WorldWideScience

Sample records for home visiting program

  1. Assessing Quality in Home Visiting Programs

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    Korfmacher, Jon; Laszewski, Audrey; Sparr, Mariel; Hammel, Jennifer

    2013-01-01

    Defining quality and designing a quality assessment measure for home visitation programs is a complex and multifaceted undertaking. This article summarizes the process used to create the Home Visitation Program Quality Rating Tool (HVPQRT) and identifies next steps for its development. The HVPQRT measures both structural and dynamic features of…

  2. Family perspective on home visiting program

    Directory of Open Access Journals (Sweden)

    Sebahattin Ziyanak

    2015-08-01

    Full Text Available This study focused on a lately constructed survey instrument that was intended to test the family perspective on a home visiting program and school. The four areas investigated were parent-teacher communications, student-teacher interactions, the parent’s perception of the school and the parents’ understanding of the home visiting program. The participants were selected from parents/guardians of 7th, 8th, 9th and 10th grade students at a Charter school in a southwestern major city in Texas, the United States of America. Twenty-two questions were asked to evaluate parent’s viewpoint with the four designated areas of interaction and communication of among school-parent-teacher. The findings showed that 73.5% of the students’ families living were in low income. The outcomes for reliability were promising (a = .909. Yet, the factor analysis outcomes of a rotated four-factor solution were insufficient to assess validity. This might be related to a small sample size (n = 45.

  3. Program home visit Costa Rica's health system: guidelines for improvement

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    Katherine Solís Cordero

    2015-07-01

    Full Text Available Introduction. Home visit is the main strategy of primary care by bringing health services to the homes and workplaces of people, which allows knowing the needs of the population firsthand. Thus, home visit by the ATAP represents the first contact of the individual, family and community with the health system, with significant benefits both individually and collectively. This research responds to the need to identify the elements that the home visiting program needs to improve modify or replace in order to maximize the provision of this service.Method. It is a qualitative, observational analytic study. Data were collected through documentary research, key informant interviews and focus group. The analysis was performed from the grounded theory.Results. The main results showed the existence of elements at the level of the health system, home visiting program and the figure of the ATAP that should be reviewed, modified or replaced to the home visit, thus it has bigger and better results for the population and the health system.Conclusion. The Home Visiting Program is strength of the Costa Rican health system to address health inequities. However, it is imperative to make decisions and implementation of actions that promote the improvement and increased results of the home visit at a family and community level.

  4. Maternal Engagement in Home Visiting: The MOM Program

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    Radcliffe, Jerilynn; Schwarz, Donald F.

    2013-01-01

    The MOM Program is an innovative home visiting program whose aim is to empower low-income urban mothers to obtain health and early intervention services for their children. The authors discuss a recent evaluation of the MOM program which sought to examine maternal involvement in the program. The results raise important questions and call for…

  5. 76 FR 12977 - Advisory Committee on the Maternal, Infant and Early Childhood Home Visiting Program Evaluation

    Science.gov (United States)

    2011-03-09

    ... Advisory Committee on the Maternal, Infant and Early Childhood Home Visiting Program Evaluation AGENCY... Committee on the Maternal, Infant and Early Childhood Home Visiting Program Evaluation. SUMMARY: HRSA and... and Early Childhood Home Visiting Program Evaluation (``the Committee''), pursuant to subsection...

  6. 78 FR 53150 - Advisory Committee on the Maternal, Infant and Early Childhood Home Visiting Program Evaluation...

    Science.gov (United States)

    2013-08-28

    ... Advisory Committee on the Maternal, Infant and Early Childhood Home Visiting Program Evaluation; Notice of... Visiting Program Evaluation (MIECHVE). Authority: Section 10(a)(2) of the Federal Advisory Committee Act... Maternal, Infant, and Early Childhood Home Visiting Program Evaluation. Date and Time: September 12,...

  7. Evaluating fidelity in home-visiting programs a qualitative analysis of 1058 home visit case notes from 105 families.

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    Thomas Saïas

    Full Text Available OBJECTIVE: Implementation fidelity is a key issue in home-visiting programs as it determines a program's effectiveness in accomplishing its original goals. This paper seeks to evaluate fidelity in a 27-month program addressing maternal and child health which took place in France between 2006 and 2011. METHOD: To evaluate implementation fidelity, home visit case notes were analyzed using thematic qualitative and computer-assisted linguistic analyses. RESULTS: During the prenatal period, home visitors focused on the social components of the program. Visitors discussed the physical changes in pregnancy, and psychological and social environment issues. Discussing immigration, unstable employment and financial related issues, family relationships and dynamics and maternity services, while not expected, were found in case notes. Conversely, health during pregnancy, early child development and postpartum mood changes were not identified as topics within the prenatal case notes. During the postnatal period, most components of the intervention were addressed: home visitors observed the mother's adaptation to the baby; routine themes such as psychological needs and medical-social networks were evaluated; information on the importance of social support and on adapting the home environment was given; home visitors counseled on parental authority, and addressed mothers' self-esteem issues; finally, they helped to find child care, when necessary. Some themes were not addressed or partially addressed: health education, child development, home environment, mother's education plans and personal routine, partner support and play with the child. Other themes were not expected, but found in the case notes: social issues, mother-family relationship, relation with services, couple issues, quality of maternal behavior and child's language development. CONCLUSIONS: In this program, home visitors experienced difficulties addressing some of the objectives because they

  8. 76 FR 12978 - Advisory Committee on the Maternal, Infant and Early Childhood Home Visiting Program Evaluation...

    Science.gov (United States)

    2011-03-09

    ... Advisory Committee on the Maternal, Infant and Early Childhood Home Visiting Program Evaluation; Notice of..., Infant and Early Childhood Home Visiting Program Evaluation. Date and Time: March 23, 2011, 9 a.m.-3 p.m... Program Evaluation will meet for its first session on Wednesday, March 23, 2011, from 9 a.m. to 3 p.m....

  9. [Current Status of Home Visit Programs: Activities and Barriers of Home Care Nursing Services].

    Science.gov (United States)

    Oh, Eui Geum; Lee, Hyun Joo; Kim, Yukyung; Sung, Ji Hyun; Park, Young Su; Yoo, Jae Yong; Woo, Soohee

    2015-10-01

    The purpose of this study was to examine the current status of home care nursing services provided by community health nurses and to identify barriers to the services. A cross-sectional survey was conducted with three types of community health care nurses. Participants were 257 nurses, 46 of whom were hospital based home care nurses, 176 were community based visiting nurses, and 35 were long term care insurance based visiting nurses. A structured questionnaire on 7 domains of home care nursing services with a 4-point Likert scale was used to measure activities and barriers to care. Data were analyzed using SPSS WIN 21.0 program. Hospital based home care nurses showed a high level of service performance activity in the domain of clinical laboratory tests, medications and injections, therapeutic nursing, and education. Community based visiting nurses had a high level of service performance in the reference domain. Long term care insurance based visiting nurses showed a high level of performance in the service domains of fundamental nursing and counseling. The results show that although health care service provided by the three types of community health nurse overlapped, the focus of the service is differentiated. Therefore, these results suggest that existing home care services will need to be utilized efficiently in the development of a new nursing care service for patients living in the community after hospital discharge.

  10. Pilot Evaluation of a Home Visit Parent Training Program in Disadvantaged Families

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    Leung, Cynthia; Tsang, Sandra; Heung, Kitty

    2013-01-01

    Objectives: The study reported the pilot evaluation of the Healthy Start Home Visit Program for disadvantaged Chinese parents with preschool children, delivered by trained parent assistants. Home visiting was used to make services more accessible to disadvantaged families. Method: The participants included 21 parent-child dyads. Outcome measures…

  11. The importance of trust in successful home visit programs for older people.

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    Muntinga, M.E.; Leeuwen, K.M. van; Jansen, A.P.D.; Nijpels, G.; Schellevis, F.G.; Abma T.A.

    2016-01-01

    Outcomes of proactive home visit programs for frail, older people might be influenced by aspects of the caregiver–receiver interaction. We conducted a naturalistic case study to explore the interactional process between a nurse and an older woman during two home visits. Using an ethics of care, we p

  12. Home Visiting in Two Cultures

    Science.gov (United States)

    Lamorey, Suzanne

    2017-01-01

    The home visiting component of early childhood education programs provides an important portal through which to observe family interactions as well as gain insights about the ethnotheories of the home visitor. Home visits were videotaped in the United States and in Turkey to analyze training and program effectiveness. One striking feature of this…

  13. The Mother and Infant Home Visiting Program Evaluation: Early Findings on the Maternal, Infant, and Early Childhood Home Visiting Program. A Report to Congress. OPRE Report 2015-11

    Science.gov (United States)

    Michalopoulos, Charles; Lee, Helen; Duggan, Anne; Lundquist, Erika; Tso, Ada; Crowne, Sarah Shea; Burrell, Lori; Somers, Jennifer; Filene, Jill H.; Knox, Virginia

    2015-01-01

    "The Mother and Infant Home Visiting Program Evaluation: Early Findings on the Maternal, Infant, and Early Childhood Home Visiting Program--A Report to Congress" presents the first findings from the Mother and Infant Home Visiting Program Evaluation (MIHOPE), the legislatively mandated national evaluation of the Maternal, Infant, and…

  14. Case Study of Home-School Visits

    Science.gov (United States)

    Aguerrebere, Yolanda

    2009-01-01

    This case study evaluated one site of a California teacher home visit program. Home visits have been an important means of connecting families and schooling. In 1999, California inaugurated a statewide home visit program to promote effective partnership between home and school for low-achieving schools. At this site, families in 3 kindergarten…

  15. The Effectiveness of Healthy Start Home Visit Program: Cluster Randomized Controlled Trial

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    Leung, Cynthia; Tsang, Sandra; Heung, Kitty

    2015-01-01

    Purpose: The study reported the effectiveness of a home visit program for disadvantaged Chinese parents with preschool children, using cluster randomized controlled trial design. Method: Participants included 191 parents and their children from 24 preschools, with 84 dyads (12 preschools) in the intervention group and 107 dyads (12 preschools) in…

  16. The Importance of Trust in Successful Home Visit Programs for Older People

    Directory of Open Access Journals (Sweden)

    Maaike E. Muntinga

    2016-11-01

    Full Text Available Outcomes of proactive home visit programs for frail, older people might be influenced by aspects of the caregiver–receiver interaction. We conducted a naturalistic case study to explore the interactional process between a nurse and an older woman during two home visits. Using an ethics of care, we posit that a trusting relationship is pivotal for older people to accept care that is proactively offered to them. Trust can be build when nurses meet the relational needs of older people. Nurses can achieve insight in these needs by exploring older people’s value systems and life stories. We argue that a strong focus on older people’s relational needs might contribute to success of proactive home visits for frail, older people.

  17. The Importance of Trust in Successful Home Visit Programs for Older People

    Directory of Open Access Journals (Sweden)

    Maaike E. Muntinga

    2016-11-01

    Full Text Available Outcomes of proactive home visit programs for frail, older people might be influenced by aspects of the caregiver–receiver interaction. We conducted a naturalistic case study to explore the interactional process between a nurse and an older woman during two home visits. Using an ethics of care, we posit that a trusting relationship is pivotal for older people to accept care that is proactively offered to them. Trust can be build when nurses meet the relational needs of older people. Nurses can achieve insight in these needs by exploring older people’s value systems and life stories. We argue that a strong focus on older people’s relational needs might contribute to success of proactive home visits for frail, older people.

  18. Impact of a Kentucky Maternal, Infant, and Early Childhood Home-Visitation Program on Parental Risk Factors

    Science.gov (United States)

    Ferguson, Jonnisa M.; Vanderpool, Robin C.

    2013-01-01

    As public health organizations continue to implement maternal and child health home-visitation programs, more evaluation of these efforts is needed, particularly as it relates to improving parental behaviors. The purpose of our study was to assess the impact of families' participation in a home-visitation program offered by a central Kentucky…

  19. [Nurse home visits in France].

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    Monguillon, Dominique; Gracia, Pierre-Benjamin

    2011-10-01

    Nurse home visits in France. More and more nurses carry out home visits, either as freelance nurses or employees of a nurse home visits service, a home hospital care structure or a nursing care centre. These home visits are both demanded by patients and encouraged by the health authorities. As a consequence, the service is expanding every year.

  20. Effectiveness of home visiting programs on child outcomes: a systematic review

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    Peacock Shelley

    2013-01-01

    Full Text Available Abstract Background The effectiveness of paraprofessional home-visitations on improving the circumstances of disadvantaged families is unclear. The purpose of this paper is to systematically review the effectiveness of paraprofessional home-visiting programs on developmental and health outcomes of young children from disadvantaged families. Methods A comprehensive search of electronic databases (e.g., CINAHL PLUS, Cochrane, EMBASE, MEDLINE from 1990 through May 2012 was supplemented by reference lists to search for relevant studies. Through the use of reliable tools, studies were assessed in duplicate. English language studies of paraprofessional home-visiting programs assessing specific outcomes for children (0-6 years from disadvantaged families were eligible for inclusion in the review. Data extraction included the characteristics of the participants, intervention, outcomes and quality of the studies. Results Studies that scored 13 or greater out of a total of 15 on the validity tool (n = 21 are the focus of this review. All studies are randomized controlled trials and most were conducted in the United States. Significant improvements to the development and health of young children as a result of a home-visiting program are noted for particular groups. These include: (a prevention of child abuse in some cases, particularly when the intervention is initiated prenatally; (b developmental benefits in relation to cognition and problem behaviours, and less consistently with language skills; and (c reduced incidence of low birth weights and health problems in older children, and increased incidence of appropriate weight gain in early childhood. However, overall home-visiting programs are limited in improving the lives of socially high-risk children who live in disadvantaged families. Conclusions Home visitation by paraprofessionals is an intervention that holds promise for socially high-risk families with young children. Initiating the

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

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

    2016-01-01

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

  2. Effectiveness of a promotora home visitation program for underserved Hispanic children with asthma.

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    Rashid, Shumyla; Carcel, Consuelo; Morphew, Tricia; Amaro, Silvia; Galant, Stanley

    2015-06-01

    Retention in a mobile asthma clinic, the Breathmobile™, of ≥3 visits has previously been shown to be essential for attaining asthma control in underserved children. The objective of this study in primarily Hispanic-American children was to determine the difference in retention between those seen in the Breathmobile™ compared to those receiving an additional promotora-based home visit (HV). Children with asthma in the Breathmobile™ program were evaluated for asthma status and aeroallergen sensitivity. Indication for HV included poor asthma control, educational and environmental control needs. An initial visit consisted of environmental assessment as well as a 3-h interactive educational session covering asthma basics. A follow-up visit 1 month later assessed implementation. The primary outcome measure of retention was ≥6 months in the Breathmobile™ program. Of the 1007 asthmatic children seen between April 2002 and June of 2005, 136 received HV. These children showed significantly greater retention compared to those without HV with a median number of visits (5 visits versus 2 visits), ≥3 Breathmobile™ visits (86.0% versus 38.8%), median number of days in the program (299 versus 63 days) and percentage of patients in the program ≥6 months (67.8% versus 31.3%) p asthma severity were each independent predictors of retention. The addition of a promotora HV program proved effective in providing greater retention in the Breathmobile™ program essential for asthma control. Randomized clinical trials will be needed to show the impact on health care utilization and asthma control.

  3. Is the Families First Home Visiting Program Effective in Reducing Child Maltreatment and Improving Child Development?

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    Chartier, Mariette J; Brownell, Marni D; Isaac, Michael R; Chateau, Dan; Nickel, Nathan C; Katz, Alan; Sarkar, Joykrishna; Hu, Milton; Taylor, Carole

    2017-05-01

    While home visiting programs are among the most widespread interventions to support at-risk families, there is a paucity of research investigating these programs under real-world conditions. The effectiveness of Families First home visiting (FFHV) was examined for decreasing rates of being in care of child welfare, decreasing hospitalizations for maltreatment-related injuries, and improving child development at school entry. Data for 4,562 children from home visiting and 5,184 comparison children were linked to deidentified administrative health, social services, and education data. FFHV was associated with lower rates of being in care by child's first, second, and third birthday (adjusted risk ratio [aRR] = 0.75, 0.79, and 0.81, respectively) and lower rates of hospitalization for maltreatment-related injuries by third birthday (aRR = 0.59). No differences were found in child development at kindergarten. FFHV should be offered to at-risk families to decrease child maltreatment. Program enhancements are required to improve child development at school entry.

  4. Structured social relationships: a review of volunteer home visiting programs for parents of young children.

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    Byrne, Fiona; Grace, Rebekah; Tredoux, Jaimie; Kemp, Lynn

    2016-06-01

    Objective The aims of the present paper were to: (1) review the research literature that contributes to an understanding of the role of volunteer home visiting programs in supporting the health and well being of families with young children; and (2) propose a conceptual model outlining service pathways for families in need of additional support. Methods An integrative literature review method was used, with a mix of electronic and manual search methods for the period January 1980-January 2014. Forty-five studies were identified that met the inclusion criteria for review and were coded according to themes developed a priori. Results There is little formal research that has examined the effectiveness of volunteer home visiting programs for supporting family health and well being. The available research suggests that volunteer home visiting programs provide socioemotional support through structured social relationships; however, there is limited empirical evidence to explicate the factors that contribute to these outcomes. Conclusion In recognition of the importance of peer support for new parents, the not-for-profit sector has been involved in providing volunteer home visiting services to families for decades. However, the body of research to support this work is characterised by methodological limitations, and rigorous evidence is limited. What is clear anecdotally and qualitatively from the existing research is that parents who are in need of additional support value engagement with a community volunteer. These structured social relationships appear to fulfil a service need within the community, helping build bridges to support social networks, and thus complementing professional services and relationships. Overall, structured social relationships in the form of volunteer home visiting programs appear to provide an important pathway to support family health and well being. Findings from the existing research are mixed and often characterised by methodological

  5. Moving beyond Depression: A Collaborative Approach to Treating Depressed Mothers in Home Visiting Programs

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    Ammerman, Robert T.; Putnam, Frank W.; Teeters, Angelique R.; Van Ginkel, Judith B.

    2014-01-01

    Research indicates that up to half of mothers in home visiting experience clinically significant levels of depression during their participation in services. Depression alters maternal life course, negatively impacts child development, and contributes to poorer home visiting outcomes. This article describes the Moving Beyond Depression (MBD)…

  6. Moving beyond Depression: A Collaborative Approach to Treating Depressed Mothers in Home Visiting Programs

    Science.gov (United States)

    Ammerman, Robert T.; Putnam, Frank W.; Teeters, Angelique R.; Van Ginkel, Judith B.

    2014-01-01

    Research indicates that up to half of mothers in home visiting experience clinically significant levels of depression during their participation in services. Depression alters maternal life course, negatively impacts child development, and contributes to poorer home visiting outcomes. This article describes the Moving Beyond Depression (MBD)…

  7. Assessing adverse experiences from infancy through early childhood in home visiting programs.

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    McKelvey, Lorraine M; Whiteside-Mansell, Leanne; Conners-Burrow, Nicola A; Swindle, Taren; Fitzgerald, Shalese

    2016-01-01

    The general aim of early intervention and home visiting programs is to support families to minimize Adverse Childhood Experiences (ACEs). However, assessing children's exposure to these risks is complicated because parents serve as the conduit for both measurement and intervention. The primary aims of the study were to develop an assessment of children's exposure to ACEs and to examine concurrently measured parental child abuse and neglect potential and child social-emotional functioning. Home visiting programs in a southern state implemented the Family Map Inventories (FMI) as comprehensive family assessment and child screenings (N=1,282) within one month of enrollment. Children (M=33 months of age, SD=20) were exposed at rates of 27% to one, 18% to two, 11% to three, and 12% to four or more FMI-ACEs. FMI-ACEs were associated with increased parental beliefs and behaviors associated with child abuse and neglect. FMI-ACEs also significantly predicted the likelihood of the child having at-risk social-emotional development; children with 4 or more FMI-ACEs were over 6 times more likely than those with none to have at-risk scores. The findings add to our understanding of the negative impact of trauma on children and families. Assessing these risks as they occur in a family-friendly manner provides a platform for early intervention programs to work with families to increase family strengths and reduce the impacts of adverse experiences for their children.

  8. Creating a national home visiting research network.

    Science.gov (United States)

    Duggan, Anne; Minkovitz, Cynthia S; Chaffin, Mark; Korfmacher, Jon; Brooks-Gunn, Jeanne; Crowne, Sarah; Filene, Jill; Gonsalves, Kay; Landsverk, John; Harwood, Robin

    2013-11-01

    Home visiting can play a key role in the early childhood system of services. For home visiting to achieve its potential, decision-makers must make informed choices regarding adoption, adaptation, coordination, scale-up, and sustainment. We need a coordinated, focused, and theory-based home visiting research infrastructure to inform such decisions. The transdisciplinary Home Visiting Research Network (HVRN) was established in July 2012 with funding from the Health Resources and Services Administration. Its goal is to promote the translation of research findings into policy and practice. Its objectives are to (1) develop a national home visiting research agenda, (2) advance the use of innovative research methods; and (3) provide a research environment that is supportive of the professional development of emerging researchers interested in home visiting. A Management Team designs and directs activities to achieve these objectives through Work Teams. A Steering Committee of national leaders representing stakeholder groups oversees progress. HVRN's Coordinating Center supports the Work Teams and HVRN's Home visiting Applied Research Collaborative, a practice-based research network of home visiting programs. This article describes HVRN's rationale, approach, and anticipated products. We use home visiting-primary care coordination as an illustration, noting potential roles for pediatric practices and pediatric researchers and research educators in HVRN activities. HVRN creates the infrastructure for a rigorous program of research to inform policy and practice on home visiting as part of the system of services to improve family functioning, parenting, and child outcomes.

  9. Development and implementation of a quality assurance infrastructure in a multisite home visitation program in Ohio and Kentucky.

    Science.gov (United States)

    Ammerman, Robert T; Putnam, Frank W; Kopke, Jonathan E; Gannon, Thomas A; Short, Jodie A; Van Ginkel, Judith B; Clark, Margaret J; Carrozza, Mark A; Spector, Alan R

    2007-01-01

    As home visitation programs go to scale, numerous challenges are faced in implementation and quality assurance. This article describes the origins and implementation of Every Child Succeeds, a multisite home visitation program in southwestern Ohio and Northern Kentucky. In order to optimize quality assurance and generate new learning for the field, a Web-based system (eECS) was designed to systematically collect and use data. Continuous quality assurance procedures derived from business and industry have been established. Findings from data collection have documented outcomes, and have identified clinical needs that potentially undermine the impact of home visitation. An augmented module approach has been used to address these needs, and a program to treat maternal depression is described as an example of this approach. Challenges encountered are also discussed.

  10. Healthy Start Programa Madrina: A Promotora Home Visiting Outreach and Education Program to Improve Perinatal Health among Latina Pregnant Women

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    Bill, Debra E.; Hock-Long, Linda; Mesure, Maryann; Bryer, Pamela; Zambrano, Neydary

    2009-01-01

    The purpose of this article is to describe the development, implementation, and evaluation of Healthy Start Programa Madrina (HSPM), a home visiting promotora outreach and education program for Latina pregnant women and to present the 10-year findings of the program (1996-2005). Perinatal health disparities continue to persist among low-income…

  11. Association Between Home Visit Programs and Emergency Preparedness Among Elderly Vulnerable People in New South Wales, Australia

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    W. Kathy Tannous PhD

    2017-03-01

    Full Text Available Objective: The purpose of this study is to examine the association between home visit programs and emergency preparedness among elderly vulnerable people in New South Wales, Australia. Method: The study used data acquired from an intervention program run by emergency agencies and consisted of 370 older people. Seven emergency outcome measures were examined by adjusting for key demographic factors, using a generalized estimating equation model, to examine the association between home visit programs and emergency preparedness. Results: The study revealed that knowledge demonstrated by participants during visits and post home visits showed significant improvements in the seven emergency outcome measures. The odds of finding out what emergencies might affect one’s area were significantly lower among older participants who were born outside Australia and those who were women. Discussion: The findings suggest that the intervention via home visits and periodic reminders post these visits may be a useful intervention in improving emergency preparedness among older people, especially among men and those who were born outside of Australia. In addition, other reminders such as safety messaging via mobile or landline telephone calls may also be a supplementary and useful intervention to improve emergency preparedness among older people.

  12. Clinical application of the Omaha system with the Nightingale Tracker: a community health nursing student home visit program.

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    Sloan, Helen L; Delahoussaye, Carolyn P

    2003-01-01

    The application of computer use in the clinical and educational arena needs to be emphasized for both the improved management of patient data and nursing knowledge. Faculty commitment to automation of home visit documentation records was essential to sustain the trial of implementing the Nightingale Trackers in the clinical area. The Nightingale Tracker is a software program that automates the Omaha system, a community-friendly nursing language that encourages a focus on health promotion. A team approach involving students, faculty, and technical support enabled the automation of the patient record of a home visiting program in a community health nursing course.

  13. Boston children's hospital community asthma initiative: Five-year cost analyses of a home visiting program.

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    Bhaumik, Urmi; Sommer, Susan J; Giller-Leinwohl, Judith; Norris, Kerri; Tsopelas, Lindsay; Nethersole, Shari; Woods, Elizabeth R

    2017-03-01

    To evaluate the costs and benefits of the Boston Children's Hospital Community Asthma Initiative (CAI) through reduction of Emergency Department (ED) visits and hospitalizations for the full pilot-phase program participants. A cost-benefit analyses was conducted using hospital administrative data to determine an adjusted Return on Investment (ROI): on all 268 patients enrolled in the CAI program during the 33-month pilot program phase of CAI intervention between October 1, 2005 and June 30, 2008 using a comparison group of 818 patients from a similar cohort in neighboring ZIP codes without CAI intervention. Cost data through June 30, 2013 were used to examine cost changes and calculate an adjusted ROI over a 5-year post-intervention period. CAI patients had a cost reduction greater than the comparison group of $1,216 in Year 1 (P = 0.001), $1,320 in Year 2 (P Year 3, $1,123 (P = 0.004) in Year 4, and $997 (P = 0.022) in Year 5. Adjusting for the cost savings for the comparison group, the cost savings from the intervention resulted in an adjusted ROI of 1.91 over 5 years. Community-based, multidisciplinary, coordinated disease management programs can decrease the incidence of costly hospitalizations and ED visits from asthma. An ROI of greater than one, as found in this cost analysis, supports the business case for the provision of community-based asthma services as part of patient-centered medical homes and Accountable Care Organizations.

  14. [Home visits as a component of the Family Health Program: user's perceptions in Fortaleza, Ceará State, Brazil].

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    Albuquerque, Adriana Bezerra Brasil de; Bosi, Maria Lúcia Magalhães

    2009-05-01

    Home visits have become increasingly widespread in Brazil since the emergence of the Family Health Program. The present study deals with users' perceptions of these visits, focusing on comprehensiveness and humanization of care. The study was exploratory and qualitative. Twenty-one interviews were performed with users from the six administrative health districts of Fortaleza, capital of Ceará State, Brazil. Analysis of the interviews revealed the existence of three core themes: (1) health professional-user relationships, i.e. users' perceptions of completeness and humanization of care during visits; (2) characterization of visits, with emphasis on operational aspects; and (3) user-health facility interaction, focusing on integration with other service. This theme was divided into three items: health facility management, equity, and integration of care. In conclusion, the study suggests that home visiting practices can be improved by enhancing the aspects of intersubjectivity, dialogue, and negotiation between health professionals, users, and the community.

  15. The SKI*HI Model: Programming for Hearing Impaired Infants through Home Intervention, Home Visit Curriculum. Fourth Edition.

    Science.gov (United States)

    Clark, Thomas C.; Watkins, Susan

    The manual describes the SKI*HI Model, a comprehensive approach to identification and home intervention treatment of hearing impaired children and their families. The model features home programing in four basic areas: the home hearing aid program (nine lessons which facilitate the proper fit and acceptance of amplification by the child), home…

  16. Implementing Universal Maternal Depression Screening in Home Visiting Programs: A Pragmatic Overview

    Science.gov (United States)

    Segre, Lisa S.; Taylor, Darby

    2014-01-01

    Maternal depression, although prevalent in low-income women, is not an inevitable consequence of poverty. Nevertheless, depression is a double burden for impoverished women: compromising infant development and diminishing mothers' ability to benefit from or effectively use home visiting services. Without universal screening, depression is often…

  17. Implementation of evidence-based home visiting programs aimed at reducing child maltreatment: A meta-analytic review.

    Science.gov (United States)

    Casillas, Katherine L; Fauchier, Angèle; Derkash, Bridget T; Garrido, Edward F

    2016-03-01

    In recent years there has been an increase in the popularity of home visitation programs as a means of addressing risk factors for child maltreatment. The evidence supporting the effectiveness of these programs from several meta-analyses, however, is mixed. One potential explanation for this inconsistency explored in the current study involves the manner in which these programs were implemented. In the current study we reviewed 156 studies associated with 9 different home visitation program models targeted to caregivers of children between the ages of 0 and 5. Meta-analytic techniques were used to determine the impact of 18 implementation factors (e.g., staff selection, training, supervision, fidelity monitoring, etc.) and four study characteristics (publication type, target population, study design, comparison group) in predicting program outcomes. Results from analyses revealed that several implementation factors, including training, supervision, and fidelity monitoring, had a significant effect on program outcomes, particularly child maltreatment outcomes. Study characteristics, including the program's target population and the comparison group employed, also had a significant effect on program outcomes. Implications of the study's results for those interested in implementing home visitation programs are discussed. A careful consideration and monitoring of program implementation is advised as a means of achieving optimal study results.

  18. Home Visits: Shortening the Path between Home and School.

    Science.gov (United States)

    Acosta, Dolores; Keith, Joe; Patin, Debra

    1997-01-01

    Describes the Home Visit Initiative at Socorro Middle School in Texas. Discusses the purpose of home visits; selection of families for teacher home visits; the visiting team; parents', students', and teachers' reactions to visits, and the results of an evaluation of the home visits, especially the impact on parent volunteerism and schooling,…

  19. Effect of home visit training program on growth and development of preterm infants: a double blind randomized controlled trial.

    Science.gov (United States)

    Edraki, Mitra; Moravej, Hossian; Rambod, Masoume

    2015-01-01

    Home visit program can be effective in infants' growth and development. The present study aimed to investigate the effect of home visit program on preterm infants' growth and development within 6 months. It was a double-blind clinical trial study. The study was conducted in Hafez, Hazrat-e-Zeinab, and Namazee Hospitals affiliated to Shiraz University of Medical Sciences, Shiraz, Iran from 2010 to 2011. Preterm infants were divided into intervention (n=30) and control groups (n=30) through blocked randomization. The intervention group received home visit training program for 6 months, while the control group only received the hospital's routine care. Then, the infants' growth indexes, including weight, height, and head circumference, and development criteria were compared on the first day of admission in Neonatal Intensive Care Unit, and then first, second, third, and sixth months. The data were analyzed using Chi-square, independent t-test, and repeated measures ANCOVA. The mean weight of the intervention and control group infants was 7207.3±1129.74 and 6366.7±922.26 gr in the sixth month. Besides, the intervention group infants' mean weight was higher compared to the control group after six months (t=-3.05, P=0.03). Also, a significant difference was found between the two groups regarding development indexes, such as following moving objects with the head, keeping the head stable when changing the position from lying to sitting,  producing "Agha" sound, and taking objects by hand (Pdevelopment indexes at the sixth month. Considering the importance of infants' growth and development, healthcare staff is recommended to incorporate home visit training into their programs, so that steps can be taken towards improvement of preterm infants' health. IRCT2014082013690N3 

  20. Effects on health care use and associated cost of a home visiting program for older people with poor health status: a randomized clinical trial in the Netherlands.

    NARCIS (Netherlands)

    Bouman, A.; Rossum, E. van; Evers, S.; Ambergen, T.; Kempen, G.; Knipschild, P.

    2008-01-01

    BACKGROUND: Home visiting programs have been developed to improve the functional abilities of older people and subsequently to reduce the use of institutional care services. The results of trials have been inconsistent and their cost-effectiveness uncertain. Home visits for a high-risk population ra

  1. Pregnant with possibilities: drawing on hermeneutic thought to reframe home-visiting programs for young mothers.

    Science.gov (United States)

    SmithBattle, Lee

    2009-09-01

    Although the positive outcomes achieved in home-visiting interventions targeting young, disadvantaged mothers are partly credited to therapeutic relationships, researchers rarely offer philosophical or theoretical explanations for these relationships. This omission is a conspicuous oversight as nurse-family relationships have figured prominently in public health nursing practice since its inception. In this study, I suggest that the contribution of therapeutic relationships to positive outcomes will remain theoretically undeveloped as long as clinical trials and nursing practice models follow the logic of techne. After describing how a scientific-clinical gaze misrepresents teen mothers and contributes to a rational-technical model of clinical practice, I draw on contemporary hermeneutics to describe how dialog and understanding are indispensable for clinical judgment and the judicious use of scientific knowledge. This hermeneutic corrective calls attention to the dialogical nature of truth and the relational skills that disclose meaning, preserve personhood, and support possibilities available in the life-world. Dialogical understanding also disrupts the scientific-clinical gaze by disclosing the social disparities that are implicated in early childbearing and teen mothers' long-term prospects. The implications of this thought for legitimating and supporting the flexibility and clinical know-how that 'strays' from protocol-driven care is addressed.

  2. Relationship types among adolescent parents participating in a home-visiting program: A latent-transition analysis.

    Science.gov (United States)

    Raskin, Maryna; Fosse, Nathan E; Fauth, Rebecca C; Bumgarner, Erin; Easterbrooks, M Ann

    2016-04-01

    Young parents (less than 25 years of age) have been shown to have especially low rates of father involvement and union stability. However, research has also shown that parenting experiences of young fathers may not be uniform. There is a need for more research that assesses both the multidimensionality of relationship typologies and their temporality. Using a large longitudinal sample of low-income, young mothers enrolled in a randomized control study of a home-visitation program (n = 704; 61% program, 39% control), we evaluated how mother-father relationship dynamics changed over time. Ten mother-reported indicators of relationships (e.g., coresidence, marital status, types of father support) were used to conduct a latent-class analysis of relationship types. A 4-class solution was identified at each time point: Single Parent, Supportive Nonresident Partner, Supportive Resident Partner, and Questioning/Ambivalent Coupling. Latent-transition analyses were used to evaluate stability of relationships across 2 years. At each transition, a large proportion of women moved from one relationship class to another, indicating heterogeneity in relationship dynamics of adolescent parents. Results revealed the potential of a home-visiting program targeted at young parents to favorably promote more stable and supportive mother-father relationships and coparenting arrangements.

  3. Promoting uptake of child HIV testing: an evaluation of the role of a home visiting program for orphans and vulnerable children in South Africa.

    Science.gov (United States)

    Thurman, Tonya R; Luckett, Brian; Taylor, Tory; Carnay, Melissa

    2016-03-01

    HIV counseling and testing (HCT) is critical for children in generalized epidemic settings, but significant shortfalls in coverage persist, notably among orphans and others at disproportionate risk of infection. This study investigates the impact of a home visiting program in South Africa on orphaned and vulnerable children's uptake of HCT. Using propensity score matching, survey data for children receiving home visits from trained community-based care workers were compared to data from children living in similar households that had not yet received home visits (n = 1324). Home visits by community-based care workers increased the odds of a child being tested by 97% (OR = 1.97, 95% CI = 1.34-2.92). The home visitation program had an especially pronounced effect on orphans, more than doubling their odds of being tested (OR = 2.12, 95% CI = 1.00-4.47) compared to orphans living in similar households that did not receive home visits. Orphan status alone had no effect on HCT independent of program exposure, suggesting that the program was uniquely able to increase testing in this subgroup. Results highlight the potential for increasing HCT access among children at high risk through targeted community-based initiatives.

  4. PTSD in Depressed Mothers in Home Visitation

    Science.gov (United States)

    Ammerman, Robert T.; Putnam, Frank W.; Chard, Kathleen M.; Stevens, Jack; Van Ginkel, Judith B.

    2013-01-01

    Recent research has suggested that mothers participating in home visitation programs have a high incidence of mental health problems, particularly depression. Posttraumatic stress disorder (PTSD) is a common comorbidity with depression, yet its prevalence among home visiting populations and implications for parenting and maternal functioning have not been examined. This study contrasted depressed mothers with (n = 35) and without PTSD (n = 55) who were enrolled in a home visitation program. Results indicated that depressed mothers with comorbid PTSD were more likely to have experienced childhood sexual abuse, had greater severity of depressive symptoms, increased social isolation, and lower overall functioning than their counterparts without PTSD. Among PTSD mothers, greater severity of PTSD symptoms, in particular avoidance and emotional numbness, were associated with increased maternal psychopathology and parenting deficits even after controlling for depression severity. These findings add to the literature documenting the negative impacts of PTSD on maternal functioning and parenting. Implications for screening and treatment in the context of home visitation are discussed. PMID:24307928

  5. Impact of a Manualized Multifocal Perinatal Home-Visiting Program Using Psychologists on Postnatal Depression: The CAPEDP Randomized Controlled Trial

    Science.gov (United States)

    Dugravier, Romain; Tubach, Florence; Saias, Thomas; Guedeney, Nicole; Pasquet, Blandine; Purper-Ouakil, Diane; Tereno, Susana; Welniarz, Bertrand; Matos, Joana

    2013-01-01

    Context Postnatal maternal depression (PND) is a significant risk factor for infant mental health. Although often targeted alongside other factors in perinatal home-visiting programs with vulnerable families, little impact on PND has been observed. Objective This study evaluates the impact on PND symptomatology of a multifocal perinatal home-visiting intervention using psychologists in a sample of women presenting risk factors associated with infant mental health difficulties. Methods 440 primiparous women were recruited at their seventh month of pregnancy. All were future first-time mothers, under 26, with at least one of three additional psychosocial risk factors: low educational level, low income, or planning to raise the child without the father. The intervention consisted of intensive multifocal home visits through to the child’s second birthday. The control group received care as usual. PND symptomatology was assessed at baseline and three months after birth using the Edinburgh Postnatal Depression Scale (EPDS). Results At three months postpartum, mean (SD) EPDS scores were 9.4 (5.4) for the control group and 8.6 (5.4) for the intervention group (p = 0.18). The difference between the mean EPDS scores was 0.85 (95% CI: 0.35; 1.34). The intervention group had significantly lower EPDS scores than controls in certain subgroups: women with few depressive symptoms at inclusion (EPDS <8): difference = 1.66 (95%CI: 0.17; 3.15), p = 0.05, adjusted for baseline EPDS score), women who were planning to raise the child with the child’s father: difference = 1.45 (95%CI: 0.27; 2.62), p = 0.04 (adjusted); women with a higher educational level: difference = 1.59 (95%CI: 0.50; 2.68) p = 0.05 (adjusted). Conclusion CAPEDP failed to demonstrate an overall impact on PND. However, post-hoc analysis reveals the intervention was effective in terms of primary prevention and in subgroups of women without certain risk factors. Effective overall reduction

  6. Impact of a manualized multifocal perinatal home-visiting program using psychologists on postnatal depression: the CAPEDP randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Romain Dugravier

    Full Text Available CONTEXT: Postnatal maternal depression (PND is a significant risk factor for infant mental health. Although often targeted alongside other factors in perinatal home-visiting programs with vulnerable families, little impact on PND has been observed. OBJECTIVE: This study evaluates the impact on PND symptomatology of a multifocal perinatal home-visiting intervention using psychologists in a sample of women presenting risk factors associated with infant mental health difficulties. METHODS: 440 primiparous women were recruited at their seventh month of pregnancy. All were future first-time mothers, under 26, with at least one of three additional psychosocial risk factors: low educational level, low income, or planning to raise the child without the father. The intervention consisted of intensive multifocal home visits through to the child's second birthday. The control group received care as usual. PND symptomatology was assessed at baseline and three months after birth using the Edinburgh Postnatal Depression Scale (EPDS. RESULTS: At three months postpartum, mean (SD EPDS scores were 9.4 (5.4 for the control group and 8.6 (5.4 for the intervention group (p = 0.18. The difference between the mean EPDS scores was 0.85 (95% CI: 0.35; 1.34. The intervention group had significantly lower EPDS scores than controls in certain subgroups: women with few depressive symptoms at inclusion (EPDS <8: difference = 1.66 (95%CI: 0.17; 3.15, p = 0.05, adjusted for baseline EPDS score, women who were planning to raise the child with the child's father: difference = 1.45 (95%CI: 0.27; 2.62, p = 0.04 (adjusted; women with a higher educational level: difference = 1.59 (95%CI: 0.50; 2.68 p = 0.05 (adjusted. CONCLUSION: CAPEDP failed to demonstrate an overall impact on PND. However, post-hoc analysis reveals the intervention was effective in terms of primary prevention and in subgroups of women without certain risk factors. Effective overall reduction of PND

  7. A group randomized controlled trial integrating obesity prevention and control for postpartum adolescents in a home visiting program.

    Science.gov (United States)

    Haire-Joshu, Debra L; Schwarz, Cynthia D; Peskoe, Sarah B; Budd, Elizabeth L; Brownson, Ross C; Joshu, Corinne E

    2015-06-26

    Adolescence represents a critical period for the development of overweight that tracks into adulthood. This risk is significantly heightened for adolescents that become pregnant, many of whom experience postpartum weight retention. The aim of this study was to evaluate Balance Adolescent Lifestyle Activities and Nutrition Choices for Energy (BALANCE), a multicomponent obesity prevention intervention targeting postpartum adolescents participating in a national home visiting child development-parent education program. A group randomized, nested cohort design was used with 1325 adolescents, 694 intervention and 490 control, (mean age = 17.8 years, 52 % underrepresented minorities) located across 30 states. Participatory methods were used to integrate lifestyle behavior change strategies within standard parent education practice. Content targeted replacement of high-risk obesogenic patterns (e.g. sweetened drink and high fat snack consumption, sedentary activity) with positive behaviors (e.g. water intake, fruit and vegetables, increased walking). Parent educators delivered BALANCE through home visits, school based classroom-group meetings, and website activities. Control adolescents received standard child development information. Phase I included baseline to posttest (12 months); Phase II included baseline to follow-up (24 months). When compared to the control group, BALANCE adolescents who were ≥12 weeks postpartum were 89 % more likely (p = 0.02) to maintain a normal BMI or improve an overweight/obese BMI by 12 months; this change was not sustained at 24 months. When compared to the control group, BALANCE adolescents significantly improved fruit and vegetable intake (p = .03). In stratified analyses, water intake improved among younger BALANCE teens (p = .001) and overweight/obese BALANCE teens (p = .05) when compared to control counterparts. There were no significant differences between groups in sweetened drink and snack consumption

  8. Federal Home Visiting under the Affordable Care Act

    Science.gov (United States)

    Strader, Kathleen; Counts, Jacqueline; Filene, Jill

    2013-01-01

    The Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program is part of The Patient Protection and Affordable Care Act and provides $1.5 billion over 5 years to states, territories, and tribes with the goal of delivering evidence-based home visiting services as part of a high-quality, comprehensive early childhood system that promotes…

  9. Enriching Preschool Classrooms and Home Visits with Evidence-Based Programming: Sustained Benefits for Low-Income Children

    Science.gov (United States)

    Bierman, Karen L.; Heinrichs, Brenda S.; Welsh, Janet A.; Nix, Robert L.; Gest, Scott D.

    2017-01-01

    Background: Growing up in poverty undermines healthy development, producing disparities in the cognitive and social-emotional skills that support early learning and mental health. Preschool and home-visiting interventions for low-income children have the potential to build early cognitive and social-emotional skills, reducing the disparities in…

  10. Maternal, Infant and Early Childhood Home Visiting Program in the Affordable Care Act: Supplemental Instruction Request-February 2011

    Science.gov (United States)

    Schmit, Stephanie

    2011-01-01

    The latest Evidence-Based Home Visiting Supplemental Information Request (SIR) has recently been released by the Department of Health and Human Services (HHS) with collaboration from the Health Resources and Services Administration (HRSA) and the Administration for Children and Families (ACF) as outlined in the first Funding Opportunity…

  11. Exploring patients' reasons for participation in a medical education home visit program: a qualitative study in Malaysia.

