.gov (United States)

    Gray, Karen A.; Galande, Mugdha

    2011-01-01

    This instrumental case study examined the role of grassroots community organizing in a community land trust (CLT) in a southern U.S. city. Twenty-nine homeowners, renters, board members, community members, and current and former CLT employees were interviewed. In addition, two focus groups of 11 and six participants composed of CLT residents and…

  9. COMMUNITY MEDICINE & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    Journal of Community Medicine and Primary Health Care. ... Ladoke Akintola University of Technology, PMB 4400, Osogbo, Osun State. ... weak management and poor adherence to the basic infrastructure e.g. primary, secondary and tertiary.

  10. COMMUNITY MEDICINE & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    ajiboro

    3Department of Community and Primary Health Care, College of Medicine, University of Lagos, Idiaraba, ... Some of the participants (45.3%) carry out physical exercises such as walking ..... hypertension, continuous effective management of.

  11. British Columbia's health reform: "new directions" and accountability.

    Science.gov (United States)

    Davidson, A R

    1999-01-01

    The health policy New Directions committed the British Columbia government to a population health perspective and extensive community involvement in the health services reform process. The policy envisaged elected citizen boards with authority to raise revenues and exercise a significant degree of local autonomy. Academic and public attention has been paid to the decision in November 1996 to collapse New Directions' two-tier governance structure into a single level. Less attention has been paid to the profound changes that occurred prior to the government's reversal on the question of governance. This paper focuses on those changes. During the critical three years between the 1993 launch of the reform and its formal revision in 1996, the government's positions on elections, taxation power, local autonomy and scope of action for regional boards all changed. Those changes marked a retreat from political accountability to the community and an advance towards managerial accountability to the government.

  12. A qualitative assessment of health extension workers' relationships with the community and health sector in Ethiopia: opportunities for enhancing maternal health performance.

    Science.gov (United States)

    Kok, Maryse C; Kea, Aschenaki Z; Datiko, Daniel G; Broerse, Jacqueline E W; Dieleman, Marjolein; Taegtmeyer, Miriam; Tulloch, Olivia

    2015-09-30

    Health extension workers (HEWs) in Ethiopia have a unique position, connecting communities to the health sector. This intermediary position requires strong interpersonal relationships with actors in both the community and health sector, in order to enhance HEW performance. This study aimed to understand how relationships between HEWs, the community and health sector were shaped, in order to inform policy on optimizing HEW performance in providing maternal health services. We conducted a qualitative study in six districts in the Sidama zone, which included focus group discussions (FGDs) with HEWs, women and men from the community and semi-structured interviews with HEWs; key informants working in programme management, health service delivery and supervision of HEWs; mothers; and traditional birth attendants. Respondents were asked about facilitators and barriers regarding HEWs' relationships with the community and health sector. Interviews and FGDs were recorded, transcribed, translated, coded and thematically analysed. HEWs were selected by their communities, which enhanced trust and engagement between them. Relationships were facilitated by programme design elements related to support, referral, supervision, training, monitoring and accountability. Trust, communication and dialogue and expectations influenced the strength of relationships. From the community side, the health development army supported HEWs in liaising with community members. From the health sector side, top-down supervision and inadequate training possibilities hampered relationships and demotivated HEWs. Health professionals, administrators, HEWs and communities occasionally met to monitor HEW and programme performance. Expectations from the community and health sector regarding HEWs' tasks sometimes differed, negatively affecting motivation and satisfaction of HEWs. HEWs' relationships with the community and health sector can be constrained as a result of inadequate support systems, lack of

  13. Supporting the spread of health technology in community services.

    Science.gov (United States)

    Sitton-Kent, Lucy; Humphreys, Catriona; Miller, Phillip

    2018-03-02

    Health technology has been proposed as a route to financial savings and improved patient safety for many years within the NHS. Nurses have a key role to play in transforming care through such technology but, despite high-level endorsement, implementation of health technology has been uneven across NHS community services. This article looks at three promising applications of health technology in community nursing: mobile access to digital care records; digital imaging; and remote face-to-face consultations. Current evidence for these technologies gives some indication of what is required before health technologies can benefit patients. Rapidly changing health technologies make it difficult for community services to make fully informed decisions when implementing them. There are challenges in predicting the full financial and efficiency impacts, in making robust estimates of costs and workload implications and in anticipating the effects on patient care and staff experience. Despite these problems, there is mounting evidence of the benefits of technological innovations available to community nurses and their patients.

  14. Engaging students in community health: a public health advocacy curriculum.

    Science.gov (United States)

    Curran, Nell; Ned, Judith; Winkleby, Marilyn

    2014-03-01

    Individual risk assessment and behavior change dominate the content of high school health education instruction whereas broader social, political, and economic factors that influence health-known as upstream causes-are less commonly considered. With input from instructors and students, we developed a 10-lesson experiential Public Health Advocacy Curriculum that uses classroom-based activities to teach high school students about the upstream causes of health and engages them in community-based health advocacy. The Curriculum, most suitable for health- or advocacy-related elective classes or after-school programs, may be taught in its entirety or as single lessons integrated into existing coursework. Although students at many schools are using the Curriculum, it has been formally evaluated with 110 predominantly Latino students at one urban and one semirural public high school in Northern California (six classes). In pre-post surveys, students showed highly significant and positive changes in the nine questions that covered the three main Curriculum domains (Upstream Causes, Community Exploration, and Public Health Advocacy), p values .02 to Curriculum is being widely disseminated without charge to local, national, and international audiences, with the objective of grooming a generation of youth who are committed to the public health perspective to health.

  15. Evaluation of health centre community nurse team.

    Science.gov (United States)

    Dixon, P N; Trounson, E

    1969-02-01

    This report gives an account of the work during six months of a community nurse team attached to the doctors working from a new health centre. The team consisted of two community nurses, who had both health visiting and Queen's nursing qualifications, and a State-enrolled nurse. The community nurses, in addition to undertaking all the health visiting for the population at risk, assessed the social and nursing needs of patients at the request of the general practitioners and ensured that these needs were met. When necessary they undertook practical nursing tasks in the home and in the health centre, but most of the bedside nursing in the home was done by the State-enrolled nurse.The needs of the population at risk were such that only one State-enrolled nurse could usefully be employed, and this proved to be a considerable disadvantage. Despite this, the experimental work pattern held advantages to patients, doctors, and nurses, and is potentially capable of providing a satisfying and economic division of responsibilities, with different tasks being carried out by the individual most appropriately qualified.

  16. Internet message boards for pregnancy loss: who's on-line and why?

    Science.gov (United States)

    Gold, Katherine J; Boggs, Martha E; Mugisha, Emeline; Palladino, Christie Lancaster

    2012-01-01

    Pregnancy loss is common, but its significance is often minimized by family, friends, and the community, leaving bereaved parents with unmet need for support. This study sought to describe demographics, usage patterns, and perceived benefits for women participating in Internet pregnancy loss support groups. We requested permission to post an anonymous Internet survey on large and active United States Internet message boards for women with miscarriages and stillbirths. The study purposefully oversampled stillbirth sites and included both closed- and open-ended questions. The University of Michigan Institutional Review Board approved the study. Closed-ended questions were summarized and evaluated with bivariate analysis. We performed a qualitative analysis of open-ended data using an iterative coding process to identify key themes. Of 62 sites queried, 15 granted permission to post the survey on 18 different message boards. We collected 1,039 surveys, of which 1,006 were complete and eligible for analysis. Women were typically white, well educated, and frequent users. They noted message boards helped them to feel less isolated in their loss and grief and they appreciated unique aspects of Internet communication such as convenience, access, anonymity, and privacy. Pregnancy loss message boards are an important aspect of support for many bereaved mothers. African-American women seem to be substantially underrepresented on-line despite being at higher risk for stillbirth. Internet message boards serve a unique function in providing support for women with miscarriage and stillbirth. The benefits are often significantly different from those encountered in traditional face-to-face bereavement support. Copyright © 2012 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  17. Health Promotion in the Community: Impact of Faith-Based Lay Health Educators in Urban Neighborhoods.

    Science.gov (United States)

    Galiatsatos, Panagis; Sundar, Siddhi; Qureshi, Adil; Ooi, Gavyn; Teague, Paula; Daniel Hale, W

    2016-06-01

    Promoting wellness and providing reliable health information in the community present serious challenges. Lay health educators, also known as community health workers, may offer a cost-effective solution to such challenges. This is a retrospective observational study of graduates from the Lay Health Educator Program (LHEP) at Johns Hopkins Bayview Medical Center from 2013 to 2014. Students were enrolled from the surrounding community congregations and from the hospital's accredited clinical pastoral education program. There were 50 events implemented by the lay health educators during the 2014-2015 time period, reaching a total of 2004 individuals. The mean time from date of graduation from the LHEP to implementation of their first health promotional event was 196 ± 76 days. A significant number of lay health educators implemented events within the first year after completing their training. Ongoing monitoring of their community activity and the clinical impact of their efforts should be a priority for future studies.

  18. An Evaluation of the Effectiveness of Local Site-Specific Advisory Boards for US Department of Energy Environmental Restoration Programs

    Energy Technology Data Exchange (ETDEWEB)

    Bradbury, J.A.; Branch, K.M.

    1999-03-12

    In the early 1990s, the US Department of Energy (DOE) undertook a major new effort to involve community stakeholders in decisions that would affect them and their communities and interests. An important component of this effort was the establishment of local Site-Specific Advisory Boards (SSABs) at 12 DOE environmental remediation sites. These boards were a formal representation of a change in the way DOE conducts its missions, adding consideration of community concerns and values to the Department's decision-making processes. DOE's purpose in creating the SSAB Initiative was to obtain broadly based, independent, consensus advice and recommendations on issues that have the potential to affect communities surrounding DOE sites, so that it could formulate policies that could be implemented with community consent. Because the boards represented a significant commitment by DOE to change its relationships with community stakeholders, the Department has conducted several assessments of the boards. In 1996 and 1997 a survey was administered to board members and others involved in the work of the boards (DOE/EM 0311, 1996; DOE/EM, 1997). As part of the first survey, DOE and the boards established a set of performance criteria. The surveys provided data that revealed wide variations in board performance and significant change over time. To gain a better understanding of the factors affecting board performance, DOE initiated a more in-depth, qualitative study of nine of the boards across the complex. This study focused on identifying and analyzing the factors affecting board performance and presenting that information in a format that helped the boards and DOE gain insight into their strengths and weaknesses and learn from one another. This report presents the results of this in-depth study. It begins with an overview report that identifies and discusses the six factors that were found to affect board performance. The overview report provides the framework and

  19. The Role of Discussion Boards in Facilitating Communities of Inquiry: A Case of ICT and Sociology Courses at Zagreb School of Economics and Management

    Science.gov (United States)

    Aleksic-Maslac, Karmela; Magzan, Masha; Juric, Visnja

    2009-01-01

    The study focuses on the use of technology to design an electronic learning community for students. The importance of social experience in education and social participation through communication is examined through discussion boards of two different freshmen courses offered at Zagreb School of Economics and Management (ZSEM). Effectiveness and…

  20. 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

  1. Knowledge translation in eHealth: building a virtual community.

    Science.gov (United States)

    Bassi, Jesdeep; Lau, Francis; Hagens, Simon; Leaver, Chad; Price, Morgan

    2013-01-01

    Knowledge can be powerful in eliciting positive change when it is put into action. This is the belief that drives knowledge translation. The University of Victoria (UVic) eHealth Observatory is focused on deriving knowledge from health information system (HIS) evaluation, which needs to be shared with HIS practitioners. Through an application of the Knowledge-to-Action Framework and the concept of a virtual community, we have established the virtual eHealth Benefits Evaluation Knowledge Translation (KT) Community. This paper describes the foundational elements of the KT Community and our overall KT strategy.

  2. Factors influencing perceived sustainability of Dutch community health programs

    NARCIS (Netherlands)

    Vermeer, A. J. M.; van Assema, P.; Hesdahl, B.; Harting, J.; de Vries, N. K.

    2015-01-01

    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

  3. Engaging Youth on Climate & Health to Cultivate Community Resilience

    Science.gov (United States)

    Haine, D. B.; Gray, K. M.; Chang, D.; Morton, T.; Steele, B.; Backus, A.; Hauptman, M.

    2017-12-01

    Cultivating climate literacy among youth positions them to develop solutions and advocate for actions that prepare communities to adapt to climate change, mitigate emissions and ultimately protect human health and well-being, with an eye towards protecting the most vulnerable populations. This presentation will describe an innovative partnership among three university environmental health programs—based at the University of North Carolina at Chapel Hill, Columbia University and Harvard University—and their community collaborators: the Alliance for Climate Education, Boston Children's Hospital Pediatric Environmental Health Center and WE ACT for Environmental Justice. This project engages youth through non-formal educational programming that promotes climate literacy while also building the capacity of today's youth to promote community resilience. This partnership led to the development and implementation of two, long-duration extracurricular youth science enrichment programs in 2017, one in North Carolina (NC) and one in New York, with joint activities conducted virtually and in person to connect students with each other and with leading public health professionals and others working to promote community resilience and climate justice. Forty high school students, 20 from central NC and 20 from West Harlem in New York City, are enrolled in each program. In July 2017, students came together for a 3-day summer institute in NC. This session will feature the strategies, STEM-based activities and resources used in this project to engage students in the examination of their communities, identification and evaluation of climate adaptation and mitigation strategies and promotion of community resilience. Programming entailed having students interact with public health professionals, scientists and others to learn about climate impacts to public health and its infrastructure, vulnerable populations and planning for resilient communities. Ultimately, we sought to promote

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

    Science.gov (United States)

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

    2016-01-01

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

  5. Community vulnerability to health impacts of wildland fire ...

    Science.gov (United States)

    Identifying communities vulnerable to adverse health effects from exposure to wildfire smoke may help prepare responses, increase the resilience to smoke and improve public health outcomes during smoke days. We developed a Community Health-Vulnerability Index (CHVI) based on factors known to increase the risks of health effects from air pollution and wildfire smoke exposures. These factors included county prevalence rates for asthma in children and adults, chronic obstructive pulmonary disease, hypertension, diabetes, obesity, percent of population 65 years of age and older, and indicators of socioeconomic status including poverty, education, income and unemployment. Using air quality simulated for the period between 2008 and 2012 over the continental U.S. we also characterized the population size at risk with respect to the level and duration of exposure to fire-originated fine particulate matter (fire-PM2.5) and CHVI. We estimate that 10% of the population (30.5 million) lived in the areas where the contribution of fire-PM2.5 to annual average ambient PM2.5 was high (>1.5 µg m3) and that 10.3 million individuals experienced unhealthy air quality levels for more than 10 days due to smoke. Using CHVI we identified the most vulnerable counties and determined that these communities experience more smoke exposures in comparison to less vulnerable communities. We describe the development of an index of community vulnerability for the health effects of smoke based o

  6. The Communication, Awareness, Relationships and Empowerment (C.A.R.E. Model: An Effective Tool for Engaging Urban Communities in Community-Based Participatory Research

    Directory of Open Access Journals (Sweden)

    Joniqua Ceasar

    2017-11-01

    Full Text Available Little is known about recruitment methods for racial/ethnic minority populations from resource-limited areas for community-based health and needs assessments, particularly assessments that incorporate mobile health (mHealth technology for characterizing physical activity and dietary intake. We examined whether the Communication, Awareness, Relationships and Empowerment (C.A.R.E. model could reduce challenges recruiting and retaining participants from faith-based organizations in predominantly African American Washington, D.C. communities for a community-based assessment. Employing C.A.R.E. model elements, our diverse research team developed partnerships with churches, health organizations, academic institutions and governmental agencies. Through these partnerships, we cultivated a visible presence at community events, provided cardiovascular health education and remained accessible throughout the research process. Additionally, these relationships led to the creation of a community advisory board (CAB, which influenced the study’s design, implementation, and dissemination. Over thirteen months, 159 individuals were recruited for the study, 99 completed the initial assessment, and 81 used mHealth technology to self-monitor physical activity over 30 days. The culturally and historically sensitive C.A.R.E. model strategically engaged CAB members and study participants. It was essential for success in recruitment and retention of an at-risk, African American population and may be an effective model for researchers hoping to engage racial/ethnic minority populations living in urban communities.

  7. The Communication, Awareness, Relationships and Empowerment (C.A.R.E.) Model: An Effective Tool for Engaging Urban Communities in Community-Based Participatory Research.

    Science.gov (United States)

    Ceasar, Joniqua; Peters-Lawrence, Marlene H; Mitchell, Valerie; Powell-Wiley, Tiffany M

    2017-11-21

    Little is known about recruitment methods for racial/ethnic minority populations from resource-limited areas for community-based health and needs assessments, particularly assessments that incorporate mobile health (mHealth) technology for characterizing physical activity and dietary intake. We examined whether the Communication, Awareness, Relationships and Empowerment (C.A.R.E.) model could reduce challenges recruiting and retaining participants from faith-based organizations in predominantly African American Washington, D.C. communities for a community-based assessment. Employing C.A.R.E. model elements, our diverse research team developed partnerships with churches, health organizations, academic institutions and governmental agencies. Through these partnerships, we cultivated a visible presence at community events, provided cardiovascular health education and remained accessible throughout the research process. Additionally, these relationships led to the creation of a community advisory board (CAB), which influenced the study's design, implementation, and dissemination. Over thirteen months, 159 individuals were recruited for the study, 99 completed the initial assessment, and 81 used mHealth technology to self-monitor physical activity over 30 days. The culturally and historically sensitive C.A.R.E. model strategically engaged CAB members and study participants. It was essential for success in recruitment and retention of an at-risk, African American population and may be an effective model for researchers hoping to engage racial/ethnic minority populations living in urban communities.

  8. Conversations on telemental health: listening to remote and rural First Nations communities.

    Science.gov (United States)

    Gibson, Kerri L; Coulson, Heather; Miles, Roseanne; Kakekakekung, Christal; Daniels, Elizabeth; O'Donnell, Susan

    2011-01-01

    Telemental health involves technologies such as videoconferencing to deliver mental health services and education, and to connect individuals and communities for healing and health. In remote and rural First Nations communities there are often challenges to obtaining mental healthcare in the community and to working with external mental health workers. Telemental health is a service approach and tool that can address some of these challenges and potentially support First Nations communities in their goal of improving mental health and wellbeing. Community members' perspectives on the usefulness and appropriateness of telemental health can greatly influence the level of engagement with the service. It appears that no research or literature exists on First Nations community members' perspectives on telemental health, or even on community perspectives on the broader area of technologies for mental health services. Therefore, this article explores the perspectives on telemental health of community members living in two rural and remote First Nations communities in Ontario, Canada. METHODS; This study was part of the VideoCom project, a collaborative research project exploring how remote and rural First Nations communities are using ICTs. This current exploration was conducted with the support of Keewaytinook Okimakanak (KO), our partner in Northwestern Ontario. With the full collaboration of the communities' leadership, a team involving KO staff and VideoCom researchers visited the two communities in the spring of 2010. Using a participatory research design, we interviewed 59 community members, asking about their experiences with and thoughts on using technologies and their attitudes toward telemental health, specifically. A thematic analysis of this qualitative data and a descriptive quantitative analysis of the information revealed the diversity of attitudes among community members. Finally, based on a discussion with the community telehealth staff, a 'ways forward

  9. Institutionalising health technology assessment: establishing the Medical Technology Assessment Board in India.

    Science.gov (United States)

    Downey, Laura E; Mehndiratta, Abha; Grover, Ashoo; Gauba, Vijay; Sheikh, Kabir; Prinja, Shankar; Singh, Ravinder; Cluzeau, Francoise A; Dabak, Saudamini; Teerawattananon, Yot; Kumar, Sanjiv; Swaminathan, Soumya

    2017-01-01

    India is at crossroads with a commitment by the government to universal health coverage (UHC), driving efficiency and tackling waste across the public healthcare sector. Health technology assessment (HTA) is an important policy reform that can assist policy-makers to tackle inequities and inefficiencies by improving the way in which health resources are allocated towards cost-effective, appropriate and feasible interventions. The equitable and efficient distribution of health budget resources, as well as timely uptake of good value technologies, are critical to strengthen the Indian healthcare system. The government of India is set to establish a Medical Technology Assessment Board to evaluate existing and new health technologies in India, assist choices between comparable technologies for adoption by the healthcare system and improve the way in which priorities for health are set. This initiative aims to introduce a more transparent, inclusive, fair and evidence-based process by which decisions regarding the allocation of health resources are made in India towards the ultimate goal of UHC. In this analysis article, we report on plans and progress of the government of India for the institutionalisation of HTA in the country. Where India is home to one-sixth of the global population, improving the health services that the population receives will have a resounding impact not only for India but also for global health.

  10. Perceptions of cardiovascular health in underserved communities.

    Science.gov (United States)

    Bryant, Lucinda L; Chin, Nancy P; Cottrell, Lesley A; Duckles, Joyce M; Fernandez, I Diana; Garces, D Marcela; Keyserling, Thomas C; McMilin, Colleen R; Peters, Karen E; Samuel-Hodge, Carmen D; Tu, Shin-Ping; Vu, Maihan B; Fitzpatrick, Annette L

    2010-03-01

    Cardiovascular disease is the leading cause of deaths and illnesses in US adults, and the prevalence is disproportionately high in underserved populations. In this study, we assessed respondents' understanding of context-specific differences in knowledge and perceptions of disease, risk, and prevention in 6 underserved communities, with the longer-term goal of developing appropriate interventions. Thirty-nine small-group sessions and 14 interviews yielded data from 318 adults. Each site's researchers coded, analyzed, and extracted key themes from local data. Investigators from all sites synthesized results and identified common themes and differences. Themes clustered in 3 areas (barriers to cardiovascular health, constraints related to multiple roles, and suggestions for effective communications and programs). Barriers spanned individual, social and cultural, and environmental levels; women in particular cited multiple roles (eg, competing demands, lack of self-care). Programmatic suggestions included the following: personal, interactive, social context; information in language that people use; activities built around cultural values and interests; and community orientation. In addition, respondents preferred health-related information from trusted groups (eg, AARP), health care providers (but with noticeable differences of opinion), family and friends, and printed materials. Interventions to decrease barriers to cardiovascular health are needed; these strategies should include family and community context, small groups, interactive methods, culturally sensitive materials, and trusted information sources. New-immigrant communities need culturally and linguistically tailored education before receiving more substantive interventions.

  11. Avoiding "culture rejection" in healthcare mergers and acquisitions: how New Heights Community Health Centres and York Community Services minimized the culture risk when forming Unison Health and Community Services.

    Science.gov (United States)

    Chan, Jeff

    2013-01-01

    Among the requirements for a successful merger or acquisition are strategic rationale, rigorous due diligence, the right price and revenue and cost synergies. However, bridging the culture gap between organizations is frequently overlooked. The leaders of New Heights Community Health Centres and York Community Services explicitly considered culture in their merger to form Unison Health and Community Services, and they used employee engagement surveys to assess culture in their merger planning and post-merger integration. How Unison Health leaders avoided the risk of culture rejection to achieve a successful merger, and the lessons learned from their experience, is the focus of this article.