    Science.gov (United States)

    Tan, Chai-Eng; Jaffar, Aida; Tohit, Noorlaili; Hamzah, Zuhra; Hashim, Syahnaz Mohd

    2017-06-01

    Direct contact with patients for medical education is essential in healthcare professional training. Patients who were recruited for a medical education home visit program in Malaysia did so on a voluntary basis without remuneration. This paper aims to explore their reasons for participation in this program. An exploratory qualitative study was conducted on patients who had been visited during the 2012/2013 academic session. Purposive sampling was done to select adult participants from varying ethnicities and ages from the list of patients. In-depth interviews were conducted at the participants' homes and were audio recorded. The transcripts of these interviews were analyzed using thematic analysis. A total of nine in-depth interviews were conducted. Four main themes were identified from thematic analysis: 1) Perceived meaning of the visit; 2) Perceived benefits and risks; 3) Past healthcare experiences; 4) Availability for visits. The home visits meant different things to different participants, including a teaching-learning encounter, a social visit, a charitable deed or a healthcare check-up. The benefits and risks of accepting unknown students to their homes and sharing their health issues with them had been weighed prior to participation. Prior experience with healthcare services such as gratitude to healthcare providers or having a relative in the healthcare profession increased their receptivity for involvement. Lastly, enabling factors such as availability of time would determine their acceptance for home visits. Patients agree to participate in medical education activities on a voluntary basis for various reasons. Providing good healthcare service and sufficient preparation are crucial to increase patient receptivity for such activities.

  12. 76 FR 22713 - Advisory Committee on the Maternal, Infant and Early Childhood Home Visiting Program Evaluation...

    Science.gov (United States)

    2011-04-22

    ... impact and implementation study designs, sampling design, analysis of state needs assessments, and cost... provide a state-by-state analysis of the needs assessments and the States' actions in response to the... status, school readiness, and domestic violence, among others); (b) the effectiveness of such programs on...

  13. 76 FR 71979 - Advisory Committee on the Maternal, Infant and Early Childhood Home Visiting Program Evaluation...

    Science.gov (United States)

    2011-11-21

    .../participant outcome for impact, implementation measurement, cost analysis measurement, and administrative data... state-by-state analysis of the needs assessments and ] the States' actions in response to the... status, school readiness, and domestic violence); (b) the effectiveness of such programs on different...

  14. Promoting Early Intervention Referral through a Randomized Controlled Home-Visiting Program

    Science.gov (United States)

    Schwarz, Donald F.; O'Sullivan, Ann L.; Guinn, Judith; Mautone, Jennifer A.; Carlson, Elyse C.; Zhao, Huaqing; Zhang, Xuemei; Esposito, Tara L.; Askew, Megan; Radcliffe, Jerilynn

    2012-01-01

    The MOM Program is a randomized, controlled trial of an intervention to promote mothers' care for the health and development of their children, including accessing early intervention (EI) services. Study aims were to determine whether, relative to controls, this intervention increased receipt of and referral to EI services. Mothers (N = 302)…

  15. BEST PRACTICE IN INDIVIDUAL SUPERVISION OF PSYCHOLOGISTS WORKING IN THE FRENCH CAPEDP PREVENTIVE PERINATAL HOME-VISITING PROGRAM: RESULTS OF A DELPHI CONSENSUS PROCESS.

    Science.gov (United States)

    Greacen, Tim; Welniarz, Bertrand; Purper-Ouakil, Diane; Wendland, Jaqueline; Dugravier, Romain; Saïas, Thomas; Tereno, Susana; Tubach, Florence; Haddad, Alain; Guedeney, Antoine

    2017-03-01

    Individual supervision of home-visiting professionals has proved to be a key element for perinatal home-visiting programs. Although studies have been published concerning quality criteria for supervision in North American contexts, little is known about this subject in other national settings. In the context of the CAPEDP program (Compétences parentales et Attachement dans la Petite Enfance: Diminution des risques liés aux troubles de santé mentale et Promotion de la résilience; Parental Skills and Attachment in Early Childhood: Reducing Mental Health Risks and Promoting Resilience), the first randomized controlled perinatal mental health promotion research program to take place in France, this article describes the results of a study using the Delphi consensus method to identify the program supervisors' points of view concerning best practice for the individual supervision of home visitors involved in such programs. The final 18 recommendations could be grouped into four general themes: the organization and setting of supervision sessions; supervisor competencies; relationship between supervisor and supervisee; and supervisor intervention strategies within the supervision process. The quality criteria identified in this perinatal home-visiting program in the French cultural context underline the importance of clinical supervision and not just reflective supervision when working with families with multiple, highly complex needs.

  16. A Visitation/Training Program for Institutionalized Elderly.

    Science.gov (United States)

    Fling, Sheila; Tayloe, Bryan

    Research on the use of paraprofessionals and trained volunteers for visitation programs with elders is limited. To determine the effects of a visitation program on nursing home residents and their college student and elder visitors, and to explore the effectiveness of special training for such visitation, nursing home residents (N=25) visited with…

  17. Current evidence on perinatal home visiting and intimate partner violence.

    Science.gov (United States)

    Sharps, Phyllis W; Campbell, Jacquelyn; Baty, Marguerite L; Walker, Keisha S; Bair-Merritt, Megan H

    2008-01-01

    To describe current evidence on home visiting interventions for pregnant or postpartum women with specific intimate partner violence assessment and content. Online bibliographic databases including PubMed, CINAHL Plus, and Web of Science and a hand search of bibliographies of relevant articles. Original research and intervention studies were included that contained (a) a well-described prenatal and/or postpartum home visitation; (b) an assessment of perinatal intimate partner violence; and (c) quantitative data describing health outcomes for the women and their infants. The search yielded 128 articles, and 8 relevant articles met all of the inclusion criteria. Nonresearch, nonintervention, and international articles were excluded. No perinatal home visiting interventions were designed to address intimate partner violence. Programs that screened for intimate partner violence found high rates, and the presence of intimate partner violence limited the ability of the intervention to improve maternal and child outcomes. Perinatal home visitation programs likely improve pregnancy and infant outcomes. Home visiting interventions addressing intimate partner violence in nonperinatal population groups have been effective in minimizing intimate partner violence and improving outcomes. This suggests that perinatal home visiting programs adding specific intimate partner violence interventions may reduce intimate partner violence and improve maternal and infant health. Continued rigorous research is needed.

  18. Predictors of Study Attrition in a Randomized Controlled Trial Evaluating a Perinatal Home-Visiting Program with Mothers with Psychosocial Vulnerabilities.

    Directory of Open Access Journals (Sweden)

    Stéphanie Foulon

    Full Text Available Randomised controlled trials evaluating perinatal home-visiting programs are frequently confronted with the problem of high attrition rates. The aim of the present study is to identify predictors of study attrition in a trial evaluating a perinatal home-visiting program in France.CAPEDP is a French randomized trial comparing a perinatal home-visiting program using psychologists versus usual care (N = 440. The first assessment was at inclusion into the trial at the 27th week of pregnancy and the final assessment when the child reached the age of two. Attrition rates were calculated at 3 and 24 months postpartum. Stepwise logistic regression was used to identify predictors of early (between inclusion and 3 months postpartum and later (between 3 and 24 months postpartum attrition among social, psychological and parenting factors.Attrition rates were 17% and 63% at 3 and 24 months respectively. At 24 months, there was significantly more attrition in the control arm (70.6% compared to the intervention arm (55.2%. Five independent predictors of early attrition were identified: having already had an abortion; having greater attachment insecurity as measured with the Vulnerable Attachment Style Questionnaire (VASQ; having lower global severity of psychiatric symptoms as assessed with the Symptom Check-List (SCL-90 at inclusion, being neither currently employed nor studying; and declaring no tobacco consumption during pregnancy. Being randomized into the control arm, having undergone early parental loss before age 11 and having lower global severity of psychiatric symptoms (SCL-90 at 3 months postpartum were the only variables associated with later attrition.This study provides key information for identifying mothers who may require specific support to avoid study attrition in trials evaluating a home-visiting program.

  19. Predictors of Study Attrition in a Randomized Controlled Trial Evaluating a Perinatal Home-Visiting Program with Mothers with Psychosocial Vulnerabilities

    Science.gov (United States)

    Foulon, Stéphanie; Greacen, Tim; Pasquet, Blandine; Dugravier, Romain; Saïas, Thomas; Guedeney, Nicole; Guedeney, Antoine; Tubach, Florence

    2015-01-01

    Objective Randomised controlled trials evaluating perinatal home-visiting programs are frequently confronted with the problem of high attrition rates. The aim of the present study is to identify predictors of study attrition in a trial evaluating a perinatal home-visiting program in France. Materials and Methods CAPEDP is a French randomized trial comparing a perinatal home-visiting program using psychologists versus usual care (N = 440). The first assessment was at inclusion into the trial at the 27th week of pregnancy and the final assessment when the child reached the age of two. Attrition rates were calculated at 3 and 24 months postpartum. Stepwise logistic regression was used to identify predictors of early (between inclusion and 3 months postpartum) and later (between 3 and 24 months postpartum) attrition among social, psychological and parenting factors. Results Attrition rates were 17% and 63% at 3 and 24 months respectively. At 24 months, there was significantly more attrition in the control arm (70.6%) compared to the intervention arm (55.2%). Five independent predictors of early attrition were identified: having already had an abortion; having greater attachment insecurity as measured with the Vulnerable Attachment Style Questionnaire (VASQ); having lower global severity of psychiatric symptoms as assessed with the Symptom Check-List (SCL-90) at inclusion, being neither currently employed nor studying; and declaring no tobacco consumption during pregnancy. Being randomized into the control arm, having undergone early parental loss before age 11 and having lower global severity of psychiatric symptoms (SCL-90) at 3 months postpartum were the only variables associated with later attrition. Conclusion This study provides key information for identifying mothers who may require specific support to avoid study attrition in trials evaluating a home-visiting program. PMID:26554839

  20. Home Visiting: A Service Strategy to Reduce Poverty and Mitigate Its Consequences.

    Science.gov (United States)

    Minkovitz, Cynthia S; O'Neill, Kay M G; Duggan, Anne K

    2016-04-01

    Home visiting programs are increasingly recognized as an important part of the early childhood system of care in the United States. The objectives of this report are to review the rationale for home visiting; characterize the Federal Home Visiting Program; highlight the evidence of home visiting effectiveness, particularly for low income families; identify opportunities to promote coordination between medical homes and home visiting programs; and explain the critical role of research, evaluation, and quality improvement to strengthen home visiting effectiveness. Home visiting programs offer voluntary home-based services and other supports to meet the needs of vulnerable pregnant women and young families. Home visiting intends to address poverty in 2 ways. First, it promotes economic self-sufficiency directly by building parents' knowledge, skills, and motivation related to employment opportunities and by linking families with community services such as adult education and job training. Second, it mitigates the effects of poverty through direct service and community linkages to enhance parents' capacity for positive parenting and for their own health and family functioning. Home visiting has shown effectiveness in multiple domains, including family economic self-sufficiency, birth outcomes, maternal health, child health and development, and positive parenting practices. Authorized as part of the Affordable Care Act in 2010 and reauthorized in 2015, the Federal Home Visiting Program invests an unprecedented $1.9 billion in the form of grants to states to expand home visiting programs and support rigorous research. As part of the early childhood system of services, home visiting programs must coordinate with other community services and supports. Programs will be most effective when resources are used efficiently, duplication of services is avoided, and alignment and reinforcement of other providers' messages are achieved. The Federal Home Visiting Program has

  1. A clinical trial of in-home CBT for depressed mothers in home visitation.

    Science.gov (United States)

    Ammerman, Robert T; Putnam, Frank W; Altaye, Mekibib; Stevens, Jack; Teeters, Angelique R; Van Ginkel, Judith B

    2013-09-01

    Despite negative outcomes for depressed mothers and their children, no treatment specifically designed to address maternal depression in the context of home visitation has emerged. In-Home Cognitive Behavioral Therapy (IH-CBT) is an adapted treatment that is delivered in the home, focuses on the needs of new mothers, and leverages ongoing home visiting to optimize engagement and outcomes. This study examined the efficacy of IH-CBT using a randomized clinical trial. Subjects were 93 new mothers in a home visiting program. Mothers with major depressive disorder identified at 3months postpartum were randomized into IH-CBT and ongoing home visitation (n=47) or standard home visitation (SHV; n=46) in which they received home visitation alone and could obtain treatment in the community. Depression was measured at pre- and posttreatment, and 3-month follow-up using interviews, clinician ratings, and self-report. Mothers receiving IH-CBT showed improvements in all indicators of depression relative to the SHV condition and these gains were maintained at follow-up. For example, 70.7% of mothers receiving IH-CBT were no longer depressed at posttreatment in terms of meeting criteria for major depressive disorder compared to 30.2% in the SHV group. These findings suggest that IH-CBT is an efficacious treatment for depressed mothers in home visitation programs. Copyright © 2013. Published by Elsevier Ltd.

  2. Training Family Medicine Residents to Perform Home Visits: A CERA Survey.

    Science.gov (United States)

    Sairenji, Tomoko; Wilson, Stephen A; D'Amico, Frank; Peterson, Lars E

    2017-02-01

    Home visits have been shown to improve quality of care, save money, and improve outcomes. Primary care physicians are in an ideal position to provide these visits; of note, the Accreditation Council for Graduate Medical Education no longer requires home visits as a component of family medicine residency training. To investigate changes in home visit numbers and expectations, attitudes, and approaches to training among family medicine residency program directors. This research used the Council of Academic Family Medicine Educational Research Alliance (CERA) national survey of family medicine program directors in 2015. Questions addressed home visit practices, teaching and evaluation methods, common types of patient and visit categories, and barriers. There were 252 responses from 455 possible respondents, representing a response rate of 55%. At most programs, residents performed 2 to 5 home visits by graduation in both 2014 (69% of programs, 174 of 252) and 2015 (68%, 172 of 252). The vast majority (68%, 172 of 252) of program directors expect less than one-third of their graduates to provide home visits after graduation. Scheduling difficulties, lack of faculty time, and lack of resident time were the top 3 barriers to residents performing home visits. There appeared to be no decline in resident-performed home visits in family medicine residencies 1 year after they were no longer required. Family medicine program directors may recognize the value of home visits despite a lack of few formal curricula.

  3. Design and implementation of an integrated, continuous evaluation, and quality improvement system for a state-based home-visiting program.

    Science.gov (United States)

    McCabe, Bridget K; Potash, Dru; Omohundro, Ellen; Taylor, Cathy R

    2012-10-01

    To describe the design and implementation of an evaluation system to facilitate continuous quality improvement (CQI) and scientific evaluation in a statewide home visiting program, and to provide a summary of the system's progress in meeting intended outputs and short-term outcomes. Help Us Grow Successfully (HUGS) is a statewide home visiting program that provides services to at-risk pregnant/post-partum women, children (0-5 years), and their families. The program goals are to improve parenting skills and connect families to needed services and thus improve the health of the service population. The evaluation system is designed to: (1) integrate evaluation into daily workflow; (2) utilize standardized screening and evaluation tools; (3) facilitate a culture of CQI in program management; and, (4) facilitate scientifically rigorous evaluations. The review of the system's design and implementation occurred through a formative evaluation process (reach, dose, and fidelity). Data was collected through electronic and paper surveys, administrative data, and notes from management meetings, and medical chart review. In the design phase, four process and forty outcome measures were selected and are tracked using standardized screening and monitoring tools. During implementation, the reach and dose of training were adequate to successfully launch the evaluation/CQI system. All staff (n = 165) use the system for management of families; the supervisors (n = 18) use the system to track routine program activities. Data quality and availability is sufficient to support periodic program reviews at the region and state level. In the first 7 months, the HUGS evaluation system tracked 3,794 families (7,937 individuals). System use and acceptance is high. A successful implementation of a structured evaluation system with a strong CQI component is feasible in an existing, large statewide program. The evaluation/CQI system is an effective mechanism to drive modest change in management

  4. Maximizing Home Visit Time In Rural Early Intervention.

    Science.gov (United States)

    Jung, Lee Ann

    The 1997 reauthorization of the Individuals with Disabilities Education Act requires early intervention programs to serve children in natural environments. Because of geography and resources, it is often impossible for service providers to visit rural families at home as frequently as families were seen via a center-based model. At first glance,…

  5. Implementing Paraprofessional Strength-Based Early Intervention Home Visitations

    Science.gov (United States)

    Mykota, David B.

    2008-01-01

    The purpose of the present study is to evaluate the implementation process for Parenting Plus, an early intervention program in a rural, western Canadian health district. Parenting Plus, as modeled after Hawaii Healthy Start, provides strength-based paraprofessional home visitations to overburdened parents of newborns. The general inductive…

  6. An open trial of in-home CBT for depressed mothers in home visitation.

    Science.gov (United States)

    Ammerman, Robert T; Putnam, Frank W; Stevens, Jack; Bosse, Nicole R; Short, Jodie A; Bodley, Amy L; Van Ginkel, Judith B

    2011-11-01

    Research has demonstrated that low income mothers participating in home visitation programs have high rates of depression. This study used an open trial design to evaluate In-Home Cognitive Behavioral Therapy (IH-CBT), an evidence-based treatment for depression that is delivered in the home setting and has been adapted to address the needs of low income mothers participating in home visitation. 64 depressed mothers recruited from a home visitation program and who had completed IH-CBT were compared to 241 mothers from the same setting who met identical screening criteria at enrollment but did not receive the treatment. In addition, pre- and post-treatment measures of depression and related clinical features were contrasted in the 64 mothers receiving IH-CBT. There was a significantly greater reduction in depressive symptoms in the IH-CBT group relative to their counterparts who did not receive the treatment. Results from pre-post comparisons showed that treated mothers had decreased diagnosis of major depression, lower reported stress, increased coping and social support, and increased positive views of motherhood at post-treatment. Findings suggest that IH-CBT is a promising approach to addressing maternal depression in the context of home visitation and warrants further study. Public health implications for home visiting programs are discussed.

  7. Collaborative relationship in preventive home visits to older people

    DEFF Research Database (Denmark)

    Yamada, Yukari; Vass, Mikkel; Hvas, Lotte

    2011-01-01

    To describe what characterizes preventive home visits with collaborative relationships among non-disabled home-dwelling older people in Japan. Background. Preventive home visits have the potential to result in improved health outcomes among older people. Collaboration, mutual understanding...... communication skills and professionalism, and practical actions after the visits characterized cases, where favourable changes in behaviour were obtained in non-disabled home-dwelling older people in Japan. Relevance to clinical practice. Education should be emphasized, because preventive home visitor...

  8. Changes in Depressive Symptoms in First Time Mothers in Home Visitation

    Science.gov (United States)

    Ammerman, Robert T.; Putnam, Frank W.; Altaye, Mekibib; Chen, Liang; Holleb, Lauren J.; Stevens, Jack; Short, Jodie A.; Van Ginkel, Judith B.

    2009-01-01

    Objective: The expansion of Home Visitation Programs for at-risk, first-time mothers and their young children has drawn attention to the potential impact of depression on program outcomes, yet little research has examined depression in the context of home visitation. The purpose of this study was to determine the prevalence of and changes in…

  9. Insights in public health: the Hawai'i Home Visiting Network: evidence-based home visiting services in Hawai'i.

    Science.gov (United States)

    Yoshimoto, D Kaulana; Robertson, N Tod; Hayes, Donald K

    2014-05-01

    Home visiting services are cost-effective and improve the health of children and families among those at increased risk. From 1985-2008, home visiting services in Hawai'i were provided primarily through state funding of the Hawai'i Healthy Start Program, but the program was severely reduced due to the economy and state budget changes over the past decade. The Maternal and Child Health Branch (MCHB) in the Family Health Services Division responded to these changes by seeking out competitive grant opportunities and collaborations in order to continue to promote home visiting services to those children and families in need. In 2010, the MCHB was awarded a federally funded Maternal, Infant and Early Childhood Home Visiting (MIECHV) grant for home visiting services to promote maternal, infant, and early childhood health, safety and development, strong parent-child relationships, and responsible parenting. In 2011, the MCHB was also awarded a competitive MIECHV development grant that funded the re-establishment of the hospital Early Identification program. Families in need of additional support identified through this program are referred for family strengthening services to a network of existing home visiting programs called the Hawai'i Home Visiting Network (HHVN). The HHVN is supported by MIECHV and a small amount of state funds to assist programs with capacity building, training, professional development, quality assurance, and accreditation/certification support. The MIECHV grant requires that programs are evidence-based and address specific outcome measures and benchmarks. The HHVN provides home visiting services to families prenatally through 5 years of age that reside in specific at-risk communities, and is aimed at fostering positive parenting and reducing child maltreatment using a strength-based approach by targeting six protective factors: (1) social connections, (2) nurturing and attachment, (3) knowledge of parenting and child development, (4) parental

  10. Tai Chi-based exercise program provided via telerehabilitation compared to home visits in a post-stroke population who have returned home without intensive rehabilitation: study protocol for a randomized, non-inferiority clinical trial.

    Science.gov (United States)

    Tousignant, Michel; Corriveau, Hélène; Kairy, Dahlia; Berg, Katherine; Dubois, Marie-France; Gosselin, Sylvie; Swartz, Richard H; Boulanger, Jean-Martin; Danells, Cynthia

    2014-01-30

    The incidence of strokes in industrialized nations is on the rise, particularly in the older population. In Canada, a minority of individuals who have had a stroke actually receive intensive rehabilitation because most stroke patients do not have access to services or because their motor recovery was judged adequate to return home. Thus, there is a considerable need to organize home-based rehabilitation services for everyone who has had a stroke. To meet this demand, telerehabilitation, particularly from a service center to the patient's home, is a promising alternative approach that can help improve access to rehabilitation services once patients are discharged home. This non-inferiority study will include patients who have returned home post-stroke without requiring intensive rehabilitation. To be included in the study, participants will: 1) not be referred to an Intensive Functional Rehabilitation Unit, 2) have a Rankin score of 2 or 3, and 3) have a balance problem (Berg Balance Scale score between 46 and 54). Participants will be randomly assigned to either the teletreatment group or the home visits group. Except for the delivery mode, the intervention will be the same for both groups, that is, a personalized Tai Chi-based exercise program conducted by a trained physiotherapist (45-minute session twice a week for eight consecutive weeks). The main objective of this research is to test the non-inferiority of a Tai Chi-based exercise program provided via telerehabilitation compared to the same program provided in person at home in terms of effectiveness for retraining balance in individuals who have had a stroke but do not require intensive functional rehabilitation. The main outcome of this study is balance and mobility measured with the Community Balance and Mobility Scale. Secondary outcomes include physical and psychological capacities related to balance and mobility, participants' quality of life, satisfaction with services received, and cost

  11. Predictors of Treatment Response in Depressed Mothers Receiving In-Home Cognitive-Behavioral Therapy and Concurrent Home Visiting

    Science.gov (United States)

    Ammerman, Robert T.; Peugh, James L.; Putnam, Frank W.; Van Ginkel, Judith B.

    2012-01-01

    Home visiting is a child abuse prevention strategy that seeks to optimize child development by providing mothers with support, training, and parenting information. Research has consistently found high rates of depression in mothers participating in home visiting programs and low levels of obtaining mental health treatment in the community.…

  12. Predictors of Treatment Response in Depressed Mothers Receiving In-Home Cognitive-Behavioral Therapy and Concurrent Home Visiting

    Science.gov (United States)

    Ammerman, Robert T.; Peugh, James L.; Putnam, Frank W.; Van Ginkel, Judith B.

    2012-01-01

    Home visiting is a child abuse prevention strategy that seeks to optimize child development by providing mothers with support, training, and parenting information. Research has consistently found high rates of depression in mothers participating in home visiting programs and low levels of obtaining mental health treatment in the community.…

  13. Facilitating Mental Health Intervention in Home Visiting: Learning From Content, Context, Clients, and Community

    Science.gov (United States)

    Price, Sarah Kye; Gray, Lisa A.; El-Khoury, Dalia

    2014-01-01

    Home visiting programs recognize the importance of promoting women's mental health during and around the time of pregnancy. However, the process of planning and integrating mental health promotion and intervention into the home visiting setting can seem daunting. Using examples and lessons learned from research and practice, the authors provide a…

  14. Prevention of Child Abuse and Neglect: An Evaluation of a Home Visitation Parent Aide Program Using Recidivism Data

    Science.gov (United States)

    Harder, Jeanette

    2005-01-01

    Objective: The purpose of this research was to examine the secondary and tertiary prevention of child abuse and neglect through an evaluation of the Parent Aide Program at the Child Abuse Prevention Center in Dallas, Texas. Method: Using a quasi-experimental, retrospective research design, this project compared abuse recidivism rates for those…

  15. Inside the Black Box of Home Visiting: A Qualitative Analysis of Why Intended Outcomes Were Not Achieved.

    Science.gov (United States)

    Hebbeler, Kathleen M.; Gerlach-Downie, Suzanne G.

    2002-01-01

    This qualitative longitudinal investigation examined why a home visiting program was not more effective. Findings indicated that home visits had a consistent structure and that home visitors emphasized their social support role, placing little emphasis on changing parenting behavior. It was suggested that the program's flawed theory of change,…

  16. Home Visiting Processes: Relations with Family Characteristics and Outcomes

    Science.gov (United States)

    Peterson, Carla A.; Roggman, Lori A.; Green, Beth; Chazan-Cohen, Rachel; Korfmacher, Jon; McKelvey, Lorraine; Zhang, Dong; Atwater, Jane B.

    2013-01-01

    Variations in dosage, content, and family engagement with Early Head Start (EHS) home visiting services were examined for families participating in the EHS Research and Evaluation Project. Families were grouped by characteristics of maternal age, maternal ethnicity, and level of family risk. All home visiting variables were related differentially…

  17. Home Visiting for At-Risk Preschoolers: A Successful Model for Latino Families

    Science.gov (United States)

    Nievar, M. Angela; Jacobson, A.; Dier, S.

    2008-01-01

    The Home Instruction for Parents of Preschool Youngsters (HIPPY) program promotes school readiness by providing services directly to parents through home visitation. This study describes the outcomes of the HIPPY program for Latino immigrant families in a large Southwestern city. A quasi-experimental design compared 48 families on the program…

  18. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... You Want to Be a Surgeon Resident Resources Teaching Resources Online Guide to Choosing a Surgical Residency ... Ostomy Home Skills Program Ostomy Home Skills Program Adult Ostomy Pediatric Ostomy Programa de Destrezas para manejo ...

  19. Piloting a Statewide Home Visiting Quality Improvement Learning Collaborative.

    Science.gov (United States)

    Goyal, Neera K; Rome, Martha G; Massie, Julie A; Mangeot, Colleen; Ammerman, Robert T; Breckenridge, Jye; Lannon, Carole M

    2017-02-01

    Objective To pilot test a statewide quality improvement (QI) collaborative learning network of home visiting agencies. Methods Project timeline was June 2014-May 2015. Overall objectives of this 8-month initiative were to assess the use of collaborative QI to engage local home visiting agencies and to test the use of statewide home visiting data for QI. Outcome measures were mean time from referral to first home visit, percentage of families with at least three home visits per month, mean duration of participation, and exit rate among infants learning. A statewide data system was used to generate monthly run charts. Results Mean time from referral to first home visit was 16.7 days, and 9.4% of families received ≥3 visits per month. Mean participation was 11.7 months, and the exit rate among infants learning network, agencies tested and measured changes using statewide and internal data. Potential next steps are to develop and test new metrics with current pilot sites and a larger collaborative.

  20. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Ostomy Home Skills Program Ostomy Home Skills Program Adult Ostomy Pediatric Ostomy Programa de Destrezas para manejo Doméstico de Ostomía Ostomy Home Skills Program Adult Ostomy Pediatric Ostomy Programa de Destrezas para manejo ...

  1. Pathways to Resilience: Enhancing Family Well-Being with a Home Visitation Model

    Directory of Open Access Journals (Sweden)

    Iván A. de la Rosa

    2015-03-01

    Full Text Available This paper highlights a study that examined outcome measures of a home visitation program, which provided services to first-born children and their parents living in Southwestern New Mexico. Home visitation workers conducted pre/posttest assessments for prenatal and postpartum periods for 109 families. The Revised North Carolina Family Assessment Scale measured family resilience. Paired sample t test and effect size analyses assessed for intervention effects. OLS regression measured effect of increased home visitation services on family well-being. Significant improvements with moderate to large effect sizes were observed for measures of social support, caregiver characteristics, family interaction, and a reduction in personal problems affecting parenting. These preliminary findings suggest that early intervention home visitation programs is an effective and acceptable method to enhance family well-being. Future directions could involve more comprehensive randomized controlled trials to examine the effectiveness of the group intervention. Practice implications are discussed.

  2. Preventive home visits to elderly people in Denmark

    DEFF Research Database (Denmark)

    Hendriksen, C; Vass, M

    2005-01-01

    are obliged to offer home visits twice a year to all citizens 75 years and older. After six years with this law, there is still variation of how the law is managed and implemented. About 60% of the elderly people accept and receive the visits. Less than 50% of the municipalities have made specific guidelines......, manageable and ongoing educational intervention towards professionals working with preventive home visits is feasible and improves older people's functional mobility.......During the last 20 years several randomised controlled trials have been published about preventive home visits to old people, but the benefit of the visits is still controversial and under debate. Based on a state law from the Ministry of Social Affairs in 1998, the municipalities in Denmark...

  3. Impact of Depression and Childhood Trauma in Mothers Receiving Home Visitation

    OpenAIRE

    Ammerman, Robert T.; Shenk, Chad E.; Teeters, Angelique R.; Noll, Jennie G.; Putnam, Frank W.; Van Ginkel, Judith B.

    2011-01-01

    Research has documented the deleterious effects of maternal depression and childhood trauma on parenting and child development. There are high rates of both depression and childhood trauma in new mothers participating in home visitation programs, a prevention approach designed to optimize mother and child outcomes. Little is known about the impacts of maternal depression and childhood trauma on parenting in the context of home visitation. This study contrasted depressed and non-depressed moth...

  4. Infant Mental Health Home Visitation: Setting and Maintaining Professional Boundaries

    Science.gov (United States)

    Barron, Carla; Paradis, Nichole

    2010-01-01

    Relationship-based infant mental health home visiting services for infants, toddlers, and their families intensify the connection between the personal and professional. To promote the therapeutic relationship and maximize the effectiveness of the intervention, home visitors must exercise good judgment, in the field and in the moment, to set and…

  5. Home visits: why do rates vary so much?

    LENUS (Irish Health Repository)

    Stewart, P

    2012-03-01

    Data including information on patient age, gender, who initiated the visit and call classification was collected during office hours from 12 G.P. rural teaching practices with a combined GMS patient population of 24,720, over a 2 month period. There were a total of 603 home visits, giving an annual visiting rate of 143\\/1000. Visiting rates varied between practices from 45 to 305\\/1000 per year. When high visiting practices (>210\\/1000\\/year) were compared to low visiting rate practices (>90\\/1000\\/year), patients tended to be older (79.7 v. 74.5 years) and calls were 12 times more likely to be doctor initiated (16.6% v. 1.4%) or classified as routine( 50.7% v. 44.9%). The variation between practices was related in part to patient age but appears largely due to differences in doctor home visiting behaviour. There are no recent figures on home visiting in Ireland.

  6. Effects of Home Exercise Programmes During Home Visits After Hip Replacement: A Systematic Review.

    Science.gov (United States)

    Ozdemir, Ozlem; Tosun, Bet Uuml L

    2017-01-01

    This study systematically reviews the research, focused on the effects of home exercise programmes implemented during home visits after hip replacement on patients. PubMed (MEDLINE), Wiley Online Library, EBSCOhost, Science Direct databases (between 2004 and June 2015) were searched with the keywords "hip replacement, home exercise programme and home visit". Eleven original articles were retrieved. Different parameters were used in the trials to assess the physical functions, mobility and quality of life of patients. In six trials, the intervention group achieved significantly better improvements statistically in all parameters after home exercise programmes. In three trials, the intervention group achieved better but not significant outcomes. Early recovery in daily living activities with home exercise programme was reported only in one trial. Reviewed studies suggest that home exercise programmes, implemented during home visits after hip replacement, improve patients' physical functions and life quality.

  7. Preventive home visits to older home-dwelling people in Denmark: are invitational procedures of importance?

    DEFF Research Database (Denmark)

    Ekmann, A; Vass, M; Avlund, K

    2010-01-01

    Since 1998 all municipalities in Denmark have been required by law to offer two annual preventive home visits to all home-dwelling citizens aged 75 or over. The influence of invitational procedures on acceptance rates has not been investigated. The aim of this study was to describe and investigate...... whether different invitational procedures were associated with first preventive home visit acceptance rates. The study was based on secondary analyses of data from the Danish Intervention Study on Preventive Home Visits. Data were collected from 1998 to 2002. Of the 4060 participants in the main study......, 3245 reported receiving an offer for an identifiable preventive home visit, of whom 2399 (73.9%) provided complete data for the main analyses in the present study. Invitational procedures were categorised as: (1) a letter with a proposed date and time for the visit, (2) a visitor telephone call, and (3...

  8. Father participation in a community-doula home-visiting intervention with young, African American mothers.

    Science.gov (United States)

    Thullen, Matthew J; McMillin, Stephen Edward; Korfmacher, Jon; Humphries, Marisha L; Bellamy, Jennifer; Henson, Linda; Hans, Sydney

    2014-01-01

    This article examines the extent and nature of father participation in a perinatal, community-based doula home-visiting intervention that served young, African American mothers from low-income backgrounds and their infants. Home-visitor service records were used to assess the quantity, setting, and content of father-attended visits. Correlates of fathers' participation and thematic insights from mothers' and home-visitors' perspectives on how fathers perceived and interacted with the home-visiting program were analyzed to further characterize the nature of father participation. Although the community-doula home-visiting model does not include special outreach to increase father participation, almost half of the mothers had a doula visit at which their baby's father was present, many of which took place in medical settings. Mothers and doulas reported that fathers were generally positive about the doula, but expressed that fathers viewed the doula as a substitute provider of support that fathers seemed reticent to provide themselves. These results suggest that community doulas who visit pre- and postpartum in multiple settings have unique opportunities to have contact with fathers that traditional home visitors or early childhood specialists may not have.

  9. Reinventing the home visit for undergraduate nursing students.

    Science.gov (United States)

    Pohl, Carla J; Malin, Shelly; Kennell, Lynn

    2014-12-01

    The Family Outreach Project was designed to teach senior-level undergraduate nursing students how to assess, care for, and develop care plans for children with chronic health conditions and their families. Nursing students (n=24) could attend one focus group conducted at the end of the semester as part of the evaluation of the America's Promise School Project. Responses were audiotaped and transcribed verbatim. Qualitative methods were used to identify themes. Comfort with the visit, professionalism of the students, and usefulness of the home visit to families was assessed. Analysis of focus group responses identified four major themes: learning experience, observations about home environment, concerns about having nothing to offer families, and difficulties with arranging and carrying out the home visits. Family responses (n=10) supported students' perception that families were knowledgeable about their children's chronic health conditions. Families indicated that students were professional and treated families respectfully. Copyright 2014, SLACK Incorporated.

  10. Universal and targeted early home visiting: perspectives of public health nurses, managers and mothers

    Directory of Open Access Journals (Sweden)

    Megan Aston

    2014-07-01

    Full Text Available Early home visits provided by public health nurses (PHNs around the world have been proven to positively impact physical, social, emotional and mental health outcomes of mothers and babies. Most of the research has focused on home visiting programs delivered by public health nurses and lay home visitors to support at risk or targeted mothers. Little research has been conducted to examine universal home visiting programs for mothers who are perceived to be lower-risk. The purpose of this research was to explore how universal and targeted early home visiting programs for mothers and babies were organized, delivered and experienced through the everyday practices of PHNs, mothers, and managers in one city in Atlantic Canada. Feminist post-structuralism was used to collect and analyze data through semi-structured face-to-face interviews with 16 PHNs, 16 mothers and 4 managers. Personal, social and institutional discourses of program delivery were examined using discourse analysis. Four main themes of the study include: i understanding targeted and universal programming; ii health outcomes; iii building relationships; and iv exploring a new surveillance. This article will discuss the first theme; understanding targeted and universal programming.

  11. Effects of home visiting on adolescent mothers' parenting attitudes.

    Science.gov (United States)

    McKelvey, Lorraine M; Burrow, Nicola A; Balamurugan, Appathurai; Whiteside-Mansell, Leanne; Plummer, Pamela

    2012-10-01

    We examined the impact of a home visiting intervention on 227 adolescent mothers' parenting attitudes. At enrollment, half of mothers were at risk for child maltreatment. Mothers assigned to intervention (n = 161) received home visits and case management. Intervention and comparison mothers (n = 66) participated in monthly peer group meetings. Regression analyses controlling for enrollment differences indicated that intervention group mothers had significant improvements in 3 of 5 subscales and in total Adult-Adolescent Parenting Inventory-2 scores relative to the comparison group.

  12. A pilot study of palliative medicine fellows' hospice home visits.

    Science.gov (United States)

    Shoemaker, Laura K; Aktas, Aynur; Walsh, Declan; Hullihen, Barbara; Khan, Mohammed I Ahmed; Russell, Kraig M; Davis, Mellar P; Lagman, Ruth; LeGrand, Susan

    2012-12-01

    This was a prospective descriptive study of hospice physician home visits (HVs) conducted by Hospice and Palliative Medicine Fellows. Our objectives were 1) to improve our knowledge of hospice care at home by describing physician HVs 2) to identify the indications for physician HVs and the problems addressed during the HV. Data was collected on 58 consecutive patients using a standardized form completed before and after the home visit. More than half of the persons were women. Most were Caucasian. Median age was 75 years; 57% had cancer; 77% were do-not-resuscitate. 76% HV occurred in the home. The median visit duration was 60 minutes; median travel distance and time 25 miles and 42 minutes, respectively. A hospice nurse case manager was present in 95%. The most common issues addressed during HVs were: health education, symptom management, and psychosocial support. Medication review was prominent. Physicians identified previously unreported issues. Symptom control was usually pain, although 27 symptoms were identified. Medications were important; all home visits included drug review and two thirds drug change. Physicians had unique responsibilities and identified important issues in the HV. Physicians provided both education and symptom management. Physician HVs are an important intervention. HVs were important in continuity of care, however, time-consuming, and incurred considerable travel, and professional time and costs.

  13. Supporting Family Engagement in Home Visiting with the Family Map Inventories

    Science.gov (United States)

    Kyzer, Angela; Whiteside-Mansell, Leanne; McKelvey, Lorraine; Swindle, Taren

    2016-01-01

    The purpose of this study was to examine the feasibility and usefulness of a universal screening tool, the Family Map Inventory (FMI), to assess family strengths and needs in a home visiting program. The FMI has been used successfully by center-based early childcare programs to tailor services to family needs and build on existing strengths. Home…

  14. Does Home Visiting Benefit Only First-Time Mothers?: Evidence from Healthy Families Virginia

    Science.gov (United States)

    Huntington, Lee; Galano, Joseph

    2013-01-01

    It is a common assumption that mothers who have had previous births would participate less fully and have poorer outcomes from early home visitation programs than would first-time mothers. The authors conducted a qualitative and quantitative study to test that assumption by measuring three aspects of participation: time in the program, the number…

  15. The Home Visit: Creating Connections & Building Relationships with Parents

    Science.gov (United States)

    Patton, Melody

    2015-01-01

    One of the most important things teachers do is to create relationships and connections with the children and parents with whom they work. The strength of the individual relationships teachers have with parents and children affects the daily interactions with them and can act as a foundation later if difficult situations arise. Home visits (for…

  16. Child Maltreatment History and Response to CBT Treatment in Depressed Mothers Participating in Home Visiting.

    Science.gov (United States)

    Ammerman, Robert T; Peugh, James L; Teeters, Angelique R; Putnam, Frank W; Van Ginkel, Judith B

    2016-03-01

    Child maltreatment contributes to depression in adults. Evidence indicates that such experiences are associated with poorer outcomes in treatment. Mothers in home visiting programs display high rates of depression and child maltreatment histories. In-Home Cognitive Behavioral Therapy (IH-CBT) was developed to treat maternal depression in home visiting. The purpose of this study was to examine the moderating effects of child maltreatment history on depression, social functioning, and parenting in mothers participating in a clinical trial of IH-CBT. Ninety-three depressed mothers in home visiting between 2 and 10 months postpartum were randomly assigned to IH-CBT (n = 47) plus home visiting or standard home visiting (SHV; n = 46). Mothers were identified via screening and then confirmation of major depressive disorder diagnosis. Measures of child maltreatment history, depression, social functioning, and parenting were administered at pre-treatment, post-treatment, and 3-month follow-up. Results indicated high rates of maltreatment in both conditions relative to the general population. Mixed model analyses found a number of main effects in which experiences of different types of trauma were associated with poorer functioning regardless of treatment condition. Evidence of a moderating effect of maltreatment on treatment outcomes was found for physical abuse and parenting and emotional abuse and social network size. Future research should focus on increasing the effectiveness of IH-CBT with depressed mothers who have experienced child maltreatment. © The Author(s) 2014.

  17. Maternal Depression in Home Visitation: A Systematic Review

    Science.gov (United States)

    Ammerman, Robert T.; Putnam, Frank W.; Bosse, Nicole R.; Teeters, Angelique R.; Van Ginkel, Judith B.

    2010-01-01

    Depression is prevalent in new mothers and has been shown to have profound negative impacts on parenting, maternal life course, and child development. High rates of maternal depression have been found in home visitation, a widely disseminated prevention approach for high risk mothers and their children. This paper reviews the emerging literature on the prevalence, impact, and treatment of depression in the context of home visitation. Findings are synthesized and methodological and design limitations are considered in interpretation of results. Promising approaches to addressing maternal depression and supporting home visitors in working with this clinical population are described. Recommendations for research and practice are offered that build upon the strong foundation of current efforts in this area. PMID:20401324

  18. The Mother-Child Home Program.

    Science.gov (United States)

    Levenstein, Phyllis

    This paper provides a description and evaluation of the Mother-Child Program (developed by the Verbal Interaction Project) for prevention of educational disadvantage. The program consists of 46 semi-weekly home visits by "Toy Demonstrators" in each of two seven month program years, following the local school calendar. Toy Demonstrators are former…

  19. Depression improvement and parenting in low-income mothers in home visiting.

    Science.gov (United States)

    Ammerman, Robert T; Altaye, Mekibib; Putnam, Frank W; Teeters, Angelique R; Zou, Yuanshu; Van Ginkel, Judith B

    2015-06-01

    Research on older children and high-resource families demonstrates that maternal improvement in depression often leads to parallel changes in parenting and child adjustment. It is unclear if this association extends to younger children and low-income mothers. This study examined if In-Home Cognitive Behavioral Therapy (IH-CBT), a treatment for depressed mothers participating in home visiting programs, contributes to improvements in parenting and child adjustment. Ninety-three depressed mothers in home visiting between 2 and 10 months postpartum were randomly assigned to IH-CBT (n = 47) plus home visiting or standard home visiting (SHV; n = 46). Mothers were identified via screening and subsequent diagnosis of major depressive disorder (MDD). Measures of depression, parenting stress, nurturing parenting, and child adjustment were administered at pre-treatment, post-treatment, and 3 months follow-up. Results indicated that there were no differences between IH-CBT and controls on parenting and child adjustment. Low levels of depression were associated with decreased parenting stress and increased nurturing parenting. Improvement in depression was related to changes in parenting in low-income mothers participating in home visiting programs. IH-CBT was not independently associated with these improvements, although to the extent that treatment facilitated improvement; there were corresponding benefits to parenting. Child adjustment was not associated with maternal depression, a finding possibly attributed to the benefits of concurrent home visiting or measurement limitations. Future research should focus on longer-term follow-up, implications of relapse, and child adjustment in later years.

  20. Depression Improvement and Parenting in Low Income Mothers in Home Visiting

    Science.gov (United States)

    Ammerman, Robert T.; Altaye, Mekibib; Putnam, Frank W.; Teeters, Angelique R.; Zou, Yuanshu; Van Ginkel, Judith B.

    2014-01-01

    Purpose Research on older children and high resource families demonstrates that maternal improvement in depression often leads to parallel changes in parenting and child adjustment. It is unclear if this association extends to younger children and low income mothers. This study examined if In-Home Cognitive Behavioral Therapy (IH-CBT), a treatment for depressed mothers participating in home visiting programs, contributes to improvements in parenting and child adjustment. Methods Ninety-three depressed mothers in home visiting between 2–10 months postpartum were randomly assigned to IH-CBT (n=47) plus home visiting or standard home visiting (SHV; n = 46). Mothers were identified via screening and subsequent of MDD diagnosis. Measures of depression, parenting stress, nurturing parenting, and child adjustment were administered at pre-treatment, post-treatment, and three month follow-up. Results Results indicated that there were no differences between IH-CBT and controls on parenting and child adjustment. Low levels of depression were associated with decreased parenting stress and increased nurturing parenting. There was no association between maternal depression and child adjustment. Conclusions Improvement in depression was related to changes in parenting in low income mothers participating in home visiting programs. IH-CBT was not independently associated with these improvements, although to the extent that treatment facilitated improvement there were corresponding benefits to parenting. Child adjustment was not associated with maternal depression, a finding possibly attributed to the benefits of concurrent home visiting or measurement limitations. Future research should focus on longer term follow-up, implications of relapse, and child adjustment in later years. PMID:25369906

  1. Home Visits: How Do They Affect Teachers' Beliefs about Teaching and Diversity?

    Science.gov (United States)

    Lin, Miranda; Bates, Alan B.

    2010-01-01

    Based on Bronfenbrenner's ecological systems theory, this qualitative study examined the impact of home visits on a group of six Head Start educators. Each participant conducted two home visits. For the first home visit, participants were not provided any guidance. On the second visit, participants were provided a handout with questions intended…

  2. Ostomy Home Skills Program

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    Full Text Available ... de Destrezas para manejo Doméstico de Ostomía Ostomy Home Skills Program Adult Ostomy Pediatric Ostomy Programa de Destrezas para manejo Doméstico de Ostomía The Ostomy Home Skills Kit supports patients with educational and simulation ...

  3. Ostomy Home Skills Program

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    Full Text Available ... Stay Up to Date with ACS Association Management Jobs Events Find a Surgeon Patients and Family Contact My Profile Shop/Donate ( 0 ) Items American College of Surgeons Education Patients and Family Skills Programs Ostomy Home Skills ...

  4. Ostomy Home Skills Program

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    Full Text Available ... About SSC SSC Membership Directory 2016 Annual Meeting Women's Committee Mentorship Program Outside Activities ACS Archives Contact ... login or create account first) Skills Kits Broadcast Rights for Hospitals Ostomy Home Skills Hospital Quality Improvement ...

  5. Effects of general practitioner team home visiting program for community-dwelling elderlies%全科团队家访服务在高龄老人社区居家养老中的作用

    Institute of Scientific and Technical Information of China (English)

    易景娜; 陈利群; 贾守梅; 陆敏敏; 荀雪琴

    2012-01-01

    Objective To explore the effects of general practitioner team home visiting program for community-dwelling elderlies. Methods Totally 140 elderlies aged over 80 years old were divided into two groups. The elderlies in the experimental group received the general practitioner team home visiting program for 12 months. The elderlies in the control group received routine community health service. The scores of depression,loneliness and quality of life were compared by repeated-measures ANOVA, Results There were significant differences in the scores of depression,loneliness and quality of life at 3 months,6 months and 12 months after the intervention between the two groups. Conclusion The general practitioner team home visiting program can significantly improve the health status of community-dwelling elderlies and provide community-based medical support for the home care services among community-dwelling elderlies.%目的 探讨全科团队家访服务在高龄老人社区居家养老中的作用.方法 将140例80岁以上居家老人分为干预组和对照组,干预组接受12个月的全科团队家访服务,对照组接受常规社区卫生服务.采用重复测量方差分析两组在干预前及干预后抑郁、孤独及生活质量变化.结果 两组高龄老人抑郁、孤独及生活质量各维度得分在干预后3、6、12个月测量时的差异均有统计学意义.结论 全科团队家访服务能显著改善高龄居家老人的健康状况,为居家养老提供社区医疗支持.

  6. Promoting infant health through home visiting by a nurse-managed community worker team.

    Science.gov (United States)

    Barnes-Boyd, C; Fordham Norr, K; Nacion, K W

    2001-01-01

    This article describes the Resources, Education and Care in the Home program (REACH-Futures), an infant mortality reduction initiative in the inner city of Chicago built on the World Health Organization (WHO) primary health care model and over a decade of experience administering programs to reduce infant mortality through home visits. The program uses a nurse-managed team, which includes community residents selected, trained, and integrated as health advocates. Service participants were predominately African American families. All participants were low-income and resided in inner-city neighborhoods with high unemployment, high teen birth rates, violent crime, and deteriorated neighborhoods. Outcomes for the first 666 participants are compared to a previous home-visiting program that used only nurses. Participant retention rates were equivalent overall and significantly higher in the first months of the REACH-Futures program. There were two infant deaths during the course of the study, a lower death rate than the previous program or the city. Infant health problems and developmental levels were equivalent to the prior program and significantly more infants were fully immunized at 12 months. The authors conclude that the use of community workers as a part of the home-visiting team is as effective as the nurse-only team in meeting the needs of families at high risk of poor infant outcomes. This approach is of national interest because of its potential to achieve the desired outcomes in a cost-effective manner.

  7. Preventing Perinatal Depression in Low-Income Home Visiting Clients: A Randomized Controlled Trial

    Science.gov (United States)

    Tandon, S. Darius; Perry, Deborah F.; Mendelson, Tamar; Kemp, Karen; Leis, Julie A.

    2011-01-01

    Objective: To assess the efficacy of a 6-week cognitive-behavioral intervention in preventing the onset of perinatal depression and reducing depressive symptoms among low-income women in home visitation programs. Method: Sixty-one women who were pregnant or who had a child less than 6 months of age and who were assessed as at risk for perinatal…

  8. Preventing Perinatal Depression through Home Visiting: The Mothers and Babies Course

    Science.gov (United States)

    Perry, Deborah F.; Tandon, S. Darius; Edwards, Karen; Mendelson, Tamar

    2014-01-01

    Home visiting (HV) programs serve women at high risk for developing postpartum depression because of factors such as poverty and low social support. Depression poses serious threats not only to mother-child attachment and healthy infant development but also to women's ability to engage with HV services and supports. The Mothers and Babies (MB)…

  9. Impact of Depression and Childhood Trauma in Mothers Receiving Home Visitation

    Science.gov (United States)

    Ammerman, Robert T.; Shenk, Chad E.; Teeters, Angelique R.; Noll, Jennie G.; Putnam, Frank W.; Van Ginkel, Judith B.

    2012-01-01

    Research has documented the deleterious effects of maternal depression and childhood trauma on parenting and child development. There are high rates of both depression and childhood trauma in new mothers participating in home visitation programs, a prevention approach designed to optimize mother and child outcomes. Little is known about the…

  10. Impact of Depression and Childhood Trauma in Mothers Receiving Home Visitation

    Science.gov (United States)

    Ammerman, Robert T.; Shenk, Chad E.; Teeters, Angelique R.; Noll, Jennie G.; Putnam, Frank W.; Van Ginkel, Judith B.

    2012-01-01

    Research has documented the deleterious effects of maternal depression and childhood trauma on parenting and child development. There are high rates of both depression and childhood trauma in new mothers participating in home visitation programs, a prevention approach designed to optimize mother and child outcomes. Little is known about the…

  11. Preventive home visits to older home-dwelling people in Denmark: are invitational procedures of importance?

    Science.gov (United States)

    Ekmann, A; Vass, M; Avlund, K

    2010-11-01

    Since 1998 all municipalities in Denmark have been required by law to offer two annual preventive home visits to all home-dwelling citizens aged 75 or over. The influence of invitational procedures on acceptance rates has not been investigated. The aim of this study was to describe and investigate whether different invitational procedures were associated with first preventive home visit acceptance rates. The study was based on secondary analyses of data from the Danish Intervention Study on Preventive Home Visits. Data were collected from 1998 to 2002. Of the 4060 participants in the main study, 3245 reported receiving an offer for an identifiable preventive home visit, of whom 2399 (73.9%) provided complete data for the main analyses in the present study. Invitational procedures were categorised as: (1) a letter with a proposed date and time for the visit, (2) a visitor telephone call, and (3) a letter with encouragement to phone the visitor for appointment (letter without a proposed date). Covariates included sex, age, experience with preventive interventions, functional ability, self rated health, social relations and psychosocial characteristics. Statistical analyses included chi-square tests, and bi- and multivariable logistic regression analyses. Different invitational procedures were associated with first preventive home visit acceptance rates. Significantly more men (75.1%) than women (62.8%) declined the first preventive home visit regardless of the invitational procedure. Compared to 'letter with a proposed date', men had an odds ratio of 1.78 (95% CI: 1.16-2.74) for declining visits when 'telephone call' was used and an odds ratio 2.81 (95% CI: 1.79-4.40) when 'letter without a proposed date' was used as the invitational procedure. In women the odds ratios were 1.23 (95% CI: 0.91-1.68) and 1.87 (95% CI: 1.37-2.55), respectively.

  12. La visita médica al hogar Home visit

    Directory of Open Access Journals (Sweden)

    José Díaz Novás

    2007-03-01

    Full Text Available Se hace un breve resumen de la historia de la visita médica al hogar en Cuba, y se señala su evolución en las diferentes formas organizativas de la atención primaria en la etapa revolucionaria. Se enumeran las ventajas de las visitas médicas al hogar, su necesidad como componente fundamental e insustituible de la atención a los pacientes, y como complemento necesario del trabajo en el consultorio. Se exponen los motivos de la visita al hogar: enfermedades agudas, procesos crónicos, discapacidades, evaluar el entorno familiar e higiénico-epidemiológico del paciente, los ingresos domiciliarios, las altas hospitalarias precoces, y los pacientes con enfermedades terminales o con afecciones dispensarizadas, entre otros Se presenta un grupo de orientaciones para el desarrollo exitoso de la visita médica al hogarA summary of the history of home visit in Cuba is made, stressing its evolution in the different organizative ways of primary care in the revolutionary stage. The advantages of home visits, their need as a fundamental and irreplaceable component of the patients' care and a necessary complement of the work in the office are given. The reasons of the visits are explained: acute diseases, chronic processes, disabilities, evaluation of the family and hygienic-epidemiological setting of the patient, home admissions, early hospital discharges, and patients with end-stage diseases, or with categorized diseases, among others. Some instructions for the success of home visit are exposed.

  13. Foreign Students in Tianjin Visit Elderly People’s Home

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    <正>On the afternoon of December 7, 2007, the Tianjin Municipal People’s Association for Friendship with Foreign Countries (TMPAFFC) organized more than 20 Japanese and ROK teachers and students of Nankai University to visit the Tianjin Elderly People’s Home. The Tianjin Elderly People’s Home, built in 1953 and covering an area of over 40 mu, is a comprehensive welfare institution for the elderly people which provides such services as accommodation, medical care, nursing, nutrition counseling, rehabilitation, education, recreation, deathbed care and training. In it there are a branch of the Tianjin Elderly People’s University, the Tianjin Nurse Training School for Caring the Aged and a hospital for senile diseases with 500 beds. The Home mainly admits unsupported aged people, elderly people who pay for their own expenses and those who are critically ill needing deathbed care. People above 60 without infectious diseases or mental disorder can apply for admission.

  14. Daily life or diagnosis? Dual perspectives on perinatal depression within maternal and child health home visiting.

    Science.gov (United States)

    Price, Sarah Kye; Cohen-Filipic, Katherine

    2013-01-01

    This study describes a qualitative inquiry-informing program development in a maternal and child home visiting program. Low-income women's perceptions of the meaning and experiences of depression were ascertained through focus groups and interviews. Simultaneously, the study examines staff member perceptions and roles related to depression. Specific findings from clients and staff reveal culturally situated beliefs about depression and stressful life events; comparing and contrasting these beliefs offers a novel perspective on identification and intervention for maternal depression. This study offers a foundation for a translational research agenda that will be used for program and policy development to enhance mental health services situated within maternal and child health home visiting programs.

  15. Miller Early Childhood Sustained Home-visiting (MECSH trial: design, method and sample description

    Directory of Open Access Journals (Sweden)

    Anderson Teresa

    2008-12-01

    Full Text Available Abstract Background Home visiting programs comprising intensive and sustained visits by professionals (usually nurses over the first two years of life show promise in promoting child health and family functioning, and ameliorating disadvantage. Australian evidence of the effectiveness of sustained nurse home visiting in early childhood is limited. This paper describes the method and cohort characteristics of the first Australian study of sustained home visiting commencing antenatally and continuing to child-age two years for at-risk mothers in a disadvantaged community (the Miller Early Childhood Sustained Home-visiting trial. Methods and design Mothers reporting risks for poorer parenting outcomes residing in an area of socioeconomic disadvantage were recruited between February 2003 and March 2005. Mothers randomised to the intervention group received a standardised program of nurse home visiting. Interviews and observations covering child, maternal, family and environmental issues were undertaken with mothers antenatally and at 1, 12 and 24 months postpartum. Standardised tests of child development and maternal-child interaction were undertaken at 18 and 30 months postpartum. Information from hospital and community heath records was also obtained. Discussion A total of 338 women were identified and invited to participate, and 208 were recruited to the study. Rates of active follow-up were 86% at 12 months, 74% at 24 months and 63% at 30 months postpartum. Participation in particular data points ranged from 66% at 1 month to 51% at 24 months postpartum. Rates of active follow-up and data point participation were not significantly different for the intervention or comparison group at any data point. Mothers who presented for antenatal care prior to 20 weeks pregnant, those with household income from full-time employment and those who reported being abused themselves as a child were more likely to be retained in the study. The Miller Early

  16. Home Away from Home: A Toolkit for Planning Home Visiting Partnerships with Family, Friend, and Neighbor Caregivers

    Science.gov (United States)

    Johnson-Staub, Christine; Schmit, Stephanie

    2012-01-01

    Home visiting is one tool used to prevent child abuse and improve child well-being by providing education and services in families' homes through parent education and connection to community resources. This toolkit provides state policymakers and advocates with strategies for extending and expanding access to state- or federally-funded home…

  17. Increasing Participation and Improving Engagement in Home Visitation: A Qualitative Study of Early Head Start Parent Perspectives

    Science.gov (United States)

    Hubel, Grace S.; Schreier, Alayna; Wilcox, Brian L.; Flood, Mary Fran; Hansen, David J.

    2017-01-01

    Home visitation programs are designed to provide comprehensive services that promote parent's abilities to create stable, nurturing care environments for their children. In order for program goals to be met, parents must participate actively and be engaged with the programs' mission. However, promoting engagement and participation are complex…

  18. Home visits as a strategy for health promotion by nursing

    Directory of Open Access Journals (Sweden)

    Jucelia Salgueiro Nascimento

    2014-09-01

    Full Text Available Objective: To analyze the domiciliary visit performed by nurses in the Family Health Strategy as an activity to promote health. Methods: Exploratory/descriptive study with qualitative approach. The subjects were nine nurses of the Primary Health Units from Health Districts in Maceió-AL. Data was collected through semi-structured interviews in the months from April to August 2012 and were analyzed using content analysis and in light of the theoretical framework of Health Promotion. Results: The nurses recognize that the domiciliary visit can be a way to promote the health of individuals, families and community, but, in daily life, action maintains focus on disease, with curative actions of individual character, which do not take into account the social context where the user and his family are inserted. Conclusion: It is considered that the use of home visits by nurses in the family health strategy as a health promotion activity is still incipient because, although the nurses recognize the need for change in the model of care, in practice, it is observed that the focus of this action is directed to the biological model. doi:http://dx.doi.org/10.5020/18061230.2013.p513

  19. Effectiveness of Home Visits in Pregnancy as a Public Health Measure to Improve Birth Outcomes.

    Directory of Open Access Journals (Sweden)

    Kayoko Ichikawa

    Full Text Available Birth outcomes, such as preterm birth, low birth weight (LBW, and small for gestational age (SGA, are crucial indicators of child development and health.To evaluate whether home visits from public health nurses for high-risk pregnant women prevent adverse birth outcomes.In this quasi-experimental cohort study in Kyoto city, Japan, high-risk pregnant women were defined as teenage girls (range 14-19 years old, women with a twin pregnancy, women who registered their pregnancy late, had a physical or mental illness, were of single marital status, non-Japanese women who were not fluent in Japanese, or elderly primiparas. We collected data from all high-risk pregnant women at pregnancy registration interviews held at a public health centers between 1 July 2011 and 30 June 2012, as well as birth outcomes when delivered from the Maternal and Child Health Handbook (N = 964, which is a record of prenatal check-ups, delivery, child development and vaccinations. Of these women, 622 women were selected based on the home-visit program propensity score-matched sample (pair of N = 311 and included in the analysis. Data were analyzed between January and June 2014.In the propensity score-matched sample, women who received the home-visit program had lower odds of preterm birth (odds ratio [OR], 0.62; 95% confidence interval [CI], 0.39 to 0.98 and showed a 0.55-week difference in gestational age (95% CI: 0.18 to 0.92 compared to the matched controlled sample. Although the program did not prevent LBW and SGA, children born to mothers who received the program showed an increase in birth weight by 107.8 g (95% CI: 27.0 to 188.5.Home visits by public health nurses for high-risk pregnant women in Japan might be effective in preventing preterm birth, but not SGA.

  20. The Home Care Crew Scheduling Problem: Preference-based visit clustering and temporal dependencies

    DEFF Research Database (Denmark)

    Rasmussen, Matias Sevel; Justesen, Tor Fog; Dohn, Anders Høeg

    2012-01-01

    In the Home Care Crew Scheduling Problem a staff of home carers has to be assigned a number of visits to patients’ homes, such that the overall service level is maximised. The problem is a generalisation of the vehicle routing problem with time windows. Required travel time between visits and tim...

  1. The Hospital at Home program: no place like home

    Science.gov (United States)

    Lippert, M.; Semmens, S.; Tacey, L.; Rent, T.; Defoe, K.; Bucsis, M.; Shykula, T.; Crysdale, J.; Lewis, V.; Strother, D.; Lafay-Cousin, L.

    2017-01-01

    Background The treatment of children with cancer is associated with significant burden for the entire family. Frequent clinic visits and extended hospital stays can negatively affect quality of life for children and their families. Methods Here, we describe the development of a Hospital at Home program (H@H) that delivers therapy to pediatric hematology, oncology, and blood and marrow transplant (bmt) patients in their homes. The services provided include short infusions of chemotherapy, supportive-care interventions, antibiotics, post-chemotherapy hydration, and teaching. Results From 2013 to 2015, the H@H program served 136 patients, making 1701 home visits, for patients mainly between the ages of 1 and 4 years. Referrals came from oncology in 82% of cases, from hematology in 11%, and from bmt in 7%. Since inception of the program, no adverse events have been reported. Family surveys suggested less disruption in daily routines and appreciation of specialized care by hematology and oncology nurses. Staff surveys highlighted a perceived benefit of H@H in contributing to early discharge of patients by supporting out-of-hospital monitoring and teaching. Conclusions The development of a H@H program dedicated to the pediatric hematology, oncology, or bmt patient appears feasible. Our pilot program offers a potential contribution to improvement in patient quality of life and in cost–benefit for parents and the health care system. PMID:28270721

  2. Maternal Jail Time, Conviction, and Arrest as Predictors of Children's 15-Year Antisocial Outcomes in the Context of a Nurse Home Visiting Program

    Science.gov (United States)

    Shlafer, Rebecca J.; Poehlmann, Julie; Donelan-McCall, Nancy

    2012-01-01

    Data from the Nurse-Family Partnership intervention program were analyzed to compare the "selection" versus "unique" effects of maternal jail time on adolescent antisocial and health risk outcomes. Data from 320 women and their firstborn children were available from the prenatal, birth, and 15-year assessments. Consistent with…

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

    Directory of Open Access Journals (Sweden)

    Luciana Valadão Alves Kebian

    2014-03-01

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

  4. Mapping and Visiting in Functional and Object-oriented Programming

    DEFF Research Database (Denmark)

    Nørmark, Kurt; Thomsen, Bent; Thomsen, Lone Leth

    2008-01-01

    Mapping and visiting represent different programming styles for traversals of collections of data.  Mapping is rooted in the functional programming paradigm, and visiting is rooted in the object-oriented programming paradigm.  This paper explores the similarities and differences between mapping...... and visiting, seen across the traditions in the two different programming paradigms. The paper is concluded with recommendations for mapping and visiting in programming languages that support both the functional and the object-oriented paradigms....

  5. Occupational Therapy Predischarge Home Visits in Acute Hospital Care: A Randomized Trial.

    Science.gov (United States)

    Clemson, Lindy; Lannin, Natasha A; Wales, Kylie; Salkeld, Glenn; Rubenstein, Laurence; Gitlin, Laura; Barris, Sarah; Mackenzie, Lynette; Cameron, Ian D

    2016-10-01

    To determine whether an enhanced occupational therapy discharge planning intervention that involved pre- and postdischarge home visits, goal setting, and follow-up (the HOME program) would be superior to a usual care intervention in which an occupational therapy in-hospital consultation for planning and supporting discharge to home is provided to individuals receiving acute care. Randomized controlled trial. Acute and medical wards. Individuals aged 70 and older (N = 400). Primary outcomes: activities daily living (ADLs; Nottingham Extended Activities of Daily Living) and participation in life roles and activities (Late Life Disability Index (LLDI)). Occupational therapist recommendations differed significantly between groups (P occupational therapy recommendations as the in-hospital only consultation, which had a greater emphasis on equipment provision, but HOME did not demonstrate greater benefit in global measures of ADLs or participation in life tasks than in-hospital consultation alone. It is not recommended that home visits be conducted routinely as part of discharge planning for acutely hospitalized medical patients. Further work should develop guidelines for quality in-hospital consultation. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

  6. Ostomy Home Skills Program

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    Full Text Available ... kit contains: A booklet with information on the operation, home skills such as emptying and changing a pouch, problem solving, and home management. A DVD with demonstration of each skill Stoma ...

  7. Home telemonitoring and remote feedback between clinic visits for asthma.

    Science.gov (United States)

    Kew, Kayleigh M; Cates, Christopher J

    2016-08-03

    Asthma is a chronic disease that causes reversible narrowing of the airways due to bronchoconstriction, inflammation and mucus production. Asthma continues to be associated with significant avoidable morbidity and mortality. Self management facilitated by a healthcare professional is important to keep symptoms controlled and to prevent exacerbations.Telephone and Internet technologies can now be used by patients to measure lung function and asthma symptoms at home. Patients can then share this information electronically with their healthcare provider, who can provide feedback between clinic visits. Technology can be used in this manner to improve health outcomes and prevent the need for emergency treatment for people with asthma and other long-term health conditions. To assess the efficacy and safety of home telemonitoring with healthcare professional feedback between clinic visits, compared with usual care. We identified trials from the Cochrane Airways Review Group Specialised Register (CAGR) up to May 2016. We also searched www.clinicaltrials.gov, the World Health Organization (WHO) trials portal and reference lists of other reviews, and we contacted trial authors to ask for additional information. We included parallel randomised controlled trials (RCTs) of adults or children with asthma in which any form of technology was used to measure and share asthma monitoring data with a healthcare provider between clinic visits, compared with other monitoring or usual care. We excluded trials in which technologies were used for monitoring with no input from a doctor or nurse. We included studies reported as full-text articles, those published as abstracts only and unpublished data. Two review authors screened the search and independently extracted risk of bias and numerical data, resolving disagreements by consensus.We analysed dichotomous data as odds ratios (ORs) while using study participants as the unit of analysis, and continuous data as mean differences (MDs) while

  8. Universal Home Visiting: A Recommendation from the U.S. Advisory Board on Child Abuse and Neglect.

    Science.gov (United States)

    Krugman, Richard D.

    1993-01-01

    In 1991, the U.S. Advisory Board on Child Abuse and Neglect recommended the federal government begin phasing in a national, universal home visiting program for children during the neonatal period to help prevent child abuse and neglect. This article discusses the political and social factors affecting this recommendation, as well as the response…

  9. The power of relationships: exploring how Public Health Nurses support mothers and families during postpartum home visits.

    Science.gov (United States)

    Aston, Megan; Price, Sheri; Etowa, Josephine; Vukic, Adele; Young, Linda; Hart, Christine; MacLeod, Emily; Randel, Patricia

    2015-02-01

    Postpartum home visiting by Public Health Nurses (PHNs) has been used by many health departments across Canada as a way of supporting new mothers and their families. Although positive health outcomes are linked with support from PHNs, little is known about how this occurs during the home visit. The purpose of this research was to explore how home visiting programs for mothers and babies were organized, delivered, and experienced through the everyday practices of PHNs, mothers, and managers in Nova Scotia, Canada. Feminist poststructuralism was used to guide the research and semi-structured face-to-face interviews were conducted with 16 PHNs, 16 mothers, and 4 managers. Participants described how relationships were an essential part of supporting mothers and families. These findings also challenge dominant health discourses and stereotypes that are often associated with mothering and the practice of PHNs with families. © The Author(s) 2014.

  10. Home visits by neighborhood Mentor Mothers provide timely recovery from childhood malnutrition in South Africa: results from a randomized controlled trial

    OpenAIRE

    2010-01-01

    Abstract Background Child and infant malnourishment is a significant and growing problem in the developing world. Malnourished children are at high risk for negative health outcomes over their lifespans. Philani, a paraprofessional home visiting program, was developed to improve childhood nourishment. The objective of this study is to evaluate whether the Philani program can rehabilitate malnourished children in a timely manner. Methods Mentor Mothers were trained to conduct home visits. Ment...

  11. Cost effectiveness of preventive home visits to the elderly: economic evaluation alongside randomized controlled study

    DEFF Research Database (Denmark)

    Kronborg, Christian; Vass, Mikkel; Lauridsen, Jørgen

    2006-01-01

    We evaluated the cost effectiveness of preventive home visits to elderly persons in Denmark alongside a 3-year randomized controlled study. The main outcome measure was incremental costs per active life-year gained. The number of active life-years was defined as those during which the person......, and interdisciplinary follow-up. The remaining 17 municipalities offered preventive home visits as usual. Outcomes were measured in 4,034 persons aged 75 or 80 years old and dwelling at home. The difference in mean total costs between the intervention and the control group discounted at 3% was -856 euro (95% CI -2......,455 to 744) in 75-year-olds and 694 euro (-2,684 to 4,071) in 80-year-olds. The discounted difference in mean active life-years was 0.034 (-0.058 to 0.125) and 0.197 (0.013 to 0.380), respectively. The study did not provide conclusive evidence on the cost effectiveness of the programs under consideration....

  12. Effects of Home Visitation on Maternal Competencies, Family Environment, and Child Development: a Randomized Controlled Trial.

    Science.gov (United States)

    Sierau, Susan; Dähne, Verena; Brand, Tilman; Kurtz, Vivien; von Klitzing, Kai; Jungmann, Tanja

    2016-01-01

    Based on the US Nurse-Family Partnership (NFP) program, the German home visiting program "Pro Kind" offered support for socially and financially disadvantaged first-time mothers from pregnancy until the children's second birthday. A multi-centered, longitudinal randomized controlled trial (RCT) was conducted to assess its effectiveness on mothers and children. A total of 755 women with multiple risk factors were recruited, 394 received regular home visits (treatment group), while 361 only had access to standard community services (control group). Program influences on family environment (e.g., quality of home, social support), maternal competencies (e.g., maternal self-efficacy, empathy, parenting style), and child development (e.g., cognitive and motor development) were assessed from mothers' program intake in pregnancy to children's second birthday based on self-reports in regular interviews and developmental tests. Generalized estimating equations (GEE) models showed small, but significant positive treatment effects on parental self-efficacy, and marginally significant effects on social support, and knowledge on child rearing. Maternal stress, self-efficacy, and feelings of attachment in the TG tend to show a more positive development over time. Subgroup effects were found for high-risk mothers in the TG, who reported more social support over time and, generally, had children with higher developmental scores compared to their CG counterparts. Post hoc analyses of implementation variables revealed the quality of the helping relationship as a significant indicator of treatment effects. Results are discussed in terms of implementation and public policy differences between NFP and Pro Kind.

  13. Ostomy Home Skills Program

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    Full Text Available ... Safety Conference Registry Login SCR Training and Testing Cancer Cancer Programs Cancer Programs Overview of Cancer Programs Cancer Programs News American Joint Committee on ...

  14. Ostomy Home Skills Program

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    Full Text Available ... SSC About SSC SSC Membership Directory Annual Meeting ... Ostomy Pediatric Ostomy Ostomía Adulto Order Today Ostomy Home Skills Kit (login or create account first) Skills Kits Broadcast Rights for Hospitals Ostomy Home Skills Hospital Quality Improvement ...

  15. Evaluation of a Home-Based Environmental and Educational Intervention to Improve Health in Vulnerable Households: Southeastern Pennsylvania Lead and Healthy Homes Program

    OpenAIRE

    Deepa Mankikar; Carla Campbell; Rachael Greenberg

    2016-01-01

    This evaluation examined whether participation in a home-based environmental educational intervention would reduce exposure to health and safety hazards and asthma-related medical visits. The home intervention program focused on vulnerable, low-income households, where children had asthma, were at risk for lead poisoning, or faced multiple unsafe housing conditions. Home visitors conducted two home visits, two months apart, consisting of an environmental home assessment, Healthy Homes educati...

  16. Ostomy Home Skills Program

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  19. Ostomy Home Skills Program

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    Full Text Available ... and changing a pouch, problem solving, and home management. A DVD with demonstration of each skill Stoma Practice Model Stoma supplies (measurement guide, marking pen, scissors, sample ...

  20. Home visits - central to primary care, tradition or an obligation? A qualitative study

    Directory of Open Access Journals (Sweden)

    Müller Christiane A

    2011-04-01

    Full Text Available Abstract Background Home visits are claimed to be a central element of primary care. However, the frequency with which home visits are made is declining both internationally and in Germany despite the increase in the number of chronically ill elderly patients. Given this, the question arises as to how to ensure sufficient primary health care for this vulnerable patient group. The aim of this study was to explore German general practitioners' (GPs attitudes with regard to the feasibility, burden and outlook of continued home visits in German primary care. Methods Qualitative semi-structured interviews were carried out with 24 GPs from the city of Hannover, Germany, and its rural surroundings. Data was analysed using qualitative content analysis. Results The GPs indicated that they frequently conduct home visits, but not all of them were convinced of their benefit. Most were not really motivated to undertake home visits but some felt obliged to. The basic conditions covering home visits were described as unsatisfactory, in particular with respect to reimbursement and time constraints. House calls for vulnerable, elderly people remained undisputed, whereas visits of a social nature were mostly deleted. Urgent house calls were increasingly delegated to the emergency services. Visits to nursing homes were portrayed as being emotionally distressing. GPs considered good cooperation with nursing staff the key factor to ensure a successful nursing home visit. The GPs wanted to ease their work load while still ensuring quality home care but were unable to suggest how this might be achieved. Better financial compensation was proposed most often. The involvement of specially trained nurses was considered possible, but viewed with resentment. Conclusions Home visits are still an integral aspect of primary care in Germany and impose a considerable workload on many practices. Though the existing situation was generally perceived as unsatisfactory, German GPs

  1. A randomized comparison of home visits and hospital-based group follow-up visits after early postpartum discharge.

    Science.gov (United States)

    Escobar, G J; Braveman, P A; Ackerson, L; Odouli, R; Coleman-Phox, K; Capra, A M; Wong, C; Lieu, T A

    2001-09-01

    Short postpartum stays are common. Current guidelines provide scant guidance on how routine follow-up of newly discharged mother-infant pairs should be performed. We aimed to compare 2 short-term (within 72 hours of discharge) follow-up strategies for low-risk mother-infant pairs with postpartum length of stay (LOS) of costs were studied using computerized databases and chart review. Breastfeeding continuation, maternal depressive symptoms, and maternal satisfaction were assessed by means of telephone interviews at 2 weeks postpartum. During a 17-month period in 1998 to 1999, we enrolled and randomized 1014 mother-infant pairs (506 to the control group and 508 to the intervention group). There were no significant differences between the study groups with respect to maternal age, race, education, household income, parity, previous breastfeeding experience, early initiation of prenatal care, or postpartum LOS. There were no differences with respect to neonatal LOS or Apgar scores. In the control group, 264 mother-infant pairs had an individual visit only, 157 had a group visit only, 64 had both a group and an individual visit, 4 had a home health and a hospital-based follow-up, 13 had no follow-up within 72 hours, and 4 were lost to follow-up. With respect to outcomes within 2 weeks after discharge, there were no significant differences in newborn or maternal hospitalizations or urgent care visits, breastfeeding discontinuation, maternal depressive symptoms, or a combined clinical outcome measure indicating whether a mother-infant pair had any of the above outcomes. However, mothers in the home visit group were more likely than those in the control group to rate multiple aspects of their care as excellent or very good. These included the preventive advice delivered (76% vs 59%) and the skills and abilities of the provider (84% vs 73%). Mothers in the home visit group also gave higher ratings on overall satisfaction with the newborn's posthospital care (71% vs 59

  2. Ostomy Home Skills Program

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  4. Family members' perceived meaning of visiting nursing home residents in Taiwan.

    Science.gov (United States)

    Tsai, Hsiu-Hsin; Tsai, Yun-Fang

    2012-02-01

    The purpose of this article is to report the findings of a study to explore perceived family meaning of visiting older nursing home residents in Taiwan. Family involvement in the care of institutionalized elders benefits residents, family and staff. Families have traditionally been involved through in-person visits. One factor influencing family visits is motivation, which is a vague concept, creating a need to better understand the meaning families ascribe to visiting nursing home residents. Understanding this meaning is necessary to develop intervention programmes that facilitate the quality of families' nursing-home visits. However, little is known about the meaning of family visits to nursing home residents in Asian countries. Data were collected April 2009-2010 in audiotaped, individual, in-depth interviews with 15 family members of residents at four nursing homes in Taiwan. These family members included five women and 10 men, predominantly residents' children and spouses. The meaning of family visits to nursing home residents was captured by five major themes: hoping for recovery, honouring filial/karmic responsibility, insuring care quality, maintaining family relationships and making up for guilt. The findings of this study can be considered by nurses and policy makers when designing interventions and allocating resources to improve the quality of family visits with nursing home residents. These interventions can be tailored to family members' perceived meanings for visiting, e.g. those hoping for residents' recovery may benefit from health-promotion programmes, and those honouring filial/karmic responsibility might be helped by education on different ways to show filial respect. © 2011 Blackwell Publishing Ltd.

  5. Ostomy Home Skills Program

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    Full Text Available ... Safety Resources About the Patient Education Program The Recovery Room Choosing Wisely Educational Programs Educational Programs Educational ... and practice the skills needed for optimal postoperative recovery. The kit supports the entire surgical team with ...

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  10. Ostomy Home Skills Program

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  11. Ostomy Home Skills Program

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  12. [Effects of different home visit strategies on prenatal care in Southern Brazil].

    Science.gov (United States)

    Cesar, Juraci A; Mendoza-Sassi, Raul A; Ulmi, Eduardo F; Dall'Agnol, Marinel M; Neumann, Nelson A

    2008-11-01

    This non-randomized community intervention study evaluated the impact of prenatal home visits by community health agents and volunteer leaders from the Children's Mission on prenatal care among poor pregnant women in Rio Grande, Rio Grande do Sul State, Brazil. Previously trained interviewers applied pre-coded questionnaires to the women at home, investigating demographic and reproductive characteristics, socioeconomic status, housing conditions, and prenatal care. Of the 339 pregnant women interviewed, 115 were assigned to the intervention group visited by community health agents, 116 to the group visited by volunteer leaders, and 108 to the control group. Pregnant women visited by community health agents began prenatal visits earlier than other groups, had more prenatal visits, lab tests, and clinical exams, and received more counseling on breastfeeding and iron supplementation. Participation by family members during medical consultations for pregnant women visited by volunteer leaders was higher than for community health agents. Pregnant women visited by community health agents received better prenatal care than the other groups. Home visits can improve the quality of prenatal care for poor women and increase participation by family members (mainly husbands) during the pregnancy.

  13. Exploring home visits in a faith community as a service-learning opportunity.

    Science.gov (United States)

    du Plessis, Emmerentia; Koen, Magdalene P; Bester, Petra

    2013-08-01

    Within South Africa the Psychiatric Nursing Science curriculum in undergraduate Baccalaureate nursing education utilizes home visits as a service-learning opportunity. In this context faith communities are currently unexplored with regards to service-learning opportunities. With limited literature available on this topic, the question was raised as to what are these students' and family members' experience of home visits within a faith community. To explore and describe nursing students' and family members' experiences of home visits within a faith community. A qualitative approach was used that was phenomenological, explorative and descriptive and contextual in nature. The research was conducted within a faith community as service learning opportunity for Baccalaureate degree nursing students. This community was situated in a semi-urban area in the North-West Province, South Africa. Eighteen (n=18) final year nursing students from different cultural representations, grouped into seven groups conducted home visits at seven (n=7) families. Comprehensive reflective reporting after the visits, namely that the students participated in a World Café data collection technique and interviews were conducted with family members. Three main themes emerged: students' initial experiences of feeling overwhelmed but later felt more competent; students' awareness of religious and cultural factors; and students' perception of their role. Two main themes from the family members emerged: experiencing caring and growth. There is mutual benefit for nursing students and family members. Students' experiences progress during home visits from feeling overwhelmed and incompetent towards a trusting relationship. Home visits in a faith community seems to be a valuable service learning opportunity, and the emotional competence, as well as spiritual and cultural awareness of nursing students should be facilitated in preparation for such home visits. Copyright © 2012 Elsevier Ltd. All rights

  14. General practice cooperatives : long waiting times for home visits due to long distances?

    NARCIS (Netherlands)

    Giesen, P.H.J.; Lin, N.G.C.B. van; Mokkink, H.G.A.; Bosch, W.J.H.M. van den; Grol, R.P.T.M.

    2007-01-01

    BACKGROUND: The introduction of large-scale out-of-hours GP cooperatives has led to questions about increased distances between the GP cooperatives and the homes of patients and the increasing waiting times for home visits in urgent cases. We studied the relationship between the patient's waiting

  15. The effect of early postpartum home visits by health visitors: a natural experiment

    DEFF Research Database (Denmark)

    Kronborg, Hanne; Væth, Michael; Kristensen, Ingeborg

    2012-01-01

    included 3834 newborn and 375 health visitors, 75 of whom worked during the strike period. Intervention: All families were offered non- standardized home visits after discharge in the reference period. During the strike, the service was based on individual risk assessment. Results: Overall, no difference....... The mothers’ needs for postnatal visits differed depending on parity: primiparae underlined uncertainty, multiparae underlined previous breastfeeding experience. Mothers had missed out on guidance on all areas of the health visitors’ service. Conclusion: Non-standardized home visits by health visitors were...

  16. Randomized trial of a cellular phone-enhanced home visitation parenting intervention.

    Science.gov (United States)

    Carta, Judith J; Lefever, Jennifer Burke; Bigelow, Kathryn; Borkowski, John; Warren, Steven F

    2013-11-01

    Although home visiting programs have been documented to improve parenting in high-risk families, their effectiveness is diminished when parents disengage from programs. Cellular phones offer an approach to promoting parent engagement and enhancing parenting outcomes. Our objective was to examine whether mothers in a parenting intervention, Planned Activities Training (PAT), or cellular phone-enhanced version (CPAT) of the intervention would demonstrate greater use of parenting strategies after treatment and at 6 months post-treatment compared with a wait-list control (WLC). A sample of 371 low-income mothers and their 3.5- to 5.5-year-old children were randomly assigned to condition and assessed at pre-test, post-intervention, and 6 months post-intervention. Treatment efficacy was evaluated through observations of mother-child interactions as well as maternal interviews about depression, parenting stress, and child behaviors. Mothers receiving PAT and CPAT demonstrated more frequent use of parenting strategies and engaged in more responsive parenting than mothers in the WLC. Mothers receiving CPAT used more PAT parenting strategies than mothers in the other 2 groups and experienced greater reductions in depression and stress. Children of mothers receiving PAT and CPAT demonstrated higher rates of positive engagement, and children of CPAT mothers demonstrated higher levels of adaptive behaviors than children in the WLC. Importantly, changes in parenting, depression, and stress predicted positive child behaviors. PAT and CPAT conditions improved parenting strategies and child engagement and reduced children's challenging behaviors. The addition of cellular phones to a home visiting program enhanced maternal responsivity and reduced depression and stress.

  17. Peer supporter experiences of home visits for people with HIV infection

    Directory of Open Access Journals (Sweden)

    Lee HJ

    2015-09-01

    Full Text Available Han Ju Lee,1 Linda Moneyham,2 Hee Sun Kang,3 Kyung Sun Kim41Department of Nursing, Sangmyung University, Cheonan-si, Chungcheongnam-do, South Korea; 2School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA; 3Red Cross College of Nursing, Chung-Ang University, Seoul, South Korea; 4Gyeonggi Branch, Korean Alliance to Defeat AIDS, Anyang, Gyeonggi-do, South KoreaPurpose: This study's purpose was to explore the experiences of peer supporters regarding their work in a home visit program for people with HIV infection.Patients and methods: A qualitative descriptive study was conducted using focus groups. Participants were 12 HIV-positive peer supporters conducting home visits with people living with HIV/AIDS in South Korea. Thematic analysis was used to analyze the data.Results: Six major themes emerged: feeling a sense of belonging; concern about financial support; facing HIV-related stigma and fear of disclosure; reaching out and acting as a bridge of hope; feeling burnout; and need for quality education. The study findings indicate that although peer supporters experience several positive aspects in the role, such as feelings of belonging, they also experience issues that make it difficult to be successful in the role, including the position's instability, work-related stress, and concerns about the quality of their continuing education.Conclusion: The findings suggest that to maintain a stable and effective peer supporter program, such positions require financial support, training in how to prevent and manage stress associated with the role, and a well-developed program of education and training.Keywords: human immunodeficiency virus, qualitative research, workplace experience

  18. Randomized Trial of a Cellular Phone-Enhanced Home Visitation Parenting Intervention

    Science.gov (United States)

    Lefever, Jennifer Burke; Bigelow, Kathryn; Borkowski, John; Warren, Steven F.