  12. Community vulnerability to health impacts of wildland fire smoke exposure

    Science.gov (United States)

    Identifying communities vulnerable to adverse health effects from exposure to wildfire smoke may help prepare responses, increase the resilience to smoke and improve public health outcomes during smoke days. We developed a Community Health-Vulnerability Index (CHVI) based on fact...

  13. Reiki Reduces Burnout Among Community Mental Health Clinicians.

    Science.gov (United States)

    Rosada, Renee M; Rubik, Beverly; Mainguy, Barbara; Plummer, Julie; Mehl-Madrona, Lewis

    2015-08-01

    Clinicians working in community mental health clinics are at high risk for burnout. Burnout is a problem involving emotional exhaustion, depersonalization, and reduced personal accomplishment. Reiki is a holistic biofield energy therapy beneficial for reducing stress. The purpose of this study was to determine if 30 minutes of healing touch could reduce burnout in community mental health clinicians. We utilized a crossover design to explore the efficacy of Reiki versus sham Reiki, a pseudo treatment designed to mimic true Reiki, as a means to reduce symptoms of burnout. Subjects were randomized to whether they started with Reiki or sham. The Maslach Burnout Inventory-Human Services Survey (MBI-HSS) and the Measure Your Medical Outcome Profile Version 2 (MYMOP-2) were used as outcome measures. Multilevel modeling was used to represent the relations among variables. Reiki was statistically significantly better than sham Reiki in reducing burnout among community mental health clinicians (p=0.011). Reiki was significant in reducing depersonalization (pReiki reduced the primary symptom on the MYMOP also only among single people (p=0.03). The effects of Reiki were differentiated from sham Reiki. Reiki could be helpful in community mental health settings for the mental health of the practitioners.

  14. Work Profile of Community Health Extension Workers in Cross River ...

    African Journals Online (AJOL)

    Introdution: The goal of significant reduction in maternal and child mortality could be achieved if national health services de-emphasizes vertical public health programs and services and strengthen community services9. Community based service are usually directed toward identification of at risk groups in the community ...

  15. Factors that influence Asian communities' access to mental health care.

    Science.gov (United States)

    Wynaden, Dianne; Chapman, Rose; Orb, Angelica; McGowan, Sunita; Zeeman, Zenith; Yeak, SiewHo

    2005-06-01

    This paper presents the findings of a qualitative study to identify factors that influence Asian communities' access to mental health care and how mental health care is delivered to them. Semistructured interviews were completed with Asian community members/leaders and health-care professionals. Content analysis identified major themes. Participants also completed a demographic data sheet. The research aimed to provide health professionals with an increased understanding of the values and beliefs held by people from Asian communities regarding the cause and treatment of mental illness. Data analysis identified six main themes that influenced Asian communities' access to mental health care and how mental health care is delivered to them. They were: shame and stigma; causes of mental illness; family reputation; hiding up; seeking help; and lack of collaboration. The findings highlighted that people from Asian communities are unwilling to access help from mainstream services because of their beliefs, and that stigma and shame are key factors that influence this reluctance. The findings also highlight that the mental health needs of refugee women are significant, and that they comprise a vulnerable group within Australian society.

  16. Effects of a dedicated regional psychiatric emergency service on boarding of psychiatric patients in area emergency departments.

    Science.gov (United States)

    Zeller, Scott; Calma, Nicole; Stone, Ashley

    2014-02-01

    Mental health patients boarding for long hours, even days, in United States emergency departments (EDs) awaiting transfer for psychiatric services has become a considerable and widespread problem. Past studies have shown average boarding times ranging from 6.8 hours to 34 hours. Most proposed solutions to this issue have focused solely on increasing available inpatient psychiatric hospital beds, rather than considering alternative emergency care designs that could provide prompt access to treatment and might reduce the need for many hospitalizations. One suggested option has been the "regional dedicated emergency psychiatric facility," which serves to evaluate and treat all mental health patients for a given area, and can accept direct transfers from other EDs. This study sought to assess the effects of a regional dedicated emergency psychiatric facility design known at the "Alameda Model" on boarding times and hospitalization rates for psychiatric patients in area EDs. Over a 30-day period beginning in January 2013, 5 community hospitals in Alameda County, California, tracked all ED patients on involuntary mental health holds to determine boarding time, defined as the difference between when they were deemed stable for psychiatric disposition and the time they were discharged from the ED for transfer to the regional psychiatric emergency service. Patients were also followed to determine the percentage admitted to inpatient psychiatric units after evaluation and treatment in the psychiatric emergency service. In a total sample of 144 patients, the average boarding time was approximately 1 hour and 48 minutes. Only 24.8% were admitted for inpatient psychiatric hospitalization from the psychiatric emergency service. The results of this study indicate that the Alameda Model of transferring patients from general hospital EDs to a regional psychiatric emergency service reduced the length of boarding times for patients awaiting psychiatric care by over 80% versus

  17. Achieving Health Equity Through Community Engagement in Translating Evidence to Policy: The San Francisco Health Improvement Partnership, 2010?2016

    OpenAIRE

    Grumbach, Kevin; Vargas, Roberto A.; Fleisher, Paula; Arag?n, Tom?s J.; Chung, Lisa; Chawla, Colleen; Yant, Abbie; Garcia, Estela R.; Santiago, Amor; Lang, Perry L.; Jones, Paula; Liu, Wylie; Schmidt, Laura A.

    2017-01-01

    Background The San Francisco Health Improvement Partnership (SFHIP) promotes health equity by using a novel collective impact model that blends community engagement with evidence-to-policy translational science. The model involves diverse stakeholders, including ethnic-based community health equity coalitions, the local public health department, hospitals and health systems, a health sciences university, a school district, the faith community, and others sectors. Community Context We report o...

  18. The effect of a community mental health training program for multidisciplinary staff.

    Science.gov (United States)

    Yang, Bing Xiang; Stone, Teresa E; Davis, Scott A

    2018-06-01

    Primary health workers play a critical role in providing health education to people with mental disorders. In China community health workers working with people with mental health problems lack experience and training in this area. Additionally, coordination between hospital and community staff is not well established. The aim of this study was to provide an interdisciplinary community mental health training program and to evaluate the effect of the training on staff knowledge about mental health and confidence in their roles. A three-day community mental health training program was offered specifically for interdisciplinary mental health professionals. Using a one-group pre-test post-test design, participants completed a self-assessment of mental health concepts and program evaluation which included asking participants to rate their satisfaction using a five-point Likert scale and to respond to open-ended questions. Forty-eight participants including health professionals from colleges, hospital and community health centers were recruited. Only 8.7% of participants had ever received community mental health training. Post-test evaluation demonstrated improvements in knowledge, and most participants were very satisfied with the program. The findings indicate that this brief interdisciplinary training program had a positive effect in improving knowledge about community mental health concepts and confidence in dealing with people with mental health disorders for multidisciplinary staff working in primary health care areas. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Population health improvement: a community health business model that engages partners in all sectors.

    Science.gov (United States)

    Kindig, David A; Isham, George

    2014-01-01

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

  20. 77 FR 8330 - Health Services Research and Development Service Scientific Merit Review Board; Notice of Meeting

    Science.gov (United States)

    2012-02-14

    ... Disorders; HCR 2--Substance Use Disorders; HCR 3--Rehabilitation/Rural; HCR 4--Women's Health; HCR 5--Pain... Development Service Scientific Merit Review Board will meet on March 6-8, 2012, at the Hilton New Orleans... to the Chief Research and Development Officer. On March 6, the subcommittee on Nursing Research...

  1. Challenges facing community health workers in Brazil's Family Health Strategy: A qualitative study.

    Science.gov (United States)

    Grossman-Kahn, Rebecca; Schoen, Julia; Mallett, John William; Brentani, Alexandra; Kaselitz, Elizabeth; Heisler, Michele

    2017-09-21

    Community health worker (CHW) programs are implemented in many low- and middle-income countries such as Brazil to increase access to and quality of care for underserved populations; CHW programs have been found to improve certain indicators of health, but few studies have investigated the daily work of CHWs, their perspectives on what both helps and hinders them from fulfilling their roles, and ways that their effectiveness and job satisfaction could be increased. To examine these questions, we observed clinic visits, CHW home visits, and conducted semistructured interviews with CHWs in 7 primary care centers in Brazil-2 in Salvador, Bahia, and 5 in São Paulo, SP-in which CHWs are incorporated into the work of all primary care health teams. In addition to enhancing communication between the medical system and the community, CHWs consider their key roles to be helping persuade community members to seek medical care and increasing health professionals' awareness of the social conditions affecting their patients' health. Key obstacles that CHWs face include failure to be fully integrated into the primary care team, inability to follow-up on identified health needs due to limited resources, as well as community members' lack of understanding of their work and undervaluing of preventative medicine. Increased training, better incorporation of CHWs into clinic flow and decision making, and establishing a clear community awareness of the roles and value of CHWs will help increase the motivation and effectiveness of CHWs in Brazil. Copyright © 2017 John Wiley & Sons, Ltd.

  2. Building and measuring infrastructure and capacity for community health assessment and health improvement planning in Florida.

    Science.gov (United States)

    Abarca, Christine; Grigg, C Meade; Steele, Jo Ann; Osgood, Laurie; Keating, Heidi

    2009-01-01

    COMPASS (Comprehensive Assessment, Strategic Success) is the Florida Department of Health's community health assessment and health improvement planning initiative. Since 2002, COMPASS built state and county health department infrastructure to support a comprehensive, systematic, and integrated approach to community health assessment and planning. To assess the capacity of Florida's 67 county health departments (CHDs) to conduct community health assessment and planning and to identify training and technical assistance needs, COMPASS surveyed the CHDs using a Web-based instrument annually from 2004 through 2008. Response rate to the survey was 100 percent annually. In 2007, 96 percent of CHDs reported conducting assessment and planning within the past 3 years; 74 percent used the MAPP (Mobilizing for Action through Planning and Partnerships) framework. Progress was greater for the organizational and assessment phases of the MAPP-based work; only 10 CHDs had identified strategic priorities in 2007, and even fewer had implemented strategies for improving health. In 2007, the most frequently requested types of training were measuring success, developing goals and action plans, and using qualitative data; technical assistance was most frequently requested for program evaluation and writing community health status reports. Florida's CHDs have increased their capacity to conduct community health assessment and planning. Questions remain about sustaining these gains with limited resources.

  3. Use of electronic bulletin boards for environmental management

    International Nuclear Information System (INIS)

    Kumar, A.; Rao, H.G.

    1991-01-01

    As a result of changes to existing environmental protection legislation, and the numerous changes to existing regulations that continually take place, environmental managers need updated information on federal mandated programs and regulation, approved and other mathematical models, control technologies, acceptable measurement techniques and continuing education courses. The US Environmental Protection Agency (EPA) is providing help to state and local air pollution control agencies, the regulated community, consultants and the general public through electronic bulletin boards. Each bulletin board (BB) uses data base management system and communication technology to provide access to information on several specific topics of interest to the environmental manager. This review discusses nine bulletin board systems available to the public from the EPA. Several alternative bulletin board systems are also available and will be discussed in future columns

  4. Citizenship, Community Mental Health, and the Common Good.

    Science.gov (United States)

    Atterbury, Kendall; Rowe, Michael

    2017-07-01

    In this article, we address the issue of community mental health and the common good via an applied theory of citizenship to support the social inclusion, empowerment, and inclusion of persons diagnosed with psychiatric disorders. We begin by discussing citizenship, and the concept of the common good, in regard to historical conceptions of citizenship, including the historical exclusion of women, people of color, persons with mental illness, and others. We then review the development of our citizenship framework in response to the limitations of even the most innovative community mental health interventions, specifically the practice of mental health outreach to persons who are homeless. We review findings from three citizenship research studies - a community-level intervention, an individual- and group-level intervention, and development of an individual instrument of citizenship - along with brief comments on current citizenship research. We conclude with a discussion of the challenges of realizing both the individual and collective potential of, and challenges to, the citizenship framework in relation to current and future community mental health systems of care. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

  5. Buddhist monks as community health workers in Thailand.

    Science.gov (United States)

    Hathirat, S

    1983-01-01

    In Thailand, Buddhist monks and temples are scattered throughout the country even in the rural poor. There are approximately one temple and four monks for every two villages of about 1000 people. If Buddhist monks are able to expand their roles to health care and education, Buddhist temples will automatically become community health posts and 'Health for All by The Year 2000' will be achieved within 5-10 years in Thailand. Therefore, a volunteer monk-training program has been carried out and about 2000 graduates have returned to their community to disseminate primary health care. However, a systematic and 'industrialized' approach is necessary to get some visible impact on the health of the rural Thai population.

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

    Directory of Open Access Journals (Sweden)

    Wilson Michael G

    2012-11-01

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

  7. Integrating Journalism Into Health Promotion: Creating and Disseminating Community Narratives.

    Science.gov (United States)

    Brown, Louis D; Berryhill, Joseph C; Jones, Eric C

    2018-06-01

    Media coverage of mental health and other social issues often relies on episodic narratives that suggest individualistic causes and solutions, while reinforcing negative stereotypes. Community narratives can provide empowering alternatives, serving as media advocacy tools used to shape the policy debate on a social issue. This article provides health promotion researchers and practitioners with guidance on how to develop and disseminate community narratives to broaden awareness of social issues and build support for particular programs and policy solutions. To exemplify the community narrative development process and highlight important considerations, this article examines a narrative from a mental health consumer-run organization. In the narrative, people with mental health problems help one another while operating a nonprofit organization, thereby countering stigmatizing media portrayals of people with mental illness as dangerous and incompetent. The community narrative frame supports the use of consumer-run organizations, which are not well-known and receive little funding despite evidence of effectiveness. The article concludes by reviewing challenges to disseminating community narratives, such as creating a product of interest to media outlets, and potential solutions, such as engaging media representatives through community health partnerships and using social media to draw attention to the narratives.

  8. A unique strategy for pediatric community health nursing for ADN students.

    Science.gov (United States)

    Janvier, K A

    1999-01-01

    Students were overwhelmingly positive when given the opportunity to evaluate the pilot project and the model of pediatric community health nursing. According to the students, the strong points of the model were the orientation before the community experience, the presence of faculty of the community, the ability to contact faculty when needed, and the postclinical conference. The students' comments confirmed the faculty's belief that a clinical experience in community health nursing must place more emphasis on the specialty of community health nursing to be meaningful for students. To do the of job of educating tomorrow's nurses, ADN faculty should develop new strategies for teaching the pediatric clinical component of community health nursing. Clearly, hospitals are no longer the exclusive sites where students learn about patient and family needs and nursing care delivery. Community-based and community-focused experiences will continue to be required so that nursing students are prepared to practice in a dynamic and changing healthcare environment.

  9. [Extension of health coverage and community based health insurance schemes in Africa: Myths and realities].

    Science.gov (United States)

    Boidin, B

    2015-02-01

    This article tackles the perspectives and limits of the extension of health coverage based on community based health insurance schemes in Africa. Despite their strong potential contribution to the extension of health coverage, their weaknesses challenge their ability to play an important role in this extension. Three limits are distinguished: financial fragility; insufficient adaptation to characteristics and needs of poor people; organizational and institutional failures. Therefore lessons can be learnt from the limits of the institutionalization of community based health insurance schemes. At first, community based health insurance schemes are to be considered as a transitional but insufficient solution. There is also a stronger role to be played by public actors in improving financial support, strengthening health services and coordinating coverage programs.

  10. Optimising the benefits of community health workers' unique position between communities and the health sector: A comparative analysis of factors shaping relationships in four countries.

    Science.gov (United States)

    Kok, Maryse C; Ormel, Hermen; Broerse, Jacqueline E W; Kane, Sumit; Namakhoma, Ireen; Otiso, Lilian; Sidat, Moshin; Kea, Aschenaki Z; Taegtmeyer, Miriam; Theobald, Sally; Dieleman, Marjolein

    2017-11-01

    Community health workers (CHWs) have a unique position between communities and the health sector. The strength of CHWs' relationships with both sides influences their motivation and performance. This qualitative comparative study aimed at understanding similarities and differences in how relationships between CHWs, communities and the health sector were shaped in different Sub-Saharan African settings. The study demonstrates a complex interplay of influences on trust and CHWs' relationships with their communities and actors in the health sector. Mechanisms influencing relationships were feelings of (dis)connectedness, (un)familiarity and serving the same goals, and perceptions of received support, respect, competence, honesty, fairness and recognition. Sometimes, constrained relationships between CHWs and the health sector resulted in weaker relationships between CHWs and communities. The broader context (such as the socio-economic situation) and programme context (related to, for example, task-shifting, volunteering and supervision) in which these mechanisms took place were identified. Policy-makers and programme managers should take into account the broader context and could adjust CHW programmes so that they trigger mechanisms that generate trusting relationships between CHWs, communities and other actors in the health system. This can contribute to enabling CHWs to perform well and responding to the opportunities offered by their unique intermediary position.

  11. 75 FR 6360 - Federal Advisory Committee; DoD Medicare-Eligible Retiree Health Care Board of Actuaries

    Science.gov (United States)

    2010-02-09

    ... Retiree Health Care Board of Actuaries AGENCY: Department of Defense (DoD). ACTION: Meeting notice... Actuaries will meet on August 18, 2010. Subject to the availability of space, the meeting is open to the...: Margot Kaplan at the DoD Office of the Actuary, 4040 N. Fairfax Drive, Suite 308, Arlington, VA 22203...

  12. COMMUNITY MEDICINE & PRIMARY HEALTH CARE

    African Journals Online (AJOL)

    the_monk

    rural Nigerian communities, out-of-pocket more than a stated percentage ... experience for final year medical students of A total of six hundred and eighty six (686) .... health centre were lack of money (55.2%), household income was not ...

  13. Identifying Value Indicators and Social Capital in Community Health Partnerships

    Science.gov (United States)

    Hausman, Alice J.; Becker, Julie; Brawer, Rickie

    2005-01-01

    Increasingly, public health practice is turning to the application of community collaborative models to improve population health status. Despite the growth of these activities, however, evaluations of the national demonstrations have indicated that community health partnerships fail to achieve measurable results and struggle to maintain integrity…

  14. Development, Implementation and Evaluation of an M3 Community Health Curriculum.

    Science.gov (United States)

    Beck, Barbra; Wolff, Marie; Bates, Tovah; Beverdorf, Sarah; Young, Staci; Ahmed, Syed

    2004-12-01

    This paper describes the development, implementation and evaluation of an M3 community health curriculum that responds to recent changes within the health care finance and delivery system. The new curriculum was developed based on AAMC recommendations, LCME requirements, a national review of undergraduate community health curricula, and an internal review of the integration of community health concepts in M3 clerkships. The M3 curriculum teaches: 1) the importance of being a community responsive physician; 2) SES factors that influence health; 3) cultural competency; and 4) the role of physicians as health educators. Student evaluations for the first twelve months of implementation indicate that students are most satisfied with presentations and less satisfied with required readings and a patient interview project. Most students agree that at the completion of the course they understand what it means to be a community-responsive physician, and they have developed skills to help them become more community responsive. Evaluation tools need to be developed to assess if students' behavior has changed due to course participation.

  15. Development, Implementation and Evaluation of an M3 Community Health Curriculum

    Directory of Open Access Journals (Sweden)

    Staci Young, MS

    2004-03-01

    Full Text Available Objectives: This paper describes the development, implementation and evaluation of an M3 community health curriculum that responds to recent changes within the health care finance and delivery system. Methods: The new curriculum was developed based on AAMC recommendations, LCME requirements, a national review of undergraduate community health curricula, and an internal review of the integration of community health concepts in M3 clerkships. Results: The M3 curriculum teaches: 1 the importance of being a community responsive physician; 2 SES factors that influence health; 3 cultural competency; and 4 the role of physicians as health educators. Student evaluations for the first twelve months of implementation indicate that students are most satisfied with presentations and less satisfied with required readings and a patient interview project. Discussion: Most students agree that at the completion of the course they understand what it means to be a community-responsive physician, and they have developed skills to help them become more community responsive. Evaluation tools need to be developed to assess if students’ behavior has changed due to course participation.

  16. Rural Embedded Assistants for Community Health (REACH) network: first-person accounts in a community-university partnership.

    Science.gov (United States)

    Brown, Louis D; Alter, Theodore R; Brown, Leigh Gordon; Corbin, Marilyn A; Flaherty-Craig, Claire; McPhail, Lindsay G; Nevel, Pauline; Shoop, Kimbra; Sterner, Glenn; Terndrup, Thomas E; Weaver, M Ellen

    2013-03-01

    Community research and action projects undertaken by community-university partnerships can lead to contextually appropriate and sustainable community improvements in rural and urban localities. However, effective implementation is challenging and prone to failure when poorly executed. The current paper seeks to inform rural community-university partnership practice through consideration of first-person accounts from five stakeholders in the Rural Embedded Assistants for Community Health (REACH) Network. The REACH Network is a unique community-university partnership aimed at improving rural health services by identifying, implementing, and evaluating innovative health interventions delivered by local caregivers. The first-person accounts provide an insider's perspective on the nature of collaboration. The unique perspectives identify three critical challenges facing the REACH Network: trust, coordination, and sustainability. Through consideration of the challenges, we identified several strategies for success. We hope readers can learn their own lessons when considering the details of our partnership's efforts to improve the delivery infrastructure for rural healthcare.

  17. Community mental health care worldwide: current status and further developments

    Science.gov (United States)

    Thornicroft, Graham; Deb, Tanya; Henderson, Claire

    2016-01-01

    This paper aims to give an overview of the key issues facing those who are in a position to influence the planning and provision of mental health systems, and who need to address questions of which staff, services and sectors to invest in, and for which patients. The paper considers in turn: a) definitions of community mental health care; b) a conceptual framework to use when evaluating the need for hospital and community mental health care; c) the potential for wider platforms, outside the health service, for mental health improvement, including schools and the workplace; d) data on how far community mental health services have been developed across different regions of the world; e) the need to develop in more detail models of community mental health services for low‐ and middle‐income countries which are directly based upon evidence for those countries; f) how to incorporate mental health practice within integrated models to identify and treat people with comorbid long‐term conditions; g) possible adverse effects of deinstitutionalization. We then present a series of ten recommendations for the future strengthening of health systems to support and treat people with mental illness. PMID:27717265

  18. Beyond access: the role of family and community in children's oral health.

    Science.gov (United States)

    Mouradian, Wendy E; Huebner, Colleen E; Ramos-Gomez, Francisco; Slavkin, Harold C

    2007-05-01

    Children's health outcomes result from the complex interaction of biological determinants with sociocultural, family, and community variables. Dental professionals' efforts to reduce oral health disparities often focus on improving access to dental care. However, this strategy alone cannot eliminate health disparities. Rising rates of early childhood caries create an urgent need to study family and community factors in oral health. Using Los Angeles as a multicultural laboratory for understanding health disparities, the Santa Fe Group convened an experiential conference to consider models of ensuring child and family health within communities. This article summarizes key conference themes and insights regarding 1) children's needs and societal priorities; 2) the science of child health determinants; 3) the rapidly changing demographics of the United States; and 4) the importance of communities that support children and families. Conference participants concluded that to eliminate children's oral health disparities we must change paradigms to promote health, integrate oral health into other health and social programs, and empower communities. Oral health advocates have a key role in ensuring oral health is integrated into policy for children. Dental schools have a leadership role to play in expanding community partnerships and providing education in health determinants. Participants recommended replicating this experiential conference in other venues.