    2013-01-01

    BACKGROUND AND OBJECTIVES: Although home visiting programs have been documented to improve parenting in high-risk families, their effectiveness is diminished when parents disengage from programs. Cellular phones offer an approach to promoting parent engagement and enhancing parenting outcomes. Our objective was to examine whether mothers in a parenting intervention, Planned Activities Training (PAT), or cellular phone-enhanced version (CPAT) of the intervention would demonstrate greater use of parenting strategies after treatment and at 6 months post-treatment compared with a wait-list control (WLC). METHODS: A sample of 371 low-income mothers and their 3.5- to 5.5-year-old children were randomly assigned to condition and assessed at pre-test, post-intervention, and 6 months post-intervention. Treatment efficacy was evaluated through observations of mother-child interactions as well as maternal interviews about depression, parenting stress, and child behaviors. RESULTS: Mothers receiving PAT and CPAT demonstrated more frequent use of parenting strategies and engaged in more responsive parenting than mothers in the WLC. Mothers receiving CPAT used more PAT parenting strategies than mothers in the other 2 groups and experienced greater reductions in depression and stress. Children of mothers receiving PAT and CPAT demonstrated higher rates of positive engagement, and children of CPAT mothers demonstrated higher levels of adaptive behaviors than children in the WLC. Importantly, changes in parenting, depression, and stress predicted positive child behaviors. CONCLUSIONS: PAT and CPAT conditions improved parenting strategies and child engagement and reduced children’s challenging behaviors. The addition of cellular phones to a home visiting program enhanced maternal responsivity and reduced depression and stress. PMID:24187120

  19. Delegation of GP-home visits to qualified practice assistants: assessment of economic effects in an ambulatory healthcare centre

    Directory of Open Access Journals (Sweden)

    Fleßa Steffen

    2010-06-01

    Full Text Available Abstract Background Against the background of a decreasing number of general practitioners (GPs in rural regions in Germany, the AGnES-concept (AGnES = GP-supporting, community-based, e-health-assisted, systemic intervention supports the delegation of regular GP-home visits to qualified practice assistants. The concept was implemented and evaluated in different model projects in Germany. To explore the economic effects of this concept, the development of the number of home visits in an ambulatory healthcare centre was analysed and compared with the number of home visits in the surrounding county. Methods Information about GP-home visits was derived from reimbursement data of the ambulatory healthcare centre and a statutory health insurance. Information about home visits conducted by AGnES-practice assistants was collected from the project documentation over a time period of 12 consecutive quarter years, four quarter years before the beginning of the project and 8 quarter years while the project was implemented, considering background temporal trends on the population level in the study region. Results Within the ambulatory healthcare centre, the home visits by the GPs significantly decreased, especially the number of medically urgent home visits. However, the overall rate of home visits (conducted by the GPs and the AGnES-practice assistants together did not change significantly after implementation of the AGnES-concept. In the surrounding county, the home visit rates of the GPs were continuous; the temporal patterns were approximately equal for both usual and urgent home visits. Conclusion The results of the analyses show that the support by AGnES-practice assistants led to a decrease of GP-home visits rather than an induction of additional home visits by the AGnES-practice assistants. The most extended effect is related to the medically urgent home visits rather than to the usual home visits.

  20. Ostomy Home Skills Program

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  13. First Steps towards Evidence-Based Preventive Home Visits: Experiences Gathered in a Swedish Municipality

    Directory of Open Access Journals (Sweden)

    Charlotte Löfqvist

    2012-01-01

    Full Text Available The purpose of preventive home visits is to promote overall health and wellbeing in old age. The aim of this paper was to describe the process of the development of evidence-based preventive home visits, targeting independent community-living older persons. The evidence base was generated from published studies and practical experiences. The results demonstrate that preventive home visits should be directed to persons 80 years old and older and involve various professional competences. The visits should be personalized, lead to concrete interventions, and be followed up. The health areas assessed should derive from a broad perspective and include social, psychological, and medical aspects. Core components in the protocol developed in this study captured physical, medical, psychosocial, and environmental aspects. Results of a pilot study showed that the protocol validly identified health risks among older people with different levels of ADL dependence.

  14. Visiting nurses' posthospital medication management in home health care

    DEFF Research Database (Denmark)

    Kollerup, Mette Geil; Curtis, Tine; Schantz Laursen, Birgitte

    2017-01-01

    BACKGROUND: Medication management is the most challenging component of a successful transition from hospital to home, a challenge of growing complexity as the number of older persons living with chronic conditions grows, along with increasingly specialised and accelerated hospital treatment plans...

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  3. Ostomy Home Skills Program

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    Full Text Available ... Education Cancer Education Cancer Programs Conference: Creating a Culture of Quality CoC Events Quality Education Quality Education ... Search Relevant Publications Optimal Access Resources Members Contact Us Publications ACS Publications ACS Catalog About the ACS ...

  4. Ostomy Home Skills Program

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    Full Text Available ... Advocacy Summit Webinars Practice Management Practice Management Practice Management CPT Coding Bulletin Articles CPT Coding Workshops ICD-10 Coding Physicians as Assistants at Surgery Webinars Primers and Compendiums Quality Payment Program AMA House of Delegates ACS in ...

  5. Identification of the need for home visiting nurse: development of a new assessment tool

    Directory of Open Access Journals (Sweden)

    Atsuko Taguchi

    2014-03-01

    Full Text Available Objective: To develop a Home Visiting Nursing Service Need Assessment Form (HVNS-NAF to standardize the decision about the need for home visiting nursing service. Methods: The sample consisted of older adults who had received coordinated services by care managers. We defined the need for home visiting nursing service by elderly individuals as the decision of the need by a care manager so that the elderly can continue to live independently. Explanatory variables included demographic factors, medical procedure, severity of illness, and caregiver variables. Multiple logistic regression was carried out after univariate analyses to decide the variables to include and the weight of each variable in the HVNS-NAF. We then calculated the sensitivity and specificity of each cut-off value, and defined the score with the highest sensitivityand specificity as the cut-off value. Results: Nineteen items were included in the final HVNS-NAF. When the cut-off value was 2 points, the sensitivity was 77.0%, specificity 68.5%, and positive predictive value 56.8%. Conclusions: HVNS-NAF is the first validated standard based on characteristics of elderly clients who required home visiting nursing service. Using the HVNS-NAF may result in reducing the unmet need for home visiting nursing service and preventing hospitalization.

  6. Individual and organizational factors related to work engagement among home-visiting nurses in Japan.

    Science.gov (United States)

    Naruse, Takashi; Sakai, Mahiro; Watai, Izumi; Taguchi, Atsuko; Kuwahara, Yuki; Nagata, Satoko; Murashima, Sachiyo

    2013-12-01

    The increasing number of elderly people has caused increased demand for home-visiting nurses. Nursing managers should develop healthy workplaces in order to grow their workforce. This study investigated the work engagement of home-visiting nurses as an index of workplace health. The aim of the present study was to reveal factors contributing to work engagement among Japanese home-visiting nurses. An anonymous, self-administered questionnaire was sent to 208 home-visiting nurses from 28 nursing agencies in three districts; 177 (85.1%) returned the questionnaires. The Job Demands-Resources model, which explains the relationship between work environment and employee well-being, was used as a conceptual guide. The authors employed three survey instruments: (i) questions on individual variables; (ii) questions on organizational variables; and (iii) the Utrecht Work Engagement Scale (Japanese version). Multiple regression analyses were performed in order to examine the relationships between individual variables, organizational variables, and work engagement. Nurse managers and nurses who felt that there was a positive relationship between work and family had significantly higher work engagement levels than others. The support of a supervisor was significantly associated with work engagement. Nurses in middle-sized but not large agencies had significantly higher work engagement than nurses in small agencies. Supervisor support and an appropriate number of people reporting to each supervisor are important factors in fostering work engagement among home-visiting nurses. © 2013 The Authors. Japan Journal of Nursing Science © 2013 Japan Academy of Nursing Science.

  7. Healthy Homes University: A Home-Based Environmental Intervention and Education Program for Families with Pediatric Asthma in Michigan

    OpenAIRE

    2011-01-01

    Environmental conditions within the home can exacerbate asthmatic children's symptoms. To improve health outcomes among this group, we implemented an in-home environmental public health program—Healthy Homes University—for low-income families in Lansing, Michigan, from 2005 to 2008. Families received four visits during a six-month intervention. Program staff assessed homes for asthma triggers and subsequently provided products and services to reduce exposures to cockroaches, dust mites, mold,...

  8. Projected Outcomes of Nurse-Family Partnership Home Visitation During 1996-2013, United States

    Science.gov (United States)

    Miller, Ted R.

    2015-01-01

    Nurse-Family Partnership (NFP) targets intensive prenatal and postnatal home visitation by registered nurses to low-income first-time mothers. Through 2013, 177,517 pregnant women enrolled in NFP programs. This article projects how NFP will affect their lives and the lives of their babies. NFP has been evaluated in six randomized trials and several more limited analyses of operational programs. We systematically reviewed evaluation findings on 21 outcomes and calculated effects on 3 more. We added outcome data from the NFP national data system and personal communications that filled outcome data gaps on some trials. We assumed effectiveness in replication declined by 21.8%, proportionally with the decline in mean visits per family from trials to operational programs. By 2031, NFP program enrollments in 1996-2013 will prevent an estimated 500 infant deaths, 10,000 preterm births, 13,000 dangerous closely spaced second births, 4,700 abortions, 42,000 child maltreatment incidents, 36,000 intimate partner violence incidents, 90,000 violent crimes by youth, 594,000 property and public order crimes (e.g., vandalism, loitering) by youth, 36,000 youth arrests, and 41,000 person-years of youth substance abuse. They will reduce smoking during pregnancy, pregnancy complications, childhood injuries, and use of subsidized child care; improve language development, increase breast-feeding, and raise compliance with immunization schedules. They will eliminate the need for 4.8 million person-months of child Medicaid spending and reduce estimated spending on Medicaid, TANF, and food stamps by $3.0 billion (present values in 2010 dollars). By comparison, NFP cost roughly $1.6 billion. Thus, NFP appears to be a sound investment. It saves money while enriching the lives of participating low-income mothers and their offspring and benefiting society more broadly by reducing crime and safety net demand. PMID:26076883

  9. Projected Outcomes of Nurse-Family Partnership Home Visitation During 1996-2013, USA.

    Science.gov (United States)

    Miller, Ted R

    2015-08-01

    Nurse-Family Partnership (NFP) targets intensive prenatal and postnatal home visitation by registered nurses to low-income first-time mothers. Through 2013, 177,517 pregnant women enrolled in NFP programs. This article projects how NFP will affect their lives and the lives of their babies. NFP has been evaluated in six randomized trials and several more limited analyses of operational programs. We systematically reviewed evaluation findings on 21 outcomes and calculated effects on three more. We added outcome data from the NFP national data system and personal communications that filled outcome data gaps on some trials. We assumed effectiveness in replication declined by 21.8 %, proportionally with the decline in mean visits per family from trials to operational programs. By 2031, NFP program enrollments in 1996-2013 will prevent an estimated 500 infant deaths, 10,000 preterm births, 13,000 dangerous closely spaced second births, 4700 abortions, 42,000 child maltreatment incidents, 36,000 intimate partner violence incidents, 90,000 violent crimes by youth, 594,000 property and public order crimes (e.g., vandalism, loitering) by youth, 36,000 youth arrests, and 41,000 person-years of youth substance abuse. They will reduce smoking during pregnancy, pregnancy complications, childhood injuries, and use of subsidized child care; improve language development; increase breast-feeding; and raise compliance with immunization schedules. They will eliminate the need for 4.8 million person-months of child Medicaid spending and reduce estimated spending on Medicaid, TANF, and food stamps by $3.0 billion (present values in 2010 dollars). By comparison, NFP cost roughly $1.6 billion. Thus, NFP appears to be a sound investment. It saves money while enriching the lives of participating low-income mothers and their offspring and benefiting society more broadly by reducing crime and safety net demand.

  10. Ostomy Home Skills Program

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    Full Text Available ... Want to Be a RAS-ACS Leader International Exchange Scholar Program Resources RAS E-News Operation Giving ... E-Learning Evidence-Based Decisions in Surgery Medical Student Resources So You Want to Be a Surgeon ...

  11. Ostomy Home Skills Program

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    Full Text Available ... ASE Medical Student Core Curriculum ACS/ASE Medical Student Simulation-Based Surgical Skills Curriculum Cancer Education Cancer Education Cancer Education Cancer Programs Conference: Creating a Culture of Quality CoC Events Quality Education Quality Education ...

  12. Ostomy Home Skills Program

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    Full Text Available ... Collection Medicare Inpatient & Outpatient Rules Physician Quality Reporting System Value-Based Payment Modifier DEA, FDA, and Medicare Part B ... Health Records (EHR) Incentive Program Physician Quality Reporting System Value-Based Payment Modifier Quality and Resource Use Reports Physician ...

  13. Effects of nurse home-visiting on maternal life course and child development: age 6 follow-up results of a randomized trial.

    Science.gov (United States)

    Olds, David L; Kitzman, Harriet; Cole, Robert; Robinson, JoAnn; Sidora, Kimberly; Luckey, Dennis W; Henderson, Charles R; Hanks, Carole; Bondy, Jessica; Holmberg, John

    2004-12-01

    To test, with an urban, primarily black sample, the effects of prenatal and infancy home visits by nurses on mothers' fertility and economic self-sufficiency and the academic and behavioral adjustment of their children as the children finished kindergarten, near their sixth birthday. We conducted a randomized, controlled trial of a program of prenatal and infancy home-visiting in a public system of obstetric and pediatric care in Memphis, Tennessee. A total of 743 primarily black women at or =2 sociodemographic risk characteristics (unmarried, violence, current partner's educational level, or behavioral problems attributable to the use of alcohol or drugs. This program of prenatal and infancy home-visiting by nurses continued to improve the lives of women and children at child age 6 years, 4 years after the program ended.

  14. Preventive home visits to older people in Denmark: methodology of a randomized controlled study

    DEFF Research Database (Denmark)

    Vass, Mikkel; Avlund, Kirsten; Hendriksen, Carsten

    2002-01-01

    BACKGROUND AND AIMS: Preventive home visits were introduced by legislation in Denmark in 1998. This ongoing randomized controlled intervention study introduces a model where preventive home visits to elderly people are carried out in a standardized way, focusing on early signs of disability...... and on physical activity. The study includes general practitioners (GPs) in relevant parts of the assessment and endeavors coordinated interdisciplinary follow-up. Our main aim was to investigate whether this model gives enhanced active life expectancy, but the focus of the present paper is the design...

  15. General practitioners' home visit tendency and readmission-free survival after COPD hospitalisation

    DEFF Research Database (Denmark)

    Lykkegaard, Jesper; Larsen, Pia V; Paulsen, Maja S;

    2014-01-01

    obstructive pulmonary disease.Methods:All Danish patients first-time hospitalised with COPD during the years 2006-2008 were identified. The association between the GP's tendency to conduct home visits and the time from hospital discharge until death or all-cause readmission was analysed by means of Cox...... been readmitted and 1.6% had died without readmission. A U-shaped dose-response relationship was found between GP home visit tendency and readmission-free survival. The lowest adjusted risk of readmission or death was recorded among patients who were listed with a general practice in which >20...

  16. Identifying potentially preventable emergency department visits by nursing home residents in the United States

    Science.gov (United States)

    Burke, Robert E.; Rooks, Sean P.; Levy, Cari; Schwartz, Robert; Ginde, Adit A.

    2015-01-01

    Objectives To identify and describe potentially preventable emergency department (ED) visits by nursing home (NH) residents in the United States. These visits are important because they are common, frequently lead to hospitalization, and can be associated with significant cost to the patient and the health care system. Design Retrospective analysis of the 2005-2010 National Hospital Ambulatory Care Survey (NHAMCS), comparing ED visits by nursing home residents that did not lead to hospital admission (potentially preventable) to those that led to admission (less likely preventable). Setting Nationally representative sample of United States EDs; Federal hospitals and hospitals with less than six beds were excluded. Participants Older (age ≥65 years) nursing home residents with an ED visit during this time period. Measurements Patient demographics, ED visit information including testing performed, interventions (both procedures and medications) provided, and diagnoses treated. Results Older NH residents accounted for 3,857 of 208,956 ED visits during the time period of interest (1.8%). When weighted to be nationally representative, these represent 13.97 million ED visits, equivalent to 1.8 ED visits annually per NH resident in the United States. More than half of visits (53.5%) did not lead to hospital admission; of those discharged from the ED, 62.8% had normal vital signs on presentation and 18.9% did not have any diagnostic testing prior to ED discharge. Injuries were 1.78 times more likely to be discharged than admitted (44.8% versus 25.3%, respectively, p<0.001), while infections were 2.06 times as likely to be admitted as discharged (22.9% versus 11.1%, respectively). CT scans were performed in 25.4% and 30.1% of older NH residents who were discharged from the ED and admitted to the hospital, respectively, and more than 70% of these were CTs of the head. NH residents received centrally acting, sedating medications prior to ED discharge in 9.4% of visits

  17. Cardiac surgery nurse practitioner home visits prevent coronary artery bypass graft readmissions

    National Research Council Canada - National Science Library

    Hall, Michael H; Esposito, Rick A; Pekmezaris, Renee; Lesser, Martin; Moravick, Donna; Jahn, Lynda; Blenderman, Robert; Akerman, Meredith; Nouryan, Christian N; Hartman, Alan R

    2014-01-01

    We designed and tested an innovative transitional care program, involving cardiac surgery nurse practitioners, to improve care continuity after patient discharge home from coronary artery bypass graft (CABG...

  18. 76 FR 4919 - Regulatory Site Visit Training Program

    Science.gov (United States)

    2011-01-27

    ... HUMAN SERVICES Food and Drug Administration Regulatory Site Visit Training Program AGENCY: Food and Drug... quality, and the quality of its regulatory efforts and interactions, by providing CBER staff with a better... priorities for staff training as well as the limited available resources for this program. In addition to...

  19. Home audit program: management manual

    Energy Technology Data Exchange (ETDEWEB)

    1980-09-01

    Many public power systems have initiated home energy audit programs in response to the requests of their consumers. The manual provides smaller public power systems with the information and specific skills needed to design and develop a program of residential energy audits. The program is based on the following precepts: locally owned public systems are the best, and in many cases the only agencies available to organize and coordinate energy conservation programs in many smaller communities; consumers' rights to energy conservation information and assistance should not hinge on the size of the utility that serves them; in the short run, public power systems of all sizes should offer residential energy conservation assistance to their consumers, because such assistance is desirable, necessary, and in the public interest; and in the long run, such programs will complement national energy goals and will produce economic benefits for both consumers and the public power system. A detailed description of home audit program planning, organization, and management are given. (MCW)

  20. Effectiveness of home visiting in reducing partner violence for families experiencing abuse: A systematic review

    NARCIS (Netherlands)

    Prosman, G.J.; Wong, S.H.; Wouden, J.C. van der; Lagro-Janssen, A.L.M.

    2015-01-01

    BACKGROUND: Intimate partner violence (IPV) against women is a major, global societal problem with enormous health consequences both for mother and child. Home visiting interventions in families at risk of abuse seem promising in decreasing IPV. In this systematic review, we aim to assess the effect

  1. Effectiveness of Home Visiting as a Strategy for Promoting Children's Adjustment to School

    Science.gov (United States)

    Kirkland, Kristen

    2013-01-01

    A growing body of evidence suggests that involving families in home visiting services promotes positive experiences during the initial years of a child's life; however less is known about whether or not the benefits continue to accrue after a child enters school. This article describes the results of a study examining the effectiveness of an…

  2. Social Work Home Visits to Children and Families in the UK: A Foucauldian Perspective.

    Science.gov (United States)

    Winter, Karen; Cree, Viviene E

    2016-07-01

    The home visit is at the heart of social work practice with children and families; it is what children and families' social workers do more than any other single activity (except for recording), and it is through the home visit that assessments are made on a daily basis about risk, protection and welfare of children. And yet it is, more than any other activity, an example of what Pithouse has called an 'invisible trade': it happens behind closed doors, in the most secret and intimate spaces of family life. Drawing on conceptual tools associated with the work of Foucault, this article sets out to provide a critical, chronological review of research, policy and practice on home visiting. We aim to explain how and in what ways changing discourses have shaped the emergence, legitimacy, research and practice of the social work home visit to children and families at significant time periods and in a UK context. We end by highlighting the importance for the social work profession of engagement and critical reflection on the identified themes as part of their daily practice.

  3. Social Work Home Visits to Children and Families in the UK: A Foucauldian Perspective

    Science.gov (United States)

    Winter, Karen; Cree, Viviene E.

    2016-01-01

    The home visit is at the heart of social work practice with children and families; it is what children and families' social workers do more than any other single activity (except for recording), and it is through the home visit that assessments are made on a daily basis about risk, protection and welfare of children. And yet it is, more than any other activity, an example of what Pithouse has called an ‘invisible trade’: it happens behind closed doors, in the most secret and intimate spaces of family life. Drawing on conceptual tools associated with the work of Foucault, this article sets out to provide a critical, chronological review of research, policy and practice on home visiting. We aim to explain how and in what ways changing discourses have shaped the emergence, legitimacy, research and practice of the social work home visit to children and families at significant time periods and in a UK context. We end by highlighting the importance for the social work profession of engagement and critical reflection on the identified themes as part of their daily practice. PMID:27559221

  4. Building Practice Evidence for Parent Mentoring Home Visiting in Early Childhood

    Science.gov (United States)

    Zajicek-Farber, Michaela L.

    2010-01-01

    Objective: A multidisciplinary preventive parent mentoring intervention was applied through home visiting with high-risk families receiving well-baby health care. Two implementations were examined for effectiveness. Method: The first implementation employed a quasiexperimental nonequivalent group design, whereas the second used a randomized…

  5. Early detection of parenting and developmental problems in toddlers : A randomized trial of home visits versus well-baby clinic visits in the Netherlands

    NARCIS (Netherlands)

    Staal, Ingrid I E; van Stel, Henk F.; Hermanns, Jo M A; Schrijvers, Augustinus J P

    2015-01-01

    Objective: The early detection of parenting and developmental problems by preventive child health care (CHC) services in the Netherlands takes place almost exclusively at the well-baby clinic. This study assesses whether, compared to a visit to the well-baby clinic, a home visit improves early detec

  6. The Impact on Child Developmental Status at 12 Months of Volunteer Home-Visiting Support

    Directory of Open Access Journals (Sweden)

    Jacqueline Barnes

    2012-01-01

    Full Text Available Home-visiting support during pregnancy or soon after the birth of an infant can be advantageous for maternal well-being and infant development. The best results have been identified when home visitors are professionals, especially nurses, and if a theoretically driven curriculum is followed with fidelity. Some suggest that disadvantaged families, who may avoid professional services, respond well to support from community volunteers, but there is less evidence about their impact. This study identified potentially vulnerable mothers during pregnancy in randomly allocated neighbourhoods where local volunteer home-visiting schemes agreed to offer proactive volunteer support and control areas where the local home-visiting schemes did not offer this proactive service. Taking demographic, child, and family factors into account, there were no significant differences in infant cognitive development at 12 months of age between families who had been supported by a volunteer and those who had not. Better cognitive development was predicted by less reported parenting stress when infants were 2 months and a more stimulating and responsive home environment at 12 months. The results suggest that unstructured proactive volunteer support for potentially vulnerable families is not likely to enhance infant development. Limitations of the cluster-randomised design are discussed.

  7. The Relationship Between the Use of a Worksite Medical Home and ED Visits or Hospitalizations

    Directory of Open Access Journals (Sweden)

    Marissa Stroo BS

    2015-10-01

    Full Text Available Worksite medical homes may be a good model for improving employee health. The aim of this study was to compare the likelihood of being seen in the emergency department (ED or being hospitalized by level of use (no use, occasional use, or primary care of a worksite medical home, overall and by type of user (employee, adult dependent, or pediatric dependent. This was a retrospective analysis of claims data, using covariate-adjusted logistic regression models for ED visits and inpatient hospitalizations. Secondary data for the years 2006 to 2008 from a company that offers an on-site health care center (HCC were used. Analyses were based on a data set that combines health plan claims and human resources demographic data. Overall, people who did not use the HCC were more likely to be seen in the ED (adjusted odds ratio [OR] = 1.20, 95% confidence interval or CI [1.06, 1.37], P = .005 or to be hospitalized (adjusted OR = 1.58; 95% CI [1.34, 1.86]; P < .0001 compared with those who used the HCC for primary care. Both ED visits and hospitalizations for employees and dependents in this study were lower among those who used the worksite medical home for primary care. Worksite medical homes can improve chronic disease management and thus reduce ED visits and hospitalizations. These findings contribute to growing evidence that worksite medical homes are potentially cost-effective.

  8. Evaluation of a public health nurse visiting program for pregnant and parenting teens.

    Science.gov (United States)

    Schaffer, Marjorie A; Goodhue, Amy; Stennes, Kaye; Lanigan, Cheryl

    2012-01-01

    A visiting nurse agency created the Pregnant and Parenting Team Program, an innovative program for serving pregnant and parenting teen mothers to promote family and child health and family self-sufficiency. Public health nurses (PHNs) provide home visits that offer social, emotional, educational, and health care support to pregnant and parenting teen mothers 19 years of age and younger and their children. Foundational program pillars include: (1) a trusting relationship between teen mothers and a PHN through home visits; (2) outreach and coordination with schools, hospital, clinics, and human service agencies; (3) a comprehensive and intensive maternal mental health curriculum; and (4) community support and caring through provision of essential items needed for success in parenting. Measures of program effectiveness included identification of pregnant and parenting adolescent mothers, birth outcomes, active enrollment in school, delay of repeat pregnancy, maternal-infant bonding and attachment, use of community resources, and infant growth and development. Participants in the program were more likely to be enrolled in school and had better birth outcomes in comparison with nonparticipants. Outcome data collected from January 1, 2008 to July 23, 2010 demonstrated progress toward stated goals.

  9. Improving newborn care practices through home visits: lessons from Malawi, Nepal, Bangladesh, and Uganda

    Directory of Open Access Journals (Sweden)

    Deborah Sitrin

    2015-03-01

    Full Text Available Background: Nearly all newborn deaths occur in low- or middle-income countries. Many of these deaths could be prevented through promotion and provision of newborn care practices such as thermal care, early and exclusive breastfeeding, and hygienic cord care. Home visit programmes promoting these practices were piloted in Malawi, Nepal, Bangladesh, and Uganda. Objective: This study assessed changes in selected newborn care practices over time in pilot programme areas in four countries and evaluated whether women who received home visits during pregnancy were more likely to report use of three key practices. Design: Using data from cross-sectional surveys of women with live births at baseline and endline, the Pearson chi-squared test was used to assess changes over time. Generalised linear models were used to assess the relationship between the main independent variable – home visit from a community health worker (CHW during pregnancy (0, 1–2, 3+ – and use of selected practices while controlling for antenatal care, place of delivery, and maternal age and education. Results: There were statistically significant improvements in practices, except applying nothing to the cord in Malawi and early initiation of breastfeeding in Bangladesh. In Malawi, Nepal, and Bangladesh, women who were visited by a CHW three or more times during pregnancy were more likely to report use of selected practices. Women who delivered in a facility were also more likely to report use of selected practices in Malawi, Nepal, and Uganda; association with place of birth was not examined in Bangladesh because only women who delivered outside a facility were asked about these practices. Conclusion: Home visits can play a role in improving practices in different settings. Multiple interactions are needed, so programmes need to investigate the most appropriate and efficient ways to reach families and promote newborn care practices. Meanwhile, programmes must take advantage of

  10. Therapeutic effects of dog visits in nursing homes for the elderly

    DEFF Research Database (Denmark)

    Thodberg, Karen; Uhrskov, Lisbeth; Christensen, Janne Winther

    2016-01-01

    .5 years; [79; 90]) from four nursing homes were randomly assigned to receive biweekly visits for 6 weeks from a person accompanied by either a dog, a robot seal (PARO), or a soft toy cat. Sleep patterns were measured using actigraphy technology before, during (the third and sixth week), and after...... by a dog rather than the robot seal or soft toy cat (dog: 610 1 127 min; seal: 498 1 146 min; cat: 540 1 163 min; F2,37 = 4.99; P = 0.01). No effects were found in the sixth week or after the visit period had ended. We found that visit type had no effect on weight (F2,88 = 0.13; P > 0.05), body mass index......Background: Previous studies have suggested that visiting dogs can have positive effects on elderly people in nursing homes. We wanted to study the effects of biweekly dog visits on sleep patterns and the psychiatric wellbeing of elderly people. Methods: A total of 100 residents (median age: 85...

  11. ACED Allegheny Home Improvement Loan Program (AHILP)

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — The Allegheny Home Improvement Loan Program (AHILP) is the most affordable way for eligible Allegheny County residents to rehabilitate and improve their homes....

  12. 76 FR 76168 - Regulatory Site Visit Training Program

    Science.gov (United States)

    2011-12-06

    ... HUMAN SERVICES Food and Drug Administration Regulatory Site Visit Training Program AGENCY: Food and Drug... and quality, and the quality of its regulatory efforts and interactions, by providing CBER staff with... coordination of CBER's priorities for staff training as well as the limited available resources for this...

  13. Team Visitation Guidelines for Wisconsin Secondary Vocational Programs. Revised.

    Science.gov (United States)

    Dale, Dorothy; Klitzke, Elizabeth

    These guidelines outline the role of the visiting team members and the team leader and familiarize the team with details necessary to conduct a comprehensive external evaluation of Wisconsin secondary vocational programs. First, the three goals of the on-site evaluation are outlined. A discussion of the team selection and team members' functions…

  14. Continuity in a VA patient-centered medical home reduces emergency department visits.

    Directory of Open Access Journals (Sweden)

    Krisda H Chaiyachati

    Full Text Available One major goal of the Patient-Centered Medical Home (PCMH is to improve continuity of care between patients and providers and reduce the utilization of non-primary care services like the emergency department (ED.To characterize continuity under the Veterans Health Administration's PCMH model--the Patient Aligned Care Team (PACT, at one large Veterans Affair's (VA's primary care clinic, determine the characteristics associated with high levels of continuity, and assess the association between continuity and ED visits.Retrospective, observational cohort study of patients at the West Haven VA (WHVA Primary Care Clinic from March 2011 to February 2012.The 13,495 patients with established care at the Clinic, having at least one visit, one year before March 2011.Our exposure variable was continuity of care--a patient seeing their assigned primary care provider (PCP at each clinic visit. The outcome of interest was having an ED visit.The patients encompassed 42,969 total clinic visits, and 3185 (24% of them had 15,458 ED visits. In a multivariable logistic regression analysis, patients with continuity of care--at least one visit with their assigned PCP--had lower ED utilization compared to individuals without continuity (adjusted odds ratio [AOR] 0.54; 95% CI: 0.41, 0.71, controlling for frequency of primary care visits, comorbidities, insurance, distance from the ED, and having a trainee PCP assigned. Likewise, the adjusted rate of ED visits was 544/1000 person-year (PY for patients with continuity vs. 784/1000 PY for patients without continuity (p = 0.001. Compared to patients with low continuity (50% continuity were less likely to utilize the ED.Strong continuity of care is associated with decreased ED utilization in a PCMH model and improving continuity may help reduce the utilization of non-primary care services.

  15. Review of the US Department of Energy Classified Visits Program

    Energy Technology Data Exchange (ETDEWEB)

    Martin, S W; Killinger, M H; Segura, M A

    1992-07-01

    This review examines the US Department of Energy (DOE) Classified Visits Program, which is administered by the Office of Safeguards and Security. The overall purpose of this analysis is to (1) ensure that DOE policy and implementing procedures are appropriate to maintain US national security intentions; (2) evaluate the effectiveness of the process used across the DOE complex; and (3) recommend changes which will enhance the overall efficiency of the process while maintaining the program's integrity.

  16. Preventive home visits to older people in Denmark--why, how, by whom, and when?

    DEFF Research Database (Denmark)

    Vass, M; Avlund, K; Hendriksen, C;

    2007-01-01

    or prevent functional decline. There is an urgent need of an interdisciplinary teamwork and management for such programmes, incorporating flexible cooperation between the primary and secondary health care sector. The value and importance of geriatric and gerontological education is evidence based....... older persons not normally seen in the health care system. In-home assessment is not just a health check, but also an opportunity to meet individual needs that may be of importance for older people to stay independent. Preventive home visits may be part of an overall culture and strategy to avoid...

  17. Development of a nurse home visitation intervention for intimate partner violence

    Directory of Open Access Journals (Sweden)

    Jack Susan M

    2012-02-01

    Full Text Available Abstract Background Despite an increase in knowledge about the epidemiology of intimate partner violence (IPV, much less is known about interventions to reduce IPV and its associated impairment. One program that holds promise in preventing IPV and improving outcomes for women exposed to violence is the Nurse-Family Partnership (NFP, an evidence-based nurse home visitation program for socially disadvantaged first-time mothers. The present study developed an intervention model and modification process to address IPV within the context of the NFP. This included determining the extent to which the NFP curriculum addressed the needs of women at risk for IPV or its recurrence, along with client, nurse and broader stakeholder perspectives on how best to help NFP clients cope with abusive relationships. Methods Following a preliminary needs assessment, an exploratory multiple case study was conducted to identify the core components of the proposed IPV intervention. This included qualitative interviews with purposeful samples of NFP clients and community stakeholders, and focus groups with nurse home visitors recruited from four NFP sites. Conventional content analysis and constant comparison guided data coding and synthesis. A process for developing complex interventions was then implemented. Results Based on data from 69 respondents, an IPV intervention was developed that focused on identifying and responding to IPV; assessing a client's level of safety risk associated with IPV; understanding the process of leaving and resolving an abusive relationship and system navigation. A need was identified for the intervention to include both universal elements of healthy relationships and those tailored to a woman's specific level of readiness to promote change within her life. A clinical pathway guides nurses through the intervention, with a set of facilitators and corresponding instructions for each component. Conclusions NFP clients, nurses and stakeholders

  18. Preventive home visits for mortality, morbidity, and institutionalization in older adults: a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Evan Mayo-Wilson

    Full Text Available BACKGROUND: Home visits for older adults aim to prevent cognitive and functional impairment, thus reducing institutionalization and mortality. Visitors may provide information, investigate untreated problems, encourage medication compliance, and provide referrals to services. METHODS AND FINDINGS: DATA SOURCES: Ten databases including CENTRAL and Medline searched through December 2012. STUDY SELECTION: Randomized controlled trials enrolling community-dwelling persons without dementia aged over 65 years. Interventions included visits at home by a health or social care professional that were not related to hospital discharge. DATA EXTRACTION AND SYNTHESIS: Two authors independently extracted data. Outcomes were pooled using random effects. MAIN OUTCOMES AND MEASURES: Mortality, institutionalization, hospitalization, falls, injuries, physical functioning, cognitive functioning, quality of life, and psychiatric illness. RESULTS: Sixty-four studies with 28642 participants were included. Home visits were not associated with absolute reductions in mortality at longest follow-up, but some programs may have small relative effects (relative risk = 0.93 [0.87 to 0.99]; absolute risk = 0.00 [-0.01 to 0.00]. There was moderate quality evidence of no overall effect on the number of people institutionalized (RR = 1.02 [0.88 to 1.18] or hospitalized (RR = 0.96 [0.91 to 1.01]. There was high quality evidence for number of people who fell, which is consistent with no effect or a small effect (odds ratio = 0.86 [0.73 to 1.01], but there was no evidence that these interventions increased independent living. There was low and very low quality evidence of effects for quality of life (standardised mean difference = -0.06 [-0.11 to -0.01] and physical functioning (SMD = -0.10 [-0.17 to -0.03] respectively, but these may not be clinically important. CONCLUSIONS: Home visiting is not consistently associated with differences in mortality or

  19. A cluster randomised controlled effectiveness trial evaluating perinatal home visiting among South African mothers/infants.

    Directory of Open Access Journals (Sweden)

    Mary Jane Rotheram-Borus

    Full Text Available Interventions are needed to reduce poor perinatal health. We trained community health workers (CHWs as home visitors to address maternal/infant risks.In a cluster randomised controlled trial in Cape Town townships, neighbourhoods were randomised within matched pairs to 1 the control, healthcare at clinics (n = 12 neighbourhoods; n = 594 women, or 2 a home visiting intervention by CBW trained in cognitive-behavioural strategies to address health risks (by the Philani Maternal, Child Health and Nutrition Programme, in addition to clinic care (n = 12 neighbourhoods; n = 644 women. Participants were assessed during pregnancy (2% refusal and 92% were reassessed at two weeks post-birth, 88% at six months and 84% at 18 months later. We analysed 32 measures of maternal/infant well-being over the 18 month follow-up period using longitudinal random effects regressions. A binomial test for correlated outcomes evaluated overall effectiveness over time. The 18 month post-birth assessment outcomes also were examined alone and as a function of the number of home visits received.Benefits were found on 7 of 32 measures of outcomes, resulting in significant overall benefits for the intervention compared to the control when using the binomial test (p = 0.008; nevertheless, no effects were observed when only the 18 month outcomes were analyzed. Benefits on individual outcomes were related to the number of home visits received. Among women living with HIV, intervention mothers were more likely to implement the PMTCT regimens, use condoms during all sexual episodes (OR = 1.25; p = 0.014, have infants with healthy weight-for-age measurements (OR = 1.42; p = 0.045, height-for-age measurements (OR = 1.13, p<0.001, breastfeed exclusively for six months (OR = 3.59; p<0.001, and breastfeed longer (OR = 3.08; p<0.001. Number of visits was positively associated with infant birth weight ≥2500 grams (OR = 1.07; p = 0

  20. Predictors of Better Self-Care in Patients with Heart Failure after Six Months of Follow-Up Home Visits

    Science.gov (United States)

    Trojahn, Melina Maria; Ruschel, Karen Brasil; Nogueira de Souza, Emiliane; Mussi, Cláudia Motta; Naomi Hirakata, Vânia; Nogueira Mello Lopes, Alexandra; Rabelo-Silva, Eneida Rejane

    2013-01-01

    This study aimed to examine the predictors of better self-care behavior in patients with heart failure (HF) in a home visiting program. This is a longitudinal study nested in a randomized controlled trial (ISRCTN01213862) in which the home-based educational intervention consisted of a six-month followup that included four home visits by a nurse, interspersed with four telephone calls. The self-care score was measured at baseline and at six months using the Brazilian version of the European Heart Failure Self-Care Behaviour Scale. The associations included eight variables: age, sex, schooling, having received the intervention, social support, income, comorbidities, and symptom severity. A simple linear regression model was developed using significant variables (P ≤ 0.20), followed by a multivariate model to determine the predictors of better self-care. One hundred eighty-eight patients completed the study. A better self-care behavior was associated with patients who received intervention (P < 0.001), had more years of schooling (P = 0.016), and had more comorbidities (P = 0.008). Having received the intervention (P < 0.001) and having a greater number of comorbidities (P = 0.038) were predictors of better self-care. In the multivariate regression model, being in the intervention group and having more comorbidities were a predictor of better self-care. PMID:24083023

  1. Outcomes of Planned Home Visits of Intern Public Health Nurses: An Example from Turkey.

    Science.gov (United States)

    Ozkan, Ozlem; Ozdemir, Saadet

    This study aimed at evaluating the outcomes of planned home visits of intern public health nurses enrolled to a school of health over 8 educational years. The descriptive research consisted of 181 families (N = 745 individuals) who received primary services through the planned home visits undertaken by 431 intern public health nurses at Kocaeli province in Turkey. The data were collected from Family Nursing Process Records and Family Health Achievement Forms. Both of these data collection forms were classified according to North American Nursing Diagnosis Association (NANDA) Taxonomy II. Intern public health nurses provided primary health services to 181 families (N = 745 persons) with a total of 8771 planned home visits undertaken over 802 days and 14.874 student/practice days. A total of 1539 nursing diagnoses were identified and 1677 achievements about these diagnoses were reported. Nursing diagnosis per family and per individual turned out to be 8.50 and 2.1, respectively, and achievements were 9.3 per family and 2.3 per individual. Among the nursing diagnosis domains, health promotion (20.3%), safety/protection (16.8%), and activity/rest (16.0%) were the top 3 domains identified. The most common diagnoses turned out to be ineffective health maintenance (47.4%) in health promotion domain and risk for trauma (18.2%) in safety/protection domain. The achievements were reported most in health promotion (37.9%), activity/rest (17.6%), and safety/protection (9.6%), respectively. Planned and continuous home visits by intern public health nurses resulted in positive health achievements in families, especially for women and children. Copyright © 2016. Published by Elsevier Inc.

  2. Characteristics of communication with older people in home care: A qualitative analysis of audio recordings of home care visits.

    Science.gov (United States)

    Kristensen, Dorte V; Sundler, Annelie J; Eide, Hilde; Hafskjold, Linda; Ruud, Iren; Holmström, Inger K

    2017-03-16

    To describe the characteristics of communication practice in home care visits between older people (over 65 years old) and nurse assistants and to discuss the findings from a person-centered perspective. The older population is increasing worldwide, along with the need for healthcare services in the person's home. To achieve a high-quality care, person-centered communication is crucial. A descriptive design with a qualitative inductive approach was used. Fifteen audio recordings of naturally occurring conversations between 12 nurse assistants and 13 older people in Norway were analysed by qualitative content analysis. Four categories were revealed through analysis: (i) supporting older people's connection to everyday life; (ii) supporting older people's involvement in their own care; (iii) attention to older people's bodily and existential needs; and (iv) the impact of continuity and predictability on older people's well-being. The communication between the older people and the nurse assistants during home care visits was mainly task-oriented, but also related to the person. The older people were involved in the tasks to be carried out and humour was part of the communication. Greater attention was paid to bodily than existential needs. The communication was connected with the older people's everyday life in several ways. Time frames and interruptions concern the older people; hearing and speech impairments were a challenge to communication. To enhance person-centred communication, further studies are needed, especially intervention studies for healthcare professionals and students. Being responsive to older people's subjective experiences is important in meeting their needs in home care. Communication that addresses the need for trust and predictability is important for older people. Responding to existential needs require more attention. The home care setting has an impact on communication. © 2017 John Wiley & Sons Ltd.

  3. A Case for Increasing Empirical Attention to Head Start's Home-Based Program: An Exploration of Routine Collaborative Goal Setting

    Science.gov (United States)

    Manz, Patricia H.; Lehtinen, Jaana; Bracaliello, Catherine

    2013-01-01

    Collaborative goal setting among home visitors and family members is a mandate for Head Start's home-based program. Yet, a dearth of research is available for advancing evidence-based practices for setting and monitoring home visiting goals or for understanding how family characteristics or program features are associated with them. With the…

  4. Evaluation of a Home-Based Environmental and Educational Intervention to Improve Health in Vulnerable Households: Southeastern Pennsylvania Lead and Healthy Homes Program.

    Science.gov (United States)

    Mankikar, Deepa; Campbell, Carla; Greenberg, Rachael

    2016-09-09

    This evaluation examined whether participation in a home-based environmental educational intervention would reduce exposure to health and safety hazards and asthma-related medical visits. The home intervention program focused on vulnerable, low-income households, where children had asthma, were at risk for lead poisoning, or faced multiple unsafe housing conditions. Home visitors conducted two home visits, two months apart, consisting of an environmental home assessment, Healthy Homes education, and distribution of Healthy Homes supplies. Measured outcomes included changes in participant knowledge and awareness of environmental home-based hazards, rate of children's asthma-related medical use, and the presence of asthma triggers and safety hazards. Analysis of 2013-2014 baseline and post-intervention program data for a cohort of 150 families revealed a significantly lower three-month rate (p interventions may effectively reduce environmental home hazards and improve the health of asthmatic children in the short term.

  5. Clinical supervision in the provision of intensive home visiting by health visitors.

    Science.gov (United States)

    Jarrett, Patricia; Barlow, Jane

    2014-02-01

    The objective of this paper is to explore the perceptions of health visitors working in frontline child protection concerning the role of clinical supervision. Fifteen health visitors ('home visitors') providing an intensive home visiting service to high-risk families in the south east of England were interviewed about their experience of receiving supervision. The model of clinical supervision used was based on the Family Partnership Programme and delivered by two trained psychotherapists. The data were analysed using thematic analysis. Home visitors believed that clinical supervision enabled them to maintain boundaries, regulate and reflect on their practice, and develop a better understanding of the issues clients were facing. The model of supervision used and the organisational context were believed to be important factors in the delivery of clinical supervision and to have contributed to its success.

  6. The value of pre-discharge occupational therapy home visits for patients who have had a stroke: p erceptions of patients, occupational therapists and experts

    OpenAIRE

    Fellows, Karen Rachael

    2014-01-01

    Pre-discharge occupational therapy home visits after stroke are routinely conducted during the discharge planning process. However, there is limited research evidence about the value of these visits for patients. The aims of this study were two fold. Firstly, to identify and report on the value of pre- discharge occupational therapy home visits for patients returning home after stroke. Secondly, to gain knowledge to inform the design of future research into home visits after stroke. M...

  7. Identification and assessment of intimate partner violence in nurse home visitation.

    Science.gov (United States)

    Jack, Susan M; Ford-Gilboe, Marilyn; Davidov, Danielle; MacMillan, Harriet L

    2017-08-01

    To develop strategies for the identification and assessment of intimate partner violence in a nurse home visitation programme. Nurse home visitation programmes have been identified as an intervention for preventing child abuse and neglect. Recently, there is an increased focus on the role these programmes have in addressing intimate partner violence. Given the unique context of the home environment, strategies for assessments are required that maintain the therapeutic alliance and minimise client attrition. A qualitative case study. A total of four Nurse-Family Partnership agencies were engaged in this study. Purposeful samples of nurses (n = 32), pregnant or parenting mothers who had self-disclosed experiences of abuse (n = 26) and supervisors (n = 5) participated in this study. A total of 10 focus groups were completed with nurses: 42 interviews with clients and 10 interviews with supervisors. The principles of conventional content analysis guided data analysis. Data were categorised using the practice-problem-needs analysis model for integrating qualitative findings in the development of nursing interventions. Multiple opportunities to ask about intimate partner violence are valued. The use of structured screening tools at enrolment does not promote disclosure or in-depth exploration of women's experiences of abuse. Women are more likely to discuss experiences of violence when nurses initiate nonstructured discussions focused on parenting, safety or healthy relationships. Nurses require knowledge and skills to initiate indicator-based assessments when exposure to abuse is suspected as well as strategies for responding to client-initiated disclosures. A tailored approach to intimate partner violence assessment in home visiting is required. Multiple opportunities for exploring women's experiences of violence are required. A clinical pathway outlining a three-pronged approach to identification and assessment was developed. © 2016 John Wiley & Sons Ltd.

  8. Attrition in longitudinal randomized controlled trials: home visits make a difference

    Directory of Open Access Journals (Sweden)

    Peterson Janey C

    2012-11-01

    likely to require Home F/U. In addition, those in the Home F/U group were more likely to have sustained 2 or more complications (p=0.05. Conclusions Home visits are an effective approach to reduce attrition and improve accuracy of study outcome reporting. Trial results may be influenced by this method of reducing attrition. Older participants, those with greater medical burden and those who sustain multiple complications are at higher risk for attrition.

  9. Parent Experience of Implementing Effective Home Programs

    Science.gov (United States)

    Novak, Iona

    2011-01-01

    The aim of this preliminary study was to describe parent views about implementing effective home programs to inform practice recommendations. Semi-structured interviews were conducted with 10 parents of children with cerebral palsy (2 fathers and 8 mothers) who had participated in a home program by using a partnership-based approach. Transcripts…

  10. Targeted home visiting intervention: the impact on mother-infant relationships.

    Science.gov (United States)

    Walker, Anne Marie; Johnson, Rebecca; Banner, Catherine; Delaney, Jill; Farley, Rita; Ford, Margaret; Lake, Helen; Douglas, Hazel

    2008-03-01

    This paper reviews and reflects on six papers, which describe various early home visiting interventions that resulted in positive outcomes, particularly in relation to the mother-infant relationship. The papers were published in a special issue of the Infant Mental Health Journal in 2006. We provide a brief overview of each paper, highlighting the conclusions drawn across the six papers. Key learning points for health visitors in the UK are explored throughout. Suggestions are described for improvements to the way in which health visiting services in the UK are structured in order to further enhance mother-infant relationships. The overall finding is that mother-infant relationships and interactions can be improved through early home visiting interventions over a period of time, and that this prevents childhood problems later on. It is recommended that specific patient groups be targeted and offered tailored programmes of interventions that have a relevant theoretical base, by trained nursing staff who are supported by an infant mental health consultant.

  11. EFEKTIVITAS HOME VISIT TERHADAP PERUBAHAN PENGETAHUAN, SIKAP, DAN KETERAMPILAN KLIEN TBC DI WILAYAH PUSKESMAS KECAMATAN PASAR MINGGU JAKARTA SELATAN

    Directory of Open Access Journals (Sweden)

    Rani Chairani

    2012-11-01

    Full Text Available Home Visit represent materialization of nurse caring to problems of health faced by client in society, including  the problem of tuberkulosis. DKI Jakarta is one of the province having tuberkulosis prevalensi above national prevalensi that is 1,26%. Through visit home nurse of community get information about growth of health of client of tuberkulosis, running effort off is make-up of health, watching growth of run by medication of client, and also assist tired family and client of its independence level. This research aim to obtain; get picture about visit home efektivitas to make-up of knowledge, attitude, and is skilled of client of tuberkulosis in the effort operation  of failure of medication. Design this research is experiment kuasi with approach of pre-post  test with group control and intervention  group. lntervence in this research is to conduct to visit home counted 4 times visit conducted activity during visit home. Activity during visit home is continuation giving of education of health which have been given by Puskesmas, giving conseling, care direct, family entangling and society. This Research sampel is adult client of Positive BTA or client of BTA negative of positive thorax photo (old and new case which get medication of tuberkulosis during 6-8 months in the year 2009, comparison between group intervence and control 1:1 (33 group people intervence and 33 control group people, so that totalize sampel is 66 people. Result of test of t-paired prove there is difference which is very have a meaning of at knowledge, attitude, and is skilled of client about treatment and medication of tuberkulosis after done with 4 times visit home compared to previously. Result of test of t-pooled prove there is difference  which is very have a meaning  of  at knowledge, attitude, and is skilled of client about treatment and medication of tuberkulosis between group intervence  after conducted four times visit home with control group which do

  12. Home visits by neighborhood Mentor Mothers provide timely recovery from childhood malnutrition in South Africa: results from a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Mbewu Nokwanele

    2010-11-01

    Full Text Available Abstract Background Child and infant malnourishment is a significant and growing problem in the developing world. Malnourished children are at high risk for negative health outcomes over their lifespans. Philani, a paraprofessional home visiting program, was developed to improve childhood nourishment. The objective of this study is to evaluate whether the Philani program can rehabilitate malnourished children in a timely manner. Methods Mentor Mothers were trained to conduct home visits. Mentor Mothers went from house to house in assigned neighborhoods, weighed children age 5 and younger, and recruited mother-child dyads where there was an underweight child. Participating dyads were assigned in a 2:1 random sequence to the Philani intervention condition (n = 536 or a control condition (n = 252. Mentor Mothers visited dyads in the intervention condition for one year, supporting mothers' problem-solving around nutrition. All children were weighed by Mentor Mothers at baseline and three, six, nine and twelve month follow-ups. Results By three months, children in the intervention condition were five times more likely to rehabilitate (reach a healthy weight for their ages than children in the control condition. Throughout the course of the study, 43% (n = 233 of 536 of children in the intervention condition were rehabilitated while 31% (n = 78 of 252 of children in the control condition were rehabilitated. Conclusions Paraprofessional Mentor Mothers are an effective strategy for delivering home visiting programs by providing the knowledge and support necessary to change the behavior of families at risk.

  13. Toddlers' Expressive Vocabulary Outcomes after One Year of Parent-Child Home Program Services

    Science.gov (United States)

    Manz, Patricia H.; Bracaliello, Catherine B.; Pressimone, Vanessa J.; Eisenberg, Rachel A.; Gernhart, Amanda C.; Fu, Qiong; Zuniga, Cesar

    2016-01-01

    This quasi-experimental study examined expressive vocabulary outcomes for Parent-Child Home Program (PCHP) toddlers, after one year of home-visiting services. First, this study applied Rasch modelling to establish the construct validity and reliability of a widely used expressive vocabulary measure, as modified for a sample of ethnic and…

  14. Evaluation of a Home-Based Environmental and Educational Intervention to Improve Health in Vulnerable Households: Southeastern Pennsylvania Lead and Healthy Homes Program

    Directory of Open Access Journals (Sweden)

    Deepa Mankikar

    2016-09-01

    Full Text Available This evaluation examined whether participation in a home-based environmental educational intervention would reduce exposure to health and safety hazards and asthma-related medical visits. The home intervention program focused on vulnerable, low-income households, where children had asthma, were at risk for lead poisoning, or faced multiple unsafe housing conditions. Home visitors conducted two home visits, two months apart, consisting of an environmental home assessment, Healthy Homes education, and distribution of Healthy Homes supplies. Measured outcomes included changes in participant knowledge and awareness of environmental home-based hazards, rate of children’s asthma-related medical use, and the presence of asthma triggers and safety hazards. Analysis of 2013–2014 baseline and post-intervention program data for a cohort of 150 families revealed a significantly lower three-month rate (p < 0.05 of children’s asthma-related doctor visits and hospital admissions at program completion. In addition, there were significantly reduced reports of the presence of home-based hazards, including basement or roof leaks (p = 0.011, plumbing leaks (p = 0.019, and use of an oven to heat the home (p < 0.001. Participants’ pre- and post- test scores showed significant improvement (p < 0.05 in knowledge and awareness of home hazards. Comprehensive home interventions may effectively reduce environmental home hazards and improve the health of asthmatic children in the short term.

  15. Chilean Teachers Begin Exchange Program Visit in Magdalena

    Science.gov (United States)

    2007-01-01

    Two teachers from the town of San Pedro de Atacama, in the northern desert of the South American nation of Chile, arrive in Magdalena, New Mexico, Sunday, January 28, for a two-week visit that is part of a Sister Cities program sponsored by Associated Universities, Inc. (AUI), the nonprofit research corporation that operates the National Radio Astronomy Observatory (NRAO). They will be accompanied by their town's mayor. Myriam Nancy Rivera Mercado, Head of the high school in San Pedro, Gabriela Fernanda Rodriguez Moraleda, a tourism teacher there, and San Pedro Mayor Sandra Berna Martinez will begin a visit that includes classroom observations in the Magdalena schools, a reception hosted by the Magdalena Village Council, and a Mayor's Breakfast with Magdalena Mayor Jim Wolfe. They also will meet local residents, tour the Bosque del Apache National Wildlife Refuge with a second-grade class, visit an area ranch, tour the Very Large Array (VLA) radio telescope, and see Socorro's Community Arts Party. "These teachers will learn much about New Mexico, the United States, and our educational system, and will take this new knowledge back to their students and their community," said NRAO Education Officer Robyn Harrison. The visit is part of a Sister Cities program initiated and funded by AUI, which operates the NRAO for the U.S. National Science Foundation. Radio astronomy is a common link between San Pedro de Atacama and Magdalena. San Pedro is near the site of the Atacama Large Millimeter/submillimeter Array (ALMA), an international telescope project now under construction with funding by major partners in North America, Europe, and Japan. Magdalena is near the site of NRAO's VLA radio telescope. In Magdalena, the Village Council and Mayor Wolfe formalized their participation in the Sister Cities program last September, and San Pedro ratified the program in December. In San Pedro, the ceremony ratifying the agreement was attended by U.S. Ambassador to Chile Craig K

  16. Comparison of Home Retrofit Programs in Wisconsin

    Energy Technology Data Exchange (ETDEWEB)

    Cunningham, Kerrie [Univ. of Minnesota, St. Paul, MN (United States). NorthernSTAR Building America Partnership; Hannigan, Eileen [Univ. of Minnesota, St. Paul, MN (United States). NorthernSTAR Building America Partnership

    2013-03-01

    To explore ways to reduce customer barriers and increase home retrofit completions, several different existing home retrofit models have been implemented in the state of Wisconsin. This study compared these programs' performance in terms of savings per home and program cost per home to assess the relative cost-effectiveness of each program design. However, given the many variations in these different programs, it is difficult to establish a fair comparison based on only a small number of metrics. Therefore, the overall purpose of the study is to document these programs' performance in a case study approach to look at general patterns of these metrics and other variables within the context of each program. This information can be used by energy efficiency program administrators and implementers to inform home retrofit program design. Six different program designs offered in Wisconsin for single-family energy efficiency improvements were included in the study. For each program, the research team provided information about the programs' approach and goals, characteristics, achievements and performance. The program models were then compared with performance results-program cost and energy savings-to help understand the overall strengths and weaknesses or challenges of each model.

  17. Comparison of Home Retrofit Programs in Wisconsin

    Energy Technology Data Exchange (ETDEWEB)

    Cunningham, K.; Hannigan, E.

    2013-03-01

    To explore ways to reduce customer barriers and increase home retrofit completions, several different existing home retrofit models have been implemented in the state of Wisconsin. This study compared these programs' performance in terms of savings per home and program cost per home to assess the relative cost-effectiveness of each program design. However, given the many variations in these different programs, it is difficult to establish a fair comparison based on only a small number of metrics. Therefore, the overall purpose of the study is to document these programs' performance in a case study approach to look at general patterns of these metrics and other variables within the context of each program. This information can be used by energy efficiency program administrators and implementers to inform home retrofit program design. Six different program designs offered in Wisconsin for single-family energy efficiency improvements were included in the study. For each program, the research team provided information about the programs' approach and goals, characteristics, achievements and performance. The program models were then compared with performance results -- program cost and energy savings -- to help understand the overall strengths and weaknesses or challenges of each model.

  18. [Preventive home visits for elderly patients: development and pilot testing of a multidimensional assessment instrument].

    Science.gov (United States)

    Peter-Wüest, I; Stuck, A E; Dapp, U; Nikolaus, T; Goetz, S M; Gillmann, G; Minder, C E; Beck, J C

    2000-02-01

    Preventive home visits with multidimensional geriatric assessment have been shown to delay or prevent the onset of disability and reduce nursing home admissions in older people. The purpose of the present study was to develop and test a multidimensional instrument for in-home preventive assessments in older persons. In developing the instrument, we conducted a systematic literature review of risk factors for functional status decline and of appropriate instruments for measuring these risk factors. Based on an Expert Panel using a modified Delphi process [1] the risk factor domains for functional status decline were chosen, [2] the instruments for evaluating each of the included risk factor domains were selected, and [3] the individual instruments were combined into one comprehensive assessment instrument. A German language version of the original English version of the instrument was developed based on translation, backtranslation, and cultural adaptation. The feasibility of use of the new instrument was evaluated in a field test in 150 people aged 75 years and older in Hamburg, Ulm, Germany, and Bern, Switzerland. The instrument was well accepted by the older persons. The prevalence of risk factors for functional status decline in these populations (e.g., physical inactivity, urinary incontinence, vision impairment) was high. There was also a high prevalence of underuse of preventive care measures (e.g., no pneumococcal vaccination in over 95 percent of persons). These preliminary results support the possible usefulness of this instrument for conducting preventive home visits or for epidemiological purposes (e.g., prevention surveillance). In a next phase, the test-retest reliability of the instrument, and the feasibility and reliability of self-administration as compared to interviewer administration will be described in a separate paper.

  19. "Carol I" Central University Library Continuous Training Program through Documentary Visits. A Documentary Visit to Cotroceni Museum

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    Emanuela Florea-Paraipan

    2016-01-01

    Full Text Available In this essay we aim to emphasize the role of documentary visits in continuous training programs of library professionals. As alternative form of continuous training, the "Carol I" Central University Library runs an annual program of documentary visits to Bucharest museums, in order to identify from the historical, biographical, literary, artistic and scientific perspective, the manner in which evolved Romanian spirituality nationally and beyond. As a form of initial training for national inheritance understanding, the professional visits to cultural institutions allows the discovery of the categories of collections, the structure and their pedagogical value in learning, teaching and training.

  20. Motivation to take part in integrated care - an assessment of follow-up home visits to elderly persons

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    Ulf Hjelmar

    2011-08-01

    Full Text Available Objectives: The aim of follow-up visits by the general practitioner and district nurse (within a week after discharge from hospital is to reduce hospital readmissions and improve the overall wellbeing of the patient. There is strong evidence that these programmes are effective, but are difficult to implement because of a number of organizational obstacles, including co-ordination between the organizations involved in the process. In this paper we look at the factors that affect motivation to participate in a cross-sectoral programme in Copenhagen, Denmark, implementing follow-up home visits to elderly persons. Theory and methods: The analysis is based on inter-organisational network theory in an attempt to explain the role of motivation in network formation between organizational systems. The empirical findings are based on focus groups and in-depth interviews with hospital staff, general practitioners, and district nurses. Results: Care providers are motivated to collaborate by a number of factors. The focus of collaboration needs to be clearly defined and agreed upon, there needs to be a high degree of equality between the professionals involved, and there has to be a will to co-operate based on a shared understanding of values and learning potentials. Conclusions: The study concludes that we need to focus on specific care fields and actors to reduce complexity in the area and more fully understand what motivates care providers to participate in cross-sectoral activities such as a follow-up home visit programme. One lesson for current policy is that motivational factors need to be addressed in future collaborative programs in order to fully exploit the potential health benefits.

  1. Motivation to take part in integrated care - an assessment of follow-up home visits to elderly persons

    Directory of Open Access Journals (Sweden)

    Ulf Hjelmar

    2011-08-01

    Full Text Available Objectives: The aim of follow-up visits by the general practitioner and district nurse (within a week after discharge from hospital is to reduce hospital readmissions and improve the overall wellbeing of the patient. There is strong evidence that these programmes are effective, but are difficult to implement because of a number of organizational obstacles, including co-ordination between the organizations involved in the process. In this paper we look at the factors that affect motivation to participate in a cross-sectoral programme in Copenhagen, Denmark, implementing follow-up home visits to elderly persons.Theory and methods: The analysis is based on inter-organisational network theory in an attempt to explain the role of motivation in network formation between organizational systems. The empirical findings are based on focus groups and in-depth interviews with hospital staff, general practitioners, and district nurses.Results: Care providers are motivated to collaborate by a number of factors. The focus of collaboration needs to be clearly defined and agreed upon, there needs to be a high degree of equality between the professionals involved, and there has to be a will to co-operate based on a shared understanding of values and learning potentials.Conclusions: The study concludes that we need to focus on specific care fields and actors to reduce complexity in the area and more fully understand what motivates care providers to participate in cross-sectoral activities such as a follow-up home visit programme. One lesson for current policy is that motivational factors need to be addressed in future collaborative programs in order to fully exploit the potential health benefits.

  2. An innovative night service program in home care.

    Science.gov (United States)

    Tennant, J; Narayan, M C

    1997-05-01

    Comprehensive night service by a home care agency has resulted in increased customer satisfaction and referrals to the agency. The description of this innovative night nurse program includes the job requirements and duties of a visiting night nurse and the tools the nurse uses to accomplish the task of nighttime care delivery. The use of self-directed work groups and mentorship to manage the demands of night service are discussed. Continuity of care, nurse safety, professional development, and program cost also are addressed.

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

    Science.gov (United States)

    Strong, Carol J.; And Others

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

  4. Avaliação das condições de habitação e saneamento: a importância da visita domiciliar no contexto do Programa de Saúde da Família Assessment of sanitation and housing conditions: the importance of home visits in the Family Health Program context

    Directory of Open Access Journals (Sweden)

    Catarina Machado Azeredo

    2007-06-01

    Full Text Available O conhecimento das condições do meio pertinente à saúde, como saneamento e moradia, são essenciais no estabelecimento de medidas de promoção da qualidade de vida do indivíduo, famílias e comunidades. Objetivou-se avaliar, através de visitas domiciliares, as condições habitacionais e de saneamento básico das famílias adstritas no PSF de Teixeiras-MG. Tratou-se de estudo observacional transversal, com realização de entrevistas a 10% (n=364 das famílias adstritas no PSF, utilizando questionário semi-estruturado. A cobertura por rede de abastecimento de água era de 83% dos domicílios da zona urbana e 11,7% da zona rural, e a rede pública era o destino final da água utilizada em 82,2% dos domicílios da zona urbana e de apenas 10,9% da zona rural. Destaca-se distribuição desigual de infra-estrutura e saneamento entre as zonas urbana e rural. A visita domiciliar permitiu um olhar in loco da realidade do usuário do PSF e se constitui em importante instrumento na Estratégia Saúde da Família, identificando determinantes do processo saúde-doença percebidos no ambiente em que vivem as famílias e possibilitando promoção da saúde por meio da educação em saúde.Knowledge of health-related environmental conditions - such as basic sanitation and housing - are of singular importance for establishing measures designed to upgrade the quality of life at the individual, family and community levels. Through home visits, this paper evaluates families enrolled in the Family Health Program (FHP in Teixeiras, Minas Gerais State, Brazil, including their housing and basic sanitation conditions. A transverse observational study, its semi-structured questionnaire was applied to 10% (n=364 of the families enrolled in this Program. The net water supply coverage reached 83% of homes in urban areas and 11.7% in rural areas. The public water supply was the final disposal point for the water used in 82.2% of urban dwellings and 10.9% of rural

  5. Ethical Considerations in Home-Based Programs.

    Science.gov (United States)

    Levenstein, Phyllis

    This paper provides a checklist of 10 potential ethical problems associated with intervention in families through home-based programs. Problems which directly involve program participants are (1) pressure on parents to join the program, (2) violation of confidentiality, (3) intrusiveness, (4) need to respect the family's style of living, (5)…

  6. Early intervention of multiple home visits to prevent childhood obesity in a disadvantaged population: a home-based randomised controlled trial (Healthy Beginnings Trial

    Directory of Open Access Journals (Sweden)

    Alperstein Garth

    2007-05-01

    Full Text Available Abstract Background Studies have shown that a proportion of children as young as two years are already overweight. This indicates that obesity prevention programs that commence as early as possible and are family-focused are needed. This Healthy Beginnings Trial aims to determine the efficacy of a community-based randomized controlled trial (RCT of a home visiting intervention in preventing the early onset of childhood overweight and obesity. The intervention will be conducted over the first two years of life to increase healthy feeding behaviours and physical activity, decrease physical inactivity, enhance parent-child interaction, and hence reduce overweight and obesity among children at 2 and 5 years of age in the most socially and economically disadvantaged areas of Sydney, Australia. Methods/design This RCT will be conducted with a consecutive sample of 782 first time mothers with their newborn children. Pregnant women who are expecting their first child, and who are between weeks 24 and 34 of their pregnancy, will be invited to participate in the trial at the antenatal clinic. Informed consent will be obtained and participants will then be randomly allocated to the intervention or the control group. The allocation will be concealed by sequentially numbered, sealed opaque envelopes containing a computer generated random number. The intervention comprises eight home visits from a specially trained community nurse over two years and pro-active telephone support between the visits. Main outcomes include a duration of breastfeeding measured at 6 and 12 months, b introduction of solids measured at 4 and 6 months, c nutrition, physical activity and television viewing measured at 24 months, and d overweight/obesity status at age 2 and 5 years. Discussion The results of this trial will ascertain whether the home based early intervention is effective in preventing the early onset of childhood overweight and obesity. If proved to be effective, it

  7. Access to Difficult-to-reach Population Subgroups: A Family Midwife Based Home Visiting Service for Implementing Nutrition-related Preventive Activities - A Mixed Methods Explorative Study

    Directory of Open Access Journals (Sweden)

    Helena Walz

    2015-08-01

    Full Text Available Health and social inequality are tightly linked and still pose an important public health problem. However, vulnerable and disadvantaged populations are difficult to reach for health-related interventions. Given the long-lasting effects of an adverse, particular nutrition-related, intrauterine and neonatal environment on health development (perinatal programming, an early and easy access is essential for sustainable interventions. The goal of this explorative study was therefore to elucidate whether an existing access of family midwives (FMs to families in need of support could be an option to implement effective public health and nutrition interventions. To that end three research objectives were formulated: (1 to determine whether a discernible impact of home visits by FMs can be described; (2 to identify subgroups among these families in need of more specific interventions; (3 to determine how relevant nutrition-related topics are for both FMs and the supported families. For addressing these objectives a mixed methods design was used: Routine documentation data from 295 families visited by a family midwife (FM were analyzed (secondary analysis, and structured expert interviews with FMs were conducted and analyzed. Study reporting followed the STROBE (STrengthening the Reporting of OBservational studies in Epidemiology statement. Based on the FMs reports, a significant improvement (p < 0.001 regarding psycho-social variables could be determined after the home visits. Single mothers, however, seemed to benefit less from the FMs service compared to their counterparts (p = 0.015. Nutritional counseling was demanded by 89% of the families during the home visits. In addition, nutrition-related topics were reported in the interviews to be of high interest to both families and the FMs. Based on the obtained results it is concluded that FMs home visits offer a promising access to vulnerable and disadvantaged families for implementing nutrition

  8. Tackling community integration in mental health home visit integration in Finland.

    Science.gov (United States)

    Raitakari, Suvi; Haahtela, Riikka; Juhila, Kirsi

    2016-09-01

    Integration - and its synonym inclusion - is emphasised in the western welfare states and in the European Union in particular. Integration is also a central topic in the social sciences and in current mental health and homelessness research and practice. As mental healthcare has shifted from psychiatric hospitals to the community, it has inevitably become involved with housing and integration issues. This article explores how community integration is understood and tackled in mental health floating support services (FSSs) and, more precisely, in service user-practitioner home visit interaction. The aim, through shedding light on how the idea of integration is present and discussed in front-line mental health practices, is to offer a 'template' on how we might, in a systematic and reflective way, develop community integration research and practice. The analysis is based on ethnomethodological and micro-sociological interaction research. The research settings are two FSSs located in a large Finnish city. The data contain 24 audio-recorded and transcribed home visits conducted in 2011 and 2012 with 16 different service users. The study shows how the participants in service user-practitioner interaction give meaning to community integration and make decisions about how it should (or should not) be enhanced in each individual case. This activity is called community integration work in action. Community integration work in action is based on various dimensions of integration: getting out of the house, participating in group activities and getting along with those involved in one's life and working life. Additionally, the analysis demonstrates how community integration work is accomplished by discursive devices (resistance, positioning, excuses and justifications, delicacy and advice-giving). The article concludes that community integration is about interaction: it is not only service users' individual challenge but also a social challenge, our challenge.

  9. Infusing Technology Into Perinatal Home Visitation in the United States for Women Experiencing Intimate Partner Violence: Exploring the Interpretive Flexibility of an mHealth Intervention.

    Science.gov (United States)

    Bacchus, Loraine J; Bullock, Linda; Sharps, Phyllis; Burnett, Camille; Schminkey, Donna L; Buller, Ana Maria; Campbell, Jacquelyn

    2016-11-17

    Intimate partner violence (IPV) is common during pregnancy and the postpartum. Perinatal home visitation provides favorable conditions in which to identify and support women affected by IPV. However, the use of mHealth for delivering IPV interventions in perinatal home visiting has not been explored. Our objective was to conduct a nested qualitative interpretive study to explore perinatal home visitors' and women's perceptions and experiences of the Domestic Violence Enhanced Home Visitation Program (DOVE) using mHealth technology (ie, a computer tablet) or a home visitor-administered, paper-based method. We used purposive sampling, using maximum variation, to select women enrolled in a US-based randomized controlled trial of the DOVE intervention for semistructured interviews. Selection criteria were discussed with the trial research team and 32 women were invited to participate. We invited 45 home visitors at the 8 study sites to participate in an interview, along with the 2 DOVE program designers. Nonparticipant observations of home visits with trial participants who chose not to participate in semistructured interviews were undertaken. We conducted 51 interviews with 26 women, 23 home visiting staff at rural and urban sites, and the 2 DOVE program designers. We conducted 4 nonparticipant observations. Among 18 IPV-positive women, 7 used the computer tablet and 11 used the home visitor method. Among 8 IPV-negative women, 7 used the home visitor method. The computer tablet was viewed as a safe and confidential way for abused women to disclose their experiences without fear of being judged. The meanings that the DOVE technology held for home visitors and women led to its construction as either an impersonal artifact that was an impediment to discussion of IPV or a conduit through which interpersonal connection could be deepened, thereby facilitating discussion about IPV. Women's and home visitors' comfort with either method of screening was positively influenced

  10. Use of a geriatric home visit experience to teach medical students the functional status assessment.

    Science.gov (United States)

    Tung, Ericka E; Thomas, Matthew R

    2009-02-01

    Functional status measures strongly predict hospital outcomes and mortality, yet teaching of these measures is often missing from medical schools' curricula. To address this deficiency, we developed a Geriatric Home-based Assessment (GHA) module for third-year medical students. The module was composed of a workshop and two to three home visits. To determine whether the GHA module would improve students' knowledge and proficiency in the functional status assessment. Students completed a validated questionnaire and evaluated a standardized patient in an Observed Structured Clinical Examination (OSCE). Scores from students completing the GHA were compared to the scores of students without this experience. Thirty-one students participated in the GHA module, and 19 students were in the control group. The mean score on the written assessment was 87% among GHA students vs. 46% in the control group (p students' knowledge and proficiency in the functional status assessment. "Hands on" experiences like the GHA allow students to develop a solid foundation for assessing functional status and mobility.

  11. Are acceptance rates of a national preventive home visit programme for older people socially imbalanced?: a cross sectional study in Denmark

    DEFF Research Database (Denmark)

    Yamada, Yukari; Ekmann, Anette Addy; Nilsson, Charlotte Juul

    2012-01-01

    Preventive home visits are offered to community dwelling older people in Denmark aimed at maintaining their functional ability for as long as possible, but only two thirds of older people accept the offer from the municipalities. The purpose of this study is to investigate 1) whether socioeconomic...... status was associated with acceptance of preventive home visits among older people and 2) whether municipality invitational procedures for the preventive home visits modified the association....

  12. Older persons' expressions of emotional cues and concerns during home care visits. Application of the Verona coding definitions of emotional sequences (VR-CoDES) in home care.

    Science.gov (United States)

    Sundler, Annelie J; Höglander, Jessica; Eklund, Jakob Håkansson; Eide, Hilde; Holmström, Inger K

    2017-02-01

    This study aims to a) explore to what extent older persons express emotional cues and concerns during home care visits; b) describe what cues and concerns these older persons expressed, and c) explore who initiated these cues and concerns. A descriptive and cross-sectional study was conducted. Data consisted of 188 audio recorded home care visits with older persons and registered nurses or nurse assistants, coded with the Verona coding definitions on emotional sequences (VR-CoDES). Emotional expressions of cues and concerns occurred in 95 (51%) of the 188 recorded home care visits. Most frequent were implicit expressions of cues (n=292) rather than explicit concerns (n=24). Utterances with hints to hidden concerns (63,9%, n=202) were most prevalent, followed by vague or unspecific expressions of emotional worries (15,8%, n=50). Most of these were elicited by the nursing staff (63%, n=200). Emotional needs expressed by the older persons receiving home care were mainly communicated implicitly. To be attentive to such vaguely expressed emotions may demand nursing staff to be sensitive and open. The VR-CoDES can be applied on audio recorded home care visits to analyse verbal and emotional communication, and may allow comparative research. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  13. Cost of a home parenteral nutrition program.

    Science.gov (United States)

    Wateska, L P; Sattler, L L; Steiger, E

    1980-11-21

    We analyzed the costs to a hospital of providing complete home parenteral nutrition (HPN) services for eight patients. Identified cost components include patient training, equipment, supplies, and follow-up. The average annual cost of maintaining parenteral nutrition at home was 73% lower than it would have been in the hospital. The establishment of private companies to provide patients with HPN supplies and services will reduce the financial burden of HPN programs for hospitals.

  14. Occupational therapy predischarge home visits for patients with a stroke (HOVIS): results of a feasibility randomized controlled trial.

    Science.gov (United States)

    Drummond, A E R; Whitehead, P; Fellows, K; Sprigg, N; Sampson, C J; Edwards, C; Lincoln, N B

    2013-05-01

    To assess the feasibility of conducting a randomized controlled trial of occupational therapy predischarge home visits for people after stroke. Randomized controlled trial and cohort study. We randomized eligible patients for whom there was clinical uncertainty about the need to conduct a home visit to a randomized controlled trial; patients for whom a visit was judged 'essential' were enrolled into a cohort study. Stroke rehabilitation unit of teaching hospital. One hundred and twenty-six participants hospitalized following recent stroke. Predischarge home visit or structured, hospital-based interview. The primary objective was to collect information on the feasibility of a randomized controlled trial, including eligibility, control intervention and outcome assessments. The primary outcome measure was the Nottingham Extended Activities of Daily Living Scale at one month after discharge from hospital. Secondary outcomes included mood, quality of life and costs at one week and one month following discharge. Ninety-three people were allocated to the randomized controlled trial; 47 were randomized to intervention and 46 to control. Thirty-three were enrolled into the cohort study. More people were allocated to the randomized controlled trial as the study progressed. One hundred and thirteen people (90%) received the proposed intervention, although there was a need for stricter protocol adherence. Follow-up was good: at one month 114 (90%) were assessed. There were no significant differences between the groups in the randomized controlled trial for the primary outcome measure at one month. The average cost of a home visit was £208. A trial is feasible and warranted given the resource implications of predischarge occupational therapy home visits.

  15. Healthy Homes University: a home-based environmental intervention and education program for families with pediatric asthma in Michigan.

    Science.gov (United States)

    Largo, Thomas W; Borgialli, Michele; Wisinski, Courtney L; Wahl, Robert L; Priem, Wesley F

    2011-01-01

    Environmental conditions within the home can exacerbate asthmatic children's symptoms. To improve health outcomes among this group, we implemented an in-home environmental public health program-Healthy Homes University--for low-income families in Lansing, Michigan, from 2005 to 2008. Families received four visits during a six-month intervention. Program staff assessed homes for asthma triggers and subsequently provided products and services to reduce exposures to cockroaches, dust mites, mold, tobacco smoke, and other triggers. We also provided asthma education that included identification of asthma triggers and instructions on specific behaviors to reduce exposures. Based on self-reported data collected from 243 caregivers at baseline and six months, the impact of asthma on these children was substantially reduced, and the proportion who sought acute unscheduled health care for their asthma decreased by more than 47%.

  16. Effects of a video feedback parent training program during child welfare visitation.

    Science.gov (United States)

    Nese, Rhonda N T; Anderson, Cynthia M; Ruppert, Traci; Fisher, Philip A

    2016-12-01

    Behavioral parent training programs have documented efficacy for improving behaviors among parents and their children and are frequently used by child welfare agencies to prevent removal of a child from the parental home or to facilitate reunification. Although an ideal time for parent training might be during supervised visits where parents may practice skills with their children under the guidance and support of a therapist or caseworker, this is not typically the case. Most often, parents within the child welfare system receive parent training in small groups without their children present, and to date, few studies have examined effects of behavioral parent training interventions during supervised visitation. In this study, concurrent multiple baseline across behaviors design was used to examine effects of a behavioral parent training program, Filming Interactions to Nurture Development (FIND), on parental skill acquisition with four mothers who had lost custody of their children but were being considered for reunification. Children emitted little or no problem behaviors during baseline or intervention, so parenting behavior was the primary dependent variable. Results obtained across participants documented a clear functional relation between implementation of the FIND intervention and increases in developmentally supportive parenting behaviors. Results of social validity and contextual fit measures suggest the intervention was perceived by mothers to be positive, feasible, and appropriate within the child welfare context. Practical and conceptual implications, limitations of this study, and directions for future research are discussed.

  17. A feasibility study of UMTS mobile phones for supporting nurses doing home visits to patients with diabetic foot ulcers

    DEFF Research Database (Denmark)

    Larsen, Simon Bo; Clemensen, Jane; Ejskjær, Niels

    2006-01-01

    We tested the feasibility of Universal Mobile Telephone System (UMTS) mobile phones for video consultations in the home. Five patients with diabetic foot ulcers were included in the study. Each of them was offered three video consultations instead of visits to the hospital outpatient clinic...

  18. A scale for home visiting nurses to identify risks of physical abuse and neglect among mothers with newborn infants

    NARCIS (Netherlands)

    Grietens, H; Geeraert, L; Hellinckx, W

    2004-01-01

    Objective: The aim was to construct and test the reliability (utility, internal consistency, interrater agreement) and the validity (internal validity, concurrent validity) of a scale for home visiting social nurses to identify risks of physical abuse and neglect in mothers with a newborn child. Met

  19. Patient Home Visits: Measuring Outcomes of a Community Model for Palliative Care Education

    Science.gov (United States)

    Allo, Julio A.; Cuello, Deanna; Zhang, Yi; Reddy, Suresh K.; Azhar, Ahsan

    2016-01-01

    Abstract Background: Health care professionals may have limited exposure to home-based care. There is no published literature that has described the experiences and satisfaction of participation in patient home visits (PHV). Objective: The objective of this article is to describe the characteristics of PHV, our approach, and evaluation by participants over a nine-year period. Methods: We conducted a review of surveys completed by participants in PHV from 2005–2013. All participants anonymously completed the evaluation questionnaires at the end of PHVs. Different PHV assessment forms were used for the 2005–2010 and 2011–2013 time periods. Results: A total of 34 PHVs were conducted with 106 patients and approximately 750 participants with a mean of 3 patients and 22 participants per PHV between 2005 and 2013. For 18 PHVs there are 317 surveys completed with 353 participants, making it a 90% response rate. Responding participants were physicians 125/543 (23%) and other professionals 418/543 (77%). In both time periods of 2005–2010 and 2011–2013 a survey with a 1 (completely agree) to 5 (completely disagree) scale was used. Agreeing that PHV was an effective teaching tool during 2005–2010 were 335/341 (98%); during 2011–2013, 191/202 (95%) agreed that PHV provided increased understanding and sharing of best practices in palliative care. Conclusions: PHV was perceived by participants as an effective way of providing interactive community education. A broad range of themes were addressed, and the participants reported high levels of learning in all domains of palliative care. There were no cases of patient or relative expression of distress as a result of PHV. PMID:26652056

  20. Cost-effectiveness of home visits in the outpatient treatment of patients with alcohol dependence.

    Science.gov (United States)

    Moraes, Edilaine; Campos, Geraldo M; Figlie, Neliana B; Laranjeira, Ronaldo; Ferraz, Marcos B

    2010-01-01

    The purpose of this study was to compare the cost-effectiveness of conventional outpatient treatment for alcoholic patients (CT) with this same conventional treatment plus home visits (HV), a new proposal for intervention within the Brazilian outpatient treatment system. A cost-effectiveness evaluation alongside a 12-week randomized clinical trial was performed. We identified the resources utilized by each intervention, as well as the cost according to National Health System (SUS), Brazilian Medical Association (AMB) tables of fees, and others based on 2005 data. The incremental cost-effectiveness ratio (ICER) was estimated as the main outcome measure - abstinent cases at the end of treatment. There were 51.8% abstinent cases for HV and 43.1% for CT, a clinically relevant finding. Other outcome measures, such as quality of life, also showed significant improvements that favored HV. The baseline scenario presented an ICER of USD 1,852. Sensitivity analysis showed an ICER of USD 689 (scenario favoring HV) and USD 2,334 (scenario favoring CT). The HV treatment was found to be cost-effective according to the WHO Commission on Macroeconomics and Health. 2009 S. Karger AG, Basel.

  1. Useful tool for general practitioners, home health care nurses and social workers in assessing determinants of the health status and treatment of patients visited in their homes

    Directory of Open Access Journals (Sweden)

    Andrzej Brodziak

    2012-09-01

    Full Text Available The necessity is emphasized to distinguish between the traditional model of data acquisition reported by a patient in doctor’s office and the more valuable and desired model to become acquainted with the core of the problem by going to a patient’s domicile. In the desired model it is possible to come across various determinants of health during home visits. Family members can be approached and there is a possibility to evaluate the relationships between the patient and his loved ones. One can visually assess one’s living conditions and predictable environmental hazard. For several years, the desired model has been put into practice by general practitioners and home health care nurses. Recently this model is also promoted by “health care therapists” who are members of “teams of home health care”. The authors, being convinced of the merits of “home and environmental model” of practical medicine, have developed a method of recording and illustrating data collected during visits in patient’s home. The elaborated tool helps to communicate and exchange information among general practitioners, home health care nurses, social workers of primary health care centers and specialists. The method improves the formulation of the plan of further therapeutic steps and remedial interventions in psycho-social relations and living conditions of patients.

  2. Healthy Homes University: A Home-Based Environmental Intervention and Education Program for Families with Pediatric Asthma in Michigan

    Science.gov (United States)

    Largo, Thomas W.; Borgialli, Michele; Wisinski, Courtney L.; Wahl, Robert L.; Priem, Wesley F.

    2011-01-01

    Environmental conditions within the home can exacerbate asthmatic children's symptoms. To improve health outcomes among this group, we implemented an in-home environmental public health program—Healthy Homes University—for low-income families in Lansing, Michigan, from 2005 to 2008. Families received four visits during a six-month intervention. Program staff assessed homes for asthma triggers and subsequently provided products and services to reduce exposures to cockroaches, dust mites, mold, tobacco smoke, and other triggers. We also provided asthma education that included identification of asthma triggers and instructions on specific behaviors to reduce exposures. Based on self-reported data collected from 243 caregivers at baseline and six months, the impact of asthma on these children was substantially reduced, and the proportion who sought acute unscheduled health care for their asthma decreased by more than 47%. PMID:21563708

  3. Growing old at home – A randomized controlled trial to investigate the effectiveness and cost-effectiveness of preventive home visits to reduce nursing home admissions: study protocol [NCT00644826

    Directory of Open Access Journals (Sweden)

    Riedel-Heller Steffi G

    2008-05-01

    Full Text Available Abstract Background Regarding demographic changes in Germany it can be assumed that the number of elderly and the resulting need for long term care is increasing in the near future. It is not only an individual's interest but also of public concern to avoid a nursing home admission. Current evidence indicates that preventive home visits can be an effective way to reduce the admission rate in this way making it possible for elderly people to stay longer at home than without home visits. As the effectiveness and cost-effectiveness of preventive home visits strongly depends on existing services in the social and health system existing international results cannot be merely transferred to Germany. Therefore it is necessary to investigate the effectiveness and cost-effectiveness of such an intervention in Germany by a randomized controlled trial. Methods The trial is designed as a prospective multi-center randomized controlled trial in the cities of Halle and Leipzig. The trial includes an intervention and a control group. The control group receives usual care. The intervention group receives three additional home visits by non-physician health professionals (1 geriatric assessment, (2 consultation, (3 booster session. The nursing home admission rate after 18 months will be defined as the primary outcome. An absolute risk reduction from a 20% in the control-group to a 7% admission rate in the intervention group including an assumed drop out rate of 30% resulted in a required sample size of N = 320 (n = 160 vs. n = 160. Parallel to the clinical outcome measurement the intervention will be evaluated economically. The economic evaluation will be performed from a society perspective. Discussion To the authors' knowledge for the first time a trial will investigate the effectiveness and cost-effectiveness of preventive home visits for people aged 80 and over in Germany using the design of a randomized controlled trial. Thus, the trial will contribute to

  4. Cardiac surgery nurse practitioner home visits prevent coronary artery bypass graft readmissions.

    Science.gov (United States)

    Hall, Michael H; Esposito, Rick A; Pekmezaris, Renee; Lesser, Martin; Moravick, Donna; Jahn, Lynda; Blenderman, Robert; Akerman, Meredith; Nouryan, Christian N; Hartman, Alan R

    2014-05-01

    We designed and tested an innovative transitional care program, involving cardiac surgery nurse practitioners, to improve care continuity after patient discharge home from coronary artery bypass graft (CABG) operations and decrease the composite end point of 30-day readmission and death. A total of 401 consecutive CABG patients were eligible between May 1, 2010, and August 31, 2011, for analysis. Patient data were entered prospectively into The Society of Thoracic Surgeons database and the New York State Cardiac Surgery Reporting System and retrospectively analyzed with Institutional Review Board approval. The "Follow Your Heart" program enrolled 169 patients, and 232 controls received usual care. Univariate and multivariate analyses were used to identify readmission predictors, and propensity score matching was performed with 13 covariates. Binary logistic regression analysis identified "Follow Your Heart" as the only independently significant variable in preventing the composite outcome (p=0.015). Odds ratios for readmission were 3.11 for dialysis patients, 2.17 for Medicaid recipients, 1.87 for women, 1.86 for non-Caucasians, 1.78 for chronic obstructive pulmonary disease, 1.26 for diabetes, and 1.09 for congestive heart failure. Propensity score matching yielded matches for 156 intervention patients (92%). The intervention showed a significantly lower 30-day readmission/death rate of 3.85% (6 of 156) compared with 11.54% (18 of 156) for the usual care matched group (p=0.023). A home transition program providing continuity of care, communication hub, and medication management by treating hospital nurse practitioners significantly reduced the 30-day composite end point of readmission/death after CABG. More targeted resource allocation based on odds ratios of readmission may further improve results and be applicable to other patient groups. Copyright © 2014 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  5. Study protocol: follow-up home visits with nutrition: a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Beck Anne Marie

    2011-12-01

    Full Text Available Abstract Background Geriatric patients are at high risk of re-admission after discharge. Pre-existing nutritional risk amongst these patients is of primary concern, with former nutritional intervention studies being largely ineffective. None of these studies has included individual dietary counselling by a registered dietician or has considered competing medical conditions in the participants. A former randomised study has shown that comprehensive discharge follow-up in geriatric patients homes by general practitioners and district nurses was effective in reducing the re-admission risk in the intervention group compared to the control group. That study did not include a nutritional intervention. The purpose of this study is to assess the combined benefits of an intervention consisting of discharge follow-up in geriatric patients' home by a general practitioner and a registered dietician. Methods/design This single-blind randomised controlled study, will recruit 160 hospitalised geriatric medical patients (65+ y at nutritional risk. Participants will be randomly allocated to receive in their homes, either 12 weeks individualised nutritional counselling by a registered dietician complemented with follow-up by general practitioners or a 12 weeks follow-up by general practitioners alone. Discussion This trial is the first of its kind to provide individual nutritional intervention combined with follow-up by general practitioner as an intervention to reduce risk of re-admission after discharge among geriatric medical patients. The results will hopefully help to guide the development of more effective rehabilitation programs following hospital admissions, which may ultimately lead to reduced health care costs, and improvement in mobility, independence and quality of life for geriatric patients at nutritional risk. Trial Registration ClinicalTrials.gov 2010 NCT01249716

  6. Effects of home visits by home nurses to elderly people with health problems: design of a randomised clinical trial in the Netherlands [ISRCTN92017183

    Directory of Open Access Journals (Sweden)

    Kempen Gertrudis IJM

    2004-12-01

    Full Text Available Abstract Background Preventive home visits to elderly people by public health nurses aim to maintain or improve the functional status of elderly and reduce the use of institutional care services. A number of trials that investigated the effects of home visits show positive results, but others do not. The outcomes can depend on differences in characteristics of the intervention programme, but also on the selection of the target population. A risk group approach seems promising, but further evidence is needed. We decided to carry out a study to investigate the effects in a population of elderly with (perceived poor health rather than the general population. Also, we test whether nurses who are qualified at a lower professional level (home nurses instead of public health nurses are able to obtain convincing effects. The results of this study will contribute to the discussion on effective public health strategies for the aged. Methods/design The study is carried out as a parallel group randomised trial. To screen eligible participants, we sent a postal questionnaire to 4901 elderly people (70–84 years living at home in a town in the south of the Netherlands. After applying inclusion criteria (e.g., self-reported poor health status and exclusion criteria (e.g., those who already receive home nursing care, we selected 330 participants. They entered the randomisation procedure; 160 were allocated to the intervention group and 170 to the control group. The intervention consists of (at least 8 systematic home visits over an 18 months period. Experienced home nurses from the local home care organisation carry out the visits. The control group receives usual care. Effects on health status are measured by means of postal questionnaires after 12 months, 18 months (the end of the intervention period and after 24 months (the end of 6-months follow-up, and face-to-face interviews after 18 months. Data on mortality and service use are continuously registered

  7. 75 FR 32459 - National Energy Rating Program for Homes

    Science.gov (United States)

    2010-06-08

    ... Efficiency and Renewable Energy National Energy Rating Program for Homes AGENCY: Energy Efficiency and... voluntary National Energy Rating Program for Homes. The purpose of this program is to encourage consumers to invest in energy improvements in existing homes by providing reliable information to them at low cost...