  19. Tangible Evidence, Trust and Power: Public Perceptions of Community Environmental Health Studies

    Science.gov (United States)

    Scammell, Madeleine Kangsen; Senier, Laura; Darrah-Okike, Jennifer; Brown, Phil; Santos, Susan

    2009-01-01

    Communities with environmental health concerns in the USA frequently request studies from their local or state departments of public health. This paper presents findings from three focus groups conducted in communities north of Boston that have been the subject of two different environmental health studies. The focus groups were designed to elicit residents’ perceptions of environmental health, and of the particular studies conducted in their communities. In all focus groups, participants had difficulty accepting the findings of health studies that contradicted their own experiences of environmental exposures and illness. Our results suggest that lay knowledge, informed in varying degrees by the experience of what we term “tangible evidence,” creates a lens through which communities interpret a health study’s findings. The differences in reliance on tangible evidence were related to participants’ sense of trust in public officials, and the institutions responsible for conducting health studies. Participants from the wealthier, predominantly white communities discussed trust in study design and methodologies used. In contrast, participants from the lower income, higher minority communities assessed health studies with reference to their trust (or lack thereof) in study sponsors and public health institutions. Participants’ experience of tangible evidence, trust or distrust in health agencies and research institutions, and a sense of relative community power, influence how they assess the findings of environmental health studies and may have implications for pubic health. PMID:18995942

  20. Community participation in rural health: a scoping review

    Directory of Open Access Journals (Sweden)

    Kenny Amanda

    2013-02-01

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

  1. The process of community health nursing clinical clerkship: A grounded theory.

    Science.gov (United States)

    Ildarabadi, Eshagh; Karimi Moonaghi, Hossein; Heydari, Abbas; Taghipour, Ali

    2013-11-01

    The performance of the community health nurse depends on a combination of scientific and practical competencies acquired by educational experiences during the nursing course. Curriculum planners of nursing education need to understand nursing education to train professional and community-oriented nurses. The aim of this article is to explore the experiences of nursing students during their community health nursing clinical clerkship courses. A grounded theory approach was used to conduct this study. Twelve nursing students, 13 health-care staff members, and 10 nursing instructors were interviewed individually in 2011-2012. The interviews were tape-recorded and later transcribed verbatim. The transcriptions were analyzed using the method of Strauss and Corbin. AMBIVALENCE OF MOTIVATION WAS THE MAIN CATEGORY AND INCLUDED FIVE SUBCATEGORIES: Professional identity, educational atmosphere, educational management, motivation-based approaches, and inadequate productivity. This paper presents the aspects of the community health nursing clerkship course from the viewpoint of students in areas such as the role of the community health nurse, attitude toward the course, medical orientation, prerequisite skills/knowledge, poor administrative planning, rotation of students, insufficient activity for students, passiveness, providing service to clients, responsibility, and inproductivity. These categories could explain the nature of the community health nursing clerkship of the Mashhad Faculty of Nursing and probably others in Iran. The findings revealed inadequate productivity of the community health nursing education; so, it is suggested to define a position for nurses in this setting and remove barriers and provide conditions for them to play more important roles in the promotion of community health.

  2. Promoting Community Health Resources: Preferred Communication Strategies

    Science.gov (United States)

    Background: Community health promotion efforts involve communicating resource information to priority populations. Which communication strategies are most effective is largely unknown for specific populations. Objective: A random-dialed telephone survey was conducted to assess health resource comm...

  3. Community Context and Child Health: A Human Capital Perspective.

    Science.gov (United States)

    Smith-Greenaway, Emily

    2017-09-01

    Human capital theory suggests that education benefits individuals' and their children's health through the educational skills people acquire in school. This perspective may also be relevant at the community level: the greater presence of adults with educational skills in a community may be a reason why living in a more highly educated setting benefits health. I use Demographic and Health Survey data for 30 sub-Saharan African countries to investigate whether the percentage of literate adults-specifically women-in a community is associated with children's likelihood of survival. I characterize 13,785 African communities according to the prevalence of women who are literate. Multilevel discrete-time hazard models ( N = 536,781 children) confirm that living in a community where more women are literate is positively associated with child survival. The study supports the conceptualization of literacy, and potentially other educational skills, as forms of human capital that can spill over to benefit others.

  4. The Effect of an Interdisciplinary Community Health Project on Student Attitudes toward Community Health, People Who Are Indigent and Homeless, and Team Leadership Skill Development.

    Science.gov (United States)

    Rose, Molly A.; Lyons, Kevin J.; Miller, Kathleen Swenson; Cornman-Levy, Diane

    2003-01-01

    A study of 22 health occupations students examined whether participation in an interdisciplinary community health empowerment project with urban homeless and formerly homeless people changed their attitudes about community health practice, attitudes toward people who are indigent and homeless, and perceived leadership skills. Posttests revealed a…

  5. [Health vulnerability mapping in the Community of Madrid (Spain)].

    Science.gov (United States)

    Ramasco-Gutiérrez, Milagros; Heras-Mosteiro, Julio; Garabato-González, Sonsoles; Aránguez-Ruiz, Emiliano; Aguirre Martín-Gil, Ramón

    The Public Health General Directorate of Madrid has developed a health vulnerability mapping methodology to assist regional social health teams in health planning, prioritisation and intervention based on a model of social determinants of health and an equity approach. This process began with the selection of areas with the worst social indicators in health vulnerability. Then, key stakeholders of the region jointly identified priority areas of intervention and developed a consensual plan of action. We present the outcomes of this experience and its connection with theoretical models of asset-based community development, health-integrated georeferencing systems and community health interventions. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  6. Improving healthcare for Aboriginal Australians through effective engagement between community and health services.

    Science.gov (United States)

    Durey, Angela; McEvoy, Suzanne; Swift-Otero, Val; Taylor, Kate; Katzenellenbogen, Judith; Bessarab, Dawn

    2016-07-07

    Effectively addressing health disparities between Aboriginal and non-Aboriginal Australians is long overdue. Health services engaging Aboriginal communities in designing and delivering healthcare is one way to tackle the issue. This paper presents findings from evaluating a unique strategy of community engagement between local Aboriginal people and health providers across five districts in Perth, Western Australia. Local Aboriginal community members formed District Aboriginal Health Action Groups (DAHAGs) to collaborate with health providers in designing culturally-responsive healthcare. The purpose of the strategy was to improve local health service delivery for Aboriginal Australians. The evaluation aimed to identify whether the Aboriginal community considered the community engagement strategy effective in identifying their health service needs, translating them to action by local health services and increasing their trust in these health services. Participants were recruited using purposive sampling. Qualitative data was collected from Aboriginal participants and health service providers using semi-structured interviews or yarning circles that were recorded, transcribed and independently analysed by two senior non-Aboriginal researchers. Responses were coded for key themes, further analysed for similarities and differences between districts and cross-checked by the senior lead Aboriginal researcher to avoid bias and establish reliability in interpreting the data. Three ethics committees approved conducting the evaluation. Findings from 60 participants suggested the engagement process was effective: it was driven and owned by the Aboriginal community, captured a broad range of views and increased Aboriginal community participation in decisions about their healthcare. It built community capacity through regular community forums and established DAHAGs comprising local Aboriginal community members and health service representatives who met quarterly and were

  7. Answers to Health Questions: Internet Search Results Versus Online Health Community Responses.

    Science.gov (United States)

    Kanthawala, Shaheen; Vermeesch, Amber; Given, Barbara; Huh, Jina

    2016-04-28

    About 6 million people search for health information on the Internet each day in the United States. Both patients and caregivers search for information about prescribed courses of treatments, unanswered questions after a visit to their providers, or diet and exercise regimens. Past literature has indicated potential challenges around quality in health information available on the Internet. However, diverse information exists on the Internet-ranging from government-initiated webpages to personal blog pages. Yet we do not fully understand the strengths and weaknesses of different types of information available on the Internet. The objective of this research was to investigate the strengths and challenges of various types of health information available online and to suggest what information sources best fit various question types. We collected questions posted to and the responses they received from an online diabetes community and classified them according to Rothwell's classification of question types (fact, policy, or value questions). We selected 60 questions (20 each of fact, policy, and value) and the replies the questions received from the community. We then searched for responses to the same questions using a search engine and recorded the Community responses answered more questions than did search results overall. Search results were most effective in answering value questions and least effective in answering policy questions. Community responses answered questions across question types at an equivalent rate, but most answered policy questions and the least answered fact questions. Value questions were most answered by community responses, but some of these answers provided by the community were incorrect. Fact question search results were the most clinically valid. The Internet is a prevalent source of health information for people. The information quality people encounter online can have a large impact on them. We present what kinds of questions people ask

  8. Indigenous community based participatory research and health impact assessment: A Canadian example

    International Nuclear Information System (INIS)

    Kwiatkowski, Roy E.

    2011-01-01

    The Environmental Health Research Division (EHRD) of the First Nations and Inuit Health Branch, Health Canada conducts science-based activities and research with Canadian Indigenous communities in areas such as climate change adaptation, environmental contaminants, water quality, biomonitoring, risk assessment, health impact assessment, and food safety and nutrition. EHRD's research activities have been specifically designed to not only inform Health Canada's policy decision-makers but as well, Indigenous community decision-makers. This paper will discuss the reasons why Indigenous community engagement is important, what are some of the barriers preventing community engagement; and the efforts by EHRD to carry out community-based participatory research activities with Indigenous peoples.

  9. Stakeholders' perceptions of integrated community case management by community health workers: a post-intervention qualitative study.

    Directory of Open Access Journals (Sweden)

    Denise L Buchner

    Full Text Available Integrated community case management (iCCM involves delivery of simple medicines to children with pneumonia, diarrhea and/or malaria by community health workers (CHWs. Between 2010 and 2012, an iCCM intervention trial was implemented by Healthy Child Uganda. This study used qualitative tools to assess whether project stakeholders perceived that iCCM improved access to care for children under five years of age.The intervention involved training and equipping 196 CHWs in 98 study villages in one sub-county in Uganda in iCCM. During the eight-month intervention, CHWs assessed sick children, provided antimalarials (coartem for fever, antibiotics (amoxicillin for cough and fast breathing, oral rehydration salts/zinc for diarrhea, and referred very sick children to health facilities. In order to examine community perceptions and acceptability of iCCM, post-intervention focus groups and key respondent interviews involving caregivers, health workers, CHWs and local leaders were carried out by experienced facilitators using semi-structured interview guides. Data were analyzed using thematic analysis techniques.Respondents reported increased access to health care for children as a result of iCCM. Access was reportedly closer to home, available more hours in a day, and the availability of CHWs was perceived as more reliable. CHW care was reported to be trustworthy and caring. Families reported saving money especially due to reduced transportation costs, and less time away from home. Respondents also perceived better health outcomes. Linkages between health facilities and communities were reportedly improved by the iCCM intervention due to the presence of trained CHWs in the community.iCCM delivered by CHWs may improve access to health care and is acceptable to families. Policymakers should continue to seek opportunities to implement and support iCCM, particularly in remote communities where there are health worker shortages.

  10. How can a change in the operating system of the mental health review board promote the discharge of long-term hospitalized psychiatric patients? A case study of Seoul city.

    Science.gov (United States)

    Lee, Myung-Soo; Lim, Hee-Young; Kim, Youngki; Lee, Yong-Suk

    2014-01-01

    One of the most typical and chronic problem in Korean mental health system is the prolonged length of hospital stay. In contrast to there are many components which leads to long length of stay of psychiatric patients in Korean situation such as low and fixed medical fee for psychiatric inpatient treatment, shortage of community resources, lack of care-givers' awareness and so on, there are just few mechanisms to handle this issue such as Mental Health Review Board (MHRB) which is based on Mental Health Act since 1995. However, the discharge order rate was very low and there community care system after discharge order is still very weak. The Korean government has revised the Mental Health Act in 2008 and changed the operating principals of the MHRB from a regional level to a local level to strengthen the function of MHRB. However, the discharge order rate versus the whole evaluation requests still remains at a very low level or less than 5%. And it is still very difficult to execute a discharge order against a patient whose symptoms and conditions become psychiatrically stabilized enough for discharge, due to a shortage of community care facilities and a lack of social support system. These results are exactly same with former studies. Any policies to promote psychiatric discharge including MHRB are needed to take the comprehensive factors into consideration, such as payment program, community infrastructure, increasing care-givers' acceptance and so on. Despite of the political trial of Korean government to reduce length of stay of chronic psychiatric patients, it was not successful. Still it had failed to propose a detailed policy measure in terms of the above-mentioned prerequisites. Therefore, new system and program developments including reform of payment system which reflect prior studies' recommendations are essential.

  11. Significance of mental health legislation for successful primary care for mental health and community mental health services: A review

    Directory of Open Access Journals (Sweden)

    Getinet Ayano

    2018-03-01

    Conclusion: Mental health legislation plays a crucial role in community integration of persons with mental disorders, integration of mental health at primary health care, the provision of care of high quality and the improvement of access to care at community level. It is vital and essential to have MHL for every country.

  12. Case Study in Designing a Research Fundamentals Curriculum for Community Health Workers: A University - Community Clinic Collaborative

    Science.gov (United States)

    Dumbauld, Jill; Kalichman, Michael; Bell, Yvonne; Dagnino, Cynthia; Taras, Howard

    2014-01-01

    Introduction Community health workers are increasingly incorporated into research teams. Training them in research methodology and ethics, while relating these themes to a community’s characteristics, may help to better integrate these health promotion personnel into research teams. Approach and Strategies This pilot project involved the design and implementation of an interactive training course on research fundamentals for community health workers from clinics in a rural, predominately Latino setting. Curriculum development was guided by collaborative activities arising from a university - clinic partnership, a community member focus group, and the advice of community-based researchers. The resulting curriculum was interactive and stimulated dialogue between trainees and academic researchers. Discussion and Conclusions Collaboration between researchers and health agency professionals proved to be a practical method to develop curriculum for clinic staff. An interactive curriculum allowed trainees to incorporate community-specific themes into the discussion. This interaction educated course instructors from academia about the community as much as it educated course participants about research. The bidirectional engagement that occurs during the development and teaching of this course can potentially lead to research partnerships between community agencies and academia, better-informed members of the public, and research protocols that accommodate community characteristics. PMID:24121537

  13. Transforming community members into diabetes cultural health brokers: the Neighborhood Health Talker project.

    Science.gov (United States)

    Cadzow, Renee B; Craig, Mary; Rowe, Jimmy; Kahn, Linda S

    2013-01-01

    The purpose of this study was to evaluate a community-based diabetes education pilot project. The Neighborhood Health Talker project aimed to train and implement cultural health brokers primarily targeting communities of color to improve community members' diabetes knowledge and diabetes self-management skills. A secondary aim was to establish diabetes resource libraries accessible to communities that normally experience barriers to these resources. Recruited community members completed 1 week of formal training developed by a multidisciplinary team in Buffalo, NY. The effect of training was evaluated through the use of baseline surveys, a pretest/posttest covering all training content, and daily quizzes evaluating knowledge relevant to each of the five training modules. Trained NHTs then held at least five community conversations in various locations and administered anonymous postconversation surveys to participants. Descriptive statistics and qualitative analysis techniques were used to summarize test, quiz, and survey results. Twelve women and 1 man completed the training program. Working alone as well as in pairs, each held at least five community conversations reaching over 700 community members of all ages over 3 months and established 8 diabetes resource libraries in the community. All trainees increased their diabetes knowledge and confidence as well as their abilities to perform the tasks of a cultural health broker. Trainees also indicated that the goals they set at training initiation were met. The training was successful in increasing trainee knowledge and confidence about diabetes prevention and self-management. Participants not only developed proficiency in discussing diabetes, they also made important lifestyle changes that demonstrated their commitment to the cause and the project. Low-cost initiatives like this are easily reproducible in other communities of color and could be modified to meet the needs of other communities as well.

  14. Role of Nurses in Community Mental Health Centers: Example of England

    Directory of Open Access Journals (Sweden)

    Beyhan Bag

    2012-12-01

    Full Text Available The goal of the community mental health centers, which constitute the core of community based mental health service model, is to register the patients who live in a certain geographical region and have serious mental disorder in the center, to observe them regularly and to bring them back to community by providing their rehabilitation and treatment. The practice of community based mental health, which English health service carries out in one hand for the psychiatry patients’ treatment and care, has many benefits, such as minimizing the sequence of going to hospital. The community mental health nurse, who works as an incidence manager, takes on the responsibility of treatment and care of the patient in the place where he/she lives, and the directly protective effect of this responsibility is an unquestionable fact. With this practice, the process of taking cure in hospital and the cost of treatment and care decrease. In our country, this sub-field of psychiatry is still in its incipient stage. Being familiar with the successful model practices in different countries may constitute a good model for the community mental health nursing practices which are on the first level in our country. For this purpose, the role of the nurses who work for the community mental health service in England is presented in this study.

  15. The Community Mental Health Center as a Matrix Organization.

    Science.gov (United States)

    White, Stephen L.

    1978-01-01

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

  16. Perceptions of community participation and health gain in a community project for the South Asian population: a qualitative study.

    Science.gov (United States)

    Bandesha, G; Litva, A

    2005-09-01

    The new public health rejects old individualist attempts at improving health and embraces community-based approaches in reducing health inequalities. Primary Care Trusts in England face the challenge of converting community participation in health into reality. This study explores differences in perception of participation between lay and professional stakeholders of a community health project for a South Asian population in Greater Manchester. In-depth interviews and focus groups were used to explore the views of professional and lay stakeholders. All data were audio-taped, transcribed and analysed for emerging themes using a qualitative framework. Professionals talked of working in partnership with the community but lay stakeholders did not feel that they had control over the project. There were problems in engaging the community and local health professionals in the project. Lack of cultural awareness hampered participation in the project. There was agreement that the project improved the self-confidence of participants and created a more informed population. However, there was little support for claims of improvements in social cohesion and changes in lifestyle directly as a result of the project. Converting the rhetoric of community participation in health into reality is a greater challenge than was envisaged by policy makers. Marginalized communities may not be willing participants and issues of language and cultural sensitivity are important. Project outcomes need to be agreed to ensure projects are evaluated appropriately. Projects with South Asian communities should not be seen to be dealing with all 'ethnic health' issues without addressing changes in statutory organizations and other wider social determinants of health.

  17. A community health worker-led lifestyle behavior intervention for Latina (Hispanic) women: feasibility and outcomes of a randomized controlled trial.

    Science.gov (United States)

    Koniak-Griffin, Deborah; Brecht, Mary-Lynn; Takayanagi, Sumiko; Villegas, Juan; Melendrez, Marylee; Balcázar, Héctor

    2015-01-01

    Low-income Latinas (Hispanics) face risk for cardiovascular disease due to high rates of overweight/obesity, sedentary lifestyle, and other factors. Limited access to health care and language barriers may prevent delivery of health promotion messages. Targeted approaches, including the integration of community health workers, may be required to promote healthy lifestyle and prevent chronic disease in underserved ethnic minority groups. The term commonly used to refer to female community health workers in Latino communities is "promotora(s)." This study evaluates the outcomes and feasibility of a promotora-led lifestyle behavior intervention for overweight, immigrant Latinas. A community prevention model was employed in planning and implementing this study. A randomized controlled trial design was used. A Community Advisory Board provided expertise in evaluating feasibility of study implementation in the community and other important guidance. The sample was comprised of 223 women aged 35-64 years, predominantly with low income and ≤8th grade education. The culturally tailored Lifestyle Behavior Intervention included group education (8 classes based upon Su Corazon, Su Vida), followed by 4 months of individual teaching and coaching (home visits and telephone calls). The control group received a comparable length educational program and follow-up contacts. Evaluations were conducted at baseline and at 6 and 9 months using a dietary habits questionnaire, accelerometer readings of physical activity, and clinical measures (body mass index, weight, waist circumference, blood pressure, lipids, blood glucose). Data were collected between January 2010 and August 2012. Women in the intervention group improved significantly in dietary habits, waist circumference, and physical activity in comparison to those in the control group. A treatment dosage effect was observed for weight and waist circumference. Knowledge about heart disease increased. High attendance at classes and

  18. Health journalists' perceptions of their communities and implications for the delivery of health information in the news.

    Science.gov (United States)

    Friedman, Daniela B; Tanner, Andrea; Rose, India D

    2014-04-01

    Journalists have a unique opportunity to educate the community about public health and health care. In order for health communication messages to be effective, characteristics of the intended audience must be considered. Limited attention has been given to health journalists' perceptions of their target communities and little is known about how journalists' perceptions may impact the delivery of health information in the news. Fifteen in-depth telephone interviews were conducted with health journalists from varying geographic regions and media market sizes. Interview questions examined health journalists' perceptions of their target communities, the content and delivery of their health-related stories, and the current state of health journalism. Interviews were audio-recorded for transcription and thematic analysis. Health journalists perceived their audiences to be primarily mothers and adults with limited education. Participants reported they often used personal stories and strong headlines to engage their communities. They also stated that their news stories were quite technical and may not have been written at an appropriate reading level for their audience. When asked about the current state of health journalism, participants reported that there were areas for improvement. Journalists stated that increased collaborations with public health practitioners would improve their own understanding of health and medical information and allow them to develop health news content that was more appropriate for their target communities.

  19. Violent Extremism, Community-Based Violence Prevention, and Mental Health Professionals.

    Science.gov (United States)

    Weine, Stevan M; Stone, Andrew; Saeed, Aliya; Shanfield, Stephen; Beahrs, John; Gutman, Alisa; Mihajlovic, Aida

    2017-01-01

    New community-based initiatives being developed to address violent extremism in the United States are utilizing mental health services and leadership. This article reviews current approaches to preventing violent extremism, the contribution that mental illness and psychosocial problems can make to violent extremism, and the rationale for integrating mental health strategies into preventing violent extremism. The authors describe a community-based targeted violence prevention model and the potential roles of mental health professionals. This model consists of a multidisciplinary team that assesses at-risk individuals with comprehensive threat and behavioral evaluations, arranges for ongoing support and treatment, conducts follow-up evaluations, and offers outreach, education, and resources for communities. This model would enable mental health professionals in local communities to play key roles in preventing violent extremism through their practice and leadership.

  20. Results of the Community Health Applied Research Network (CHARN) National Research Capacity Survey of Community Health Centers.

    Science.gov (United States)

    Song, Hui; Li, Vivian; Gillespie, Suzanne; Laws, Reesa; Massimino, Stefan; Nelson, Christine; Singal, Robbie; Wagaw, Fikirte; Jester, Michelle; Weir, Rosy Chang

    2015-01-01

    The mission of the Community Health Applied Research Network (CHARN) is to build capacity to carry out Patient-Centered Outcomes Research at community health centers (CHCs), with the ultimate goal to improve health care for vulnerable populations. The CHARN Needs Assessment Staff Survey investigates CHCs' involvement in research, as well as their need for research training and resources. Results will be used to guide future training. The survey was developed and implemented in partnership with CHARN CHCs. Data were collected across CHARN CHCs. Data analysis and reports were conducted by the CHARN data coordinating center (DCC). Survey results highlighted gaps in staff research training, and these gaps varied by staff role. There is considerable variation in research involvement, partnerships, and focus both within and across CHCs. Development of training programs to increase research capacity should be tailored to address the specific needs and roles of staff involved in research.