  8. Home visits by family physicians during the end-of-life: Does patient income or residence play a role?

    Directory of Open Access Journals (Sweden)

    Johnston Grace

    2005-01-01

    Full Text Available Abstract Background With a growing trend for those with advanced cancer to die at home, there is a corresponding increase in need for primary medical care in that setting. Yet those with lower incomes and in rural regions are often challenged to have their health care needs met. This study examined the association between patient income and residence and the receipt of Family Physician (FP home visits during the end-of-life among patients with cancer. Methods Data Sources/Study Setting. Secondary analysis of linked population-based data. Information pertaining to all patients who died due to lung, colorectal, breast or prostate cancer between 1992 and 1997 (N = 7,212 in the Canadian province of Nova Scotia (NS was extracted from three administrative health databases and from Statistics Canada census records. Study Design. An ecological measure of income ('neighbourhood' median household income was developed using census information. Multivariate logistic regression was then used to assess the association of income with the receipt of at least one home visit from a FP among all subjects and by region of residency during the end-of-life. Covariates in the initial multivariate model included patient demographics and alternative health services information such as total days spent as a hospital inpatient. Data Extraction Methods. Encrypted patient health card numbers were used to link all administrative health databases whereas the postal code was the link to Statistics Canada census information. Results Over 45% of all subjects received at least one home visit (n = 3265. Compared to those from low income areas, the log odds of receiving at least one home visit was significantly greater among subjects who reside in middle to high income neighbourhoods (for the highest income quintile, adjusted odds ratio [OR] = 1.37, 95% confidence interval [CI] = 1.15, 1.64; for upper-middle income, adjusted OR = 1.19, 95%CI = 1.02, 1.39; for middle income

  9. A home-visiting intervention targeting determinants of infant mental health: the study protocol for the CAPEDP randomized controlled trial in France

    Directory of Open Access Journals (Sweden)

    Tubach Florence

    2012-08-01

    Full Text Available Abstract Background Several studies suggest that the number of risk factors rather than their nature is key to mental health disorders in childhood. Method and design The objective of this multicentre randomized controlled parallel trial (PROBE methodology is to assess the impact in a multi-risk French urban sample of a home-visiting program targeting child mental health and its major determinants. This paper describes the protocol of this study. In the study, pregnant women were eligible if they were: living in the intervention area; able to speak French, less than 26 years old; having their first child; less than 27 weeks of amenorrhea; and if at least one of the following criteria were true: less than twelve years of education, intending to bring up their child without the presence of the child’s father, and 3 low income. Participants were randomized into either the intervention or the control group. All had access to usual care in mother-child centres and community mental health services free of charge in every neighbourhood. Psychologists conducted all home visits, which were planned on a weekly basis from the 7th month of pregnancy and progressively decreasing in frequency until the child’s second birthday. Principle outcome measures included child mental health at 24 months and two major mediating variables for infant mental health: postnatal maternal depression and the quality of the caring environment. A total of 440 families were recruited, of which a subsample of 120 families received specific attachment and caregiver behaviour assessment. Assessment was conducted by an independent assessment team during home visits and, for the attachment study, in a specifically created Attachment Assessment laboratory. Discussion The CAPEDP study is the first large-scale randomised, controlled infant mental health promotion programme to take place in France. A major specificity of the program was that all home visits were conducted by

  10. The New York State Healthy Neighborhoods Program: Findings From an Evaluation of a Large-Scale, Multisite, State-Funded Healthy Homes Program.

    Science.gov (United States)

    Reddy, Amanda L; Gomez, Marta; Dixon, Sherry L

    A growing evidence base suggests that a comprehensive healthy homes approach may be an effective strategy for improving housing hazards that affect health, but questions remain about the feasibility of large-scale implementation. To evaluate the impact of a large-scale, multisite, state-funded healthy homes program. Homes in high-risk neighborhoods of 13 counties funded under the New York State Healthy Neighborhoods Program (NYS HNP) from 2008 to 2012. A total of 28 491 homes received an initial visit and 6436 dwellings received a revisit (follow-up assessment 3 to 6 months after the intervention). A majority of residents are low-income renters living in buildings built prior to 1950. The NYS HNP is a low-intensity healthy homes program. Participating homes undergo a visual assessment to identify potential environmental health and safety hazards, and interventions (education, referrals, and products) are provided to address any hazards identified during the visit. The proportion of homes affected by several types of housing hazards, improvement in hazards among revisited homes, and the change in the overall number of hazards per home were assessed. Among the homes that were revisited, there were significant improvements in the conditions assessed for tobacco control, fire safety, lead poisoning prevention, indoor air quality, and other hazards (including pests and mold). There was a significant reduction in the number of hazards per home (2.8 to 1.5; P homes were not hazard-free at the revisit. This evaluation suggests that a comprehensive, low-intensity healthy housing approach can produce short-term impacts with public health significance. This evaluation provides information about hazards that are common, easily assessed, and easily corrected or improved, which may be of use to a variety of programs that already provide in-home services and are seeking to expand the scope of their visits or to inform the development of new programs.

  11. Mini-Visit Guidelines and Rating Scale in Wisconsin Secondary Vocational Programs. Revised.

    Science.gov (United States)

    Dale, Dorothy; Klitzke, Elizabeth

    These guidelines outline the role of the visiting team members and familiarize them with those details necessary to conduct a condensed external evaluation of Wisconsin secondary vocational programs. (Such condensed evaluations are conducted when a full team visitation is not appropriate.) First, the three goals of the on-site evaluation are…

  12. Feasibility and effects of preventive home visits for at-risk older people: Design of a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Catellier Diane

    2009-12-01

    Full Text Available Abstract Background The search for preventive methods to mitigate functional decline and unwanted relocation by older adults living in the community is important. Preventive home visit (PHV models use infrequent but regular visits to older adults by trained practitioners with the goal of maintaining function and quality of life. Evidence about PHV efficacy is mixed but generally supportive. Yet interventions have rarely combined a comprehensive (biopsychosocial occupational therapy intervention protocol with a home visit to older adults. There is a particular need in the USA to create and examine such a protocol. Methods/Design The study is a single-blind randomized controlled pilot trial designed to assess the feasibility, and to obtain preliminary efficacy estimates, of an intervention consisting of preventive home visits to community-dwelling older adults. An occupational therapy-based preventive home visit (PHV intervention was developed and is being implemented and evaluated using a repeated measures design. We recruited a sample of 110 from a population of older adults (75+ who were screened and found to be at-risk for functional decline. Participants are currently living in the community (not in assisted living or a skilled nursing facility in one of three central North Carolina counties. After consent, participants were randomly assigned into experimental and comparison groups. The experimental group receives the intervention 4 times over a 12 month follow-up period while the comparison group receives a minimal intervention of mailed printed materials. Pre- and post-intervention measures are being gathered by questionnaires administered face-to-face by a treatment-blinded research associate. Key outcome measures include functional ability, participation, life satisfaction, self-rated health, and depression. Additional information is collected from participants in the experimental group during the intervention to assess the feasibility of

  13. Scope of a nursing diagnostic list for fulfilling basic human needs in home-visit nursing.

    Science.gov (United States)

    Esaki, Fusako; Muranaka, Yoko; Tamaki, Miyoko; Akiba, Kimiko; Aoki, Ryouko

    2006-01-01

    Inscriptions on 291 nursing diagnosis items regarding 100 home convalescents were subjected to analysis. The 291-item nursing diagnosis was found to be consistent with a previously reported nursing diagnosis developed by the authors from Henderson's 14 items covering basic nursing practice. Additionally, the analysis indicated a need for nursing diagnosis items for family members, as caregivers for the patients recuperating at home.

  14. Are acceptance rates of a national preventive home visit programme for older people socially imbalanced?: a cross sectional study in Denmark

    Directory of Open Access Journals (Sweden)

    Yamada Yukari

    2012-06-01

    Full Text Available Abstract Background Preventive home visits are offered to community dwelling older people in Denmark aimed at maintaining their functional ability for as long as possible, but only two thirds of older people accept the offer from the municipalities. The purpose of this study is to investigate 1 whether socioeconomic status was associated with acceptance of preventive home visits among older people and 2 whether municipality invitational procedures for the preventive home visits modified the association. Methods The study population included 1,023 community dwelling 80-year-old individuals from the Danish intervention study on preventive home visits. Information on preventive home visit acceptance rates was obtained from questionnaires. Socioeconomic status was measured by financial assets obtained from national registry data, and invitational procedures were identified through the municipalities. Logistic regression analyses were used, adjusted by gender. Results Older persons with high financial assets accepted preventive home visits more frequently than persons with low assets (adjusted OR = 1.5 (CI95%: 1.1-2.0. However, the association was attenuated when adjusted by the invitational procedures. The odds ratio for accepting preventive home visits was larger among persons with low financial assets invited by a letter with a proposed date than among persons with high financial assets invited by other procedures, though these estimates had wide confidence intervals. Conclusion High socioeconomic status was associated with a higher acceptance rate of preventive home visits, but the association was attenuated by invitational procedures. The results indicate that the social inequality in acceptance of publicly offered preventive services might decrease if municipalities adopt more proactive invitational procedures.

  15. Effectiveness of a nurse-led intensive home-visitation programme for first-time teenage mothers (Building Blocks): a pragmatic randomised controlled trial

    OpenAIRE

    Robling, Michael Richard; Bekkers, Marie; Bell, Kerry; Butler, Christopher Collett; Cannings-John, Rebecca Louise; Channon, Susan Jane; Martin, Belen Corbacho; Gregory, John Welbourn; Hood, Kerenza; Kemp, Alison Mary; Kenkre, Joyce; Montgomery, Alan A; Moody, Gwenllian; Owen-Jones, Catrin Eleri; Pickett, Kate

    2015-01-01

    Summary Background Many countries now offer support to teenage mothers to help them to achieve long-term socioeconomic stability and to give a successful start to their children. The Family Nurse Partnership (FNP) is a licensed intensive home-visiting intervention developed in the USA and introduced into practice in England that involves up to 64 structured home visits from early pregnancy until the child's second birthday by specially recruited and trained family nurses. We aimed to assess t...

  16. Medicare and Medicaid Programs; CY 2017 Home Health Prospective Payment System Rate Update; Home Health Value-Based Purchasing Model; and Home Health Quality Reporting Requirements. Final rule.

    Science.gov (United States)

    2016-11-03

    This final rule updates the Home Health Prospective Payment System (HH PPS) payment rates, including the national, standardized 60-day episode payment rates, the national per-visit rates, and the non-routine medical supply (NRS) conversion factor; effective for home health episodes of care ending on or after January 1, 2017. This rule also: Implements the last year of the 4-year phase-in of the rebasing adjustments to the HH PPS payment rates; updates the HH PPS case-mix weights using the most current, complete data available at the time of rulemaking; implements the 2nd-year of a 3-year phase-in of a reduction to the national, standardized 60-day episode payment to account for estimated case-mix growth unrelated to increases in patient acuity (that is, nominal case-mix growth) between CY 2012 and CY 2014; finalizes changes to the methodology used to calculate payments made under the HH PPS for high-cost "outlier" episodes of care; implements changes in payment for furnishing Negative Pressure Wound Therapy (NPWT) using a disposable device for patients under a home health plan of care; discusses our efforts to monitor the potential impacts of the rebasing adjustments; includes an update on subsequent research and analysis as a result of the findings from the home health study; and finalizes changes to the Home Health Value-Based Purchasing (HHVBP) Model, which was implemented on January 1, 2016; and updates to the Home Health Quality Reporting Program (HH QRP).

  17. Building a peer mentor home health aide program: implications for home health aide retention.

    Science.gov (United States)

    Kreiser, Athena Lu; Adamski, Tom; Gallagher, Bridget

    2010-09-01

    The Home Health Aide (HHA) industry is challenged with low wages, little possibility of career advancement, and high turnover rates. Jewish Home Lifecare, Home Assistance Personnel Inc. (HAPI) is a home care aide agency that has developed a Peer Mentor HHA program. Peer Mentor HHAs mentor newly hired/trained HHAs within our agency. This career path leads to higher paying work that allows for growth of our workforce for the identified growing care need and positively impacts HHA retention.

  18. Evaluating Short-Term Vocational Guidance Programs Through Site Visits

    Science.gov (United States)

    Hoeltzel, Kenneth E.

    1971-01-01

    This study has shown that counselors state that they want to make changes. If these changes will make positive differences in the quality of the program, an effort is needed by counselors, with the help of teachers, educators, and administrators, to facilitate innovation implementation. (Author)

  19. Motivation to take part in integrated care-an assessment of follow-up home visits to elderly persons.

    Science.gov (United States)

    Hjelmar, Ulf; Hendriksen, Carsten; Hansen, Kirsten

    2011-07-01

    The aim of follow-up visits by the general practitioner and district nurse (within a week after discharge from hospital) is to reduce hospital readmissions and improve the overall wellbeing of the patient. There is strong evidence that these programmes are effective, but are difficult to implement because of a number of organizational obstacles, including co-ordination between the organizations involved in the process. In this paper we look at the factors that affect motivation to participate in a cross-sectoral programme in Copenhagen, Denmark, implementing follow-up home visits to elderly persons. The analysis is based on inter-organizational network theory in an attempt to explain the role of motivation in network formation between organizational systems. The empirical findings are based on focus groups and in-depth interviews with hospital staff, general practitioners, and district nurses. Care providers are motivated to collaborate by a number of factors. The focus of collaboration needs to be clearly defined and agreed upon, there needs to be a high degree of equality between the professionals involved, and there has to be a will to co-operate based on a shared understanding of values and learning potentials. The study concludes that we need to focus on specific care fields and actors to reduce complexity in the area and more fully understand what motivates care providers to participate in cross-sectoral activities, such as a follow-up home visit programme. One lesson for current policy is that motivational factors need to be addressed in future collaborative programmes in order to fully exploit the potential health benefits.

  20. Association between underweight and hospitalization, emergency room visits, and mortality among patients in community medical homes

    Directory of Open Access Journals (Sweden)

    Takahashi PY

    2013-01-01

    Full Text Available Paul Y Takahashi.1 Jennifer L St Sauver,2 Timothy C Olson,1 Jill M Huber,1 Stephen S Cha,2 Jon O Ebbert11Division of Primary Care Internal Medicine, 2Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USABackground: In older adults, underweight (body mass index [BMI] < 18.5 has been associated with increased mortality. This increased mortality risk may be associated with increased health care utilization. We evaluated the relationship between underweight and hospitalization, emergency room visits, and mortality.Methods: An analysis of a retrospective cohort study was conducted at a multisite academic primary care medical practice in Minnesota. The patients were ≥60 years of age, impaneled within primary care on January 1, 2011, and had a BMI measurement recorded between January 1, 2011, and December 31, 2011. Individuals were excluded if they refused review of their medical record. The primary measurement was BMI, which was categorized as underweight (BMI < 18.5 or normal and obese (BMI ≥ 18.5. The outcomes were hospitalization, emergency room visits, and mortality in the 2011 calendar year. Associations between underweight and each outcome were calculated using logistic regression. Interactions between underweight and gender were assessed in the logistic regression models. The final results were adjusted for age, gender, comorbid health conditions, and single living status.Results: The final cohort included 21,019 patients, of whom 220 (1% were underweight. Underweight patients had a higher likelihood of hospitalization compared with patients with higher BMI (adjusted odds ratio [OR] 1.64; 95% confidence interval [CI] 1.21–2.22. Underweight patients were also more likely to visit the emergency room (adjusted OR 1.70; 95% CI 1.28–2.25 or to die (adjusted OR 3.64; 95% CI 2.33–5.69. Men with a BMI < 18.5 compared with those having a BMI ≥ 18.5 had the highest odds of hospitalization (OR 3.45; 95% CI 1.59–7

  1. Medicare program; Home Health Prospective Payment System rate update for calendar year 2013, hospice quality reporting requirements, and survey and enforcement requirements for home health agencies. Final rule.

    Science.gov (United States)

    2012-11-08

    This final rule updates the Home Health Prospective Payment System (HH PPS) rates, including the national standardized 60-day episode rates, the national per-visit rates, the low-utilization payment amount (LUPA), the non-routine medical supplies (NRS) conversion factor, and outlier payments under the Medicare prospective payment system for home health agencies effective January 1, 2013. This rule also establishes requirements for the Home Health and Hospice quality reporting programs. This final rule will also establish requirements for unannounced, standard and extended surveys of home health agencies (HHAs) and sets forth alternative sanctions that could be imposed instead of, or in addition to, termination of the HHA's participation in the Medicare program, which could remain in effect up to a maximum of 6 months, until an HHA achieves compliance with the HHA Conditions of Participation (CoPs) or until the HHA's provider agreement is terminated.

  2. Effect of nurse home visits vs. usual care on reducing intimate partner violence in young high-risk pregnant women: a randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Jamila Mejdoubi

    Full Text Available BACKGROUND: Expectant mothers and mothers of young children are especially vulnerable to intimate partner violence (IPV. The nurse-family partnership (NFP is a home visitation program in the United States effective for the prevention of adverse child health outcomes. Evidence regarding the effect of nurse home visiting on IPV is inconsistent. This study aims to study the effect of VoorZorg, the Dutch NFP, on IPV. METHODS: A random sample of 460 eligible disadvantaged women <26 years, with no previous live births, was randomized. Women in the control group (C; n=223 received usual care; women in the intervention group (I; n=237 received usual care plus nurse home visits periodically during pregnancy and until the child's second birthday. RESULTS: At 32 weeks of pregnancy, women in the intervention group self-reported significantly less IPV victimization than women in the control group in: level 2 psychological aggression (C: 56% vs. I: 39%, physical assault level 1 (C: 58% vs. I: 40% and level 2 (C: 31% vs. I: 20%, and level 1 sexual coercion (C: 16% vs. I: 8%. Furthermore, women in the intervention group reported significantly less IPV perpetration in: level 2 psychological aggression (C: 60% vs. I: 46%, level 1 physical assault (C: 65% vs. I: 52%, and level 1 injury (C: 27% vs. I: 17%. At 24 months after birth, IPV victimization was significantly lower in the intervention group for level 1 physical assault (C: 44% vs. I: 26%, and IPV perpetration was significantly lower for level 1 sexual assault (C: 18% vs. I: 3%. Multilevel analyses showed a significant improvement in IPV victimization and perpetration among women in the intervention group at 24 months after birth. CONCLUSION: VoorZorg, compared with the usual care, is effective in reducing IPV during pregnancy and in the two years after birth among young high-risk women. TRIAL REGISTRATION: Dutch Trial Register NTR854 http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=854.

  3. Diversion, transition programs target nursing homes' status quo.

    Science.gov (United States)

    Reinhard, Susan C

    2010-01-01

    As millions of Americans age and exercise their preference for long-term care in the least restrictive environment, policymakers search for ways to increase community-based services. A new federal program--Money Follows the Person--is off to a slow but promising start. The program's "downstream" approach moves residents out of nursing homes and into community care settings. For example, states with mature nursing home transition programs have managed to relocate 25-35 percent of their nursing home residents to assisted living. Other programs successfully using "upstream" strategies to keep people out of nursing homes have not been widely copied. The challenge for policymakers is to maintain funding and flexibility so that nursing homes are no longer the default option for older adults and people with disabilities.

  4. Motivation to take part in integrated care – an assessment of follow-up home visits to elderly persons

    DEFF Research Database (Denmark)

    Hjelmar, U; Hendriksen, Carsten; Hansen, K

    2011-01-01

    persons. Theory and methods: The analysis is based on inter-organizational network theory in an attempt to explain the role of motivation in network formation between organizational systems. The empirical findings are based on focus groups and in-depth interviews with hospital staff, general practitioners...... to implement because of a number of organizational obstacles, including co-ordination between the organizations involved in the process. In this paper we look at the factors that affect motivation to participate in a cross-sectoral programme in Copenhagen, Denmark, implementing follow-up home visits to elderly......, and district nurses. Results: Care providers are motivated to collaborate by a number of factors. The focus of collaboration needs to be clearly defined and agreed upon, there needs to be a high degree of equality between the professionals involved, and there has to be a will to co-operate based on a shared...

  5. Emancipatory practices of nurses in primary health care: the home visit as an instrument of health needs assessment

    Directory of Open Access Journals (Sweden)

    Celia Maria Sivalli Campos

    2014-08-01

    Full Text Available Objective Identify nurses’ emancipatory practices in primary care, to contribute to the improvement of health care. Method A case study type social research of qualitative nature, in which nurses of a primary health care service unit in São Paulo were interviewed. Results The home visit was identified as a nursing practice possible to be expanded in order to identify social determinants of health, triggering emancipatory practices in the service. This expansion occurred because the design of health care labour intended by the service team changed its focus from the traditional object of health services, the disease. Conclusion First, it is advocated that social policies lead projects with the purpose of improving health needs. On the other hand, the daily labour needs to provide opportunities for reflection and discussion of healthcare projects, leading workers to propose labour-processes targeted to both the social determinants of health and people’s illness.

  6. Evaluation of a statewide medical home program on children and young adults with asthma.

    Science.gov (United States)

    Hamburger, Robert; Berhane, Zekarias; Gatto, Molly; Yunghans, Suzanne; Davis, Renee K; Turchi, Renee M

    2015-01-01

    Asthma, the most common chronic condition among children, accounts for significant healthcare utilization and impact on quality of life. Care coordination in a medical home is considered standard practice, but has not been rigorously evaluated. We initiated this pilot study of children/young adults with asthma (n = 967), ages: birth to 24 years, receiving care from a subset of pediatric practices (n = 20) participating in the Pennsylvania Medical Home Initiative, Educating Practices in Community-Integrated Care (92 practices statewide). We hypothesized children and youth with asthma receiving care coordination in the context of a formal medical home program would experience favorable associations with healthcare utilization and quality of life measures. A total of 9240 care coordination encounters for this cohort of children/youth occurred over 100 days. The average length of care coordination encounter was 20.7 minutes. The most common care coordination activity was referral management (21%) and the care coordinator in the practice most often contacted parent/family and specialists (75%). Children with more severe asthma had more hospitalizations and emergency department (ED) visits than children with less severe asthma. There was a significant decrease in school absences, ED visits and acute care visits for children/youth with asthma with increasing length of time in a medical home program (p children/youth with asthma is feasible and may yield improvements in healthcare utilization, expenditures and quality of life. Larger-scale implementation of care coordination and medical home models for children/youth with asthma and other diagnoses are warranted.

  7. Bridging the gap between hospital and primary care: the pharmacist home visit.

    Science.gov (United States)

    Ensing, Hendrik T; Koster, Ellen S; Stuijt, Clementine C M; van Dooren, Ad A; Bouvy, Marcel L

    2015-06-01

    Bridging the gap between hospital and primary care is important as transition from one healthcare setting to another increases the risk on drug-related problems and consequent readmissions. To reduce those risks, pharmacist interventions during and after hospitalization have been frequently studied, albeit with variable effects. Therefore, in this manuscript we propose a three phase approach to structurally address post-discharge drug-related problems. First, hospitals need to transfer up-todate medication information to community pharmacists. Second, the key phase of this approach consists of adequate follow-up at the patients' home. Pharmacists need to apply their clinical and communication skills to identify and analyze drug-related problems. Finally, to prevent and solve identified drug related problems a close collaboration within the primary care setting between pharmacists and general practitioners is of utmost importance. It is expected that such an approach results in improved quality of care and improved patient safety.

  8. Community-Service Activities Versus Traditional Activities in an Intergenerational Visiting Program

    Science.gov (United States)

    Marx, Marcia S.; Hubbard, Pamela; Cohen-Mansfield, Jiska; Dakheel-Ali, Maha; Thein, Khin

    2005-01-01

    The impact of traditional activities (e.g., playing board games) were compared with community-service activities (e.g., making first aid kits for a homeless shelter) during a monthly intergenerational visiting program. The participating seniors (n =19) gave high ratings to both types of activities. However, they felt that they had helped others…

  9. Team Visitation Guidelines. Wisconsin Department of Public Instruction Secondary Vocational Program Evaluation Project.

    Science.gov (United States)

    Klitzke, Elizabeth; And Others

    The guidelines contained in this manual were written to outline the role of the visiting team members and the team leader and to familiarize the team with the details necessary to conduct a comprehensive external evaluation of Wisconsin secondary vocational programs. The responsibilities of school personnel are also spelled out so that team…

  10. Development of the Intervention Materials for the HomeStyles Obesity Prevention Program for Parents of Preschoolers

    Directory of Open Access Journals (Sweden)

    Jennifer Martin-Biggers

    2015-08-01

    Full Text Available Home environment is key to the development of obesity-preventing behaviors during childhood, yet few resources help preschool parents address factors at home associated with obesity risk. This paper describes creation of materials for an in-home intervention (HomeStyles with this population. An advisory group of stakeholders and target audience members determined salient factors affecting childhood obesity to address in-home and developed program materials. The Social Cognitive Theory, Faith’s Core Behavior Change Strategies to Treat Childhood Obesity, Adult Learning Theory and motivational interviewing techniques guided development of 12 guides targeting strategies parents can use to shape the home environment. Interviews were conducted to determine effectiveness of the guides. Cognitive testing of guide design (n = 251 and content (n = 261 occurred in English and Spanish in New Jersey and Arizona with parents and home visitation staff who would present the guides. Interviews investigated perceptions of content usefulness and parent comprehension. Findings were also examined in light of theoretical underpinnings. Both home visitation staff and parents felt the guides were very readable and useful. Parents appreciated use of motivational interviewing techniques and Adult Learning Theory. Current research is testing these guides through an in-home, randomized control trial.

  11. Measurement of special access to home visit nursing services among Japanese disabled elderly people: using GIS and claim data.

    Science.gov (United States)

    Naruse, Takashi; Matsumoto, Hiroshige; Fujisaki-Sakai, Mahiro; Nagata, Satoko

    2017-05-30

    Home care service demands are increasing in Japan; this necessitates improved service allocation. This study examined the relationship between home visit nursing (HVN) service use and the proportion of elderly people living within 10 min' travel of HVN agencies. The population of elderly people living within reach of HVN agencies for each of 17 municipalities in one low-density prefecture was calculated using public data and geographic information systems. Multilevel logistic analysis for 2641 elderly people was conducted using medical and long-term care insurance claims data from October 2010 to examine the association between the proportion of elderly people reachable by HVNs and service usage in 13 municipalities. Municipality variables included HVN agency allocation appropriateness. Individual variables included HVN usage and demographic variables. The reachable proportion of the elderly population ranged from 0.0 to 90.2% in the examined municipalities. The reachable proportion of the elderly population was significantly positively correlated with HVN use (odds ratio: 1.938; confidence interval: 1.265-2.967). Residents living in municipalities with a lower reachable proportion of the elderly population are less likely to use HVN services. Public health interventions should increase the reachable proportion of the elderly population in order to improve HVN service use.

  12. Visiting Nurse Service of New York celebrates multiculturalism.

    Science.gov (United States)

    Kolatch, A; Brandvold, M C

    1997-10-01

    Home health providers must develop culturally sensitive and specific programs for many populations. This article outlines the steps agencies and practitioners can take to design these programs. Examples of two specialty programs developed by the Visiting Nurse Service of New York, one focusing on the Jewish and Russian Jewish community and the other on the Asian Home Care Program, provide insight into the importance of a comprehensive approach to all cultural home care programs.

  13. DNA sequence handling programs in BASIC for home computers.

    OpenAIRE

    Biro, P A

    1984-01-01

    This paper describes a DNA sequence handling program written entirely in BASIC and designed to be run on an Atari home computer. Many of the features common to more sophisticated programs have been included. The advantage of this program are its convenience, its transportability and its potential for user modification. The disadvantages are lack of sophistication and speed.

  14. A Post-Hospital Nursing Home Rehabilitation Program.

    Science.gov (United States)

    Petchers, Marcia K.; And Others

    1987-01-01

    Describes program of short-term rehabilitation care provided to elderly patients through collaboration between hospital and nursing home. Discusses program planning and implementation experiences, patient satisfaction, and rehabilitation outcomes. Notes that program, although successful, was discontinued due to financial and interorganizational…

  15. Nurse home visits with or without alert buttons versus usual care in the frail elderly: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Favela J

    2013-01-01

    Full Text Available Jesús Favela,1 Luis A Castro,2 Francisco Franco-Marina,3 Sergio Sánchez-García,4 Teresa Juárez-Cedillo,4 Claudia Espinel Bermudez,4 Julia Mora-Altamirano,4 Marcela D Rodriguez,5 Carmen García-Peña41Center for Scientific Research and Higher Education of Ensenada, Ensenada, Baja California, Mexico; 2Sonora Institute of Technology, Ciudad Obregon, Mexico; 3National Institute of Respiratory Diseases, Mexican Ministry of Health, Mexico City, Mexico; 4Epidemiologic and Health Service Research Unit, Aging Area, XXI Century National Medical Center, Mexican Institute of Social Security, Mexico City, Mexico; 5School of Engineering, MyDCI, Autonomous University of Baja California, Mexicali, MexicoObjective: To assess whether an intervention based on nurse home visits including alert buttons (NV+AB is effective in reducing frailty compared to nurse home visits alone (NV-only and usual care (control group for older adults.Design: Unblinded, randomized, controlled trial.Setting: Insured population covered by the Mexican Social Security Institute living in the city of Ensenada, Baja California, Mexico.Participants: Patients were aged over 60 years with a frailty index score higher than 0.14.Intervention: After screening and informed consent, participants were allocated randomly to the control, NV+AB, or NV-only groups.Measurements: The primary outcome was the frailty score 9 months later. Quality of life, depression, comorbidities, health status, and health service utilization were also considered.Results: The framing sample included 819 patients. Of those, 591 were not located because they did not have a landline/telephone (341 patients, they had died (107, they were ill (50, or they were not currently living in the city (28. A screening interview was applied to 228 participants, and 57 had a score ≤0.14, 171 had ≥0.14, and 16 refused to complete the baseline questionnaire. A home visit was scheduled for 155 patients. However, 22 did not complete

  16. Feasibility of a nurse-led in-home cognitive behavioral program to manage concerns about falls in frail older people: a process evaluation.

    Science.gov (United States)

    Dorresteijn, Tanja A C; Rixt Zijlstra, G A; Van Haastregt, Jolanda C M; Vlaeyen, Johan W S; Kempen, Gertrudis I J M

    2013-06-01

    Concerns about falls and related avoidance of activities are common problems among older people living in the community. In this study we examined the feasibility and acceptability of AMB-Home (the Dutch in-home version of A Matter of Balance), a nurse-led in-home cognitive behavioral program developed for frail community-living older people with concerns about falls and related activity avoidance. The multicomponent program consisted of seven individual sessions, including three home visits and four telephone contacts. Data were collected from eight nurses and 194 participants. Generally, the program was considered acceptable and feasible by both the nurses and the participants. When AMB-Home turns out to be effective, the implementation of a fine-tuned version of this in-home program in regular health care, would be a natural next step. Copyright © 2013 Wiley Periodicals, Inc.

  17. Medicare and Medicaid Programs; CY 2016 Home Health Prospective Payment System Rate Update; Home Health Value-Based Purchasing Model; and Home Health Quality Reporting Requirements. Final rule.

    Science.gov (United States)

    2015-11-01

    This final rule will update Home Health Prospective Payment System (HH PPS) rates, including the national, standardized 60-day episode payment rates, the national per-visit rates, and the non-routine medical supply (NRS) conversion factor under the Medicare prospective payment system for home health agencies (HHAs), effective for episodes ending on or after January 1, 2016. As required by the Affordable Care Act, this rule implements the 3rd year of the 4-year phase-in of the rebasing adjustments to the HH PPS payment rates. This rule updates the HH PPS case-mix weights using the most current, complete data available at the time of rulemaking and provides a clarification regarding the use of the "initial encounter'' seventh character applicable to certain ICD-10-CM code categories. This final rule will also finalize reductions to the national, standardized 60-day episode payment rate in CY 2016, CY 2017, and CY 2018 of 0.97 percent in each year to account for estimated case-mix growth unrelated to increases in patient acuity (nominal case-mix growth) between CY 2012 and CY 2014. In addition, this rule implements a HH value-based purchasing (HHVBP) model, beginning January 1, 2016, in which all Medicare-certified HHAs in selected states will be required to participate. Finally, this rule finalizes minor changes to the home health quality reporting program and minor technical regulations text changes.

  18. Occupational therapists' views on using a virtual reality interior design application within the pre-discharge home visit process.

    Science.gov (United States)

    Atwal, Anita; Money, Arthur; Harvey, Michele

    2014-12-18

    A key role of Occupational Therapists (OTs) is to carry out pre-discharge home visits (PHV) and propose appropriate adaptations to the home environment in order to enable patients to function independently after hospital discharge. However, research shows that more than 50% of specialist equipment installed as part of home adaptations is not used by patients. A key reason for this is that decisions about home adaptations are often made without adequate collaboration and consultation with the patient. Consequently, there is an urgent need to seek out new and innovative uses of technology to facilitate patient/practitioner collaboration, engagement, and shared decision making in the PHV process. Virtual reality interior design applications (VRIDAs) primarily allow users to simulate the home environment and visualize changes prior to implementing them. Customized VRIDAs, which also model specialist occupational therapy equipment, could become a valuable tool to facilitate improved patient/practitioner collaboration, if developed effectively and integrated into the PHV process. The intent of the study was to explore the perceptions of OTs with regard to using VRIDAs as an assistive tool within the PHV process. Task-oriented interactive usability sessions, utilizing the think-aloud protocol and subsequent semi-structured interviews were carried out with seven OTs who possessed significant experience across a range of clinical settings. Template analysis was carried out on the think-aloud and interview data. Analysis was both inductive and driven by theory, centering around the parameters that impact upon the acceptance, adoption, and use of this technology in practice as indicated by the Technology Acceptance Model (TAM). OTs' perceptions were identified relating to three core themes: (1) perceived usefulness (PU), (2) perceived ease of use (PEoU), and (3) actual use (AU). Regarding PU, OTs believed VRIDAs had promising potential to increase understanding, enrich

  19. Occupational Therapists’ Views on Using a Virtual Reality Interior Design Application Within the Pre-Discharge Home Visit Process

    Science.gov (United States)

    Atwal, Anita

    2014-01-01

    Background A key role of Occupational Therapists (OTs) is to carry out pre-discharge home visits (PHV) and propose appropriate adaptations to the home environment in order to enable patients to function independently after hospital discharge. However, research shows that more than 50% of specialist equipment installed as part of home adaptations is not used by patients. A key reason for this is that decisions about home adaptations are often made without adequate collaboration and consultation with the patient. Consequently, there is an urgent need to seek out new and innovative uses of technology to facilitate patient/practitioner collaboration, engagement, and shared decision making in the PHV process. Virtual reality interior design applications (VRIDAs) primarily allow users to simulate the home environment and visualize changes prior to implementing them. Customized VRIDAs, which also model specialist occupational therapy equipment, could become a valuable tool to facilitate improved patient/practitioner collaboration, if developed effectively and integrated into the PHV process. Objective The intent of the study was to explore the perceptions of OTs with regard to using VRIDAs as an assistive tool within the PHV process. Methods Task-oriented interactive usability sessions, utilizing the think-aloud protocol and subsequent semi-structured interviews were carried out with seven OTs who possessed significant experience across a range of clinical settings. Template analysis was carried out on the think-aloud and interview data. Analysis was both inductive and driven by theory, centering around the parameters that impact upon the acceptance, adoption, and use of this technology in practice as indicated by the Technology Acceptance Model (TAM). Results OTs’ perceptions were identified relating to three core themes: (1) perceived usefulness (PU), (2) perceived ease of use (PEoU), and (3) actual use (AU). Regarding PU, OTs believed VRIDAs had promising potential

  20. Home-Based Programs: Nightmare or Dream of the Future.

    Science.gov (United States)

    Levenstein, Phyllis

    This essay discusses methodological and ethical problems in the implementation and evaluation of home-based intervention programs for young children and their families. Part I notes the difficulties in (1) selecting an appropriate research design to evaluate a program (e.g., preventing sample bias), (2) specifying precisely the intervention method…

  1. Analysis of team types based on collaborative relationships among doctors, home-visiting nurses and care managers for effective support of patients in end-of-life home care.

    Science.gov (United States)

    Fujita, Junko; Fukui, Sakiko; Ikezaki, Sumie; Otoguro, Chizuru; Tsujimura, Mayuko

    2017-02-21

    To define the team types consisting of doctors, home-visiting nurses and care managers for end-of-life care by measuring the collaboration relationship, and to identify the factors related to the team types. A questionnaire survey of 43 teams including doctors, home-visiting nurses and care managers was carried out. The team types were classified based on mutual evaluations of the collaborative relationships among the professionals. To clarify the factors between team types with the patient characteristics, team characteristics and collaboration competency, univariate analysis was carried out with the Fisher's exact test or one-way analysis and multiple comparison analysis. Three team types were classified: the team where the collaborative relationships among all healthcare professionals were good; the team where the collaborative relationships between the doctors and care managers were poor; and the team where the collaborative relationships among all of the professionals were poor. There was a statistically significant association between the team types and the following variables: patient's dementia level, communication tool, professionals' experience of working with other team members, home-visiting nurses' experience of caring for dying patients, care managers' background qualifications, doctor's face-to-face cooperation with other members and home-visiting nurses' collaborative practice. It is suggested that a collaborative relationship would be fostered by more experience of working together, using communication tools and enhancing each professional's collaboration competency. Geriatr Gerontol Int 2017; ••: ••-••. © 2017 Japan Geriatrics Society.

  2. Teacher Home Visits

    Science.gov (United States)

    Kronholz, June

    2016-01-01

    Volumes of research suggest that one key to a child's academic success is having "engaged" parents, but parents know that, to teachers, engagement means a fairly circumscribed round of activities--back-to-school nights, parent-teacher conferences, potlucks, and interactive homework. Making the connection between schools and families is…

  3. Effect of the delegation of GP-home visits on the development of the number of patients in an ambulatory healthcare centre in Germany

    Directory of Open Access Journals (Sweden)

    van den Berg Neeltje

    2012-10-01

    Full Text Available Abstract Background The AGnES-concept (AGnES: GP-supporting, community-based, e-health-assisted, systemic intervention was developed to support general practitioners (GPs in undersupplied regions. The project aims to delegate GP-home visits to qualified AGnES-practice assistants, to increase the number of patients for whom medical care can be provided. This paper focuses on the effect of delegating GP-home visits on the total number of patients treated. First, the theoretical number of additional patients treated by delegating home visits to AGnES-practice assistants was calculated. Second, actual changes in the number of patients in participating GP-practices were analyzed. Methods The calculation of the theoretical increase in the number of patients was based on project data, data which were provided by the Association of Statutory Health Insurance Physicians, or which came from the literature. Setting of the project was an ambulatory healthcare centre in the rural county Oberspreewald-Lausitz in the Federal State of Brandenburg, which employed six GPs, four of which participated in the AGnES project. The analysis of changes in the number of patients in the participating GP-practices was based on the practices’ reimbursement data. Results The calculated mean capacity of AGnES-practice assistants was 1376.5 home visits/year. GPs perform on average 1200 home visits/year. Since home visits with an urgent medical reason cannot be delegated, we included only half the capacity of the AGnES-practice assistants in the analysis (corresponding to a 20 hour-work week. Considering all parameters in the calculation model, 360.1 GP-working hours/year can be saved. These GP-hours could be used to treat 170 additional patients/quarter year. In the four participating GP-practices the number of patients increased on average by 133 patients/quarter year during the project period, which corresponds to 78% of the theoretically possible number of patients

  4. Follow-up home visits with registered dietitians have a positive effect on the functional and nutritional status of geriatric medical patients after discharge

    DEFF Research Database (Denmark)

    Beck, Anne Marie; Kjær, Stine; Hansen, Birthe Stenbæk

    2013-01-01

    , rehabilitation capacity), nutritional status (weight, BMI, energy and protein intake), need of social services (home care, home nursing, meals-on-wheels) and mortality.Results:One hundred and fifty-two patients were included; 132 (87%) completed the first and 124 (82%) the second data collection after 12 weeks......Objective:To assess the additional benefits of individualized nutritional counselling by a registered dietitian in geriatric patients' home after discharge from hospital, in relation to risk of re-admissions, functional status, nutritional status, use of social services and mortality.......Design:Twelve-week single-blind randomized controlled study.Setting and subjects:Geriatric medical patients (65+ years) at nutritional risk.Interventions:Participants were randomly allocated to receive a visit in their homes, either three individualized nutritional counselling by a registered dietitian complemented...

  5. Behavioral Responses of Nursing Home Residents to Visits From a Person with a Dog,a Robot Seal or a Toy Cat

    DEFF Research Database (Denmark)

    Thodberg, Karen; Sørensen, Lisbeth U; Videbech, Poul B

    2016-01-01

    participant received a total of 12 visits, during which their behaviors, including interactions between the visitor and the accom- panying animal (real or artificial), were recorded. Also, data on cognitive im- pairment, presence of depressive symptoms, age, time lived in the nursing home, dementia diagnoses......, and gender were collected. We found that the immediate responses to, and interaction with, the visiting animal depended on the type of animal that was brought along. The dog and the interactive robot seal triggered the most interaction, in the form of physical contact (F(2,103) = 7.50, p ... contact (F(4,151) = 6.26, p animal and less toward humans...

  6. Feasibility of integrating the "Healthy moves for aging well" program into home care aide services for frail older adults.

    Science.gov (United States)

    Park, Chae-Hee; Chodzko-Zajko, Wojtek

    2014-06-01

    The purpose of the study was to assess the feasibility of implementing simple, safe, non-equipment evidence-based movements (Healthy Moves for Aging Well program) using an affordable and sustainable homecare-aide based delivery model that reaches the maximum possible number of frail older adults living at home in Illinois. Two local agencies were asked to identify two experienced home care aides and two inexperienced home care aides (n= 8). Each home care aides delivered the Healthy Moves to four clients (n= 16). Eight home care aides visited the client in the home and were asked to deliver the Healthy Moves program on a regular basis for a four-month time period. Outcome measures included a pre-and post- survey, a functional fitness test (older adults), and interviews. Evaluation procedures focused on older adult participants, homecare aids, and sites. The results showed that both interview and survey data revealed that most participants including older adults, home care aides, and site directors had a positive perception and high satisfaction with the program. Specially, 100% of older adult participants reported that they would recommend the program to others. Additionally, seniors and home care aides reported that they enjoyed working with each other on the program and both site directors reported that dissemination of the program in the State of Illinois employing home care aides was feasible and acceptable. Our study results indicate that Healthy Moves for Aging Well could be safely and successfully be disseminated to frail older adults in the State of Illinois.

  7. 论班主任家访的定位与有效家访的策略%On the Positioning and Effective Strategies of Teachers' Home Visits

    Institute of Scientific and Technical Information of China (English)

    洪伟

    2011-01-01

    Effective teachers' home visits can connect emotionally and spiritually with students and their parents,and in this process, teachers and parents can reach a consensus in teaching children so as to guide students to grow up healthily according to their characteristics. In this paper, the writer discusses the positioning and effective strategies of teachers' home visits combining with the actual class management of middle school.%班主任的有效家访可以与学生和家长架起感情联系与心灵沟通的桥梁,与家长在教育孩子方面达成共识,引导学生根据自己的特点健康成长。本文结合中学班级管理工作的实际,阐述家访的定位及有效家访的策略。

  8. Review of evaluations of utility home-energy-audit programs

    Science.gov (United States)

    Berry, L.; Soderstrom, J.; Hirst, E.; Newman, B.; Weaver, R.

    1981-03-01

    Evaluation efforts of utilities with active home energy audit programs are reviewed to suggest methodologies, issues, and data that can contribute to the development of a comprehensive Residential Conservation Service evaluation plan. On the basis mainly of written reports received from the utilities, findings about customer response to programs are summarized. The topics discussed include: correlates of program penetration rates; use of financing; attitudes toward programs; actions taken; characteristics of participants; and energy savings due to programs. Particular attention is given to three studies (Tennessee Valley Authority, Seattle City Light, and Pacific Gas and Electric) that analyze fuel consumption records as part of the evaluation.

  9. Accounting Programs' Home Pages: What's Happening.

    Science.gov (United States)

    Peek, Lucia E.; Roxas, Maria L.

    2002-01-01

    Content analysis of 62 accounting programs' websites indicated the following: 53% include mission statements; 62.9% list accreditation; many faculty biographies and personal pages used inconsistent formats; provision of information on financial aid, student organizations, career services, and certified public accountant requirements varied. Many…

  10. [Home ventilation of pediatric patients - description of a program

    Science.gov (United States)

    Resener, T D; Martinez, F E; Reiter, K; Nicolai, T

    2001-01-01

    OBJECTIVE: To describe a German program for home ventilatory support, and to analyze the possibility of applying it in Brazil. MATERIALS AND METHODS: We assessed Dr. von Haunersches Kinderklinikacute;s Pediatric Intensive Care Unity - Ludwig-Maximilians - Universität - München (Munich, Germany) home ventilatory support program between April 1997 and June 1998. RESULTS: Patients aged between 1 and 21 years - 11 boys and 15 girls - participated in the study. Fifteen out of 26 children presented neuromuscular pathologies, 8 of them had ventilatory problems of central causes, and 3 children presented obstructive pulmonary diseases. Twelve (46.2%) were receiving noninvasive ventilatory assistance, and 19 (73.1%) only needed intermittent ventilatory support. CONCLUSION: The program relies on a permanent multidisciplinary staff to treat intercurrent diseases. Patients, at predetermined periods, are re-evaluated as to the evolution of respiratory insufficiency. The adequate system organization provides patients and their families with security, and accounts for the success of the home ventilatory support program. A great deal of organizational efforts should be consolidated before implementing similar programs in Brazil.

  11. The effect of homecare team visits in terminal cancer patients: Role of health teams reaching patients homes

    Directory of Open Access Journals (Sweden)

    Pratik Banerjee

    2009-01-01

    Conclusion: The eagerness of patients wanting the teams to reach their residence may be judged by the given figures. The total number of patients visited by the homecare teams of Cansupport in the year 2008-2009 was 1025. Out of them, there were about 104 patients who were discharged. The term discharge means that the patients were not interested in our visit or were not available in our subsequent visit. It has to be mentioned here that the service is a definite demand by society provided that the cost may be catered too.

  12. Evaluation of patients with stroke monitored by home care programs

    Directory of Open Access Journals (Sweden)

    Ana Railka de Souza Oliveira

    Full Text Available The purpose of this study was to evaluate the patient with a stroke in home treatment, investigating physical capacity, mental status and anthropometric analysis. This was a cross-sectional study conducted in Fortaleza/CE, from January to April of 2010. Sixty-one individuals monitored by a home care program of three tertiary hospitals were investigated, through interviews and the application of scales. The majority of individuals encountered were female (59%, elderly, bedridden, with a low educational level, a history of other stroke, a high degree of dependence for basic (73.8% and instrumental (80.3 % activities of daily living, and a low cognitive level (95.1%. Individuals also presented with tracheostomy, gastric feeding and urinary catheter, difficulty hearing, speaking, chewing, swallowing, and those making daily use of various medications. It was concluded that home care by nurses is an alternative for care of those individuals with a stroke.

  13. Evaluation of patients with stroke monitored by home care programs

    Directory of Open Access Journals (Sweden)

    Ana Railka de Souza Oliveira

    2013-10-01

    Full Text Available The purpose of this study was to evaluate the patient with a stroke in home treatment, investigating physical capacity, mental status and anthropometric analysis. This was a cross-sectional study conducted in Fortaleza/CE, from January to April of 2010. Sixty-one individuals monitored by a home care program of three tertiary hospitals were investigated, through interviews and the application of scales. The majority of individuals encountered were female (59%, elderly, bedridden, with a low educational level, a history of other stroke, a high degree of dependence for basic (73.8% and instrumental (80.3 % activities of daily living, and a low cognitive level (95.1%. Individuals also presented with tracheostomy, gastric feeding and urinary catheter, difficulty hearing, speaking, chewing, swallowing, and those making daily use of various medications. It was concluded that home care by nurses is an alternative for care of those individuals with a stroke.

  14. What students experienced: a narrative analysis of essays written by first-year medical students participating in a geriatrics home visit.

    Science.gov (United States)

    O'Donnell, Linsey; Carson, Lesley; Forciea, Mary Ann; Kinosian, Bruce; Shea, Judy; Yudin, Jean; Miller, Rachel K

    2013-09-01

    To develop a house call experience for first-year medical students introducing them to challenges that homebound, chronically ill elderly adults face. During the semester, two students were paired with a preceptor to see two to three patients. The house call practices of the Division of Geriatric Medicine at the University of Pennsylvania and the Philadelphia Veterans Affairs Hospital. One hundred sixty-five first-year medical students. Pairs of students worked together to write an essay after the visit. Essays addressed specific areas, as detailed in a provided checklist, including noting patients' functional limitations, identifying community supports available to patients, and writing about general surprises that the students discovered during their visit. These data were then measured using narrative analysis. In all domains, students identified core goals and objectives. In the first domain (meeting challenges of functional limitations), students recognized the importance of family support. In the second domain (mentioning of functional limitation), high levels of compliance were seen. In the third domain (community support), students mentioned specific formal supports. In the fourth domain (surprises during the visit), students identified many important geriatrics concepts. In writing their essays, students demonstrated a high level of recognition of functional impairment and noted the importance of family, social networks, and home environment in enabling homebound, chronically ill elderly adults to stay in their homes. Many students also demonstrated an awareness of the possibilities of independence and happiness despite significant illness and disability. © 2013, Copyright the Authors Journal compilation © 2013, The American Geriatrics Society.

  15. Virtual Visit to the ATLAS Control Room by QuarkNet program in Portland

    CERN Multimedia

    2013-01-01

    The LHC fellows of the U.S. QuarkNet program will hold a workshop "Real LHC Data for the Classroom" for teachers using elements of the ATLAS masterclass on July 13, 2013. The workshop is part of the Summer 2013 Meeting of the American Association of Physics Teachers. In the workshop, teachers are introduced to particle physics, the ATLAS experiment, and ways to use actual data from the Large Hadron Collider at CERN to help their students understand fundamental physics. One of the highlights of this one-day workshop is an ATLAS Virtual Visit, in which the teachers connect by videoconference with the ATLAS control room. In the videoconferecne, the participants will be able to to ask questions of and have discussions with an ATLAS physicist.

  16. Cost of physician-led home visit care (Zaitaku care) compared with hospital care at the end of life in Japan.

    Science.gov (United States)

    Kinjo, Kentaro; Sairenji, Tomoko; Koga, Hidenobu; Osugi, Yasuhiro; Yoshida, Shin; Ichinose, Hidefumi; Nagai, Yasunori; Imura, Hiroshi; South-Paul, Jeannette E; Meyer, Mark; Honda, Yoshihisa

    2017-01-17

    Physician-led home visit care with medical teams (Zaitaku care) has been developed on a national scale to support those who wish to stay at home at the end of life, and promote a system of community-based integrated care in Japan. Medical care at the end of life can be expensive, and is an urgent socioeconomic issue for aging societies. However medical costs of physician-led home visits care have not been well studied. We compared the medical costs of Zaitaku care and hospital care at the end of life in a rapidly aging community in a rural area in Japan. A cross-sectional study was performed to compare the total medical costs during patients' final days of life (30 days or less) between Zaitaku care and hospital care from September 2012 to August 2013 in Fukuoka Prefecture, Japan. Thirty four patients died at home under Zaitaku care, and 72 patients died in the hospital during this period. The average daily cost of care during the last 30 days did not differ significantly between the two groups. Although Zaitaku care costs were higher than hospital care costs in the short-term (≦10 days, Zaitaku care $371.2 vs. Hospital care $202.0, p = 0.492), medical costs for Zaitaku care in the long-term care (≧30 days) were less than that of hospital care ($155.8 vs. $187.4, p = 0.055). Medical costs of Zaitaku care were less compared with hospital care if incorporated early for long term care, but it was high if incorporated late for short term care. For long term care, medical costs for Zaitaku care was 16.7% less than for hospitalization at the end of life. This physician-led home visit care model should be an available option for patients who wish to die at home, and may be beneficial financially over time.

  17. A Programming Language Approach to Safety in Home Networks

    DEFF Research Database (Denmark)

    Mortensen, Kjeld Høyer; Schougaard, Kari Rye; Schultz, Ulrik Pagh

    , even in a worst-case scenario where an unauthorized user gains remote control of the facilities. We address this safety issue at the programming language level by restricting the operations that can be performed on devices according to the physical location of the user initiating the request......-based restrictions on operations. This model has been implemented in a middleware for home AV devices written in Java, using infrared communication and a FireWire network to implement location awareness....

  18. A Programming Language Approach to Safety in Home Networks

    DEFF Research Database (Denmark)

    Mortensen, Kjeld Høyer; Schougaard, Kari Sofie Fogh; Schultz, Ulrik Pagh

    2003-01-01

    , even in a worst-case scenario where an unauthorized user gains remote control of the facilities. We address this safety issue at the programming language level by restricting the operations that can be performed on devices according to the physical location of the user initiating the request......-based restrictions on operations. This model has been implemented in a middleware for home AV devices written in Java, using infrared communication and a FireWire network to implement location awareness....

  19. An open trial in the NHS of Blues Begone: a new home based computerized CBT program.

    Science.gov (United States)

    Purves, David G; Bennett, Mary; Wellman, Nigel

    2009-10-01

    Computer based treatment for depression and anxiety has been available for several years and has demonstrated useful clinical effects. Most existing computerized CBT products in the UK that are designed to treat depression and co-morbid anxiety require patients to visit a clinic and require staff input to manage the process. Such intervention adds to the costs and bottlenecks in delivering a clinically effective treatment with mass availability. Internet treatment options are becoming more readily available, although data to support use are not yet strong, and most still require human assessment and telephone support. Blues Begone is a new computerized CBT program that has been designed to be used at home with minimal human support. This pilot project provides data from an open trial of Blues Begone with both primary and secondary care patients. One hundred patients started Blues Begone, 58 completed the program, 72% (n = 42) of completers achieved reliable change and (n = 36) 62% achieved both reliable and clinically significant change, and may be considered to have recovered by the end of the program. These data provide the first demonstration of the potential viability of Blues Begone as a home based computerized treatment for depression and anxiety.

  20. 75 FR 39641 - Medicare and Medicaid Programs; Civil Money Penalties for Nursing Homes

    Science.gov (United States)

    2010-07-12

    ... and Medicaid Programs; Civil Money Penalties for Nursing Homes AGENCY: Centers for Medicare & Medicaid... when nursing homes are not in compliance with Federal participation requirements in accordance with the... requirements for these facilities, generally referred to as ``nursing home(s),'' ``facility'' or ``facilities...

  1. Nursing Home Checklist

    Science.gov (United States)

    ... nursing home: ____________________________________________________ Address: ________________________________________________________________ Phone number: __________________________________________________________ Date of visit: _____________________________________________________________ Basic information Yes No Notes Is the nursing home Medicare certified? Is the nursing home Medicaid ...

  2. Effect of a home intervention program on pediatric asthma in an environmental justice community.

    Science.gov (United States)

    Shani, Zalika; Scott, Richard G; Schofield, Lynne Steuerle; Johnson, John H; Williams, Ellen R; Hampton, Janiene; Ramprasad, Vatsala

    2015-03-01

    Asthma prevalence rates are at an all-time high in the United States with over 25 million persons diagnosed with asthma. African Americans and other minorities have higher asthma prevalence and higher exposure to environmental factors that worsen asthma as compared to Caucasians. This article describes the evaluation of an inner-city home-based asthma education and environmental remediation program that addressed both indoor and outdoor triggers through collaboration between a health system and local environmental justice organization. The program enrolled 132 children older than 2.5 years and centers on a 4- to 6-week intervention with peer counselors using the U.S. Environmental Protection Agency Asthma Home Environment Checklist and the You Can Control Asthma curriculum. Families receive asthma-friendly environmental home kits. Peer counselors reinforce key asthma management messages and facilitate the completion of Asthma Action Plans. The environmental justice community partner organized block cleanups to reduce outdoor triggers. The evaluation used a pretest-posttest design to assess changes in client behavior and asthma symptoms. Data were collected at baseline and during a 6-month postintervention period. Participants saw enhanced conditions on asthma severity and control. The improvement was greatest for children whose asthma was considered "severe" based on the validated Asthma Control Test. Other positive results include the following: greater completion of Asthma Action Plans, significant reduction in the number of emergency room visits (p = .006), and substantial decreases in school absenteeism (p = .008) and use of rescue medications (p = .049). The evaluation suggests that the program was effective in improving asthma self-management in a high-risk population living within an environmental justice community.

  3. Nurse-led home visitation programme to improve health-related quality of life and reduce disability among potentially frail community-dwelling older people in general practice: a theory-based process evaluation.

    Science.gov (United States)

    Stijnen, Mandy M N; Jansen, Maria W J; Duimel-Peeters, Inge G P; Vrijhoef, Hubertus J M

    2014-10-25

    Population ageing fosters new models of care delivery for older people that are increasingly integrated into existing care systems. In the Netherlands, a primary-care based preventive home visitation programme has been developed for potentially frail community-dwelling older people (aged ≥75 years), consisting of a comprehensive geriatric assessment during a home visit by a practice nurse followed by targeted interdisciplinary care and follow-up over time. A theory-based process evaluation was designed to examine (1) the extent to which the home visitation programme was implemented as planned and (2) the extent to which general practices successfully redesigned their care delivery. Using a mixed-methods approach, the focus was on fidelity (quality of implementation), dose delivered (completeness), dose received (exposure and satisfaction), reach (participation rate), recruitment, and context. Twenty-four general practices participated, of which 13 implemented the home visitation programme and 11 delivered usual care to older people. Data collection consisted of semi-structured interviews with practice nurses (PNs), general practitioners (GPs), and older people; feedback meetings with PNs; structured registration forms filled-out by PNs; and narrative descriptions of the recruitment procedures and registration of inclusion and drop-outs by members of the research team. Fidelity of implementation was acceptable, but time constraints and inadequate reach (i.e., the relatively healthy older people participated) negatively influenced complete delivery of protocol elements, such as interdisciplinary cooperation and follow-up of older people over time. The home visitation programme was judged positively by PNs, GPs, and older people. Useful tools were offered to general practices for organising proactive geriatric care. The home visitation programme did not have major shortcomings in itself, but the delivery offered room for improvement. General practices received

  4. 76 FR 15105 - Medicare and Medicaid Programs; Civil Money Penalties for Nursing Homes

    Science.gov (United States)

    2011-03-18

    ... Services 42 CFR Part 488 Medicare and Medicaid Programs; Civil Money Penalties for Nursing Homes; Final... and Medicaid Programs; Civil Money Penalties for Nursing Homes AGENCY: Centers for Medicare & Medicaid... nursing homes are not in compliance with Federal participation requirements in accordance with...

  5. Transforming Teacher-Family Relationships: Shifting Roles and Perceptions of Home Visits through the Funds of Knowledge Approach

    Science.gov (United States)

    Whyte, Kristin Lyn; Karabon, Anne

    2016-01-01

    Education has embraced the idea of an "asset approach" to working with families and children, creating a focus on developing collaborative relationships with families by building on what they bring to the table. In this paper we explore what happened when early childhood teachers entered homes to learn from families and identify their…

  6. Evaluation of the Monongalia County Schools Even Start Program Child Vocabulary Outcomes.

    Science.gov (United States)

    Meehan, Merrill L.

    The Monongalia County (West Virginia) Even Start Program is a comprehensive, rural, home-based family literacy program that provides families with adult literacy education, parenting education, and early childhood education. Although all Even Start programs conduct some home visits, the Monongalia County program is unique in that home visits are…

  7. Going to Bed with Captain Marvel and a Flashlight Is Not a Home Reading Program

    Science.gov (United States)

    Greenfeld, Stuart

    1971-01-01

    Described is a home reading program for educationally disadvantaged elementary school children who need motivation to read at home. Principles of behavior change and parent role are the major motivation factors used in developing the children's reading ability. (CB)

  8. Wyandotte Neighborhood Stabilization Program: Retrofit of Two Homes

    Energy Technology Data Exchange (ETDEWEB)

    Lukachko, A.; Grin, A.; Bergey, D.

    2013-04-01

    The Wyandotte NSP2 project aims to build 20 new houses and retrofit 20 existing houses in Wyandotte, MI. This report will detail the retrofit of 2 existing houses in the program. Wyandotte is part of a Michigan State Housing Development Authority-led consortium that is funded by HUD under the NSP2 program. The City of Wyandotte has also been awarded DOE EE&CBG funds that are being used to develop a district GSHP system to service the project. This draft report examines the energy efficiency recommendations for retrofit construction at these homes. The report will be of interest to anyone planning an affordable, high performance retrofit of an existing home in a Cold Climate zone. Information from this report will also be useful to retrofit or weatherization program staff as some of the proposed retrofit solutions will apply to a wide range of projects. Preliminary results from the first complete house suggest that the technology package employed (which includes spray foam insulation and insulating sheathing) does meet the specific whole house water, air, and thermal control requirements, as well as, the project's affordability goals. Monitoring of the GSHP system has been recommended and analysis of this information is not yet available.

  9. Wyandotte Neighborhood Stabilization Program: Retrofit of Two Homes

    Energy Technology Data Exchange (ETDEWEB)

    Lukachko, A. [Building Science Corporation (BSC), Somerville, MA (United States); Grin, A. [Building Science Corporation (BSC), Somerville, MA (United States); Bergey, D. [Building Science Corporation (BSC), Somerville, MA (United States)

    2013-04-01

    The Wyandotte NSP2 project aims to build 20 new houses and retrofit 20 existing houses in Wyandotte, MI. Wyandotte is part of a Michigan State Housing Development Authority-led consortium that is funded by HUD under the NSP2 program. The City of Wyandotte has also been awarded DOE EE&CBG funds that are being used to develop a district ground source heat pump (GSHP) system to service the project. This report details the retrofit of two existing houses in the program, and examines the energy efficiency recommendations for the homes. The report will be of interest to anyone planning an affordable, high performance retrofit of an existing home in a cold climate zone. Information from this report will also be useful to retrofit or weatherization program staff as some of the proposed retrofit solutions will apply to a wide range of projects. Preliminary results from the first complete house suggest that the technology package employed (which includes spray foam insulation and insulating sheathing) does meet the specific whole house water, air, and thermal control requirements, as well as, the project’s affordability goals. Monitoring of the GSHP system has been recommended and analysis of this information is not yet available.

  10. Visiting medical student elective and clerkship programs: a survey of US and Puerto Rico allopathic medical schools

    Directory of Open Access Journals (Sweden)

    Beckman Thomas J

    2010-06-01

    Full Text Available Abstract Background No published reports of studies have provided aggregate data on visiting medical student (VMS programs at allopathic medical schools. Methods During 2006, a paper survey was mailed to all 129 allopathic medical schools in the United States and Puerto Rico using a list obtained from the Association of American Medical Colleges. Contents of the survey items were based on existing literature and expert opinion and addressed various topics related to VMS programs, including organizational aspects, program objectives, and practical issues. Responses to the survey items were yes-or-no, multiple-choice, fill-in-the-blank, and free-text responses. Data related to the survey responses were summarized using descriptive statistics. Results Representatives of 76 schools (59% responded to the survey. Of these, 73 (96% reported their schools had VMS programs. The most common reason for having a VMS program was "recruitment for residency programs" (90%. "Desire to do a residency at our institution" was ranked as the leading reason visiting medical students choose to do electives or clerkships. In descending order, the most popular rotations were in internal medicine, orthopedic surgery, emergency medicine, and pediatrics. All VMS programs allowed fourth-year medical students, and approximately half (58% allowed international medical students. The most common eligibility requirements were documentation of immunizations (92%, previous clinical experience (85%, and successful completion of United States Medical Licensing Examination Step 1 (51%. Of the programs that required clinical experience, 82% required 33 weeks or more. Most institutions (96% gave priority for electives and clerkships to their own students over visiting students, and a majority (78% reported that visiting students were evaluated no differently than their own students. During academic year 2006-2007, the number of new resident physicians who were former visiting medical

  11. Final report [Homes Tours and Green Building Program Development

    Energy Technology Data Exchange (ETDEWEB)

    MacRae, Lani

    2000-06-28

    The US Department of Energy Office of Building Technology, State and Community Programs sponsored EcoTecture Solutions, Inc. (dba Sustainable Living Alliance {trademark}) in producing two home tours showcasing energy- and resource-efficient buildings in Austin, Texas, held on October 16, 1999, and Albuquerque, New Mexico, held on May 20, 2000. Lists are given of the notable building technologies, passive solar design features, and energy- and water-efficient technologies and design employed in the houses. There were over 1200 visitors to the 22 residential and 3 commercial buildings included in the tour.

  12. Home Delivery Medicament Program: access, inactivity and cardiovascular risk

    Directory of Open Access Journals (Sweden)

    Roque da Silva Araújo

    Full Text Available ABSTRACT Objective: to verify causes of inactivity in the Home Delivery Medicament Program, as referred by users from a Primary Health Care Service in São Paulo, comparing them to the causes registered in the program and analyzing them in the theoretical model Concept of Access to Health. Methods: cross-sectional study, interviewing 111 inactive users; and documentary study in the program records. Results: half of the users did not know the condition of inactivity. Discrepancies were found between the user's and the program's information, observing different levels of agreement: Absence of physician and administrative staff member 0%; Transfer to other service 25%; Death 50%; Option to quit 50%; Address change 57% and Change in therapeutic schedule 80%. The users' feeling of accepting the program was observed. In the health access concept, inactivity can be explained in the information dimension, in the degree of asymmetry between the patient's and the health professional's knowledge, identified through the indicators: education, knowledge and information sources. Conclusions: due to the low education level, the user does not assimilate the information on the steps of the program flowchart, does not return for the assessment that guarantees its continuity. Consequently, (she stops receiving the medication and spends a long time without treatment, increasing the cardiovascular risk of hypertensive (92% of the sample, diabetic (44% and dyslipidemic patients (31%.

  13. Motivation to take part in integrated care – an assessment of follow-up home visits to elderly persons

    DEFF Research Database (Denmark)

    Hjelmar, U; Hendriksen, Carsten; Hansen, K

    2011-01-01

    Objectives: The aim of follow-up visits by the general practitioner and district nurse (within a week after discharge from hospital) is to reduce hospital readmissions and improve the overall wellbeing of the patient. There is strong evidence that these programmes are effective, but are difficult......, and district nurses. Results: Care providers are motivated to collaborate by a number of factors. The focus of collaboration needs to be clearly defined and agreed upon, there needs to be a high degree of equality between the professionals involved, and there has to be a will to co-operate based on a shared...

  14. 75 FR 43172 - Maternal, Infant, and Early Childhood Home Visiting Program

    Science.gov (United States)

    2010-07-23

    ..., and caregivers of children birth through kindergarten entry. SUMMARY: The Health Resources and... women, expectant fathers, and primary caregivers of children birth through kindergarten entry. Final... violence; improvements in family economic self-sufficiency; and improvements in the coordination and...

  15. Programmed home visits by nursing professionals to older adults: prevention or treatment?1

    Science.gov (United States)

    Dios-Guerra, Caridad; Carmona-Torres, Juan Manuel; Ruíz-Gándara, África; Muñoz-Alonso, Adoración; Rodríguez-Borrego, María-Aurora

    2015-01-01

    OBJETIVOS: conocer la repercusión de la visita domiciliaria de los profesionales en enfermería a personas de 65 años o más, pluripatológicas, en morbimortalidad. MÉTODO: estudio retrospectivo caso-control por auditoria de historias clínicas. Muestreo aleatorio. Variables principales morbilidad, mortalidad; descriptivas: visitas de la enfermera, filiación, datos clínicos y socio sanitarios. Análisis por medidas de tendencia central, dispersión, posición, tabulación, frecuencias relativas, absolutas; no paramétricas, contrastes χ2; Wilcoxon-Mann-Whitney. RESULTADOS: se estudiaron a 1743 pacientes, de ellos 199 recibieron visita domiciliaria; la edad media de quien recibe visita es de 81,99 años; estos presentan mayor número de patologías de media 3,76; habitan en domicilio particular, si bien en conjunto presentan más institucionalización que los controles; el 50% no tiene identificado el Cuidador Principal; es mayor el número de visitas de las enfermeras a los pacientes que viven en residencias (p < 0,001). El 50% de casos no tiene plan de cuidados, con relación significativa (p < 0,001). No existen diferencias significativas en tiempo de vida entre los casos y los controles. CONCLUSIÓN: la visita domiciliaria del profesional en enfermería no repercute en la morbimortalidad; visita a los pacientes cuando ya ha aparecido el problema de salud, no hay datos de prevención. PMID:26312638

  16. Programmed home visits by nursing professionals to older adults: prevention or treatment?

    Directory of Open Access Journals (Sweden)

    Caridad Dios-Guerra

    2015-06-01

    Full Text Available OBJETIVOS: conocer la repercusión de la visita domiciliaria de los profesionales en enfermería a personas de 65 años o más, pluripatológicas, en morbimortalidad.MÉTODO: estudio retrospectivo caso-control por auditoria de historias clínicas. Muestreo aleatorio. Variables principales morbilidad, mortalidad; descriptivas: visitas de la enfermera, filiación, datos clínicos y socio sanitarios. Análisis por medidas de tendencia central, dispersión, posición, tabulación, frecuencias relativas, absolutas; no paramétricas, contrastes χ2; Wilcoxon-Mann-Whitney.RESULTADOS: se estudiaron a 1743 pacientes, de ellos 199 recibieron visita domiciliaria; la edad media de quien recibe visita es de 81,99 años; estos presentan mayor número de patologías de media 3,76; habitan en domicilio particular, si bien en conjunto presentan más institucionalización que los controles; el 50% no tiene identificado el Cuidador Principal; es mayor el número de visitas de las enfermeras a los pacientes que viven en residencias (p < 0,001. El 50% de casos no tiene plan de cuidados, con relación significativa (p < 0,001. No existen diferencias significativas en tiempo de vida entre los casos y los controles.CONCLUSIÓN: la visita domiciliaria del profesional en enfermería no repercute en la morbimortalidad; visita a los pacientes cuando ya ha aparecido el problema de salud, no hay datos de prevención.

  17. Are patients reliable when self-reporting medication use? Validation of structured drug interviews and home visits by drug analysis and prescription data in acutely hospitalized patients

    DEFF Research Database (Denmark)

    Glintborg, Bente; Hillestrøm, Peter René; Olsen, Lenette Holm

    2007-01-01

    The medication history among hospitalized patients often relies on patients' self-reports due to insufficient communication between health care professionals. The aim of the present study was to estimate the reliability of patients' self-reported medication use. Five hundred patients admitted...... to an acute medical department at a Danish university hospital were interviewed on the day of admission about their recent medication use. Blood samples drawn immediately after admission were screened for contents of 5 drugs (digoxin, bendroflumethiazide, amlodipine, simvastatin, glimepiride), and the results...... were compared to the patients' self-reported medication history. Information on prescribed drugs dispensed from any Danish pharmacy was collected from nationwide real-time pharmacy records. The authors performed home visits in a subgroup of 115 patients 4 weeks after their discharge. Stored drugs were...

  18. Nursing intervention of home visiting improving post partum depression of puerpera staying in home%家庭访视护理干预改善居家产妇产后抑郁情绪的效果研究

    Institute of Scientific and Technical Information of China (English)

    侯玉翠; 李遵清

    2011-01-01

    Objective To study the nursing intervention of home visiting improving post partum depression of puerpera staying in home. Methods There were 70 cases of inpatient puerpera who were divided into observation group (28 cases) and control group (32 casea). After leaving hospital, the control group was given family nursing with self-management method, and the observation group was given nursing intervention by home visiting group composed of obstetric nurses. Before and after visiting nursing, the SSRS and LES, HAMD were used to evaluate the effect. Results The SSRS score of observation group was higher, the negative life events and stimulation were lower,the positive life events and stimulation were higher than those of control group (P<0.01). The HAMD score was no significance difference before visiting between the two group, and after visiting, the HAMD score of observation group was lower than that of control group (P<0. 01 ) . Conclusions Home visiting can improve puerpera's post partum depression, and prevent from postpartum psychosis, increase the puerpera's life quality.%目的 探讨家庭访视护理干预改善居家产妇产后抑郁情绪的效果.方法 70例住院产妇按抛硬币分组法分为研究组(28例)和对照组(32例).出院后,对照组按自我管理方法实施家庭护理,不接受任何形式的医疗干预,研究组则接受为期8周的由产科护士组成的家庭访视小组给予的生活心理等方面的护理干预,访视护理前后,两组采用社会支持评定量表(SSRS)生活事件量表(LES)和汉密顿抑郁量表(HAMD)进行效果评定.结果 研究组产妇SSRS评分高于对照组(P<0.01);研究组负性生活事件数和负性生活事件刺激量明显低于对照组(P<0.01);研究组正性生活事件数和正性生活事件刺激量明显高于对照组(P<0.01);访视前HAMD评分两组无明显差异(P>0.05),访视后比较,研究组HAMD评分明显低于对照组(P<0.01).结论 家庭访视护

  19. Feasibility of integrating the “Healthy moves for aging well” program into home care aide services for frail older adults

    Science.gov (United States)

    Park, Chae-Hee; Chodzko-Zajko, Wojtek

    2014-01-01

    The purpose of the study was to assess the feasibility of implementing simple, safe, non-equipment evidence-based movements (Healthy Moves for Aging Well program) using an affordable and sustainable homecare-aide based delivery model that reaches the maximum possible number of frail older adults living at home in Illinois. Two local agencies were asked to identify two experienced home care aides and two inexperienced home care aides (n= 8). Each home care aides delivered the Healthy Moves to four clients (n= 16). Eight home care aides visited the client in the home and were asked to deliver the Healthy Moves program on a regular basis for a four-month time period. Outcome measures included a pre-and post- survey, a functional fitness test (older adults), and interviews. Evaluation procedures focused on older adult participants, homecare aids, and sites. The results showed that both interview and survey data revealed that most participants including older adults, home care aides, and site directors had a positive perception and high satisfaction with the program. Specially, 100% of older adult participants reported that they would recommend the program to others. Additionally, seniors and home care aides reported that they enjoyed working with each other on the program and both site directors reported that dissemination of the program in the State of Illinois employing home care aides was feasible and acceptable. Our study results indicate that Healthy Moves for Aging Well could be safely and successfully be disseminated to frail older adults in the State of Illinois. PMID:25061600

  20. Weatherizing the Homes of Low-Income Home Energy Assistance Program Clients: A Programmatic Assessment

    Energy Technology Data Exchange (ETDEWEB)

    Tonn, B.

    2002-09-16

    The purpose of this project was to assess the relationships between two federal programs that support low income households, the Weatherization Assistance Program (WAP) and the Low Income Home Energy Assistance Program (LIHEAP). The specific question addressed by this research is: what impact does weatherizing homes of LIHEAP recipients have on the level of need for LIHEAP assistance? The a priori expectation is that the level of need will decrease. If this is the case, then it can be argued that a non-energy benefit of WAP is the reduction in the level of need for LIHEAP assistance for households receiving weatherization assistance. The study area for this project was Boston, Massachusetts, which is representative of large northern urban areas. Additionally, Boston was chosen because one of its social service agencies, Action for Boston Community Development (ABCD), administers both WAP and LIHEAP programs. ABCD has a substantial client base of low-income households and was willing to cooperate in this study. In the State of Massachusetts, an income test is used to determine whether low-income households qualify for standard LIHEAP benefits. Benefits provided to eligible households are determined by a schedule that gauges benefit levels based on household income and number of members in the household. Additionally, households that consume large amounts of primary heating fuel can also qualify an additional high energy subsidy. It was expected that weatherization's biggest influence on the LIHEAP program would be in reducing the number of households qualifying for high energy subsidies. Data were collected for three groups of households that received both weatherization and LIHEAP assistance and for one control group that only received LIHEAP assistance. Table ES-1 indicates the sample sizes, weatherization dates, and winter time periods when changes in energy consumption and receipt of LIHEAP benefits could be expected to be observed. The reason why there is

  1. [Outpatient Parenteral Antimicrobial Therapy (OPAT) with Elastomeric Pumps in Collaboration with Home-visit Nursing Services in Japan: Experience of the First 10 Patients].

    Science.gov (United States)

    Hase, Ryota; Uno, Shunsuke; Miyoshi, Kazuyasu; Fujita, Koji; Suzuki, Hiroyuki; Suzuki, Daisuke; Mikawa, Takahiro; Muranaka, Kiyoharu; Hosokawa, Naoto

    2015-09-01

    In 2014, we reported the first trial based on outpatient parenteral antimicrobial therapy (OPAT) with continuous infusions in Japan. Following this, we found many patients who were eligible for OPAT but could not undertake it owing to difficulties in accessing the clinic daily. To overcome this problem, we created a model in collaboration with visiting nursing stations and started providing OPAT with the services. We report herein on a summary of the investigation of the first 10 patients treated under this model. We collected data pertaining to diseases, organisms, antimicrobials, treatment duration, bed days saved, outcome, readmission rate, and cost reductions associated with these patients. The most commonly targeted disease was osteomyelitis, followed by infective endocarditis. The condition of nine of the patients was complicated by bacteremia. The most commonly targeted organism was Staphylococcus aureus. Cefazolin was the most frequently prescribed antimicrobial, followed by Penicillin G. The median duration for OPAT was 12 days (range: 5-23 days). The total number of bed days saved was 129. All patients completed the planned OPAT. Eight patients were cured and two showed improvement. Only one patient was readmitted within a month after the completion of therapy. The estimated medical cost reduction was 496,540 yen, which is approximately 4,200 US dollars. Collaboration with visiting nursing stations provided OPAT to the patients who had difficulties in accessing the clinic daily. Our study shows that OPAT administered by continuous infusion in collaboration with home-visit nursing services would be a safe and feasible practice for efficient bed utilization and medical cost saving.

  2. Quality in Australian after-hours doctor home visits: exploring the clinical, professional and security supports available to involved practitioners.

    Science.gov (United States)

    Ifediora, Chris Onyebuchi

    2017-04-01

    The after-hours house call (AHHC) services in Australia has gained huge popularity in recent years, but it is not clear how well supported the involved doctors feel regarding the clinical, professional and security aspects of their work. It is important that this knowledge gap is filled given that appropriate support helps engender quality in health service delivery. This is a questionnaire-based electronic survey involving a sample frame of all 300 doctors participating in AHHC through the National Home Doctor Service. National Home Doctor Service is Australia's largest AHHC service provider. A total of 168 valid responses (56.0%) were received. Overall, the mean support levels were mild to moderate, ranging from 2.4 to 2.8 out of 4.0 for all three parameters. Specifically, 65.3% of the respondents felt well-supported on clinical issues, 64.7% on professional issues and 43.2% on security issues. Australian-trained doctors were less likely to feel well supported on all aspects [Clinical: odds ratio (OR) 0.38, confidence interval (CI) 0.16 to 0.90; Professional: OR 0.30, CI 0.13 to 0.72; and Security: OR 0.22; CI 0.09 to 0.53] compared with overseas-trained ones. Unsurprisingly, doctors who adopted protective measures felt significantly better supported regarding security (OR 2.75; CI 1.31 to 5.78). There is room for improvement regarding support on AHHC in Australia, and concerned Surgeries should ensure that where available these supports are appropriately utilized. © 2016 John Wiley & Sons, Ltd.

  3. Wildfire ignition resistant home design(WIRHD) program: Full-scale testing and demonstration final report.

    Energy Technology Data Exchange (ETDEWEB)

    Quarles, Stephen, L.; Sindelar, Melissa

    2011-12-13

    The primary goal of the Wildfire ignition resistant home design(WIRHD) program was to develop a home evaluation tool that could assess the ignition potential of a structure subjected to wildfire exposures. This report describes the tests that were conducted, summarizes the results, and discusses the implications of these results with regard to the vulnerabilities to homes and buildings.

  4. Weatherization and Indoor Air Quality: Measured Impacts in Single Family Homes Under the Weatherization Assistance Program

    Energy Technology Data Exchange (ETDEWEB)

    Pigg, Scott [Energy Center of Wisconsin, Madison, WI (United States); Cautley, Dan [Energy Center of Wisconsin, Madison, WI (United States); Francisco, Paul [Univ. of Illinois, Urbana-Champaign, IL (United States); Hawkins, Beth A [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Brennan, Terry M [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2014-09-01

    This report summarizes findings from a national field study of indoor air quality parameters in homes treated under the Weatherization Assistance Program (WAP). The study involved testing and monitoring in 514 single-family homes (including mobile homes) located in 35 states and served by 88 local weatherization agencies.

  5. High retention and appropriate use of insecticide-treated nets distributed to HIV-affected households in Rakai, Uganda: results from interviews and home visits

    Directory of Open Access Journals (Sweden)

    Ludigo James

    2009-04-01

    Full Text Available Abstract Background Distribution of insecticide-treated nets (ITNs has recently been incorporated into comprehensive care strategies for HIV-positive people in malaria-endemic areas. WHO now recommends free or low-cost distribution of ITNs to all persons in malaria-endemic areas, regardless of age, pregnancy and HIV status. Knowledge about and appropriate use of ITNs among HIV-positive ITN recipients and their household members has not been well characterized. Methods 142 randomly selected adults were interviewed in July–August 2006 to assess knowledge, retention, and appropriate use of ITNs they had received through a PEPFAR-funded comprehensive HIV care programme in rural Uganda. Results Among all participants, 102 (72%, CI: 65%–79% reported they had no ITNs except those provided by the programme. Of 131 participants who stated they were given ≥ 1 ITN, 128 (98%, CI: 96%–100% stated they still possessed at least one programme-provided ITN. Reported programme-ITN (pITN use by participants was high: 119 participants (91%, CI: 86%–96% reported having slept under pITN the night prior to the survey and 115 (88%, CI: 82%–94% reported sleeping under pITN seven days per week. Being away from home and heat were the most common reasons given for not sleeping under an ITN. A sub-study of thirteen random home visits demonstrated concordance between participants' survey reports and actual use of ITNs in homes. Conclusion There was excellent self-reported retention and appropriate use of ITNs distributed as a part of a community-based outpatient HIV care programme. Participants perceived ITNs as useful and were unlikely to have received ITNs from other sources.

  6. Communication between key stakeholders within a medical home: a qualitative study.

    Science.gov (United States)

    Nelson, Catherine S; Tandon, S Darius; Duggan, Anne K; Serwint, Janet R

    2009-04-01

    The objective of this study was to determine perceived benefits, detriments, and barriers to communication between pediatric providers and home visitors. The authors performed a cross-sectional, qualitative study consisting of 3 focus groups with paraprofessional home visitors (n=12), 6 with parents receiving home visiting (n=33), and 4 with pediatric providers whose patients received home visiting (n=19). Emerging themes were generated by an inductive analytic approach. Perceived benefits included home visitors assisting parents with communication, giving providers family information, and reinforcing providers' guidance. Detriments included parental concern of sharing confidential information and providers becoming aware of family issues for which they are unprepared to act. Barriers included parental consent, logistics of home visitor-provider communication, and providers' lack of knowledge about home visitor programs/roles. Greater coordination between home visitation programs and pediatric providers may strengthen home visiting services and reinforce advice and anticipatory guidance given by providers.

  7. Mental health home care aide program. Enhancing services all around.

    Science.gov (United States)

    Mongeau, N; Sherman, N

    1997-10-01

    Home care aides are a vital link in the home care continuum. One agency realized that specialty training for home care aides would not only make them even more valuable to the agency but also provide a career ladder for aides. One of the agency's first areas of specialty training was mental health.

  8. 78 FR 44627 - HOME Investment Partnerships Program: Improving Performance and Accountability; Updating Property...

    Science.gov (United States)

    2013-07-24

    ... Investment Partnerships Program: Improving Performance and Accountability; Updating Property Standards #0;#0... Program: Improving Performance and Accountability; Updating Property Standards AGENCY: Office of the... enhance accountability by States and units of local government in the use of HOME funds,...

  9. 77 FR 60128 - Noncompetitive Supplements to Nursing Assistant and Home Health Aide Program Grantees

    Science.gov (United States)

    2012-10-02

    ... HUMAN SERVICES Health Resources and Services Administration Noncompetitive Supplements to Nursing Assistant and Home Health Aide Program Grantees AGENCY: Health Resources and Services Administration (HRSA... Services Administration (HRSA) will offer noncompetitive program expansion supplements of $100,000 to...

  10. 78 FR 9936 - Federal Housing Administration (FHA): PowerSaver Home Energy Retrofit Loan Pilot Program...