  1. Perspectives on utilization of community based health information systems in Western Kenya.

    Science.gov (United States)

    Flora, Otieno Careena; Margaret, Kaseje; Dan, Kaseje

    2017-01-01

    Health information systems (HIS) are considered fundamental for the efficient delivery of high quality health care. However, a large number of legal and practical constraints influence the design and introduction of such systems. The inability to quantify and analyse situations with credible data and to use data in planning and managing service delivery plagues Africa. Establishing effective information systems and using this data for planning efficient health service delivery is essential to district health systems' performance improvement. Community Health Units in Kenya are central points for community data collection, analysis, dissemination and use. In Kenya, data tend to be collected for reporting purposes and not for decision-making at the point of collection. This paper describes the perspectives of local users on information use in various socio-economic contexts in Kenya. Information for this study was gathered through semi-structured interviews. The interviewees were purposefully selected from various community health units and public health facilities in the study area. The data were organized and analysed manually, grouping them into themes and categories. Information needs of the community included service utilization and health status information. Dialogue was the main way of information utilization in the community. However, health systems and personal challenges impeded proper collection and use of information. The challenges experienced in health information utilization may be overcome by linkages and coordination between the community and the health facilities. The personal challenges can be remedied using a motivational package that includes training of the Community Health Workers.

  2. Rural Mental Health Ecology: A Framework for Engaging with Mental Health Social Capital in Rural Communities.

    Science.gov (United States)

    Wilson, Rhonda L; Wilson, G Glenn; Usher, Kim

    2015-09-01

    The mental health of people in rural communities is influenced by the robustness of the mental health ecosystem within each community. Theoretical approaches such as social ecology and social capital are useful when applied to the practical context of promoting environmental conditions which maximise mental health helping capital to enhance resilience and reduce vulnerably as a buffer for mental illness. This paper explores the ecological conditions that affect the mental health and illness of people in rural communities. It proposes a new mental health social ecology framework that makes full use of the locally available unique social capital that is sufficiently flexible to facilitate mental health helping capital best suited to mental health service delivery for rural people in an Australian context.

  3. 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.

  4. [Local health systems. Moral rationality of community decisions].

    Science.gov (United States)

    Tealdi, J C

    1990-01-01

    The author examines the points of convergence between local health systems and bioethics in three basic areas: structural or institutional, methodological or justificatory, and regulatory or normative. Comparisons are drawn between the decentralization of the health system posed by local health systems and deconcentration of the power vested in multidisciplinary ethics committees; the strategy of social participation and the movement in the United States of community decision-making in the area of health; and the basic concepts of primary health care and the principle of justice. The theories of Pellegrino and Thomasma on the philosophic bases for medical practice provide the framework of this comparative analysis. The article concludes with a call for a local health systems-bioethical nexus in which this discipline can provide the basis for infusing an ethical component into participatory planning and community decision-making.

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

    Centers for Disease Control (CDC) Podcasts

    2006-01-01

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

  6. Surviving neoliberalism, maintaining values: Community health mergers in Victoria, Australia.

    Science.gov (United States)

    Roussy, Véronique; Livingstone, Charles

    2018-04-01

    Independent, not-for-profit community health services in the state of Victoria, Australia, provide one of that country's few models of comprehensive primary health care (PHC). Recent amalgamations among some such agencies created regional-sized community health organisations, in a departure from this sector's traditionally small local structure. This study explored the motivations, desired outcomes, and decision-making process behind these mergers. Qualitative exploratory study was based on 26 semistructured interviews with key informants associated with 2 community health mergers, which took place in 2014 in Victoria, Australia. Thematic data analysis was influenced by concepts derived from institutional theory. Becoming bigger by merging was viewed as the best way to respond to mounting external pressures, such as increasingly neoliberal funding mechanisms, perceived as threatening survival. Desired outcomes were driven by comprehensive PHC values, and related to creating organisational capacity to continue providing quality services to disadvantaged communities. This study offers insights into decision-making processes geared towards protecting the comprehensiveness of PHC service delivery for disadvantaged communities, ensuring financial viability, and surviving neoliberal economic policy whilst preserving communitarian values. These are relevant to an international audience, within a global context of rising health inequities, increasingly tight fiscal environments, and growing neoliberal influences on health policymaking and funding. Copyright © 2018 John Wiley & Sons, Ltd.

  7. Geography of community health information organization activity in the United States: Implications for the effectiveness of health information exchange.

    Science.gov (United States)

    Vest, Joshua R

    The United States has invested nearly a billion dollars in creating community health information organizations (HIOs) to foster health information exchange. Community HIOs provide exchange services to health care organizations within a distinct geographic area. While geography is a key organizing principle for community HIOs, it is unclear if geography is an effective method for organization or what challenges are created by a geography-based approach to health information exchange. This study describes the extent of reported community HIO coverage in the United States and explores the practical and policy implications of overlaps and gaps in HIO service areas. Furthermore, because self-reported service areas may not accurately reflect the true extent of HIOs activities, this study maps the actual markets for health services included in each HIO. An inventory of operational community HIOs that included self-reported geographic markets and participating organizations was face-validated using a crowd-sourcing approach. Aggregation of the participating hospitals' individual health care markets provided the total geographic market served by each community HIO. Mapping and overlay analyses using geographic information system methods described the extent of community HIO activity in the United States. Evidence suggests that community HIOs may be inefficiently distributed. Parts of the United States have multiple, overlapping HIOs, while others do not have any providing health information exchange services. In markets served by multiple community HIOs, 45% of hospitals were participants of only one HIO. The current geography of community HIO activity does not provide comprehensive patient information to providers, nor community-wide information for public health agencies. The discord between the self-reported and market geography of community HIOs raises concerns about the potential effectiveness of health information exchange, illustrates the limitations of geography as

  8. Community health needs assessment with precede-proceed model: a mixed methods study

    Directory of Open Access Journals (Sweden)

    Wang Yang

    2009-10-01

    Full Text Available Abstract Background Community health services in China have developed over the last few decades. In order to use limited health resources more effectively, we conducted a community health needs assessment. This aimed to provide an understanding of the community's health problems and the range of potential factors affecting risk behaviours for the priority health problems. Methods We used the precede-proceed model for the needs assessment. Triangulation of data, methods and researchers were employed in data collection. Results Main findings include: cardiovascular diseases (CVDs were identified as the priority health problems in the study communities; risk factors associated with CVDs included smoking, physical inactivity and unhealthy eating behaviours, particularly amongst male residents with low education level; factors negatively affecting behaviours were classified into predisposing factors (limited knowledge, beliefs and lack of perceived needs, enabling factors (limited access to health promotion activities, unawareness of health promotion, lack of work-site and school health promotion, absence of health promotion related policy and reinforcing factors (culture. Policies and organization were not perfect; there were limited staff skilled in providing health promotion in the community. Conclusion CVDs were identified by the communities as priority health problems. Future health programs should focus on smoking, physical inactivity and unhealthy eating behaviours. Behaviour change strategies should take predisposing factors, enabling factors and reinforcing factors into consideration. Policies, organization and human resource need strengthening.

  9. Data governance and data sharing agreements for community-wide health information exchange: lessons from the beacon communities.

    Science.gov (United States)

    Allen, Claudia; Des Jardins, Terrisca R; Heider, Arvela; Lyman, Kristin A; McWilliams, Lee; Rein, Alison L; Schachter, Abigail A; Singh, Ranjit; Sorondo, Barbara; Topper, Joan; Turske, Scott A

    2014-01-01

    Unprecedented efforts are underway across the United States to electronically capture and exchange health information to improve health care and population health, and reduce costs. This increased collection and sharing of electronic patient data raises several governance issues, including privacy, security, liability, and market competition. Those engaged in such efforts have had to develop data sharing agreements (DSAs) among entities involved in information exchange, many of whom are "nontraditional" health care entities and/or new partners. This paper shares lessons learned based on the experiences of six federally funded communities participating in the Beacon Community Cooperative Agreement Program, and offers guidance for navigating data governance issues and developing DSAs to facilitate community-wide health information exchange. While all entities involved in electronic data sharing must address governance issues and create DSAs accordingly, until recently little formal guidance existed for doing so - particularly for community-based initiatives. Despite this lack of guidance, together the Beacon Communities' experiences highlight promising strategies for navigating complex governance issues, which may be useful to other entities or communities initiating information exchange efforts to support delivery system transformation. For the past three years, AcademyHealth has provided technical assistance to most of the 17 Beacon Communities, 6 of whom contributed to this collaborative writing effort. Though these communities varied widely in terms of their demographics, resources, and Beacon-driven priorities, common themes emerged as they described their approaches to data governance and DSA development. The 6 Beacon Communities confirmed that DSAs are necessary to satisfy legal and market-based concerns, and they identified several specific issues, many of which have been noted by others involved in network data sharing initiatives. More importantly, these

  10. Evaluation of health resource utilization efficiency in community health centers of Jiangsu Province, China.

    Science.gov (United States)

    Xu, Xinglong; Zhou, Lulin; Antwi, Henry Asante; Chen, Xi

    2018-02-20

    While the demand for health services keep escalating at the grass roots or rural areas of China, a substantial portion of healthcare resources remain stagnant in the more developed cities and this has entrenched health inequity in many parts of China. At its conception, China's Deepen Medical Reform started in 2012 was intended to flush out possible disparities and promote a more equitable and efficient distribution of healthcare resources. Nearly half a decade of this reform, there are uncertainties as to whether the attainment of the objectives of the reform is in sight. Using a hybrid of panel data analysis and an augmented data envelopment analysis (DEA), we model human resources, material, finance to determine their technical and scale efficiency to comprehensively evaluate the transverse and longitudinal allocation efficiency of community health resources in Jiangsu Province. We observed that the Deepen Medical Reform in China has led to an increase concern to ensure efficient allocation of community health resources by health policy makers in the province. This has led to greater efficiency in health resource allocation in Jiangsu in general but serious regional or municipal disparities still exist. Using the DEA model, we note that the output from the Community Health Centers does not commensurate with the substantial resources (human resources, materials, and financial) invested in them. We further observe that the case is worst in less-developed Northern parts of Jiangsu Province. The government of Jiangsu Province could improve the efficiency of health resource allocation by improving the community health service system, rationalizing the allocation of health personnel, optimizing the allocation of material resources, and enhancing the level of health of financial resource allocation.

  11. The Effects of School Board Consolidation and Financing on Student Performance

    Science.gov (United States)

    Leach, John; Payne, A. Abigail; Chan, Steve

    2010-01-01

    Over the last 20 years, states and provinces have become increasingly involved in the financing and administration of elementary and secondary education. Local school boards, however, still retain control over key aspects of the provision of education. Historically, these boards were organized at the community level so as to meet the wants of the…

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

    Directory of Open Access Journals (Sweden)

    Collins Otieno Asweto

    2016-02-01

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

  13. Promoting social responsibility for health: health impact assessment and healthy public policy at the community level.

    Science.gov (United States)

    Mittelmark, M B

    2001-09-01

    The 1997 Jakarta Declaration on Health Promotion into the 21st Century called for new responses to address the emerging threats to health. The declaration placed a high priority on promoting social responsibility for health, and it identified equity-focused health impact assessment as a high priority for action. This theme was among the foci at the 2000 Fifth Global Conference on Health Promotion held in Mexico. This paper, which is an abbreviation of a technical report prepared for the Mexico conference, advances arguments for focusing on health impact assessment at the local level. Health impact assessment identifies negative health impacts that call for policy responses, and identifies and encourages practices and policies that promote health. Health impact assessment may be highly technical and require sophisticated technology and expertise. But it can also be a simple, highly practical process, accessible to ordinary people, and one that helps a community come to grips with local circumstances that need changing for better health. To illustrate the possibilities, this paper presents a case study, the People Assessing Their Health (PATH) project from Eastern Nova Scotia, Canada. It places ordinary citizens, rather than community elites, at the very heart of local decision-making. Evidence from PATH demonstrates that low technology health impact assessment, done by and for local people, can shift thinking beyond the illness problems of individuals. It can bring into consideration, instead, how programmes and policies support or weaken community health, and illuminate a community's capacity to improve local circumstances for better health. This stands in contrast to evidence that highly technological approaches to community-level health impact assessment can be self-defeating. Further development of simple, people-centred, low technology approaches to health impact assessment at the local level is called for.

  14. [Community-based health promotion--a challenge for the evaluation].

    Science.gov (United States)

    Loss, J; Eichhorn, C; Gehlert, J; Donhauser, J; Wise, M; Nagel, E

    2007-02-01

    Community-based health promotion (CBHP) aims at mobilising citizens for health-related issues in their environment, and at implementing health-promoting projects on the community level. Whereas recent political decisions support this approach, scientific studies dealing with theories and consequences of CBHP are scarce in Germany. Evaluation of CBHP could help identify (in)effective factors and elements of community programmes and thus improve future planning. In Germany, however, there is a deficit in systematic concepts and recommendations for the evaluation of CBHP. This work outlines basic ideas and core principles of CBHP and deduces implications for the assessment of health-promoting community projects. Based on different international models and studies and on discussions with health promotion professionals, we developed a framework for the evaluation of CBHP. The proposed framework includes a guideline for CBHP programme planning. Its strategic and operational criteria can serve as a basis for a strategy evaluation. In terms of process evaluation, indicators for the dimensions (1) programme implementation and service delivery, (2) capacity building, and (3) reach of and acceptability in the target group were developed. In addition, we present different areas of OUTCOME EVALUATION; it is advisable to distinguish between measurement on the individual and on the community level. The framework further proposes strategies for the evaluation of the core principles empowerment and participation. The presented framework can serve as a basis for the development of flexible and individual instruments for the evaluation of CBHP, which should not ignore the perspective of the citizens, or complex aspects like changes on the community level. Some aspects, e.g., the potential evaluation of further targets of CBHP (improvement of quality of life, reduction of social and health inequalities), the responsibility of evaluation or the effects of financial constraints, are

  15. Community health workers in Lesotho: Experiences of health promotion activities.

    Science.gov (United States)

    Seutloali, Thato; Napoles, Lizeka; Bam, Nomonde

    2018-02-27

    Lesotho adopted primary health care in 1979, and community health workers (CHWs) were included in the programme to focus on health promotion, particularly to reach people in underserved rural areas. Although the CHW programme has been successful, the heavy burden of disease because of HIV and/or AIDS and tuberculosis shifted resources from health promotion to home-based care. The study explored the lived experience of CHWs in conducting health promotion activities in Lesotho. The study was conducted in four health centres in Berea district, Lesotho. A qualitative study was conducted using an interviewer guide translated from English into Sesotho for four CHW focus group discussions, four individual interviews of key informants and four semi-structured interviews with the health centre nurses. The roles of CHWs in health promotion ranged from offering basic first aid and home-based care to increasing access to health care services by taking patients to the facilities and promoting behaviour change through health education. Their perceived successes included increased access to health care services and reduced mortality rates. CHW challenges involved their demotivation to carry out their work because of lack of or inconsistent financial incentives and supplies, work overload which compromises quality of their work and limited community involvement. This study concludes that CHWs are beneficial to health promotion and its various activities. They had a clear understanding of their roles and responsibilities, although they did not fully comprehend that what they were describing was, in fact, health promotion. When it came to advocacy, CHWs did not fully understand it, nor did they consider it as part of their roles, although they acknowledged its importance. Their role of increasing access to health care services by accompanying patients to the facilities has increased considerably because of changes in disease burden. This is affecting their ability to practise other

  16. Covariation in community- and individual-based community capacity and health behavior: a multilevel analysis of populations in Seoul, South Korea.

    Science.gov (United States)

    Jung, Minsoo

    2012-01-01

    Community capacity is defined as the degree to which the human, physical, and potential resources of a neighborhood are organized based on mutual solidarity among the residents. The aim of this study was to elucidate the relationship between community capacity and health behaviors in Seoul, South Korea. Multilevel models controlling for socioeconomic variables were used to measure the association between community capacity and health behaviors in 25 districts and 404 subdistricts (n = 14 228). Community capacity was determined to be significant at the more local community level, as it was a significant variable in the subdistrict analysis for explaining health behaviors such as smoking, drinking, and exercising. Community capacity exists not only at the individual level but also at the community level. High community capacity further enhanced the positive effects of individual capacity on health behavior and further weakened the negative effects.

  17. Transitioning from learning healthcare systems to learning health care communities.

    Science.gov (United States)

    Mullins, C Daniel; Wingate, La'Marcus T; Edwards, Hillary A; Tofade, Toyin; Wutoh, Anthony

    2018-02-26

    The learning healthcare system (LHS) model framework has three core, foundational components. These include an infrastructure for health-related data capture, care improvement targets and a supportive policy environment. Despite progress in advancing and implementing LHS approaches, low levels of participation from patients and the public have hampered the transformational potential of the LHS model. An enhanced vision of a community-engaged LHS redesign would focus on the provision of health care from the patient and community perspective to complement the healthcare system as the entity that provides the environment for care. Addressing the LHS framework implementation challenges and utilizing community levers are requisite components of a learning health care community model, version two of the LHS archetype.

  18. Improving Health with Science: Exploring Community-Driven Science Education in Kenya

    Science.gov (United States)

    Leak, Anne Emerson

    This study examines the role of place-based science education in fostering student-driven health interventions. While literature shows the need to connect science with students' place and community, there is limited understanding of strategies for doing so. Making such connections is important for underrepresented students who tend to perceive learning science in school as disconnected to their experiences out of school (Aikenhead, Calabrese-Barton, & Chinn, 2006). To better understand how students can learn to connect place and community with science and engineering practices in a village in Kenya, I worked with community leaders, teachers, and students to develop and study an education program (a school-based health club) with the goal of improving knowledge of health and sanitation in a Kenyan village. While students selected the health topics and problems they hoped to address through participating in the club, the topics were taught with a focus on providing opportunities for students to learn the practices of science and health applications of these practices. Students learned chemistry, physics, environmental science, and engineering to help them address the health problems they had identified in their community. Surveys, student artifacts, ethnographic field notes, and interview data from six months of field research were used to examine the following questions: (1) In what ways were learning opportunities planned for using science and engineering practices to improve community health? (2) In what ways did students apply science and engineering practices and knowledge learned from the health club in their school, homes, and community? and (3) What factors seemed to influence whether students applied or intended to apply what they learned in the health club? Drawing on place-based science education theory and community-engagement models of health, process and structural coding (Saldana, 2013) were used to determine patterns in students' applications of their

  19. `Whose Shoes?` Can an educational board game engage Ugandan men in pregnancy and childbirth?

    Science.gov (United States)

    Ladur, Alice Norah; van Teijlingen, Edwin; Hundley, Vanora

    2018-03-27

    Men can play a significant role in reducing maternal morbidity and mortality in low-income countries. Maternal health programmes are increasingly looking for innovative interventions to engage men to help improve health outcomes for pregnant women. Educational board games offer a unique approach to present health information where learning is reinforced through group discussions supporting peer-to-peer interactions. A qualitative study with men from Uganda currently living in the UK on their views of an educational board game. Men were purposively sampled to play a board game and participate in a focus group discussion. The pilot study explored perceptions on whether a board game was relevant as a health promotional tool in maternal health prior to implementation in Uganda. The results of the pilot study were promising; participants reported the use of visual aids and messages were easy to understand and enhanced change in perspective. Men in this study were receptive on the use of board games as a health promotional tool and recommended its use in rural Uganda. This study provides preliminary data on the relevancy and efficacy of using board games in maternal health. Key messages from the focus group appeared to be that the board game is more than acceptable to fathers and that it needs to be adapted to the local context to make it suitable for men in rural Uganda.

  20. Assessing Community Leadership: Understanding Community Capacity for Health Improvement.

    Science.gov (United States)

    Castle, Billie; Wendel, Monica; Kelly Pryor, Brandy N; Ingram, Monique

    The purpose of this study was to pilot a quantitative instrument to measure aspects of community leadership within an assessment framework. The instrument includes 14 Likert-type questions asking residents how they perceive leaders within 5 sectors: Louisville Metro Council/Mayor's Office, the faith community, education, business, and the civic sector. Louisville/Jefferson County, Kentucky, has a population of about 743 000 residents. Respondents were asked to examine leadership within West Louisville, an economically deprived area of the city made up of 9 contiguous neighborhoods. This area is predominantly African American (78% compared with 22% in Louisville Metro), with an overall poverty rate of 43% (compared with 18% in Louisville Metro), and unemployment rate of 23% (compared with 8% in Louisville Metro). Residents of West Louisville are looking to leadership to address many of the inequities. Twenty-seven participants representing 7 community sectors completed the survey, of whom 90% work in West Louisville. The instrument measured local perceptions of leadership strength, effectiveness, trust, communication, community building, and leadership development. The majority of respondents agree that strong leadership exists across the 5 sectors, with variation regarding perceptions of the quality of that leadership. City leadership within the Mayor's Office and Metro Council is largely viewed positively, while the growing tensions within the education sector were reflected in the survey results. The perception of community leadership is important to understanding local community capacity to improve health and also inclusivity of community voice in the assessment and community improvement processes. Results from such assessments can offer useful information for strengthening community capacity and sustaining relationships needed to enact progressive and equitable solutions to address local issues. Leaders in a variety of settings can utilize this instrument to

  1. Health and health-related indicators in slum, rural, and urban communities: a comparative analysis.

    Science.gov (United States)

    Mberu, Blessing U; Haregu, Tilahun Nigatu; Kyobutungi, Catherine; Ezeh, Alex C

    2016-01-01

    It is generally assumed that urban slum residents have worse health status when compared with other urban populations, but better health status than their rural counterparts. This belief/assumption is often because of their physical proximity and assumed better access to health care services in urban areas. However, a few recent studies have cast doubt on this belief. Whether slum dwellers are better off, similar to, or worse off as compared with rural and other urban populations remain poorly understood as indicators for slum dwellers are generally hidden in urban averages. The aim of this study was to compare health and health-related indicators among slum, rural, and other urban populations in four countries where specific efforts have been made to generate health indicators specific to slum populations. We conducted a comparative analysis of health indicators among slums, non-slums, and all urban and rural populations as well as national averages in Bangladesh, Kenya, Egypt, and India. We triangulated data from demographic and health surveys, urban health surveys, and special cross-sectional slum surveys in these countries to assess differences in health indicators across the residential domains. We focused the comparisons on child health, maternal health, reproductive health, access to health services, and HIV/AIDS indicators. Within each country, we compared indicators for slums with non-slum, city/urban averages, rural, and national indicators. Between-country differences were also highlighted. In all the countries, except India, slum children had much poorer health outcomes than children in all other residential domains, including those in rural areas. Childhood illnesses and malnutrition were higher among children living in slum communities compared to those living elsewhere. Although treatment seeking was better among slum children as compared with those in rural areas, this did not translate to better mortality outcomes. They bear a disproportionately

  2. Community-Based Management of Diabetes in Nepal: Exploring the Potential Role of Female Community Health Volunteers

    DEFF Research Database (Denmark)

    Gyawali, Bishal

    2016-01-01

    , and this is particularly apparent in the South Asian countries, including Nepal. Despite the growing burden and chronic nature of type 2 diabetes, prevention and control of this disease is far from adequate in these settings. One possibility could be through the involvement of community health workers to prevent, diagnose...... and treat type 2 diabetes. We suggest that involving Female Community Health Volunteers (FCHVs) of Nepal offering culturally appropriate health promotion may be the blue print for community-based management programmes tackling type 2 diabetes. We aim to explore the potential role of FCHVs of Nepal...... for diabetes management at community level. It is anticipated that the study can give valuable information regarding effectiveness, acceptability, and feasibility of an innovative way to improve diabetes management in low resource settings....

  3. Community Advisory Boards Guiding Engaged Research Efforts within a Clinical Translational Sciences Award: Key Contextual Factors Explored.

    Science.gov (United States)

    Halladay, Jacqueline R; Donahue, Katrina E; Sleath, Betsy; Reuland, Dan; Black, Adina; Mitchell, C Madeline; Breland, Carol E; Coyne-Beasley, Tamera; Mottus, Kathleen; Watson, Sable Noelle; Lewis, Virginia; Wynn, Mysha; Corbie-Smith, Giselle

    2017-01-01

    Engaging stakeholders in research carries the promise of enhancing the research relevance, transparency, and speed of getting findings into practice. By describing the context and functional aspects of stakeholder groups, like those working as community advisory boards (CABs), others can learn from these experiences and operationalize their own CABs. Our objective is to describe our experiences with diverse CABs affiliated with our community engagement group within our institution's Clinical Translational Sciences Award (CTSA). We identify key contextual elements that are important to administering CABs. A group of investigators, staff, and community members engaged in a 6-month collaboration to describe their experiences of working with six research CABs. We identified the key contextual domains that illustrate how CABS are developed and sustained. Two lead authors, with experience with CABs and identifying contextual domains in other work, led a team of 13 through the process. Additionally, we devised a list of key tips to consider when devising CABs. The final domains include (1) aligned missions among stakeholders (2) resources/support, (3) defined operational processes/shared power, (4) well-described member roles, and (5) understanding and mitigating challenges. The tips are a set of actions that support the domains. Identifying key contextual domains was relatively easy, despite differences in the respective CAB's condition of focus, overall mission, or patient demographics represented. By contextualizing these five domains, other research and community partners can take an informed approach to move forward with CAB planning and engaged research.

  4. Community Based Health Insurance Knowledge and Willingness to ...

    African Journals Online (AJOL)

    Community Based Health Insurance Knowledge and Willingness to Pay; A Survey of a Rural Community in ... Journal Home > Vol 6, No 1 (2012) > ... and is the most appropriate insurance model for rural areas where incomes are unstable.

  5. Best practices in community-oriented health professions education: international exemplars.

    Science.gov (United States)

    Richards, R W

    2001-01-01

    During 1998-2000, an international team of five researchers described nine innovative health professions education programmes as selected by The Network: Community Partnerships for Health through Innovative Education, Service, and Research. Each researcher visited one or two schools. Criteria for selection of these nine schools included commitment to multidisciplinary and community-based education, longitudinal community placements, formal linkages with government entities and a structured approach to community participation. The purpose of these descriptions was to identify key issues in designing and implementing community-based education. Programmes in Chile, Cuba, Egypt, India, the Philippines, South Africa, Sudan, Sweden and the United States were visited. Before site visits were conducted, the researchers as a group agreed upon the elements to be described. Elements included overall institutional characteristics, curriculum, admissions practices, evaluation systems, research, service, community involvement, faculty development, postgraduate programmes and the school's relationship with government entities. Here I describe the common features of each of the nine programmes, their shared dilemmas and how each went about balancing the teaching of clinical competence and population perspectives. Based upon an analysis of the cases, I present seven "lessons learned" as well as a discussion of programme development, institutionalization of reform and long-term implications for health professions education. The seven lessons are: (1) PBL and CBE are not seen as independent curricular reforms; (2) student activities are determined based upon sensitivity to locale; (3) health professionals need to work collaboratively; (4) there is a connection between personal health and population health issues; (5) population health interventions and treatment strategies need to be appropriate to local conditions; (6) graduates need to advocate for patients and the community in the

  6. Rural Public Libraries as Community Change Agents: Opportunities for Health Promotion

    Science.gov (United States)

    Flaherty, Mary Grace; Miller, David

    2016-01-01

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

  7. Appropriate Health Promotion for Australian Aboriginal and Torres Strait Islander Communities

    DEFF Research Database (Denmark)

    Demaio, Alessandro Rhyll; Drysdale, Marlene; de Courten, Maximilian

    2012-01-01

    building, community empowerment and local ownership. Culturally-Appropriate Health Promotion is a framework of principles developed in 2008 with the World Health Organization (Geneva) and Global Alliance for Health Promotion. It guides community-focused health promotion practice built on and shaped...... by the respect, understanding and utilisation of local knowledge and culture. Culturally-Appropriate Health Promotion is not about ‘targeting’, ‘intervening’ or ‘responding’. Rather, it results in health program planners and policy-makers understanding, respecting, empowering and collaborating with communities......, and their socio-cultural environment, towards better health. This commentary aims to examine and apply the 8 principles of Culturally-Appropriate Health Promotion to the Australian Aboriginal and Torres Strait Islander context. It proposes its widespread adoption as a framework for a more respectful...

  8. Health-care users, key community informants and primary health care workers' views on health, health promotion, health assets and deficits: qualitative study in seven Spanish regions.

    Science.gov (United States)

    Pons-Vigués, Mariona; Berenguera, Anna; Coma-Auli, Núria; Pombo-Ramos, Haizea; March, Sebastià; Asensio-Martínez, Angela; Moreno-Peral, Patricia; Mora-Simón, Sara; Martínez-Andrés, Maria; Pujol-Ribera, Enriqueta

    2017-06-13

    Although some articles have analysed the definitions of health and health promotion from the perspective of health-care users and health care professionals, no published studies include the simultaneous participation of health-care users, primary health care professionals and key community informants. Understanding the perception of health and health promotion amongst these different stakeholders is crucial for the design and implementation of successful, equitable and sustainable measures that improve the health and wellbeing of populations. Furthermore, the identification of different health assets and deficits by the different informants will generate new evidence to promote healthy behaviours, improve community health and wellbeing and reduce preventable inequalities. The objective of this study is to explore the concept of health and health promotion and to compare health assets and deficits as identified by health-care users, key community informants and primary health care workers with the ultimate purpose to collect the necessary data for the design and implementation of a successful health promotion intervention. A descriptive-interpretive qualitative research was conducted with 276 participants from 14 primary care centres of 7 Spanish regions. Theoretical sampling was used for selection. We organized 11 discussion groups and 2 triangular groups with health-care users; 30 semi-structured interviews with key community informants; and 14 discussion groups with primary health care workers. A thematic content analysis was carried out. Health-care users and key community informants agree that health is a complex, broad, multifactorial concept that encompasses several interrelated dimensions (physical, psychological-emotional, social, occupational, intellectual, spiritual and environmental). The three participants' profiles consider health promotion indispensable despite defining it as complex and vague. In fact, most health-care users admit to having

  9. 29 CFR 1922.3 - Composition of the Board.

    Science.gov (United States)

    2010-07-01

    ... Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED) INVESTIGATIONAL HEARINGS UNDER SECTION 41 OF THE LONGSHOREMEN'S AND HARBOR WORKERS' COMPENSATION ACT § 1922.3 Composition of the Board. The Board shall be composed of three members appointed by the...

  10. Community Health Workers' Knowledge, Attitudes and Practices ...

    African Journals Online (AJOL)

    the moderate knowledge on good practices of malaria prevention and management hence improvement with accurate knowledge through ... received basic health training and work in the community .... CHWs (a binome comprising of a man and a women for general ..... health workers empowerment activities are required to.

  11. Exploring community participation in project design: application of the community conversation approach to improve maternal and newborn health in Zambia

    Directory of Open Access Journals (Sweden)

    Wilbroad Mutale

    2017-03-01

    Full Text Available Abstract Background The United Nations Development Programme (UNDP has adopted an approach entitled Community Conversation (CC to improve community engagement in addressing health challenges. CCs are based on Paulo Freire’s transformative communication approach, in which communities pose problems and critically examine their everyday life experiences through discussion. We adopted this approach to engage communities in maternal and newborn health discussions in three rural districts of Zambia, with the aim of developing community-generated interventions. Methods Sixty (60 CCs were held in three target districts, covering a total of 20 health facilities. Communities were purposively selected in each district to capture a range of rural and peri-urban areas at varying distances from health facilities. Conversations were held four times in each community between May and September 2014. All conversations were digitally recorded and later transcribed. NVivo version 10 was used for data analysis. Results and Discussion The major barriers to accessing maternal health services included geography, limited infrastructure, lack of knowledge, shortage of human resources and essential commodities, and insufficient involvement of male partners. From the demand side, a lack of information and misconceptions, and, from the supply side, inadequately trained health workers with poor attitudes, negatively affected access to maternal health services in target districts either directly or indirectly. At least 17 of 20 communities suggested solutions to these challenges, including targeted community sensitisation on the importance of safe motherhood, family planning and prevention of teenage pregnancy. Community members and key stakeholders committed time and resources to address these challenges with minimal external support. Conclusion We successfully applied the CC approach to explore maternal health challenges in three rural districts of Zambia. CCs functioned

  12. A Tentative Study on the Evaluation of Community Health Service Quality*

    Science.gov (United States)

    Ma, Zhi-qiang; Zhu, Yong-yue

    Community health service is the key point of health reform in China. Based on pertinent studies, this paper constructed an indicator system for the community health service quality evaluation from such five perspectives as visible image, reliability, responsiveness, assurance and sympathy, according to service quality evaluation scale designed by Parasuraman, Zeithaml and Berry. A multilevel fuzzy synthetical evaluation model was constructed to evaluate community health service by fuzzy mathematics theory. The applicability and maneuverability of the evaluation indicator system and evaluation model were verified by empirical analysis.

  13. Towards Promotion of Community rewards to Volunteer Community Health Workers? Lessons from Experiences of Village Health Teams in Luwero, Uganda

    NARCIS (Netherlands)

    Turinawe, E.B.; Rwemisisi, J.T.; Musinguzi, L.K.; de Groot, M.; Muhangi, D.; Mafigiri, D.K.; de Vries, D.H.; Pool, R.

    2016-01-01

    In the debate regarding volunteer Community Health Workers (CHWs) some argue that lack of remuneration is exploitation while others caution that any promise to pay volunteers will decrease the volunteer spirit. In this paper we discuss the possibility of community rewards for CHWs. Ethnographic

  14. Community Health Workers Promote Civic Engagement and Organizational Capacity to Impact Policy.

    Science.gov (United States)

    Sabo, Samantha; Flores, Melissa; Wennerstrom, Ashley; Bell, Melanie L; Verdugo, Lorena; Carvajal, Scott; Ingram, Maia

    2017-12-01

    Community health workers (CHW) have historically served to link structurally vulnerable populations to broad support systems. Emerging evidence suggests that CHWs engage in various forms of advocacy to promote policy and systems change. We assessed the impact of CHW community advocacy on community change, defined as civic engagement, organizational capacity and policy and systems change. Data are drawn from the 2014 National Community Health Worker Advocacy Survey (N = 1776) aimed to identify the state of the CHW profession, and their impact on health disparities through community advocacy and policy engagement. Our primary analysis used multiple linear regression to assess the association between CHW advocacy and community change. As predicted, there was a significant, positive association between CHW advocacy and change in community conditions. Additionally, both adjusted and sensitivity models had similar standardized beta estimates for advocacy, and adjusted R 2 statistics. CHW advocacy predicts positive change in community conditions and further advances the CHW Community Advocacy Framework designed to support and monitor CHW community advocacy to reduce health disparities through advocacy and policy change.

  15. Life after hospital: trials of a boarding house 'mother'.

    Science.gov (United States)

    Bailey, M; Brodaty, H

    1982-12-01

    What is life like for the many psychiatric patients discharged from hospital to boarding houses? The 'mother' of a Sydney boarding house describes how her 'family' has taken root, grown, developed and made a stable home. Many behaviours not tolerated in the community (e.g. public masturbation) are acceptable in the home but there are limits and rules (e.g. not in the dining room). A good home needs the responsible person to be open, honest, understanding and sensitive to changes in guests. Psychiatric services and welfare agencies need to recognise the major contributions of well-run boarding houses and need to liaise more with the proprietors.

  16. Trends in Mental Health and Substance Abuse Services at the Nation’s Community Health Centers: 1998–2003

    Science.gov (United States)

    Druss, Benjamin G.; Bornemann, Thomas; Fry-Johnson, Yvonne W.; McCombs, Harriet G.; Politzer, Robert M.; Rust, George

    2006-01-01

    Objective. We examined trends in delivery of mental health and substance abuse services at the nation’s community health centers. Methods. Analyses used data from the Health Resources and Services Administration (HRSA), Bureau of Primary Care’s (BPHC) 1998 and 2003 Uniform Data System, merged with county-level data. Results. Between 1998 and 2003, the number of patients diagnosed with a mental health/substance abuse disorder in community health centers increased from 210 000 to 800 000. There was an increase in the number of patients per specialty mental health/substance abuse treatment provider and a decline in the mean number of patient visits, from 7.3 visits per patient to 3.5 by 2003. Although most community health centers had some on-site mental health/substance abuse services, centers without on-site services were more likely to be located in counties with fewer mental health/substance abuse clinicians, psychiatric emergency rooms, and inpatient hospitals. Conclusions. Community health centers are playing an increasingly central role in providing mental health/substance abuse treatment services in the United States. It is critical both to ensure that these centers have adequate resources for providing mental health/substance abuse care and that they develop effective linkages with mental health/substance abuse clinicians in the communities they serve. PMID:17008573

  17. Implementation of oral health initiatives by Australian rural communities: Factors for success.

    Science.gov (United States)

    Taylor, Judy; Carlisle, Karen; Farmer, Jane; Larkins, Sarah; Dickson-Swift, Virginia; Kenny, Amanda

    2018-01-01

    In this paper, we consider factors significant in the success of community participation in the implementation of new oral health services. Our analysis draws on data from the Rural Engaging Communities in Oral Health (Rural ECOH) study (2014-2016). We aimed to assess the Australian relevance of a Scottish community participation framework for health service development; Remote Service Futures. Internationally, community participation in planning of health initiatives is common, but less common in new service implementation. Health managers query the legitimacy of "lay" community members, whether they will persist, and whether they can act as change agents. Our data provide evidence that helps answer these queries. Six communities, located within regions covered by two large rural primary healthcare organisations (Medicare Locals), were selected in two Australian states. Two university-based facilitators worked with a group of local residents (for each community) to monitor implementation of new oral health initiatives designed through participatory processes. Data about implementation were collected through interviews with 28 key stakeholders at the beginning of implementation and 12 months later. Data were coded, themed and analysed abductively. Five themes emerged; the inter-relationship between community motivation to participate with the fortunes of the oral health initiatives, having the "right" people involved, continuing involvement of sponsors and/or significant people, trusting working relationships between participants and perceiving benefits from participation. Findings provide evidence of a role for community participation in implementing new community services if solid partnerships with relevant providers can be negotiated and services are seen to be relevant and useful to the community. © 2017 John Wiley & Sons Ltd.

  18. Social and economic value of Portuguese community pharmacies in health care.

    Science.gov (United States)

    Félix, Jorge; Ferreira, Diana; Afonso-Silva, Marta; Gomes, Marta Vargas; Ferreira, César; Vandewalle, Björn; Marques, Sara; Mota, Melina; Costa, Suzete; Cary, Maria; Teixeira, Inês; Paulino, Ema; Macedo, Bruno; Barbosa, Carlos Maurício

    2017-08-29

    Community pharmacies are major contributors to health care systems across the world. Several studies have been conducted to evaluate community pharmacies services in health care. The purpose of this study was to estimate the social and economic benefits of current and potential future community pharmacies services provided by pharmacists in health care in Portugal. The social and economic value of community pharmacies services was estimated through a decision-model. Model inputs included effectiveness data, quality of life (QoL) and health resource consumption, obtained though literature review and adapted to Portuguese reality by an expert panel. The estimated economic value was the result of non-remunerated pharmaceutical services plus health resource consumption potentially avoided. Social and economic value of community pharmacies services derives from the comparison of two scenarios: "with service" versus "without service". It is estimated that current community pharmacies services in Portugal provide a gain in QoL of 8.3% and an economic value of 879.6 million euros (M€), including 342.1 M€ in non-remunerated pharmaceutical services and 448.1 M€ in avoided expense with health resource consumption. Potential future community pharmacies services may provide an additional increase of 6.9% in QoL and be associated with an economic value of 144.8 M€: 120.3 M€ in non-remunerated services and 24.5 M€ in potential savings with health resource consumption. Community pharmacies services provide considerable benefit in QoL and economic value. An increase range of services including a greater integration in primary and secondary care, among other transversal services, may add further social and economic value to the society.

  19. The response of 1578 school leavers to a campaign combining commercial, Health Boards' and GDPs' sponsorship in an effort to improve dental attendance

    DEFF Research Database (Denmark)

    Craven, R; Blinkhorn, A S; Schou, L

    1993-01-01

    A dental health promotion campaign was developed by Forth Valley Health Board in conjunction with the Scottish Health Education Group and the Department of Marketing at Strathclyde University. The aim was to encourage dental attendance among early school leavers. The emphasis was on the contribut...

  20. 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.

  1. Community Engagement to Optimize the Use of Web-Based and Wearable Technology in a Cardiovascular Health and Needs Assessment Study: A Mixed Methods Approach.

    Science.gov (United States)

    Yingling, Leah R; Brooks, Alyssa T; Wallen, Gwenyth R; Peters-Lawrence, Marlene; McClurkin, Michael; Cooper-McCann, Rebecca; Wiley, Kenneth L; Mitchell, Valerie; Saygbe, Johnetta N; Johnson, Twanda D; Curry, Rev Kendrick E; Johnson, Allan A; Graham, Avis P; Graham, Lennox A; Powell-Wiley, Tiffany M

    2016-04-25

    Resource-limited communities in Washington, D.C. have high rates of obesity-related cardiovascular disease in addition to inadequate physical activity (PA) facilities and limited Internet access. Engaging community members in the design and implementation of studies to address these health disparities is essential to the success of community-based PA interventions. The objective of the study was to use qualitative and quantitative methods to evaluate the feasibility and acceptability of PA-monitoring wristbands and Web-based technology by predominantly African American, church-based populations in resource-limited Washington, D.C. neighborhoods. To address cardiovascular health in at-risk populations in Washington, D.C., we joined community leaders to establish a community advisory board, the D.C. Cardiovascular Health and Obesity Collaborative (D.C. CHOC). As their first initiative, the Washington, D.C. Cardiovascular Health and Needs Assessment intends to evaluate cardiovascular health, social determinants of health, and PA-monitoring technologies. At the recommendation of D.C. CHOC members, we conducted a focus group and piloted the proposed PA-monitoring system with community members representing churches that would be targeted by the Cardiovascular Health and Needs Assessment. Participants (n=8) agreed to wear a PA-monitoring wristband for two weeks and to log cardiovascular health factors on a secure Internet account. Wristbands collected accelerometer-based data that participants uploaded to a wireless hub at their church. Participants agreed to return after two weeks to participate in a moderated focus group to share experiences using this technology. Feasibility was measured by Internet account usage, wristband utilization, and objective PA data. Acceptability was evaluated through thematic analysis of verbatim focus group transcripts. Study participants (5 males, 3 females) were African American and age 28-70 years. Participant wristbands recorded data on

  2. More than words: Using visual graphics for community-based health research.

    Science.gov (United States)

    Morton Ninomiya, Melody E

    2017-04-20

    With increased attention to knowledge translation and community engagement in the applied health research field, many researchers aim to find effective ways of engaging health policy and decision makers and community stakeholders. While visual graphics such as graphs, charts, figures and photographs are common in scientific research dissemination, they are less common as a communication tool in research. In this commentary, I illustrate how and why visual graphics were created and used to facilitate dialogue and communication throughout all phases of a community-based health research study with a rural Indigenous community, advancing community engagement and knowledge utilization of a research study. I suggest that it is essential that researchers consider the use of visual graphics to accurately communicate and translate important health research concepts and content in accessible forms for diverse research stakeholders and target audiences.

  3. Issues with prescribed medications in Aboriginal communities: Aboriginal health workers' perspectives.

    Science.gov (United States)

    Hamrosi, Kim; Taylor, Susan J; Aslani, Parisa

    2006-01-01

    The health of Indigenous Australians remains appalling. The causes of this situation are multi-factorial, however one contributing factor is poor medication compliance within Aboriginal populations. Anecdotal evidence provided by Aboriginal health workers in western New South Wales (NSW), Australia, has suggested that there are problems associated with the use of prescribed medications within the Aboriginal community. Aboriginal health workers form a core component of the Aboriginal health service sector and they have an in-depth knowledge of the community and its healthcare provision, as well as a familiarity with clinic patients and families. As such they are an important group whose opinions and beliefs about medication use in the Aboriginal population should be investigated. While there have been studies on the issues of prescribing in Aboriginal communities and access to medications, limited investigation into the use of prescribed medicines in Aboriginal communities and the role of the pharmacist in that process, has taken place. Therefore, this research aimed to identify the type of and reasons for inappropriate use of prescribed medications within Aboriginal communities serviced by the Mid Western Area Health Service (since incorporated into the Greater West Area Health Service) as perceived by the Aboriginal health workers in the area, and to explore strategies in conjunction with those Aboriginal health workers to address identified issues. Qualitative, in-depth interviews were held with 11 Aboriginal health workers employed in Community Health Centres and hospitals in the Mid Western Area Health service of NSW. The interviews were audiotaped and transcribed verbatim. The transcripts were content analysed for emerging themes. The interviews explored the beliefs, perceptions and experiences of the Aboriginal health workers regarding prescribed medication use, the role of the pharmacist, and identification of future strategies to improve medication use in

  4. The role of community health workers in improving child health programmes in Mali

    Directory of Open Access Journals (Sweden)

    Altmann Mathias

    2009-11-01

    Full Text Available Abstract Background Mortality of children under the age of five remains one of the most important public health challenges in developing countries. In rural settings, the promotion of household and community health practices through community health workers (CHWs is among the key strategies to improve child health. The objective of this study was to assess the performance of CHWs in the promotion of basic child heath services in rural Mali. Methods A community-based cross-sectional survey was undertaken using multi-stage cluster sampling of wards and villages. Data was collected through questionnaires among 401 child-caregivers and registers of 72 CHWs. Results Of 401 households suppose to receive a visit by a CHW, 219 (54.6%; confidence interval 95%; 49.6-59.5 had received at least one visit in the last three months before the survey. The mother is the most important caregiver (97%; high percentage being illiterate. Caregivers treat fever and diarrhoea with the correct regimen in 40% and 11% of cases respectively. Comparative analysis between households with and without CHW visits showed a positive influence of CHWs on family health practices: knowledge on the management of child fever (p = Conclusion Continuous training, transport means, adequate supervision and motivation of CHWs through the introduction of financial incentives and remuneration are among key factors to improve the work of CHWs in rural communities. Poor performance of basic household health practices can be related to irregular supply of drugs and the need of appropriate follow-up by CHWs.

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

    Directory of Open Access Journals (Sweden)

    Gopa Kothari

    2009-06-01

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

  6. Climbing the walls: prison mental health and community engagement.

    Science.gov (United States)

    Caie, Jude

    Until recently, treatment for mental health conditions has focused on medical and psychological therapy. The role and significance of social and community interventions and initiatives in fostering recovery, resilience and a sense of 'flourishing' is now being recognised. This paper seeks to explore how these principles, which are usually community-based, can be successfully applied within a prison setting, and how such interventions may have a positive effect on the mental health of prisoners through successfully engaging them with the communities they are set to return to after release while still in custody.

  7. Oceans and Human Health (OHH): a European perspective from the Marine Board of the European Science Foundation (Marine Board-ESF).

    Science.gov (United States)

    Moore, Michael N; Depledge, Michael H; Fleming, Lora; Hess, Philipp; Lees, David; Leonard, Paul; Madsen, Lise; Owen, Richard; Pirlet, Hans; Seys, Jan; Vasconcelos, Vitor; Viarengo, Aldo

    2013-05-01

    The oceans and coastal seas provide mankind with many benefits including food for around a third of the global population, the air that we breathe and our climate system which enables habitation of much of the planet. However, the converse is that generation of natural events (such as hurricanes, severe storms and tsunamis) can have devastating impacts on coastal populations, while pollution of the seas by pathogens and toxic waste can cause illness and death in humans and animals. Harmful effects from biogenic toxins produced by algal blooms (HABs) and from the pathogens associated with microbial pollution are also a health hazard in seafood and from direct contact with water. The overall global burden of human disease caused by sewage pollution of coastal waters has been estimated at 4 million lost person-years annually. Finally, the impacts of all of these issues will be exacerbated by climate change. A holistic systems approach is needed. It must consider whole ecosystems, and their sustainability, such as integrated coastal zone management, is necessary to address the highly interconnected scientific challenges of increased human population pressure, pollution and over-exploitation of food (and other) resources as drivers of adverse ecological, social and economic impacts. There is also an urgent and critical requirement for effective and integrated public health solutions to be developed through the formulation of politically and environmentally meaningful policies. The research community required to address "Oceans & Human Health" in Europe is currently very fragmented, and recognition by policy makers of some of the problems, outlined in the list of challenges above, is limited. Nevertheless, relevant key policy issues for governments worldwide include the reduction of the burden of disease (including the early detection of emerging pathogens and other threats) and improving the quality of the global environment. Failure to effectively address these issues

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

    Directory of Open Access Journals (Sweden)

    Freek Cronjé

    2013-03-01

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

  9. Building sustainable health and education partnerships: stories from local communities.

    Science.gov (United States)

    Blank, Martin J

    2015-11-01

    Growing health disparities have a negative impact on young people's educational achievement. Community schools that involve deep relationships with partners across multiple domains address these disparities by providing opportunities and services that promote healthy development of young people, and enable them to graduate from high school ready for college, technical school, on-the-job training, career, and citizenship. Results from Milwaukie High School, North Clackamas, OR; Oakland Unified School District, Oakland, CA; and Cincinnati Community Learning Centers, Cincinnati, OH were based on a review of local site documents, web-based information, interviews, and e-mail communication with key local actors. The schools and districts with strong health partnerships reflecting community schools strategy have shown improvements in attendance, academic performance, and increased access to mental, dental, vision, and health supports for their students. To build deep health-education partnerships and grow community schools, a working leadership and management infrastructure must be in place that uses quality data, focuses on results, and facilitates professional development across sectors. The leadership infrastructure of community school initiatives offers a prototype on which others can build. Moreover, as leaders build cross-sector relationships, a clear definition of what scaling up means is essential for subsequent long-term systemic change. © 2015 Institute for Educational Leadership. Journal of School Health published by Wiley Periodicals, Inc. on behalf of American School Health Association.

  10. Community Changes Address Common Health Threat

    Centers for Disease Control (CDC) Podcasts

    2013-09-30

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

  11. Depression Screening at a Community Health Fair: Descriptives and Treatment Linkage.

    Science.gov (United States)

    Opperman, Kiel J; Hanson, Devin M; Toro, Paul A

    2017-08-01

    Health fairs are a cost-efficient platform for dissemination of preventive services to vulnerable populations. Effectiveness of depression screenings and associated treatment linkage via community health fairs warrants investigation. This study offers the first examination of a depression screening at a community health fair in 261 adult men (18-87years). The PHQ-9 was administered via interview by graduate students and on-site psychiatric nurses were available for a brief consultation for those interested. Over a quarter of participants screened positive for at least moderate depressive symptomatology. Of those who screened positive, 35.8% met with an on-site psychiatric nurse for a consultation. At six-month follow-up, none of the participants given a referral made an appointment at the community mental health agency. This suggests the importance of providing on-site clinician consultations at health fairs and the need for a more coordinated system to schedule future appointments while at the event. Community health fairs reach vulnerable populations, such as those who are uninsured and who have not spoken with a professional about mental health concerns. By conducting depression screening and providing onsite access to a mental health consultation at community health fairs, participants are better able to identify their depressive symptoms and are introduced to ways to treat depression. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Board Independence and Corporate Social Responsibility (CSR Reporting in Malaysia

    Directory of Open Access Journals (Sweden)

    Nurulyasmin Binti Ju Ahmad

    2017-06-01

    Full Text Available This study aims to examine the influence of board independence on corporate social responsibility (CSR reporting by publicly listed companies in Malaysia. Content analysis was used to determine the extent of CSR reporting. A reporting index consisting of 51 items was developed based on six themes: General, Community, Environment, Human Resources, Marketplace and Other. An Ordinary Least Square (OLS regression was used to examine the relationship between board independence and firm CSR reporting. The results indicate that the association between board independence and company CSR reporting is industry specific. Overall, the empirical evidence partially supports agency theory.

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

    Directory of Open Access Journals (Sweden)

    Marjaneh M. Fooladi

    2015-10-01

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

  14. Assessment of training needs for disaster mental health preparedness in black communities.

    Science.gov (United States)

    Laborde, Danielle J; Brannock, Kristen; Parrish, Theodore

    2011-07-01

    Reducing racial disparities in postdisaster mental health requires the integration of unique and complex community challenges in disaster planning. We conducted focus group discussions with 13 community leaders and 7 clinical providers in eastern North Carolina to inform the adaptation of a competency-based training model in postdisaster mental health for black communities. The audience-specific perspectives on disaster mental health and training priorities were identified by structured thematic analyses. Community leaders and clinical providers without personal ties to the local black population were unaware of internal networks and other community resources. Conversely, most black community leaders and clinical providers were unaware of local disaster response resources. All participants identified training in coordination, outreach to reduce mental health stigma, and cultural competence as priority training needs. Black community leaders also were concerned about their inclusion in local planning and leveraging resources. These inputs and suggestions made for tailoring with culturally appropriate language and processes guided the development of learning objectives, content, and field testing of the feasibility of trainer the trainer delivery of postdisaster mental health training for clinical providers and community leaders serving vulnerable black populations.

  15. How citizen advisory boards provide input into major waste policy decisions

    Energy Technology Data Exchange (ETDEWEB)

    Rogers, E.; Murakami, L.; Hanson, L. [Rocky Flats Citizen Advisory Board, Westminster, CO (United States)

    1995-12-31

    Volunteer citizen boards, such as Site Specific Advisory Boards, can be a very important key to success for the Department of Energy`s (DOE`s) Waste Management program. These boards can provide informed, independent recommendations reflecting the diversity of the community and its values. A successful volunteer process requires collaboration among regulators, DOE and other Boards; knowing how and when to interface with the broader public; understanding the diversity and representational issues of a citizens group; knowing the {open_quotes}ins and outs{close_quotes} of working with volunteers; education and training and most importantly, planning. Volunteers on a citizens board were created to tackle the big picture, policy decisions. The chair of the Rocky Flats Citizens Advisory Board will describe her Board`s successes, including the challenges in reaching consensus agreements, as well as the need for integration with other boards and the sites` on-going public involvement programs to provide the input the department is seeking. Finally, one of the greatest challenges for the boards is interfacing with the greater public-at-large, seeing how the CAB has overcome this challenge and integrating broader public input into its decisions.

  16. Evaluation of Community Health Education Workshops among Chinese Older Adults in Chicago: A Community-Based Participatory Research Approach

    Science.gov (United States)

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

    2013-01-01

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

  17. [Mental Health Promotion Among the Chronic Disabled Population in the Community].

    Science.gov (United States)

    Huang, Hui-Chuan; Wang, Li-Hua; Chang, Hsiu-Ju

    2015-08-01

    Societal ageing and the rising prevalence of chronic disease are important causes that underlie the growth in the number of disabled individuals. The disease-induced psychological distress experienced by this population not only decreases quality of life but also increases demand for healthcare. The healthcare policy for the disabled population currently focuses on community healthcare. Therefore, developing appropriate programs to promote mental health among the disabled population in community settings is a critical issue. The present paper reviews current mental health promotion initiatives that target the disabled population in the community and addresses mental healthcare issues that are prevalent among the chronically disabled; strategies of mental health promotion that use music therapy, reminiscence therapy, and horticultural therapy; and the roles and responsibilities of community professionals in mental healthcare. We offer these perspectives as a reference to promote mental health and to establish holistic community healthcare for chronically disabled individuals.

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

    Data.gov (United States)

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

  19. 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.

  20. Assessing the integration of health center and community emergency preparedness and response planning.

    Science.gov (United States)

    Wineman, Nicole V; Braun, Barbara I; Barbera, Joseph A; Loeb, Jerod M

    2007-11-01

    To assess the state of health center integration into community preparedness, we undertook a national study of linkages between health centers and the emergency preparedness and response planning initiatives in their communities. The key objectives of this project were to gain a better understanding of existing linkages in a nationally representative sample of health centers, and identify health center demographic and experience factors that were associated with strong linkages. The objectives of the study were to gain a baseline understanding of existing health center linkages to community emergency preparedness and response systems and to identify factors that were associated with strong linkages. A 60-item questionnaire was mailed to the population of health centers supported by the Health Resources and Services Administration's Bureau of Primary Health Care in February 2005. Results were aggregated and a chi square analysis identified factors associated with stronger linkages. Overall performance on study-defined indicators of strong linkages was low: 34% had completed a hazard vulnerability analysis in collaboration with the community emergency management agency, 30% had their role documented in the community plan, and 24% participated in community-wide exercises. Stronger linkages were associated with experience responding to a disaster and a perception of high risk for experiencing a disaster. The potential for health centers to participate in an integrated response is not fully realized, and their absence from community-based planning leaves an already vulnerable population at greater risk. Community planners should be encouraged to include health centers in planning and response and centers should receive more targeted resources for community integration.

  1. From Sociocultural Disintegration to Community Connectedness Dimensions of Local Community Concepts and Their Effects on Psychological Health of Its Residents

    Directory of Open Access Journals (Sweden)

    Tom Sørensen

    2013-01-01

    Full Text Available In a series of community mental health promotion studies in Lofoten, Norway, the concept of sociocultural integration is used to describe properties of a local community that are related to people's psychological health. Starting with Durkheim's description of a cohesive society, we compare different concepts that are related to sociocultural integration, for example, sense of community, social capital, and social cohesion. We then examine the relationship of various individual oriented social psychological concepts to sociocultural integration. These concepts often share theoretical and operational definitions. The concept of sociocultural integration in the Lofoten studies was proved to be very valuable in understanding how the properties of a community can affect people's mental health and their social psychological properties. It has also shown its value in the planning of mental health services and demonstrating its success in concrete community-based mental health promotion projects. Thus they could make important contributions to further studies and actions in local communities where the intersection between the individual, their social network, and their local community occurs.

  2. Health and health-related indicators in slum, rural, and urban communities: a comparative analysis

    Science.gov (United States)

    Mberu, Blessing U.; Haregu, Tilahun Nigatu; Kyobutungi, Catherine; Ezeh, Alex C.

    2016-01-01

    Background It is generally assumed that urban slum residents have worse health status when compared with other urban populations, but better health status than their rural counterparts. This belief/assumption is often because of their physical proximity and assumed better access to health care services in urban areas. However, a few recent studies have cast doubt on this belief. Whether slum dwellers are better off, similar to, or worse off as compared with rural and other urban populations remain poorly understood as indicators for slum dwellers are generally hidden in urban averages. Objective The aim of this study was to compare health and health-related indicators among slum, rural, and other urban populations in four countries where specific efforts have been made to generate health indicators specific to slum populations. Design We conducted a comparative analysis of health indicators among slums, non-slums, and all urban and rural populations as well as national averages in Bangladesh, Kenya, Egypt, and India. We triangulated data from demographic and health surveys, urban health surveys, and special cross-sectional slum surveys in these countries to assess differences in health indicators across the residential domains. We focused the comparisons on child health, maternal health, reproductive health, access to health services, and HIV/AIDS indicators. Within each country, we compared indicators for slums with non-slum, city/urban averages, rural, and national indicators. Between-country differences were also highlighted. Results In all the countries, except India, slum children had much poorer health outcomes than children in all other residential domains, including those in rural areas. Childhood illnesses and malnutrition were higher among children living in slum communities compared to those living elsewhere. Although treatment seeking was better among slum children as compared with those in rural areas, this did not translate to better mortality

  3. Health and health-related indicators in slum, rural, and urban communities: a comparative analysis

    Directory of Open Access Journals (Sweden)

    Blessing U. Mberu

    2016-12-01

    Full Text Available Background: It is generally assumed that urban slum residents have worse health status when compared with other urban populations, but better health status than their rural counterparts. This belief/assumption is often because of their physical proximity and assumed better access to health care services in urban areas. However, a few recent studies have cast doubt on this belief. Whether slum dwellers are better off, similar to, or worse off as compared with rural and other urban populations remain poorly understood as indicators for slum dwellers are generally hidden in urban averages. Objective: The aim of this study was to compare health and health-related indicators among slum, rural, and other urban populations in four countries where specific efforts have been made to generate health indicators specific to slum populations. Design: We conducted a comparative analysis of health indicators among slums, non-slums, and all urban and rural populations as well as national averages in Bangladesh, Kenya, Egypt, and India. We triangulated data from demographic and health surveys, urban health surveys, and special cross-sectional slum surveys in these countries to assess differences in health indicators across the residential domains. We focused the comparisons on child health, maternal health, reproductive health, access to health services, and HIV/AIDS indicators. Within each country, we compared indicators for slums with non-slum, city/urban averages, rural, and national indicators. Between-country differences were also highlighted. Results: In all the countries, except India, slum children had much poorer health outcomes than children in all other residential domains, including those in rural areas. Childhood illnesses and malnutrition were higher among children living in slum communities compared to those living elsewhere. Although treatment seeking was better among slum children as compared with those in rural areas, this did not translate to

  4. Developing rural community health risk assessments for climate change: a Tasmanian pilot study.

    Science.gov (United States)

    Bell, Erica J; Turner, Paul; Meinke, Holger; Holbrook, Neil J

    2015-01-01

    This article examines the development and pilot implementation of an approach to support local community decision-makers to plan health adaptation responses to climate change. The approach involves health and wellbeing risk assessment supported through the use of an electronic tool. While climate change is a major foreseeable public health threat, the extent to which health services are prepared for, or able to adequately respond to, climate change impact-related risks remains unclear. Building health decision-support mechanisms in order to involve and empower local stakeholders to help create the basis for agreement on these adaptive actions is an important first step. The primary research question was 'What can be learned from pilot implementation of a community health and well-being risk assessment (CHWRA) information technology-based tool designed to support understanding of, and decision-making on, local community challenges and opportunities associated with health risks posed by climate change? The article examines the complexity of climate change science to adaptation translational processes, with reference to existing research literature on community development. This is done in the context of addressing human health risks for rural and remote communities in Tasmania, Australia. This process is further examined through the pilot implementation of an electronic tool designed to support the translation of physically based climate change impact information into community-level assessments of health risks and adaptation priorities. The procedural and technical nature of the CHWRA tool is described, and the implications of the data gathered from stakeholder workshops held at three rural Tasmanian local government sites are considered and discussed. Bushfire, depression and waterborne diseases were identified by community stakeholders as being potentially 'catastrophic' health effects 'likely' to 'almost certain' to occur at one or more Tasmanian rural sites

  5. Survey of community pharmacy residents' perceptions of transgender health management.

    Science.gov (United States)

    Leach, Caitlin; Layson-Wolf, Cherokee

    2016-01-01

    1) To measure the general perceptions and attitudes of community pharmacy residents toward transgender patients and health; 2) to identify gaps in didactic education regarding transgender health care among residents; and 3) to evaluate residents' level of support for pharmacists receiving education in transgender health care. This study was a cross-sectional survey delivered online. Community residency directors were e-mailed a cover letter and a 34-question online survey. The directors were asked to forward the survey to their residents for completion within 4 weeks. Responses were anonymous with no identifiers collected on the survey. Survey responses used a combination of open-response, multiple-choice, and Likert-scale questions aimed at gathering respondents' demographic information, perceptions of managing transgender patients and the need for receiving additional education in transgender health care. Overall, the results of the survey indicated that community pharmacy residents support integrating transgender health management into pharmacy education and recognize that the overwhelming barriers to care for these patients include discrimination and lack of provider knowledge. Significant findings include: 82.7% of community residents think that community pharmacists play an important role in providing care for transgender patients; 98.2% think that they have a responsibility to treat transgender patients; and 71.4% were not educated about transgender patient issues in pharmacy school. Only 36.2% of community residents felt confident in their ability to treat transgender patients. Community pharmacy residents list discrimination and lack of provider knowledge as the major barriers to care for transgender patients. Residents do not feel confident in their ability to treat and manage transgender patients. The majority of residents were not educated about transgender patient issues while in pharmacy school and think that community pharmacists need more education

  6. Development of a Faith-Based Stress Management Intervention in a Rural African American Community.

    Science.gov (United States)

    Bryant, Keneshia; Moore, Todd; Willis, Nathaniel; Hadden, Kristie

    2015-01-01

    Faith-based mental health interventions developed and implemented using a community-based participatory research (CBPR) approach hold promise for reaching rural African Americans and addressing health disparities. To describe the development, challenges, and lessons learned from the Trinity Life Management, a faith-based stress management intervention in a rural African American faith community. The researchers used a CBPR approach by partnering with the African American faith community to develop a stress management intervention. Development strategies include working with key informants, focus groups, and a community advisory board (CAB). The community identified the key concepts that should be included in a stress management intervention. The faith-based "Trinity Life Management" stress management intervention was developed collaboratively by a CAB and an academic research team. The intervention includes stress management techniques that incorporate Biblical principles and information about the stress-distress-depression continuum.

  7. Community/hospital indicators in South African public sector mental health services.

    Science.gov (United States)

    Lund, Crick; Flisher, Alan J

    2003-12-01

    The need to balance resources between community and hospital-based mental health services in the post-deinstitutionalisation era has been well-documented. However, few indicators have been developed to monitor the relationship between community and hospital services, in either developed or developing countries. There is a particular need for such indicators in the South African context, with its history of inequitable services based in custodial institutions under apartheid, and a new policy that proposes the development of more equitable community-based care. Indicators are needed to measure the distribution of resources and the relative utilisation of community and hospital-based services during the reform process. These indicators are potentially useful for assessing the implementation of policy objectives over time. To develop and document community/hospital indicators in public sector mental health services in South Africa. A questionnaire was distributed to provincial mental health coordinators requesting numbers of full-time equivalent (FTE) staff who provide mental health care at all service levels, annual patient admissions to hospitals and annual patient attendances at ambulatory care facilities. The information was supplemented by consultations with mental health coordinators in each of the 9 provinces. Population data were obtained from preliminary findings of the 1996 census. The community/hospital indicator measuring staff distribution was defined as the ratio of staff employed in community settings to all staff, expressed as a percentage. The community/hospital indicator measuring patient service utilisation was defined as the ratio of the annual ambulatory care attendance rate per 100,000 population to the sum of this rate and the annual hospital admission rate per 100,000 population, expressed as a percentage. Of psychiatric public sector staff, 25% are located in community settings in South Africa (provincial range: 11-70%). If hospital outpatient

  8. Improving hypertension self-management with community health coaches.

    Science.gov (United States)

    Dye, Cheryl J; Williams, Joel E; Evatt, Janet Hoffman

    2015-03-01

    Approximately two thirds of those older than 60 years have a hypertension diagnosis. The aim of our program, Health Coaches for Hypertension Control, is to improve hypertension self-management among rural residents older than 60 years through education and support offered by trained community volunteers called Health Coaches. Participants received baseline and follow-up health risk appraisals with blood work, educational materials, and items such as blood pressure monitors and pedometers. Data were collected at baseline, 8 weeks, and 16 weeks on 146 participants who demonstrated statistically significant increases in hypertension-related knowledge from baseline to 8 weeks that persisted at 16 weeks, as well as significant improvements in stage of readiness to change behaviors and in actual behaviors. Furthermore, clinically significant decreases in all outcome measures were observed, with statistically significant changes in systolic blood pressure (-5.781 mmHg; p = .001), weight (-2.475 lb; p definition of controlled hypertension at baseline, the proportion of participants meeting this definition at 16 weeks postintervention increased to 51.0%. This article describes a university-community-hospital system model that effectively promotes hypertension self-management in a rural Appalachian community. © 2014 Society for Public Health Education.

  9. A qualitative assessment of health extension workers' relationships with the community and health sector in Ethiopia : opportunities for enhancing maternal health performance

    NARCIS (Netherlands)

    Kok, Maryse C; Kea, Aschenaki Z.; Datiko, Daniel G; Broerse, Jacqueline E W; Dieleman, Marjolein; Taegtmeyer, Miriam; Tulloch, Olivia

    2015-01-01

    BACKGROUND: Health extension workers (HEWs) in Ethiopia have a unique position, connecting communities to the health sector. This intermediary position requires strong interpersonal relationships with actors in both the community and health sector, in order to enhance HEW performance. This study

  10. Faith communities and their assets for health promotion: the views from health professionals and faith leaders in Dundee, in Scotland.

    Science.gov (United States)

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

    2012-06-01

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

  11. [Municipal Health Councils: activity and representation of grassroots communities].

    Science.gov (United States)

    Gerschman, Silvia

    2004-01-01

    This article was based on the results of research concerning health policy in municipalities that achieved the most extensive development of decentralization and innovation in the State of Rio de Janeiro, Brazil. The study applied a questionnaire for health system users' representatives in Municipal Health Councils. The central issues were: the Councils' political role; social control by the Councils, viewed as surveillance by organized society over government actions; the nature of social representation exercised by the Council members; and the type of mandate they serve. Community representatives in the Councils reinforce aspects pertaining to the exercise of representation in unequal societies. There is a predominance of a differentiated elite consisting of older males with more schooling and higher income than the community average. The notion of "social control" as the basis for the Councils is difficult for the members to grasp. Exercise of representation is diffuse, occurring by way of designation by community associations, election in assemblies, or designation by institutional health policy agencies.

  12. Stigma-related mental health knowledge and attitudes among primary health workers and community health volunteers in rural Kenya

    NARCIS (Netherlands)

    Mutiso, Victoria N.; Musyimi, Christine W.; Nayak, Sameera S.; Musau, Abednego M.; Rebello, Tahilia; Nandoya, Erick; Tele, Albert K.; Pike, Kathleen; Ndetei, David M.

    2017-01-01

    Background: The study was conducted in rural Kenya and assessed stigma in health workers from primary health facilities. Aims: This study compared variations in stigma-related mental health knowledge and attitudes between primary health workers (HWs) and community health volunteers (CHVs). Methods:

  13. 78 FR 9890 - DoD Medicare-Eligible Retiree Health Care Board of Actuaries; Notice of Federal Advisory...

    Science.gov (United States)

    2013-02-12

    ... Actuaries; Notice of Federal Advisory Committee Meeting AGENCY: DoD. ACTION: Meeting notice. SUMMARY: Under... Retiree Health Care Board of Actuaries will take place. DATES: Friday, August 2, 2013, from 10:00 a.m. to... Activity, DoD Office of the Actuary, 4800 Mark Center Drive, STE 06J25-01, Alexandria, VA 22350-4000. Phone...

  14. Linking communities to formal health care providers through village health teams in rural Uganda: lessons from linking social capital.

    Science.gov (United States)

    Musinguzi, Laban Kashaija; Turinawe, Emmanueil Benon; Rwemisisi, Jude T; de Vries, Daniel H; Mafigiri, David K; Muhangi, Denis; de Groot, Marije; Katamba, Achilles; Pool, Robert

    2017-01-11

    Community-based programmes, particularly community health workers (CHWs), have been portrayed as a cost-effective alternative to the shortage of health workers in low-income countries. Usually, literature emphasises how easily CHWs link and connect communities to formal health care services. There is little evidence in Uganda to support or dispute such claims. Drawing from linking social capital framework, this paper examines the claim that village health teams (VHTs), as an example of CHWs, link and connect communities with formal health care services. Data were collected through ethnographic fieldwork undertaken as part of a larger research program in Luwero District, Uganda, between 2012 and 2014. The main methods of data collection were participant observation in events organised by VHTs. In addition, a total of 91 in-depth interviews and 42 focus group discussions (FGD) were conducted with adult community members as part of the larger project. After preliminary analysis of the data, we conducted an additional six in-depth interviews and three FGD with VHTs and four FGD with community members on the role of VHTs. Key informant interviews were conducted with local government staff, health workers, local leaders, and NGO staff with health programs in Luwero. Thematic analysis was used during data analysis. The ability of VHTs to link communities with formal health care was affected by the stakeholders' perception of their roles. Community members perceive VHTs as working for and under instructions of "others", which makes them powerless in the formal health care system. One of the challenges associated with VHTs' linking roles is support from the government and formal health care providers. Formal health care providers perceived VHTs as interested in special recognition for their services yet they are not "experts". For some health workers, the introduction of VHTs is seen as a ploy by the government to control people and hide its inability to provide health

  15. Engagement of National Board of Examinations in strengthening public health education in India: present landscape, opportunities and future directions.

    Science.gov (United States)

    Sharma, Anjali; Zodpey, Sanjay; Batra, Bipin

    2014-01-01

    A trained and adequate heath workforce forms the crux in designing, implementing and monitoring health programs and delivering quality health services. Education is recognized as a critical instrument for creating such trained health professionals who can effectively address the 21 st century health challenges. At present, the Public Health Education in India is offered through medical colleges and also outside the corridors of medical colleges which was not the scenario earlier. Traditionally, Public Health Education has been a domain of medical colleges and was open for medical graduates only. In order to standardize the Postgraduate Medical Education in India, the National Board of Examinations (NBE) was set up as an independent autonomous body of its kind in the country in the field of medical sciences with the prime objective of improving the quality of the medical education. NBE has also played a significant role in enhancing Public Health Education in India through its Diplomat of National Board (DNB) Programs in Social and Preventive Medicine, Health and Hospital Administration, Maternal and Child Health, Family Medicine and Field Epidemiology. It envisions creating a cadre of skilled and motivated public health professionals and also developing a roadmap for postgraduate career pathways. However, there still exists gamut of opportunities for it to engage in expanding the scope of Public Health Education. It can play a key role in accreditation of public health programs and institutions which can transform the present landscape of education of health professionals. It also needs to revisit and re-initiate programs like DNB in Tropical Medicine and Occupational Health which were discontinued. The time is imperative for NBE to seize these opportunities and take necessary actions in strengthening and expanding the scope of Public Health Education in India.

  16. An examination of the factors affecting people's participation in future health examinations based on community health exam interventions.

    Science.gov (United States)

    Tu, Shih-Kai; Liao, Hung-En

    2014-01-01

    Community-based intervention health examinations were implemented at a health care facility to comply with the government's primary health care promotion policy. The theory of planned behavior model was applied to examine the effect that community-based health examinations had on people's health concepts regarding seeking future health examinations. The research participants were individuals who had received a health examination provided at two branches of a hospital in central Taiwan in 2012. The hospital's two branches held a total of 14 free community-based health examination sessions. The hospital provided health examination equipment and staff to perform health examinations during public holidays. We conducted an exploratory questionnaire survey to collect data and implemented cross-sectional research based on anonymous self-ratings to examine the public's intention to receive future community-based or hospital-based health examinations. Including of 807 valid questionnaires, accounting for 89.4% of the total number of questionnaires distributed. The correlation coefficients of the second-order structural model indicate that attitudes positively predict behavioral intentions (γ = .66, p intentions (γ = .66, p intentions (γ = -.71, p > .05). The results of the first-order structural model indicated that the second-order constructs had a high explanatory power for the first-order constructs. People's health concepts regarding health examinations and their desire to continue receiving health examinations must be considered when promoting health examinations in the community. Regarding hospital management and the government's implementation of primary health care, health examination services should address people's medical needs to increase coverage and participation rates and reduce the waste of medical resources.

  17. Evaluation of community-based oral health promotion and oral disease prevention--WHO recommendations for improved evidence in public health practice

    DEFF Research Database (Denmark)

    Petersen, Poul Erik; Kwan, Stella

    2004-01-01

    Systematic evaluation is an integral part of the organisation and delivery of community oral health care programmes, ensuring the effectiveness of these community-based interventions. As for general health promotion programmes the common problems from effectiveness reviews of oral health...... a challenge to oral health professionals to integrate community oral health programmes into a wider health agenda. Public health research focusing on the development of evaluation methodologies has identified a variety of issues including the importance of using pluralistic evaluation approaches (quantitative...... of the evaluation of oral health promotion and oral disease prevention programmes. The aims of the workshop were to: (1) identify common problems and challenges in evaluating community-based oral health interventions; (2) explore developments in the evaluation approaches in public health; (3) share experiences...

  18. Utilization and perception of Community Health Insurance Scheme ...

    African Journals Online (AJOL)

    Shell in collaboration with four communities in Obio-Akpor LGA, Port Harcourt, started a Community Health Insurance Scheme in February 2010. An evaluation of enrollees' utilization and perception of the services provided was done. Methodology: Quantitative data were collected by the use of structured interviewer ...

  19. Sexual health needs and the LGBT community.

    Science.gov (United States)

    Campbell, Sue

    Lesbian, gay, bisexual and trans (LGBT) individuals have particular vulnerabilities to sexually transmitted infections and HIV infection. Globally, reasons for this include physiological factors, discrimination and poor understanding of their sexual health needs. In many countries LGBT individuals are not able to exercise fully their rights to health care. This raises public health concerns for the LGBT community and the wider population. This article explores these issues, and makes recommendations for the healthcare profession to address health inequalities and promote improved health outcomes for LGBT populations. This article aims to promote an evidence-based approach that focuses on rights and public health issues.

  20. Coalition Building for Health: A Community Garden Pilot Project with Apartment Dwelling Refugees.

    Science.gov (United States)

    Eggert, Lynne K; Blood-Siegfried, Jane; Champagne, Mary; Al-Jumaily, Maha; Biederman, Donna J

    2015-01-01

    Refugees often experience compromised health from both pre- and post-migration stressors. Coalition theory has helped guide the development of targeted programs to address the health care needs of vulnerable populations. Using the Community Coalition Action Theory as a framework, a coalition was formed to implement a community garden with apartment-dwelling refugees. Outcomes included successful coalition formation, a community garden, reported satisfaction from all gardeners with increased vegetable intake, access to culturally meaningful foods, and evidence of increased community engagement. The opportunity for community health nurses to convene a coalition to affect positive health for refugees is demonstrated.

  1. Beyond the biomedical: community resources for mental health care in rural Ethiopia.

    Science.gov (United States)

    Selamu, Medhin; Asher, Laura; Hanlon, Charlotte; Medhin, Girmay; Hailemariam, Maji; Patel, Vikram; Thornicroft, Graham; Fekadu, Abebaw

    2015-01-01

    The focus of discussion in addressing the treatment gap is often on biomedical services. However, community resources can benefit health service scale-up in resource-constrained settings. These assets can be captured systematically through resource mapping, a method used in social action research. Resource mapping can be informative in developing complex mental health interventions, particularly in settings with limited formal mental health resources. We employed resource mapping within the Programme for Improving Mental Health Care (PRIME), to systematically gather information on community assets that can support integration of mental healthcare into primary care in rural Ethiopia. A semi-structured instrument was administered to key informants. Community resources were identified for all 58 sub-districts of the study district. The potential utility of these resources for the provision of mental healthcare in the district was considered. The district is rich in community resources: There are over 150 traditional healers, 164 churches and mosques, and 401 religious groups. There were on average 5 eddir groups (traditional funeral associations) per sub-district. Social associations and 51 micro-finance institutions were also identified. On average, two traditional bars were found in each sub-district. The eight health centres and 58 satellite clinics staffed by Health Extension Workers (HEWs) represented all the biomedical health services in the district. In addition the Health Development Army (HDA) are community volunteers who support health promotion and prevention activities. The plan for mental healthcare integration in this district was informed by the resource mapping. Community and religious leaders, HEWs, and HDA may have roles in awareness-raising, detection and referral of people with mental illness, improving access to medical care, supporting treatment adherence, and protecting human rights. The diversity of community structures will be used to support

  2. Beyond the biomedical: community resources for mental health care in rural Ethiopia.

    Directory of Open Access Journals (Sweden)

    Medhin Selamu

    Full Text Available The focus of discussion in addressing the treatment gap is often on biomedical services. However, community resources can benefit health service scale-up in resource-constrained settings. These assets can be captured systematically through resource mapping, a method used in social action research. Resource mapping can be informative in developing complex mental health interventions, particularly in settings with limited formal mental health resources.We employed resource mapping within the Programme for Improving Mental Health Care (PRIME, to systematically gather information on community assets that can support integration of mental healthcare into primary care in rural Ethiopia. A semi-structured instrument was administered to key informants. Community resources were identified for all 58 sub-districts of the study district. The potential utility of these resources for the provision of mental healthcare in the district was considered.The district is rich in community resources: There are over 150 traditional healers, 164 churches and mosques, and 401 religious groups. There were on average 5 eddir groups (traditional funeral associations per sub-district. Social associations and 51 micro-finance institutions were also identified. On average, two traditional bars were found in each sub-district. The eight health centres and 58 satellite clinics staffed by Health Extension Workers (HEWs represented all the biomedical health services in the district. In addition the Health Development Army (HDA are community volunteers who support health promotion and prevention activities.The plan for mental healthcare integration in this district was informed by the resource mapping. Community and religious leaders, HEWs, and HDA may have roles in awareness-raising, detection and referral of people with mental illness, improving access to medical care, supporting treatment adherence, and protecting human rights. The diversity of community structures will be

  3. Building community-engaged health research and discovery infrastructure on the South Side of Chicago: science in service to community priorities.

    Science.gov (United States)

    Lindau, Stacy Tessler; Makelarski, Jennifer A; Chin, Marshall H; Desautels, Shane; Johnson, Daniel; Johnson, Waldo E; Miller, Doriane; Peters, Susan; Robinson, Connie; Schneider, John; Thicklin, Florence; Watson, Natalie P; Wolfe, Marcus; Whitaker, Eric

    2011-01-01

    To describe the roles community members can and should play in, and an asset-based strategy used by Chicago's South Side Health and Vitality Studies for, building sustainable, large-scale community health research infrastructure. The Studies are a family of research efforts aiming to produce actionable knowledge to inform health policy, programming, and investments for the region. Community and university collaborators, using a consensus-based approach, developed shared theoretical perspectives, guiding principles, and a model for collaboration in 2008, which were used to inform an asset-based operational strategy. Ongoing community engagement and relationship-building support the infrastructure and research activities of the studies. Key steps in the asset-based strategy include: 1) continuous community engagement and relationship building, 2) identifying community priorities, 3) identifying community assets, 4) leveraging assets, 5) conducting research, 6) sharing knowledge and 7) informing action. Examples of community member roles, and how these are informed by the Studies' guiding principles, are provided. Community and university collaborators, with shared vision and principles, can effectively work together to plan innovative, large-scale community-based research that serves community needs and priorities. Sustainable, effective models are needed to realize NIH's mandate for meaningful translation of biomedical discovery into improved population health. Copyright © 2011 Elsevier Inc. All rights reserved.

  4. Tacit knowledge of public health nurses in identifying community health problems and need for new services: a case study.

    Science.gov (United States)

    Yoshioka-Maeda, Kyoko; Murashima, Sachiyo; Asahara, Kiyomi

    2006-09-01

    The purpose of this study was to explore the tacit knowledge of public health nurses in identifying community health problems and developing relevant new projects. Previous research only roughly showed those skills for creating new community health services, such as lobbying. Nine Japanese public health nurses who had created new projects in their municipalities were selected by theoretical sampling and interviewed in 2002-2003. Yin's Case Study Method, especially the multiple-case study design, was used. All 9 public health nurses used similar approaches in identifying community health problems and the need for creating new services, even though their experiences differed and the kinds of projects varied. They identified the difficulties of clients, recognized clients who had the same problems, elucidated the limitations of existing services, and forecasted outcomes from the neglect of the clients' problems. Then they succeeded in creating a new project by examining individual health problems in the context of their community's characteristics, societal factors, and using existing policies to support their clients. This is the first study to explore the skills of public health nurses and their intention to use such skills in creating new projects as well as the exact process. They could identify community health problems that will be the basis for developing new services to provide care for individual clients. This is different from the traditional community assessment approach that requires the collection of a huge amount of information to clarify community health problems. The tacit knowledge of public health nurses will help to create needs-oriented new services more smoothly.

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

    Directory of Open Access Journals (Sweden)

    M. Barker

    2007-09-01

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

  6. Rhetoric and Reality of Community Participation in Health Planning ...

    African Journals Online (AJOL)

    community oriented health programmes. The fourth principle of ... vary between projects, programmes, countries and even within and ... evidence on mechanisms for inclusion of community ..... [7, 50] Celedon [75] report from Chile, however,.

  7. How citizen advisory boards provide input into major waste policy decisions

    International Nuclear Information System (INIS)

    Rogers, E.; Murakami, L.; Hanson, L.

    1995-01-01

    Volunteer citizen boards, such as Site Specific Advisory Boards, can be a very important key to success for the Department of Energy's (DOE's) Waste Management program. These boards can provide informed, independent recommendations reflecting the diversity of the community and its values. A successful volunteer process requires collaboration among regulators, DOE and other Boards; knowing how and when to interface with the broader public; understanding the diversity and representational issues of a citizens group; knowing the open-quotes ins and outsclose quotes of working with volunteers; education and training and most importantly, planning. Volunteers on a citizens board were created to tackle the big picture, policy decisions. The chair of the Rocky Flats Citizens Advisory Board will describe her Board's successes, including the challenges in reaching consensus agreements, as well as the need for integration with other boards and the sites' on-going public involvement programs to provide the input the department is seeking. Finally, one of the greatest challenges for the boards is interfacing with the greater public-at-large, seeing how the CAB has overcome this challenge and integrating broader public input into its decisions

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

    Science.gov (United States)

    South, J; Kinsella, K; Meah, A

    2012-08-01

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

  9. Amplifying Health Through Community Gardens: A Framework for Advancing Multicomponent, Behaviorally Based Neighborhood Interventions.

    Science.gov (United States)

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

    2016-09-01

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

  10. 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.

  11. Wildlife Co-management defined: The Beverly and Kaminuriak Caribou Management Board

    Directory of Open Access Journals (Sweden)

    Donald C. Thomas

    1991-10-01

    Full Text Available A comparison of indigenous and scientific forms of wildlife data gathering and conservation/management reveals similarities and differences. The two systems are needed to effectively manage wildlife in northern Canada, particularly migratory, trans-boundary species. The Beverly and Kaminuriak Caribou Management Board brought multi-jurisdictional caribou users and managers together to co-manage two large herds of caribou (Rangifer tarandus groenlan-dicus. The advisory Board's principal duties and responsibilities are communication and to maintain the two herds at population levels that will meet user needs. Goals, objectives, and principles are set out in a management plan. Board activities are structured in 15 action plans under major categories of communication, supply of caribou, use of caribou, and habitat. Board successes are attributed to use of the plan to guide actions; to the Chairmen and vice-Chairmen; to the quality of founding members and their continuity; to effective vehicles of communication such as a newspaper, radio, video, and community meetings; to a spirit of cooperation; and to high caribou numbers because of high productivity combined with poor accessibility. Problem areas include technical limitations, members' decreasing powers and increasing turnover, inadequate communication of Board objectives and activities within the communities, and accountability. Future challenges include the management of caribou shortages, obtaining better herd data, and the need for more intensive management as user populations grow.

  12. The Mental Health Status of Single-Parent Community College Students in California.

    Science.gov (United States)

    Shenoy, Divya P; Lee, Christine; Trieu, Sang Leng

    2016-01-01

    Single-parenting students face unique challenges that may adversely affect their mental health, which have not been explored in community college settings. The authors conducted secondary analysis of Spring 2013 data from the American College Health Association-National College Health Assessment to examine difficulties facing single-parent community college students and the association between single parenting and negative mental health (depression, self-injury, suicide attempt). Participants were 6,832 California community college students, of whom 309 were single parents. Demographic and mental health data were characterized using univariate descriptive analyses. Bivariate analyses determined whether single parents differed from other students regarding negative mental health or traumatic/difficult events. Finances, family, and relationship difficulties disproportionally affected single parents, who reported nearly twice as many suicide attempts as their counterparts (5.3% vs. 2.7%; p students face a higher prevalence of mental health stressors than other community college students.

  13. Integrating Community Health Workers (CHWs) into Health Care Organizations.

    Science.gov (United States)

    Payne, Julianne; Razi, Sima; Emery, Kyle; Quattrone, Westleigh; Tardif-Douglin, Miriam

    2017-10-01

    Health care organizations increasingly employ community health workers (CHWs) to help address growing provider shortages, improve patient outcomes, and increase access to culturally sensitive care among traditionally inaccessible or disenfranchised patient populations. Scholarly interest in CHWs has grown in recent decades, but researchers tend to focus on how CHWs affect patient outcomes rather than whether and how CHWs fit into the existing health care workforce. This paper focuses on the factors that facilitate and impede the integration of the CHWs into health care organizations, and strategies that organizations and their staff develop to overcome barriers to CHW integration. We use qualitative evaluation data from 13 awardees that received Health Care Innovation Awards from the Centers of Medicare and Medicaid Innovation to enhance the quality of health care, improve health outcomes, and reduce the cost of care using programs involving CHWs. We find that organizational capacity, support for CHWs, clarity about health care roles, and clinical workflow drive CHW integration. We conclude with practical recommendations for health care organizations interested in employing CHWs.

  14. Strengthening the role of Community Health Representatives in the Navajo Nation

    Directory of Open Access Journals (Sweden)

    Caroline King

    2017-04-01

    Full Text Available Abstract Background Strengthening Community Health Worker systems has been recognized to improve access to chronic disease prevention and management efforts in low-resource communities. The Community Outreach and Patient Empowerment (COPE Program is a Native non-profit organization with formal partnerships with both the Navajo Nation Community Health Representative (CHR Program and the clinical facilities serving the Navajo Nation. COPE works to better integrate CHRs into the local health care system through training, strengthening care coordination, and a standardized culturally appropriate suite of health promotion materials for CHRs to deliver to high-risk individuals in their homes. Methods The objective of this mixed methods, cross sectional evaluation of a longitudinal cohort study was to explore how the COPE Program has effected CHR teams over the past 6 years. COPE staff surveyed CHRs in concurrent years (2014 and 2015 about their perceptions of and experience working with COPE, including potential effects COPE may have had on communication among patients, CHRs, and hospital-based providers. COPE staff also conducted focus groups with all eight Navajo Nation CHR teams. Results CHRs and other stakeholders who viewed our results agree that COPE has improved clinic-community linkages, primarily through strengthened collaborations between Public Health Nurses and CHRs, and access to the Electronic Health Records. CHRs perceived that COPE’s programmatic support has strengthened their validity and reputation with providers and clients, and has enhanced their ability to positively effect health outcomes among their clients. CHRs report an improved ability to deliver health coaching to their clients. Survey results show that 80.2% of CHRs feel strongly positive that COPE trainings are useful, while 44.6% of CHRs felt that communication and teamwork had improved because of COPE. Conclusions These findings suggest that CHRs have experienced

  15. Performance management models for public health: Public Health Accreditation Board/Baldrige connections, alignment, and distinctions.

    Science.gov (United States)

    Gorenflo, Grace G; Klater, David M; Mason, Marlene; Russo, Pamela; Rivera, Lillian

    2014-01-01

    The nationally known Malcolm Baldrige Award for Excellence ("Baldrige program") recognizes outstanding performance management and is specifically cited by the Public Health Accreditation Board (PHAB) as a potential framework for PHAB's requisite performance management system. The authors developed a crosswalk that identifies alignments between the 2 programs and is a highlight of the Quest for Exceptional Performance tool that is intended to help health departments capitalize on the connections between the 2 programs. To provide deeper insight into the most robust connections between the 2 programs. The authors developed a crosswalk by listing the PHAB measures, identifying corresponding Baldrige areas to address, and assigning a rating regarding the strength of the alignment. Subsequently, they generated a matrix with numerical scores reflecting the strength of the PHAB-Baldrige alignments that were then analyzed for frequency and strength of alignment by PHAB domain and by Baldrige category. The tool developers and 3 public health leaders with experience in the Baldrige program contributed to both the design and the analyses. The measures used reflected both the frequency and strength of alignments. Of the 123 alignments identified in the crosswalk, 39 were rated as high, 40 as medium, and 44 as low. The strongest connections were in the areas of performance management, quality improvement, strategic planning, workforce development, assessment and analysis, and customer service. While the areas with the most frequent and strongest connections provide the most useful basis for health departments pursuing Baldrige recognition or using Baldrige criteria as a framework for performance management, all alignments could be considered for both purposes.

  16. Mothers' perceptions of community health professional support.

    Science.gov (United States)

    Maunders, Helena; Giles, David; Douglas, Hazel

    2007-04-01

    This qualitative study aimed to explore mothers' experiences of the support they received from community health professionals. Every third mother was selected from an NHS Trust's database of women whose health visitors had used the Solihull Approach. Forty-two women were sent information packs and consent forms. Nine mothers who returned consent forms were interviewed. The interview transcripts were analysed using interpretative phenomenological analysis. The results expand on previous research and contribute additional ideas to the existing evidence base. The findings explore the concepts of trust, expertise and understanding within the working partnership. In addition, the results address mothers' need for reliability, and a preference for professionals who understood women's beliefs about what it means to be a 'good mother'. The results and recommendations are pertinent to those community health professionals who work in the area of early childhood intervention, including practitioners who use the Solihull Approach.

  17. Community involvement in constructing village health buildings in Uganda and Sierra Leone.

    Science.gov (United States)

    Mitchell, M

    1995-11-01

    Three public health projects in Uganda and Sierra Leone are used to illustrate a new approach to construction of health buildings in villages. Emphasis is placed on community involvement. The health projects were comprehensive and relied on health education, employment of local village health workers, and establishment of village health committees. The objective of community involvement was described as encouragement of people to change their own diets and living conditions. This approach to primary health care is considered to be a strong basis for sustainable social development. Each of the three communities initiated the building projects slightly differently. There was a range of structures: traditional meeting halls, simple rooms with imported materials and a pit latrine, new buildings combining local and imported materials and labor, new nontraditional buildings, rehabilitated existing nontraditional buildings with imported labor and materials, and temporary mobile clinics. Community involvement was at different levels. All three projects were the result of a combined effort of national governments or mission hospitals, nongovernmental organizations, and the host community. The following should be considered before beginning construction: a suitable site, appropriate staff accommodation, the likely motivation of the host community, seasonality, local materials available, availability of skilled labor, and design. A plan of work during construction should include a building design, site supervision, transportation of local and non-local materials, unskilled labor, and skilled labor. Village health committees with or without government help would be responsible for maintenance of buildings after construction. A key feature of this approach is the assessment of the community's ability and capacity to contribute.

  18. The relationship between geriatric depression and health-promoting behaviors among community-dwelling seniors.

    Science.gov (United States)

    Chang, Chyong-Fang; Lin, Mei-Hsiang; Wang, Jeng; Fan, Jun-Yu; Chou, Li-Na; Chen, Mei-Yen

    2013-06-01

    People older than 65 years old account for about 10.9% of Taiwan's total population; it is also known that the older adults experience a higher incidence of depression. Public health nurses play an important role in promoting community health. Policymaking for community healthcare should reflect the relationship between health-promoting behavior and depression in community-dwelling seniors. Therefore, the encouragement of healthy aging requires strategic planning by those who provide health promotion services. This study was designed to elicit the health-promoting behaviors of community seniors and investigate the relationship between geriatric depression and health-promoting behaviors among seniors who live in rural communities. We used a cross-sectional, descriptive design and collected data using a demographic information datasheet, the Health Promotion for Seniors and Geriatric Depression Scale short forms. The study included 427 participants. Most were women; mean age was 75.8 years. Most were illiterate; roughly half engaged in a limited number of health-promoting activities. The Geriatric Depression Scale score was negatively associated with health-promoting behavior. Social participation, health responsibility, self-protection, active lifestyle, and total Health Promotion for Seniors score all reached statistical significance. Multivariate analysis indicated that geriatric depression and physical discomfort were independent predictors of health-promoting behavior after controlling the confounding factors. Participants practiced less than the recommended level of health-promoting behaviors. We found a negative correlation between the geriatric depression score and health-promoting behavior. Results can be referenced to develop strategies to promote healthy aging in the community, especially with regard to promoting greater social participation and increased activity for community-dwelling older adults experiencing depression.

  19. Achieving excellence in community health centers: implications for health reform.

    Science.gov (United States)

    Gurewich, Deborah; Capitman, John; Sirkin, Jenna; Traje, Diana

    2012-02-01

    Existing studies tell us little about care quality variation within the community health center (CHC) delivery system. They also tell us little about the organizational conditions associated with CHCs that deliver especially high quality care. The purpose of this study was to examine the operational practices associated with a sample of high performing CHCs. Qualitative case studies of eight CHCs identified as delivering high-quality care relative to other CHCs were used to examine operational practices, including systems to facilitate care access, manage patient care, and monitor performance. Four common themes emerged that may contribute to high performance. At the same time, important differences across health centers were observed, reflecting differences in local environments and CHC capacity. In the development of effective, community-based models of care, adapting care standards to meet the needs of local conditions may be important.

  20. 29 CFR 1922.4 - Responsibilities of the Board; voting.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 7 2010-07-01 2010-07-01 false Responsibilities of the Board; voting. 1922.4 Section 1922.4 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION... WORKERS' COMPENSATION ACT § 1922.4 Responsibilities of the Board; voting. (a) Determinations and...

  1. Stakeholder's perspective: Sustainability of a community health worker program in Afghanistan.

    Science.gov (United States)

    Najafizada, Said Ahmad Maisam; Labonté, Ronald; Bourgeault, Ivy Lynn

    2017-02-01

    The objectives of this study were two-fold: 1) to examine how different stakeholders define sustainability, and 2) to identify barriers to and facilitators of the sustainability of the Afghan CHW program. We interviewed 63 individual key informants, and conducted 11 focus groups [35 people] with policymakers, health managers, community health workers, and community members across Afghanistan. The participants were purposefully selected to provide a wide range of perspectives. Different stakeholders define sustainability differently. Policymakers emphasize financial resources; health managers, organizational operations; and community-level stakeholders, routine frontline activities. The facilitators they identify include integration into the health system, community support, and capable human resources. Barriers they noted include lack of financial resources, poor program design and implementation, and poor quality of services. Measures to ensure sustainability could be national revenue allocation, health-specific taxation, and community financing. Sustainability is complicated and has multiple facets. The plurality of understanding of sustainability among stakeholders should be addressed explicitly in the program design. To ensure sustainability, there is a need for a coordinated effort amongst all stakeholders. Copyright © 2016 Elsevier Ltd. All rights reserved.

  2. Community participation in international health: practical recommendations for donor and recipient organizations

    Directory of Open Access Journals (Sweden)

    Akukwe Chinua

    1999-01-01

    Full Text Available This article discusses the need for donor agencies and recipient organizations to involve target communities in the conceptualization, development, monitoring, and implementation of health services and programs in international health. This paper assumes that most donor organizations are based in industrialized countries. Given that resources are finite in both developing and developed countries, the article briefly reviews the current trend of declining public funds for health systems and an increasing role for privately funded health services worldwide. The article calls for community-based international health services that reflect the priorities of target populations, and it also discusses practi cal steps to involve local populations in community-based health planning and management in international health.

  3. SafeMed: Using pharmacy technicians in a novel role as community health workers to improve transitions of care.

    Science.gov (United States)

    Bailey, James E; Surbhi, Satya; Bell, Paula C; Jones, Angel M; Rashed, Sahar; Ugwueke, Michael O

    2016-01-01

    To describe the design, implementation, and early experience of the SafeMed program, which uses certified pharmacy technicians in a novel expanded role as community health workers (CPhT-CHWs) to improve transitions of care. A large nonprofit health care system serving the major medically underserved areas and geographic hotspots for readmissions in Memphis, TN. The SafeMed program is a care transitions program with an emphasis on medication management designed to use low-cost health workers to improve transitions of care from hospital to home for superutilizing patients with multiple chronic conditions and polypharmacy. CPhT-CHWs were given primary responsibility for patient outreach after hospital discharge with the use of home visits and telephone follow-up. SafeMed program CPhT-CHWs served as pharmacist extenders, obtaining medication histories, assisting in medication reconciliation and identification of potential drug therapy problems (DTPs), and reinforcing medication education previously provided by the pharmacist per protocol. CPhT-CHW training included patient communication skills, motivational interviewing, medication history taking, teach-back techniques, drug disposal practices, and basic disease management. Some CPhT-CHWs experienced difficulties adjusting to an expanded scope of practice. Nonetheless, once the Tennessee Board of Pharmacy affirmed that envisioned SafeMed CPhT-CHW roles were consistent with Board rules, additional responsibilities were added for CPhT-CHWs to enhance their effectiveness. Patient outreach teams including CPhT-CHWs achieved increases in home visit and telephone follow-up rates and were successful in helping identify potential DTPs. The early experience of the SafeMed program demonstrates that CPhT-CHWs are well suited for novel expanded roles to improve care transitions for superutilizing populations. CPhT-CHWs can identify and report potential DTPs to the pharmacist to help target medication therapy management. Critical

  4. Community mental health in India: A rethink

    Directory of Open Access Journals (Sweden)

    Aynkran Jothy R

    2008-07-01

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

  5. Community Mental Health: Issues for Social Work Practice and Education.

    Science.gov (United States)

    Katz, Arthur J., Ed.

    Articles by social work educators on some of the critical issues in community mental health are presented. Examined are some conceptual and program developments related to coordination, continuity of care, and the use of teams in planning and service delivery for community mental health (Lawrence K. Berg). The issue of civil commitment to and…

  6. House Parties: An Innovative Model for Outreach and Community-Based Health Education.

    Science.gov (United States)

    Anderson-Reeves, Timika; Goodman, Jacqueline; Bragg, Brian; Leruth, Chelsey

    2017-12-01

    Purpose To connect low resource communities to innovative services that address gaps in health access and knowledge. Description We describe the house party model, as a community-based workshop approach to health education developed by the Westside Healthy Start program (WHS) in Chicago, Illinois. Key elements of the WHS house party model include use of community health workers as facilitators, collaboration with participants and community-based organizations, referrals to health care and social services, and engagement strategies such as interactive activities, personal stories, and discussion. Assessment In 2014 and 2015, WHS completed 23 house parties with 271 participants, delivering education on relevant maternal and child health (MCH) topics. Participants demonstrated improvements in knowledge of several health-related areas. About half of participants were able to identify causes or signs of preterm labor prior to the house party, compared to over 80% after. In addition, 94% of participants rated the house party workshops "excellent" or "good". Conclusion House parties are a promising strategy for increasing knowledge about MCH topics and linking hard-to-reach populations to resources in the community.

  7. Health surveillance assistants as intermediates between the community and health sector in Malawi: exploring how relationships influence performance.

    Science.gov (United States)

    Kok, Maryse C; Namakhoma, Ireen; Nyirenda, Lot; Chikaphupha, Kingsley; Broerse, Jacqueline E W; Dieleman, Marjolein; Taegtmeyer, Miriam; Theobald, Sally

    2016-05-03

    There is increasing global interest in how best to support the role of community health workers (CHWs) in building bridges between communities and the health sector. CHWs' intermediary position means that interpersonal relationships are an important factor shaping CHW performance. This study aimed to obtain in-depth insight into the facilitators of and barriers to interpersonal relationships between health surveillance assistants (HSAs) and actors in the community and health sector in hard-to-reach settings in two districts in Malawi, in order to inform policy and practice on optimizing HSA performance. The study followed a qualitative design. Forty-four semi-structured interviews and 16 focus group discussions were conducted with HSAs, different community members and managers in Mchinji and Salima districts. Data were recorded, transcribed, translated, coded and thematically analysed. HSAs had relatively strong interpersonal relationships with traditional leaders and volunteers, who were generally supportive of their work. From the health sector side, HSAs linked to health professionals and managers, but found them less supportive. Accountability structures at the community level were not well-established and those within the health sector were executed irregularly. Mistrust from the community, volunteers or HSAs regarding incentives and expectations that could not be met by "higher levels" undermined support structures and led to demotivation and hampered performance. Supervision and training were sometimes a source of mistrust and demotivation for HSAs, because of the perceived disinterest of supervisors, uncoordinated supervision and favouritism in selection of training participants. Rural HSAs were seen as more disadvantaged than HSAs in urban areas. HSAs' intermediary position necessitates trusting relationships between them and all actors within the community and the health sector. There is a need to improve support and accountability structures that

  8. Building community for health: lessons from a seven-year-old neighborhood/university partnership.

    Science.gov (United States)

    Flick, L H; Reese, C G; Rogers, G; Fletcher, P; Sonn, J

    1994-01-01

    This article presents two case studies highlighting the role of community conflict in the process of community empowerment. A graduate program for community health nurses (CHNs) in a large Midwestern city formed a partnership with a diverse, integrated neighborhood for the dual purposes of enhancing the community's capacity to improve its own health and teaching CHNs community organizing as a means to improve health. Central to the partnership are a broad definition of health, trust developed through long-term involvement, a commitment to reciprocity, social justice, and Freire's model of adult learning. Two initiatives that gave rise to major conflicts between community groups are analyzed. Conflicts, external and internal to the community, proved to be both powerful catalysts and potential barriers to the use of Freirian themes in community organization. Both university and community participants report needing better skills in the early recognition and management of conflict. We conclude that conflict management theory must be integrated with empowerment education theory, particularly when empowerment education is applied in a diverse community.

  9. Health promotion and education activities of community pharmacists in Kuwait.

    Science.gov (United States)

    Awad, Abdelmoneim; Abahussain, Eman

    2010-04-01

    To investigate self-reported practice of pharmacists regarding health promotion and education activities, explore the barriers that may limit their involvement in health promotion and education, and identify their willingness to participate in continuing education programs related to health education. Community pharmacies in Kuwait. A descriptive cross-sectional study was performed using a pre-tested questionnaire on a sample of 223 community pharmacists. The extent of the pharmacists' involvement in counselling patients about health promotion and education topics, their preparation to counsel patients in health promotion and education topics, and their perceived success in changing the patients' health behaviour. The response rate was 92%. Information on medication use was the most frequent reason for consumers seeking community pharmacists' advice. The majority of respondents believed that behaviour related to the proper use of drugs was very important. There was less agreement on the importance of other health behaviours. Respondents indicated they were involved in counselling patients on health behaviours related to use of drugs as prescribed/directed, weight management, medicine contents and side effects, diet modification and stress reduction, but were less involved in counselling on other health behaviours. Respondents' perception of themselves as "most prepared" to counsel patients closely reflected their involvement. Pharmacists reported high levels of success in helping patients to achieve improvements in using their drugs properly compared to low levels in changing patients' personal health behaviours. The majority of respondents believed that pharmacists had a responsibility for counselling consumers on health behaviours (97%, 95% CI 95-99%), and indicated their willingness to learn more about health promotion (84%, 78-88%). Lack of pharmacists' time was reported by about 58% of respondents as the major barrier limiting pharmacists' provision of health

  10. The RF spectrum: managing community health concerns

    International Nuclear Information System (INIS)

    Maclean, I.

    2001-01-01

    In this presentation I would like to share with you the way in which the Australian Communications Authority (ACA) goes about 'managing' community issues relating to the RF spectrum. In particular, I would like to refer to community issues associated with concerns about health. I will refer only briefly to the siting of mobile phone base stations as that will be covered elsewhere. Before getting into the community issues, I would like to provide some context about the ACA and the arrangements it has for regulating radiofrequency electromagnetic radiation (RF EMR). Copyright (2001) Australasian Radiation Protection Society Inc

  11. Financial Reporting Practices in Illinois Public Community Colleges.

    Science.gov (United States)

    Skeadas, Gus J.

    A study was conducted to determine how well Illinois' 38 community college districts satisfied the needs of board members, creditors, investors, and tax payers for financial information. A list of 38 financial reporting requirements was developed from the requirements of the Illinois Community College Board (ICCB) and guidelines from the Audits of…

  12. Focus Group in Community Mental Health Research: Need for Adaption.

    Science.gov (United States)

    Zupančič, Vesna; Pahor, Majda; Kogovšek, Tina

    2018-04-27

    The article presents an analysis of the use of focus groups in researching community mental health users, starting with the reasons for using them, their implementation in mental health service users' research, and the adaptations of focus group use when researching the experiences of users. Based on personal research experience and a review of scientific publications in the Google Scholar, Web of Science, ProQuest, EBSCOhost, and Scopus databases, 20 articles published between 2010 and 2016 were selected for targeted content analysis. A checklist for reporting on the use of focus groups with community mental health service users, aiming to improve the comparability, verifiability and validity was developed. Adaptations of the implementation of focus groups in relation to participants' characteristics were suggested. Focus groups are not only useful as a scientific research technique, but also for ensuring service users' participation in decision-making in community mental health and evaluating the quality of the mental health system and services .

  13. Firms’ Board Independence and Corporate Social Performance: A Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Eduardo Ortas

    2017-06-01

    Full Text Available This paper investigates the influence of organizations’ board independence on corporate social performance (CSP using a meta-analytic approach. A sample of 87 published papers is used to identify a set of underlying moderating effects in that relationship. Specifically, differences in the system of corporate governance, CSP measurement models and market conditions have been considered as moderating variables. The results show that the independence of a company’s board positively influences CSP. This is because companies with more independent directors in their boards are more likely to commit to stakeholder engagement, environmental preservation and community well-being. Interestingly, the results also show that the positive connection between board independence and CSP is stronger in civil law countries and when CSP is measured by self-reporting data. Finally, the strength of the influence of the independence of a firm’s board on CSP varies significantly in different market conditions. The paper concludes by presenting the main implications for academics, practitioners and policy makers.

  14. Community Health Workers-Promotores de Salud in Mexico: History and Potential for Building Effective Community Actions.

    Science.gov (United States)

    Balcazar, Hector; Perez-Lizaur, Ana Bertha; Izeta, Ericka Escalante; Villanueva, Maria Angeles

    2016-01-01

    This article takes a historical perspective combining 3 illustrative examples of the origins of the community health worker (CHW) model in Mexico, as a community-based participatory strategy. Three examples were identified from the sparse literature about CHWs in Mexico emphasizing their key roles and functions in various community settings. The CHW models illustrate what is known of training-development and planning, implementation, and evaluation of the CHWs model in different settings addressing cardiovascular disease and risk factors. The potential exists for integrating CHW projects to expand the health promotion model with new emphasis on municipality and regional participation.

  15. Preserving community in health care.

    Science.gov (United States)

    Emanuel, E J; Emanuel, L L

    1997-02-01

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

  16. [Effects of community health promotion project for garlic cultivating farmers based on self-efficacy theory and community capacity building framework].

    Science.gov (United States)

    Kim, Hyang-Sook; Gu, Mee Ock

    2011-02-01

    This study was conducted to test the effects of a community health promotion project for farmers cultivating garlic. Bandura's self-efficacy theory (1986) and Chaskin's community capacity framework (2001) were used as the theoretical framework. A nonequivalent control group pretest-posttest design was used. Study participants were 72 garlic farmers (intervention: 36, control: 36). The community health promotion project consisted of health promotion program and community capacity building strategies and was provided for 12 weeks (8 during farming off-season and 4 during farming season). Data were collected between February 23 and May 31, 2009 and were analyzed using chi-square test, Fisher's exact test, t-test, and repeated measure ANOVA using SPSS/WIN 12.0. For the experimental group, significant improvement was found for self-efficacy, farming related health behavior, physical fitness (muscle strength, muscle endurance, upper body flexibility, lower body flexibility, cardiovascular endurance, balance, agility), farmer's syndrome, and health related quality of life as compared to the control group. The findings of the study indicate that the community health promotion project for garlic farmers is effective and can be recommended as a nursing intervention for health promotion of garlic cultivating farmers.

  17. Scientific and Popular Health Knowledge in the Education Work of Community Health Agents in Rio de Janeiro Shantytowns

    Science.gov (United States)

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

    2012-01-01

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

  18. Performance of community health workers : situating their intermediary position within complex adaptive health systems

    NARCIS (Netherlands)

    Kok, Maryse C; Broerse, Jacqueline E W; Theobald, Sally; Ormel, Hermen; Dieleman, Marjolein; Taegtmeyer, Miriam

    2017-01-01

    Health systems are social institutions, in which health worker performance is shaped by transactional processes between different actors.This analytical assessment unravels the complex web of factors that influence the performance of community health workers (CHWs) in low- and middle-income

  19. Automatic topic identification of health-related messages in online health community using text classification.

    Science.gov (United States)

    Lu, Yingjie

    2013-01-01

    To facilitate patient involvement in online health community and obtain informative support and emotional support they need, a topic identification approach was proposed in this paper for identifying automatically topics of the health-related messages in online health community, thus assisting patients in reaching the most relevant messages for their queries efficiently. Feature-based classification framework was presented for automatic topic identification in our study. We first collected the messages related to some predefined topics in a online health community. Then we combined three different types of features, n-gram-based features, domain-specific features and sentiment features to build four feature sets for health-related text representation. Finally, three different text classification techniques, C4.5, Naïve Bayes and SVM were adopted to evaluate our topic classification model. By comparing different feature sets and different classification techniques, we found that n-gram-based features, domain-specific features and sentiment features were all considered to be effective in distinguishing different types of health-related topics. In addition, feature reduction technique based on information gain was also effective to improve the topic classification performance. In terms of classification techniques, SVM outperformed C4.5 and Naïve Bayes significantly. The experimental results demonstrated that the proposed approach could identify the topics of online health-related messages efficiently.

  20. Performance of community health workers: situating their intermediary position within complex adaptive health systems.

    Science.gov (United States)

    Kok, Maryse C; Broerse, Jacqueline E W; Theobald, Sally; Ormel, Hermen; Dieleman, Marjolein; Taegtmeyer, Miriam

    2017-09-02

    Health systems are social institutions, in which health worker performance is shaped by transactional processes between different actors.This analytical assessment unravels the complex web of factors that influence the performance of community health workers (CHWs) in low- and middle-income countries. It examines their unique intermediary position between the communities they serve and actors in the health sector, and the complexity of the health systems in which they operate. The assessment combines evidence from the international literature on CHW programmes with research outcomes from the 5-year REACHOUT consortium, undertaking implementation research to improve CHW performance in six contexts (two in Asia and four in Africa). A conceptual framework on CHW performance, which explicitly conceptualizes the interface role of CHWs, is presented. Various categories of factors influencing CHW performance are distinguished in the framework: the context, the health system and intervention hardware and the health system and intervention software. Hardware elements of CHW interventions comprise the supervision systems, training, accountability and communication structures, incentives, supplies and logistics. Software elements relate to the ideas, interests, relationships, power, values and norms of the health system actors. They influence CHWs' feelings of connectedness, familiarity, self-fulfilment and serving the same goals and CHWs' perceptions of support received, respect, competence, honesty, fairness and recognition.The framework shines a spotlight on the need for programmes to pay more attention to ideas, interests, relationships, power, values and norms of CHWs, communities, health professionals and other actors in the health system, if CHW performance is to improve.