    Science.gov (United States)

    2013-02-12

    ..., 2011, HUD published a notice at 76 FR 17936 that announced HUD's FHA Home Energy Retrofit Loan Pilot... URBAN DEVELOPMENT Federal Housing Administration (FHA): PowerSaver Home Energy Retrofit Loan Pilot Program: Extension of Pilot Program AGENCY: Office of the Assistant Secretary for Housing--Federal...

  11. Medicare and Medicaid programs; CY 2015 Home Health Prospective Payment System rate update; Home Health Quality Reporting Requirements; and survey and enforcement requirements for home health agencies. Final rule.

    Science.gov (United States)

    2014-11-06

    This final rule updates Home Health Prospective Payment System (HH PPS) rates, including the national, standardized 60-day episode payment rates, the national per-visit rates, and the non-routine medical supply (NRS) conversion factor under the Medicare prospective payment system for home health agencies (HHAs), effective for episodes ending on or after January 1, 2015. As required by the Affordable Care Act, this rule implements the second year of the four-year phase-in of the rebasing adjustments to the HH PPS payment rates. This rule provides information on our efforts to monitor the potential impacts of the rebasing adjustments and the Affordable Care Act mandated face-to-face encounter requirement. This rule also implements: Changes to simplify the face-to-face encounter regulatory requirements; changes to the HH PPS case-mix weights; changes to the home health quality reporting program requirements; changes to simplify the therapy reassessment timeframes; a revision to the Speech-Language Pathology (SLP) personnel qualifications; minor technical regulations text changes; and limitations on the reviewability of the civil monetary penalty provisions. Finally, this rule also discusses Medicare coverage of insulin injections under the HH PPS, the delay in the implementation of the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM), and a HH value-based purchasing (HH VBP) model.

  12. Design and pilot results of a single blind randomized controlled trial of systematic demand-led home visits by nurses to frail elderly persons in primary care [ISRCTN05358495

    NARCIS (Netherlands)

    Hout, van H.P.J.; Nijpels, M.G.A.A.M.; Marwijk, van H.W.J.; Jansen, A.P.D.; Veer, van 't P.J.; Tybout, W.; Stalman, W.A.B.

    2005-01-01

    BACKGROUND: The objective of this article is to describe the design of an evaluation of the cost-effectiveness of systematic home visits by nurses to frail elderly primary care patients. Pilot objectives were: 1. To determine the feasibility of postal multidimensional frailty screening instruments;

  13. Analysis of drop-in visits of children and adolescents for planning the actions of the Family Health Program

    Directory of Open Access Journals (Sweden)

    Cláudia Regina Lindgren Alves

    2010-11-01

    Full Text Available Today, establishing a drop-in policy is one of the most important challenges of primary care. Find the right dimension for delivering care on this basis is one of the starting points for organizing the work of the Family Health Teams (FHT. The purpose of this study was analyzing the demand of drop-in visits of children and adolescents of one of the Family Health Teams of the São Marcos Health Center (SMHC for planning the actions of the team. The family health team of the SMHC, situated in the Northeast of the city of Belo Horizonte, accepts drop-in visits during all day. The medical records over the period October 2005-September 2006 corresponding to the drop-in visits during a certain period of the day, which was reserved for this activity, were analyzed. The sample consisted of 30% of the about 5.000 visits, selected at random. The data were analyzed using Epi-Info. From the 1602 analyzed visits, 627 (39,2% were of patients with less than 20 years of age. About 24% were children with less than 2 years and 26% were adolescents. The patients with acute complaints corresponded to 80,4% of all pediatric visits. A little more than half of the children were of feminine sex. Approximately 100 children (16,9% dropped in for making appointments or for showing the results of exams. From these, 12% were well-child care cases and 5% carriers of chronic respiratory diseases like asthma. Four adolescents came for pre-natal care. The low percentage of children with less than two years of age in the dropin visits suggests that the monthly well-child care had worked efficiently. The same refers to the children inscribed in the asthma treatment program .Criança que Chia.. However, most of the children up to 10 years with acute complaints need appointments so that they can be cared for as quickly as possible. On the basis of these results the agendas will be reorganized and the attributions of the team members will be reviewed proposing alternatives for the

  14. State "technical assistance programs" for nursing home quality improvement: variations and potential implications.

    Science.gov (United States)

    Li, Yue; Spector, William D; Glance, Laurent G; Mukamel, Dana B

    2012-01-01

    To improve nursing home quality, many states have developed "technical assistance programs" that provide on-site consultation and training for nursing facility staff. We conducted a national survey on these state programs to collect data on program design, operations, financing, and perceived effectiveness. As of 2010, 17 states had developed such programs. Compared to existing state nursing home quality regulations, these programs represent a collaborative, rather than enforcement-oriented, approach to quality. However, existing programs vary substantially in key structural features such as staffing patterns, funding levels, and relationship with state survey and certification agencies. Perceived effectiveness by program officials on quality was high, although few states have performed formal evaluations. Perceived barriers to program effectiveness included lack of appropriate staff and funding, among others. In conclusion, state technical assistance programs for nursing homes vary in program design and perceived effectiveness. Future comparative evaluations are needed to inform evidence-based quality initiatives.

  15. Impact of a Home-Based Physical and Nutritional Intervention Program Conducted by Lay-Volunteers on Handgrip Strength in Prefrail and Frail Older Adults: A Randomized Control Trial

    Science.gov (United States)

    Haider, Sandra; Dorner, Thomas E.; Luger, Eva; Kapan, Ali; Titze, Sylvia; Lackinger, Christian; Schindler, Karin E.

    2017-01-01

    A randomized controlled trial was performed to compare the effects of a home-based physical and nutritional intervention program carried out by lay-volunteers to home visits with social support alone. Buddies visited 80 prefrail or frail older persons at home twice a week for 12 weeks. The physical training and nutrition group (PTN, n = 39) performed two sets of six strength exercises, discussed nutritional topics and received social support. The social support group (SoSu, n = 41) received home visits with social support only. In the PTN group, handgrip strength increased significantly by 2.4 kg (95% CI: 1.0–3.8). In the SoSu group we did not see a significant improvement. However, no significant between-group difference was found. Physical performance increased in both groups, although with a higher increase of 1.0 point (95% CI: 0.1–2.0) in the PTN group. In none of the groups muscle mass changed. Further results showed that frail individuals benefit more from the intervention than prefrail individuals (OR: 2.78; 95% CI: 1.01–7.66). Handgrip strength in the intervention group increased by a clinically relevant value and this effect is comparable to that obtained by health-care professionals. Therefore, home visits with a physical training and nutritional program could offer a new perspective in the care of community-dwelling prefrail and frail older persons. PMID:28085913

  16. Impact of a Home-Based Physical and Nutritional Intervention Program Conducted by Lay-Volunteers on Handgrip Strength in Prefrail and Frail Older Adults: A Randomized Control Trial.

    Science.gov (United States)

    Haider, Sandra; Dorner, Thomas E; Luger, Eva; Kapan, Ali; Titze, Sylvia; Lackinger, Christian; Schindler, Karin E

    2017-01-01

    A randomized controlled trial was performed to compare the effects of a home-based physical and nutritional intervention program carried out by lay-volunteers to home visits with social support alone. Buddies visited 80 prefrail or frail older persons at home twice a week for 12 weeks. The physical training and nutrition group (PTN, n = 39) performed two sets of six strength exercises, discussed nutritional topics and received social support. The social support group (SoSu, n = 41) received home visits with social support only. In the PTN group, handgrip strength increased significantly by 2.4 kg (95% CI: 1.0-3.8). In the SoSu group we did not see a significant improvement. However, no significant between-group difference was found. Physical performance increased in both groups, although with a higher increase of 1.0 point (95% CI: 0.1-2.0) in the PTN group. In none of the groups muscle mass changed. Further results showed that frail individuals benefit more from the intervention than prefrail individuals (OR: 2.78; 95% CI: 1.01-7.66). Handgrip strength in the intervention group increased by a clinically relevant value and this effect is comparable to that obtained by health-care professionals. Therefore, home visits with a physical training and nutritional program could offer a new perspective in the care of community-dwelling prefrail and frail older persons.

  17. 奥马哈问题分类系统在系统性红斑狼疮病人居家访视中的应用效果评价%Evaluation of application effect of Omaha problem classification system in home visit of systemic lupus erythemato-sus patients

    Institute of Scientific and Technical Information of China (English)

    敬雪明; 敬雨佳; 敬剑英; 李芸; 梅小平

    2015-01-01

    drug treatment programs and unreasona-ble nutrition,the incidence was respectively 26.7% and 25.6%;the followed problems were the sleep and rest pattern and poor mental health,and the incidence was respectively 20.9% and 18.6%;the least problem was difficulty breathing,and the incidence was 5 .8%.Conclusion:The home visit has influenced the SLE patients from the 4 aspects of environment,social psychology,physiology and health behaviors,it can effectively change the patients’adverse health related behaviors.

  18. Effectiveness of a home exercise program in combination with ultrasound therapy for temporomandibular joint disorders.

    Science.gov (United States)

    Ucar, Mehmet; Sarp, Ümit; Koca, İrfan; Eroğlu, Selma; Yetisgin, Alparslan; Tutoglu, Ahmet; Boyacı, Ahmet

    2014-12-01

    [Purpose] This study compared the effectiveness of home exercise alone versus home exercise combined with ultrasound for patients with temporomandibular joint disorders. [Subjects and Methods] This study enrolled 23 female and 15 male patients who were divided randomly into two groups. The home exercise group performed a home exercise program consisting of an exercise program and patient education, and the home exercise combined with ultrasound group received ultrasound therapy in addition to the home exercise program. Pain intensity was evaluated using a visual analogue scale. Pain free maximum mouth opening was evaluated at baseline and 2 weeks after the treatment. [Results] There was no difference between the two groups in baseline values. After the treatment, the visual analogue scale decreased and pain free maximum mouth opening scores improved significantly in each group. Additionally, both values were higher in the home exercise combined with ultrasound group than in the home exercise group. [Conclusion] The combination of home exercise combined with ultrasound appears to be more effective at providing pain relief and increasing mouth opening than does home exercise alone for patients with temporomandibular joint disorders.

  19. LHC@home takes centre stage : some of the people behind the CPSS and LHC@home programs

    CERN Multimedia

    maximilien Brice

    2005-01-01

    From left to right: Frank Schmidt (AB), Jukka Klem (Helsinki Institute of Physics), Andreas Wagner (IT), Eric McIntosh (IT) and Ben Segal (IT). The program of LHC@home, which aims to use the computing power of PCs when the screen saver is activated, is being relauched as part of the World Year of Physics.

  20. Design and pilot results of a single blind randomized controlled trial of systematic demand-led home visits by nurses to frail elderly persons in primary care [ISRCTN05358495

    Directory of Open Access Journals (Sweden)

    Tybout Willemijn

    2005-09-01

    Full Text Available Abstract Background The objective of this article is to describe the design of an evaluation of the cost-effectiveness of systematic home visits by nurses to frail elderly primary care patients. Pilot objectives were: 1. To determine the feasibility of postal multidimensional frailty screening instruments; 2. to identify the need for home visits to elderly. Methods Main study: The main study concerns a randomized controlled in primary care practices (PCP with 18 months follow-up and blinded PCPs. Frail persons aged 75 years or older and living at home but neither terminally ill nor demented from 33 PCPs were eligible. Trained community nurses (1 visit patients at home and assess the care needs with the Resident Assessment Instrument-Home Care, a multidimensional computerized geriatric assessment instrument, enabling direct identification of problem areas; (2 determine the care priorities together with the patient; (3 design and execute interventions according to protocols; (4 and visit patients at least five times during a year in order to execute and monitor the care-plan. Controls receive usual care. Outcome measures are Quality of life, and Quality Adjusted Life Years; time to nursing home admission; mortality; hospital admissions; health care utilization. Pilot 1: Three brief postal multidimensional screening measures to identify frail health among elderly persons were tested on percentage complete item response (selected after a literature search: 1 Vulnerable Elders Screen, 2 Strawbridge's frailty screen, and 3 COOP-WONCA charts. Pilot 2: Three nurses visited elderly frail patients as identified by PCPs in a health center of 5400 patients and used an assessment protocol to identify psychosocial and medical problems. The needs and experiences of all participants were gathered by semi-structured interviews. Discussion The design holds several unique elements such as early identification of frail persons combined with case-management by

  1. Service and business model for technology enabled and home-based cardiac rehabilitation programs.

    Science.gov (United States)

    Sarela, Antti; Whittaker, Frank; Korhonen, Ilkka

    2009-01-01

    Cardiac rehabilitation programs are comprehensive life-style programs aimed at preventing recurrence of a cardiac event. However, the current programs have globally significantly low levels of uptake. Home-based model can be a viable alternative to hospital-based programs. We developed and analysed a service and business model for home based cardiac rehabilitation based on personal mentoring using mobile phones and web services. We analysed the different organizational and economical aspects of setting up and running the home based program and propose a potential business model for a sustainable and viable service. The model can be extended to management of other chronic conditions to enable transition from hospital and care centre based treatments to sustainable home-based care.

  2. Welfare-to-Work Program Coordination in Texas. Report on the Initial Site Visits. First in a Series of Reports on JTPA/Welfare Coordination Efforts.

    Science.gov (United States)

    Gula, Annette; King, Christopher T.

    The first round of site visits to welfare-to-work programs in Texas examined the nature and degree of program coordination at three sites: El Paso, Houston, and San Antonio. A brief overview of the growing literature on program coordination paid particular attention to welfare-related studies. At the state level, evidence was found of increasing…

  3. Home programs for upper extremity recovery post-stroke: a survey of occupational therapy practitioners.

    Science.gov (United States)

    Donoso Brown, Elena V; Fichter, Renae

    2017-09-08

    Upper extremity hemiparesis is an impairment post-stroke that impacts quality of life. Home programs are an intervention strategy used by many occupational therapists to support continued motor recovery post-stroke, yet little is known about how these programs are designed and implemented. The purpose of this study was to describe how occupational therapy practitioners approach this task and specifically what strategies they use to support adherence and what types of technology are most commonly used. An on-line survey methodology was used. Participants were recruited through multiple sources including state associations and occupational therapy educational program directors. A total of 73 occupational therapy practitioners submitted complete surveys. It was found that majority of occupational therapy practitioners in the sample (n = 53) reported creating home programs focused on upper extremity motor recovery more than 80% of the time. Range of motion and strengthening were reported as being in the top three most commonly used interventions by more than half the sample, however incorporating clients' goals and interests were reported most often as strategies to create meaning in the home program. Respondents also reported limited incorporation of technology and strategies to support adherence. Personal motivation was reported by occupational therapy practitioners to be a key moderator of adherence to a home program. Occupational therapy practitioners often provide home programs for individuals post-stroke focusing on upper extremity function. Future research that aims to understand stakeholders' perspectives on home programs and determine effective strategies for ensuring adherence is needed.

  4. The Parent-Child Home Program in Western Manitoba: A 20-Year Evaluation

    Science.gov (United States)

    Gfellner, Barbara M.; McLaren, Lorraine; Metcalfe, Arron

    2008-01-01

    This article is a 20-year evaluation of the Parent-Child Home Program (PCHP) of Child and Family Services in Western Manitoba. Following Levenstein's (1979, 1988) approach, home visitors model parent-child interchanges using books and toys to enhance children's cognitive development through appropriate parenting behaviors. The evaluation provides…

  5. A Message from Home: Findings from a Program for Non-Retarded, Low-Income Preschoolers.

    Science.gov (United States)

    Levenstein, Phyllis

    This document describes the Mother-Child Home Program (MCHP) for prevention of educational disadvantage, prepared by the Verbal Interaction Project. The MCHP consisted of 92 semi-weekly, half hour home sessions spread over two years by interviewers called "Toy Demonstrators". The latter were trained in non-didactic techniques to show a mother, by…

  6. The effect of a home physiotherapy program for persons with Parkinson's disease

    NARCIS (Netherlands)

    Nieuwboer, A; De Weerdt, W; Dom, R; Truyen, M; Janssens, L; Kamsma, Y

    2001-01-01

    The purpose of this study was to evaluate the effect of a home physiotherapy program for persons with Parkinson's disease. Thirty-three patients took part in the study using a within-subject controlled design. Functional activities including walking and carrying out transfers were measured at home a

  7. Enriched Home Environment Program for Preschool Children with Autism Spectrum Disorders

    Science.gov (United States)

    Sood, Divya; Szymanski, Monika; Schranz, Caren

    2015-01-01

    This study discusses the impact of the Enriched Home Environment Program (EHEP) on participation in home activities among two children with ASD using case study methodology. EHEP involves occupational therapists to collaborate with families of children with ASD to educate them about the impact of factors that influence child's participation within…

  8. The Effects of an Education Program on Home Renovation for Fall Prevention of Korean Older People

    Science.gov (United States)

    Jang, Miseon; Lee, Yeunsook

    2015-01-01

    This study aims to verify the effects of an education program on home renovation for fall prevention among older people, more specifically fall efficacy and home renovation intentions. A quasiexperimental study with nonequivalent control and comparative groups was conducted to demonstrate the effects of the education. A total of 51 older people…

  9. The effect of a home physiotherapy program for persons with Parkinson's disease

    NARCIS (Netherlands)

    Nieuwboer, A; De Weerdt, W; Dom, R; Truyen, M; Janssens, L; Kamsma, Y

    2001-01-01

    The purpose of this study was to evaluate the effect of a home physiotherapy program for persons with Parkinson's disease. Thirty-three patients took part in the study using a within-subject controlled design. Functional activities including walking and carrying out transfers were measured at home

  10. Effects of a simple home-based exercise program on fall prevention in older adults: A 12-month primary care setting, randomized controlled trial.

    Science.gov (United States)

    Boongird, Chitima; Keesukphan, Prasit; Phiphadthakusolkul, Soontraporn; Rattanasiri, Sasivimol; Thakkinstian, Ammarin

    2017-04-24

    To investigate the effects of a simple home-based exercise program on falls, physical functioning, fear of falling and quality of life in a primary care setting. Participants (n = 439), aged ≥65 years with mild-to-moderate balance dysfunction were randomly assigned to an exercise (n = 219) or control (n = 220) group. The program consisted of five combined exercises, which progressed in difficulty, and a walking plan. Controls received fall prevention education. Physical functioning and other outcomes were measured at 3- and 6-month follow-up visits. Falls were monitored with fall diaries and phone interviews at 3, 6, 9, and 12 months respectively. The 12 months of the home-based exercise program showed the incidence of falls was 0.30 falls per person year in the exercise group, compared with 0.40 in the control group. The estimated incidence rate ratio was 0.75 (95% CI 0.55-1.04), which was not statistically significant. The fear of falling (measured by the Thai fall efficacy scale) was significantly lower in the exercise than control group (24.7 vs 27.0, P = 0.003). Also, the trend of program adherence increased in the exercise group. (29.6% to 56.8%). This simple home-based exercise program showed a reduction in fear of falling and a positive trend towards exercise adherence. Further studies should focus on factors associated with exercise adherence, the benefits of increased home visits and should follow participants longer in order to evaluate the effects of the program. Geriatr Gerontol Int 2017; ••: ••-••. © 2017 Japan Geriatrics Society.

  11. A randomized controlled trial to assess effectiveness of a nurse-led home-based heart failure management program

    Directory of Open Access Journals (Sweden)

    Mamata Rai

    2017-01-01

    Full Text Available Introduction: The burden of cardiovascular disease is increasing in India. It is a chronic condition, and poor management can increase the risk and frequency of acute episodes resulting in poor quality of life (QOL, frequent hospital admissions, and mortality. Disease management programs can improve medication adherence and patient's QOL. Objective: The aim of this study is to assess the effectiveness of nurse-led home-based heart failure management program (HOME-N. Materials and Methods: This randomized controlled trial was conducted among fifty outpatient heart failure (HF patients visiting a tertiary care hospital. The control group received usual routine care, whereas the experimental group received HOME-N, which included formal health teaching, a HF checklist (Hriday card, telemonitoring of vital parameters (blood pressure, heart rate, and weight weekly through a mobile application named as “Dhadkan” and telephonic follow-up for 3 months. Kansas City Cardiomyopathy Questionnaire (KCCQ and adherence to refills and medications scale were used to assess QOL and drug adherence, respectively, in the study patients. The outcome measures were the QOL, drug compliance, hospitalization, and mortality rate. Results: At baseline, the demographic and morbidity profile, and QOL and drug compliance scores of both groups were comparable. After intervention, the QOL domain score of KCCQ as well as drug compliance improved significantly both within the experimental group (P = 0.001, P = 0.001 and as compared to control group (P = 0.001, P = 0.004, respectively. Conclusion: The HOME-N was significantly effective in improving QOL and drug compliance in HF patients.

  12. Visit safety

    CERN Multimedia

    2012-01-01

    Experiment areas, offices, workshops: it is possible to have co-workers or friends visit these places.     You already know about the official visits service, the VIP office, and professional visits. But do you know about the safety instruction GSI-OHS1, “Visits on the CERN site”? This is a mandatory General Safety Instruction that was created to assist you in ensuring safety for all your visits, whatever their nature—especially those that are non-official. Questions? The HSE Unit will be happy to answer them. Write to safety-general@cern.ch.   The HSE Unit

  13. Case Study: In-Home Environmental Education Program

    Science.gov (United States)

    The Children's Hospital of Philadelphia, or CHOP, case study is intended to offer providers, health insurers, public health departments and community-based organizations an overview of an asthma in-home intervention.

  14. Low Income Home Energy Assistance Program FY 2008 Household Data

    Data.gov (United States)

    U.S. Department of Health & Human Services — State-reported annual data collected on the presence of elderly, disabled, and young children in eligible households receiving Low Income Home Energy Assistance...

  15. Effectiveness of a nurse-led intensive home-visitation programme for first-time teenage mothers (Building Blocks): a pragmatic randomised controlled trial.

    Science.gov (United States)

    Robling, Michael; Bekkers, Marie-Jet; Bell, Kerry; Butler, Christopher C; Cannings-John, Rebecca; Channon, Sue; Martin, Belen Corbacho; Gregory, John W; Hood, Kerry; Kemp, Alison; Kenkre, Joyce; Montgomery, Alan A; Moody, Gwenllian; Owen-Jones, Eleri; Pickett, Kate; Richardson, Gerry; Roberts, Zoë E S; Ronaldson, Sarah; Sanders, Julia; Stamuli, Eugena; Torgerson, David

    2016-01-09

    Many countries now offer support to teenage mothers to help them to achieve long-term socioeconomic stability and to give a successful start to their children. The Family Nurse Partnership (FNP) is a licensed intensive home-visiting intervention developed in the USA and introduced into practice in England that involves up to 64 structured home visits from early pregnancy until the child's second birthday by specially recruited and trained family nurses. We aimed to assess the effectiveness of giving the programme to teenage first-time mothers on infant and maternal outcomes up to 24 months after birth. We did a pragmatic, non-blinded, randomised controlled, parallel-group trial in community midwifery settings at 18 partnerships between local authorities and primary and secondary care organisations in England. Eligible participants were nulliparous and aged 19 years or younger, and were recruited at less than 25 weeks' gestation. Field-based researchers randomly allocated mothers (1:1) via remote randomisation (telephone and web) to FNP plus usual care (publicly funded health and social care) or to usual care alone. Allocation was stratified by site and minimised by gestation (language of data collection (English vs non-English). Mothers and assessors (local researchers at baseline and 24 months' follow-up) were not masked to group allocation, but telephone interviewers were blinded. Primary endpoints were biomarker-calibrated self-reported tobacco use by the mother at late pregnancy, birthweight of the baby, the proportion of women with a second pregnancy within 24 months post-partum, and emergency attendances and hospital admissions for the child within 24 months post-partum. Analyses were by intention to treat. This trial is registered with ISRCTN, number ISRCTN23019866. Between June 16, 2009, and July 28, 2010, we screened 3251 women. After enrolment, 823 women were randomly assigned to receive FNP and 822 to usual care. All follow-up data were retrieved by

  16. In Our Program -- Everyone Gets into the Act

    Science.gov (United States)

    Stack, Patricia Marie

    1973-01-01

    The Home Visiting and Parent Education Program at De Paul Institute in Pittsburgh takes the teacher into the home situation in an attempt to involve the entire family in integrating the deaf preschool child into his natural world. (Author)

  17. Predictors of compliance with a home-based exercise program added to usual medical care in preventing postmenopausal osteoporosis: an 18-month prospective study.

    Science.gov (United States)

    Mayoux-Benhamou, M A; Roux, C; Perraud, A; Fermanian, J; Rahali-Kachlouf, H; Revel, M

    2005-03-01

    This prospective 18-month study was designed to assess long-term compliance with a program of exercise aimed to prevent osteoporosis after an educational intervention and to uncover determinants of compliance. A total of 135 postmenopausal women were recruited by flyers or instructed by their physicians to participate in an educational session added to usual medical care. After a baseline visit and dual-energy X-ray absorptiometry, volunteers participated in a 1-day educational session consisting of a lecture and discussion on guidelines for appropriate physical activity and training in a home-based exercise program taught by a physical therapist. Scheduled follow-up visits were 1, 6, and 18 months after the educational session. Compliance with the exercise program was defined as an exercise practice rate 50% or greater than the prescribed training. The 18-month compliance rate was 17.8% (24/135). The main reason for withdrawal from the program was lack of motivation. Two variables predicted compliance: contraindication for hormone replacement therapy (odds ratio [OR] = 0.13; 95% confidence interval [95% CI], 0.04 to 0.46) and general physical function scores from an SF-36 questionnaire (OR=1.26; 95% CI, 1.03 to 1.5). To a lesser extent, osteoporosis risk, defined as a femoral T-score exercise, only a minority of postmenopausal women adhered to a home-based exercise program after 18 months.

  18. Home

    Directory of Open Access Journals (Sweden)

    Rokeya Sakhawat Hossain

    2012-11-01

    Full Text Available A fiery feminist piece that argues that Indian women are all homeless; animals have homes but Indian women have none, because they have to depend on the mercy of their "keepers"; therefore, Indian women live a life worse than animals.

  19. After the Visit: An Overview of Government and Community Programs Supporting Children with Medical Complexity.

    Science.gov (United States)

    Olson, Kaitlyn B

    2017-05-04

    The optimal care of children with medical complexity (CMC) requires involvement from a network of professionals that includes physicians, nurses, ancillary service providers, and educators. Pediatric health care providers typically have early and frequent contact with the families of CMC. Therefore, they are in a unique position to connect families to developmental, educational, and psychosocial supports. This article reviews important government and community programs that support CMC living in the United States. It outlines the educational rights of children with disabilities and offers practical tips for collaborating with Early Intervention and the public school system. The article also provides an overview of financial assistance programs, respite care services, and support groups that are beneficial to CMC and their families.

  20. After the Visit: An Overview of Government and Community Programs Supporting Children with Medical Complexity

    Directory of Open Access Journals (Sweden)

    Kaitlyn B. Olson

    2017-05-01

    Full Text Available The optimal care of children with medical complexity (CMC requires involvement from a network of professionals that includes physicians, nurses, ancillary service providers, and educators. Pediatric health care providers typically have early and frequent contact with the families of CMC. Therefore, they are in a unique position to connect families to developmental, educational, and psychosocial supports. This article reviews important government and community programs that support CMC living in the United States. It outlines the educational rights of children with disabilities and offers practical tips for collaborating with Early Intervention and the public school system. The article also provides an overview of financial assistance programs, respite care services, and support groups that are beneficial to CMC and their families.

  1. Home Delivery Medicament Program: access, inactivity and cardiovascular risk.

    Science.gov (United States)

    Araújo, Roque da Silva; Arcuri, Edna Apparecida Moura; Lopes, Victor Cauê

    2016-10-10

    to verify causes of inactivity in the Home Delivery Medicament Program, as referred by users from a Primary Health Care Service in São Paulo, comparing them to the causes registered in the program and analyzing them in the theoretical model Concept of Access to Health. cross-sectional study, interviewing 111 inactive users; and documentary study in the program records. half of the users did not know the condition of inactivity. Discrepancies were found between the user's and the program's information, observing different levels of agreement: Absence of physician and administrative staff member 0%; Transfer to other service 25%; Death 50%; Option to quit 50%; Address change 57% and Change in therapeutic schedule 80%. The users' feeling of accepting the program was observed. In the health access concept, inactivity can be explained in the information dimension, in the degree of asymmetry between the patient's and the health professional's knowledge, identified through the indicators: education, knowledge and information sources. due to the low education level, the user does not assimilate the information on the steps of the program flowchart, does not return for the assessment that guarantees its continuity. Consequently, (s)he stops receiving the medication and spends a long time without treatment, increasing the cardiovascular risk of hypertensive (92% of the sample), diabetic (44%) and dyslipidemic patients (31%). verificar causas de inatividade no Programa Remédio em Casa, referidas por usuários de Unidade Básica de Saúde de São Paulo, comparando-as às registradas pelo programa e analisando-as no modelo teórico Conceito de Acesso à Saúde. estudo transversal entrevistando 111 usuários inativos; e documental, nos registros do programa. metade dos usuários desconhecia a condição de inatividade. Constatadas discrepâncias nas informações usuário versus programa, observando-se diferentes níveis de concordância: Falta de médico e funcion

  2. Student stress and academic performance: home hospital program.

    Science.gov (United States)

    Yucha, Carolyn B; Kowalski, Susan; Cross, Chad

    2009-11-01

    The purpose of this study was to evaluate whether nursing students assigned to a home hospital experience less stress and improved academic performance. Students were assigned to a home hospital clinical placement (n = 78) or a control clinical placement (n = 79). Stress was measured using the Student Nurse Stress Index (SNSI) and Spielberger's State Anxiety Inventory. Academic performance included score on the RN CAT, a standardized mock NCLEX-RN(®)-type test; nursing grade point average; and first attempt pass-fail on the NCLEX-RN. There were no statistically significant differences between the two groups for age, gender, marital status, ethnicity, or score on the nurse entrance examination. There were significant changes in SNSI over time but not between groups. Academic load and state anxiety showed an interaction of time by group, with the home hospital group showing reductions over time, compared with the control group.

  3. Visit ISOLDE!

    CERN Multimedia

    CERN Bulletin

    2013-01-01

    CERN Internal Communication is organising a visit to ISOLDE – an opportunity for you to see the CERN set-up that can produce over 1000 different isotopes!   If you wish to participate, you can sign up for a visit by sending us an e-mail. Note that the visits will take place between 18 and 22 February, and will be open only to CERN access-card holders.   The visit will include an introduction by experts and a tour of the ISOLDE set-up. NB: For security reason, pregnant women and kids under the age of 16 can not take the tour.  

  4. 45 CFR 1306.33 - Home-based program option.

    Science.gov (United States)

    2010-10-01

    ... hours each. (2) Provide, at a minimum, two group socialization activities per month for each child (a... socialization activities must be focused on both the children and parents. They may not be conducted by the home..., DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, HEAD...

  5. Operation of Wastewater Treatment Plants: A Home Study Training Program.

    Science.gov (United States)

    California State Univ., Sacramento. Dept. of Civil Engineering.

    This manual was prepared by experienced wastewater treatment plant operators to provide a home study course to develop new qualified workers and expand the abilities of existing workers. The objective of this manual is to provide the knowledge and skills necessary for certification. Participants learn the basic operational aspects of treatment…

  6. Longitudinal Evaluation of a Home Economics Education Professional Program.

    Science.gov (United States)

    Pestle, Ruth E.

    Improvements in teaching competencies, attitudes toward children, professional commitment, and philosophy of education of 31 vocational home economics teacher education students were measured through four self-evaluations during the last year in college and the first year of teaching. Comparison of mean scores was done by t-tests. Significant…

  7. Understanding why women adopt and sustain home water treatment: insights from the Malawi antenatal care program.

    Science.gov (United States)

    Wood, Siri; Foster, Jennifer; Kols, Adrienne

    2012-08-01

    In many settings in Africa, social marketing has proven more successful in generating brand recognition for chlorine water treatment products than in promoting their use. To promote household use of one such product in Malawi, WaterGuard, the Ministry of Health (MOH) and Population Services International (PSI) distributed free hygiene kits that included WaterGuard to pregnant women attending antenatal clinics in 2007. Follow-up surveys documented a sustained increase in WaterGuard use three years after the initial intervention. In 2010, PATH (www.path.org) conducted qualitative research on the factors motivating women to adopt, sustain, or discontinue use. To provide context, interviews were also conducted with their friends, relatives, and husbands. Interviews revealed that sustained use of WaterGuard does not necessarily imply consistent use. Most respondents reported switching back and forth between WaterGuard and stock chlorine distributed for free by the government, and many treated water seasonally rather than year-round. Qualitative findings suggest that two program strategies strongly influenced women's decisions to adopt, purchase, and continue using WaterGuard. First, positive, ongoing contacts with health care workers, especially during home visits, raised awareness of the need to treat water, encouraged trial use, and supported continuing use. Second, an extended free trial of the product overcame initial cost barriers and allowed women and their families to experience the health benefits of WaterGuard, appreciate its value and relevance to their lives, and get used to its taste. Social support-from like-minded relatives, friends, neighbors, health care workers, husbands, and children-was also a critical factor that promoted consistent, ongoing use of WaterGuard. The findings confirm the importance of interpersonal communication in prompting adoption of household water treatment and suggest that consumers assess the perceived value of a product, not

  8. Taking a Teen Pregnancy Prevention Program to the Home: The AIM 4 Teen Moms Experience.

    OpenAIRE

    Subuhi Asheer; Ellen Kisker

    2014-01-01

    This report discusses findings from the first 18 months of a program implementation evaluation of AIM 4 Teen Moms, a teen pregnancy intervention designed to delay rapid repeat pregnancies among parenting teen mothers in Los Angeles. The program is delivered primarily in participants' homes. The report describes the program's development and design, recruiting approach, facilitators' training in and delivery of the program, and youth engagement and response, concluding with lessons for future ...

  9. Preliminary Data on a Care Coordination Program for Home Care Recipients.

    Science.gov (United States)

    Dean, Katie M; Hatfield, Laura A; Jena, Anupam B; Cristman, David; Flair, Michael; Kator, Kylie; Nudd, Geoffrey; Grabowski, David C

    2016-09-01

    Home care recipients are often hospitalized for potentially avoidable reasons. A pilot program (Intervention in Home Care to Improve Health Outcomes (In-Home)) was designed to help home care providers identify acute clinical changes in condition and then manage the condition in the home and thereby avoid a costly hospitalization. Caregivers answer simple questions about the care recipient's condition during a telephone-based "clock-out" at the end of each shift. Responses are electronically captured in the agency management software that caregivers use to "clock-in," manage care, and "clock-out" on every shift. These are transmitted to the agency's care manager, who follows up on the change in condition and escalates appropriately. A description of the In-Home model is presented, and pilot data from 22 home care offices are reported. In the pilot, caregivers reported a change in condition after 2% of all shifts, representing an average of 1.9 changes per care recipient in a 6-month period. Changes in behavior and skin condition were the most frequently recorded domains. Interviews with participating caregivers and care managers suggested positive attitudes regarding the intervention; challenges included resistance to change on the part of home care staff and difficulties in applying a uniform intervention to individuals with varying needs in home care offices with varying capacities. In an ongoing randomized trial, the success of the overall program will be measured primarily according to the potential reduction in avoidable hospitalizations of home care recipients and the effect this potential reduction has on spending and healthcare outcomes. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

  10. Visiting and office home care workers' occupational health: An analysis of workplace flexibility and worker insecurity measures associated with emotional and physical health

    OpenAIRE

    Zeytinoglu, Isik U.; Denton, Margaret; Davies, Sharon; Seaton, M. Bianca; Millen, Jennifer

    2009-01-01

    The home health care sector in Canada experienced major restructuring in the mid-1990s creating a variety of flexibilities for organizations and insecurities for workers. This paper examines the emotional and physical health consequences of employer flexibilities and worker insecurities on home health care workers. For emotional health the focus is on stress and for physical health the focus is on selfreported musculoskeletal disorders. Data come from our survey of home health care workers in...

  11. EFFECT OF A HOME EXERCISE TRAINING-PROGRAM IN PATIENTS WITH CYSTIC-FIBROSIS

    NARCIS (Netherlands)

    DEJONG, W; GREVINK, RG; ROORDA, RJ; KAPTEIN, AA; VANDERSCHANS, CP

    1994-01-01

    Physical training in patients with pulmonary diseases, including cystic fibrosis (CF), may improve exercise tolerance in these patients. Most training programs are performed in a clinical setting. Little information is available concerning the effect of home exercise training programs in CF patients

  12. 77 FR 6673 - Removal of the Indian HOME Investment Partnerships Program Regulation

    Science.gov (United States)

    2012-02-09

    ...-determination and tribal self-governance. The Indian HOME program was one of the programs that was terminated.... Environmental Impact This final rule does not direct, provide for assistance or loan and mortgage insurance for...), this rule is categorically excluded from environmental review under the National Environmental...

  13. Visit Itinerary

    CERN Multimedia

    2002-01-01

    The visit itinerary includes five area of halls 191 and 180:. End-Cap Toroid Integration Area . Barrel Toroid Integration Area . Cryogenic Test Facility for Toroid Magnets and Helium Pumps . Liquid Argon Cryostats Assembly Area . Central Solenoid Magnet Test Station

  14. Supervised Versus Home Exercise Training Programs on Functional Balance in Older Subjects

    Science.gov (United States)

    Youssef, Enas Fawzy; Shanb, Alsayed Abd elhameed

    2016-01-01

    Background Aging is associated with a progressive decline in physical capabilities and a disturbance of both postural control and daily living activities. The aim of this study was to evaluate the effects of supervised versus home exercise programs on muscle strength, balance and functional activities in older participants. Methods Forty older participants were equally assigned to a supervised exercise program (group-I) or a home exercise program (group-II). Each participant performed the exercise program for 35–45 minutes, two times per week for four months. Balance indices and isometric muscle strength were measured with the Biodex Balance System and Hand-Held Dynamometer. Functional activities were evaluated by the Berg Balance Scale (BBS) and the timed get-up-and-go test (TUG). Results The mean values of the Biodex balance indices and the BBS improved significantly after both the supervised and home exercise programs (P balance performance. The supervised program was superior to the home program in restoring functional activities and isometric muscle strength in older participants. PMID:28090182

  15. Comparing Catheter-Associated Urinary Tract Infection Prevention Programs Between Veterans Affairs Nursing Homes and Non-Veterans Affairs Nursing Homes.

    Science.gov (United States)

    Mody, Lona; Greene, M Todd; Saint, Sanjay; Meddings, Jennifer; Trautner, Barbara W; Wald, Heidi L; Crnich, Christopher; Banaszak-Holl, Jane; McNamara, Sara E; King, Beth J; Hogikyan, Robert; Edson, Barbara S; Krein, Sarah L

    2017-03-01

    OBJECTIVE The impact of healthcare system integration on infection prevention programs is unknown. Using catheter-associated urinary tract infection (CAUTI) prevention as an example, we hypothesize that US Department of Veterans Affairs (VA) nursing homes have a more robust infection prevention infrastructure due to integration and centralization compared with non-VA nursing homes. SETTING VA and non-VA nursing homes participating in the AHRQ Safety Program for Long-Term Care collaborative. METHODS Nursing homes provided baseline information about their infection prevention programs to assess strengths and gaps related to CAUTI prevention via a needs assessment questionnaire. RESULTS A total of 353 of 494 nursing homes from 41 states (71%; 47 VA and 306 non-VA facilities) responded. VA nursing homes reported more hours per week devoted to infection prevention-related activities (31 vs 12 hours; Phomes reported tracking CAUTI rates (94% vs 66%; Phomes reported having policies for appropriate catheter use (64% vs 81%; P=.004) and catheter insertion (83% vs 94%; P=.004). CONCLUSIONS Among nursing homes participating in an AHRQ-funded collaborative, VA and non-VA nursing homes differed in their approach to CAUTI prevention. Best practices from both settings should be applied universally to create an optimal infection prevention program within emerging integrated healthcare systems. Infect Control Hosp Epidemiol 2017;38:287-293.

  16. [Healthcare and daily needs of expectant Brazilian women residing in Japan. Analysis of fieldwork conducted during prenatal examinations and home visits].

    Science.gov (United States)

    Uemura, Naoko; Martinez, Makiko; Hatashita, Hiroyo

    2012-10-01

    To investigate the everyday lives and public healthcare needs of Brazilian nursing mothers and pregnant women residing in Japan, during the pregnancy and postpartum period, and the difficulties experienced in using or accessing the Japanese public healthcare system. The participants included 10 Brazilian expectant mothers who were residing in Prefecture A, but did not understand Japanese well, and those who were delivering for the first time in Japan. From August 2007 to July 2009, the researcher and interpreter conducted fieldwork by accompanying participants to medical examinations and making home visits. Analysis of the findings of this field study was carried out by labeling the relevant field note descriptions of each participant's thoughts and feelings concerning pregnancy and childbirth, the state of their everyday lives, and any additional public health-related difficulties encountered during this time. Additionally, individuals with common occurrences were again grouped and categorized for performing the analysis. Among the 10 participants, 8 were in their twenties and 2 were in their thirties; 8 participants had lived in Japan for less than 3 years and 2 of them for less than 10 years. Eight participants had had no prior experience with childbirth, whereas 2 had experienced childbirth. All 10 had resigned from work before entering into the late pregnancy stage, rendering their economic conditions solely dependent upon their husbands' income. In fact, many participants were in a difficult financial state. 6 women lived with their husbands, 2 others lived with husbands and had children, and 2 others were living with their husbands and parents in the same house. Six participants had families nearby that could provide support. However, none of the 10 participants maintained interactions with friends after having resigned from work. Participants were organized into the following 4 major categories based on the state of their everyday lives and the difficulties

  17. Visiting Scholars Program

    Science.gov (United States)

    2016-09-01

    topology software . Recent developments in persistent homology software - largely a matter of mathematical and algorithmic development, not merely code...Engineering, Computer Science, Mathematics and other recognized technical disciplines critical to the advancement of Information technologies. SUNY Poly...technology, engineering and mathematics (STEM) disciplines as well as other recognized technical and newly emerged interdisciplinary areas to provide an

  18. Evaluation of home respiratory therapy delivered to patients in the Ministry of Health's Home Medical Program (HMP) and administered through the Madinah HMP Center, Kingdom of Saudi Arabia, 2013.

    Science.gov (United States)

    Alhelali, Rana A; McNabb, Scott J N; Memish, Ziad A

    2016-03-01

    This was an evaluation of home respiratory therapy (HRT) services administered through the Madinah Home Medical Program (MHMP) Center of the Ministry of Health (MoH), Kingdom of Saudi Arabia (KSA). Using a retrospective design and descriptive analyses, we analyzed 83 patient records for the clinical care received, outcomes, and patient satisfaction. We also assessed a subset from an economic perspective. Demographically, 72% were >60 years of age, 80% were female, and 90% were Saudi. Asthma accounted for 34% of the diagnosed respiratory diseases, followed by chronic obstructive pulmonary disease (11%). Most patients (71%) required two or three respiratory modalities: 94% used oxygen therapy and 14% were on mechanical ventilation. A full 90% of HMP patients expressed a high level of satisfaction with the HMP overall care, and 43% saw an improvement in their condition. The MHMP lowered healthcare costs for HRT-receiving patients by decreasing the frequency of emergency room (ER) and outpatient visits by 50.8% from 59 to 30 visits. HRT administered through the MHMP Center improved clinical outcomes and increased patient satisfaction while reducing hospital utilization and associated costs. A prospective study is recommended to assess HMP services in comparison with hospitalization.

  19. Improving patients' home cooking - A case series of participation in a remote culinary coaching program.

    Science.gov (United States)

    Polak, Rani; Pober, David M; Budd, Maggi A; Silver, Julie K; Phillips, Edward M; Abrahamson, Martin J

    2017-08-01

    This case series describes and examines the outcomes of a remote culinary coaching program aimed at improving nutrition through home cooking. Participants (n = 4) improved attitudes about the perceived ease of home cooking (p < 0.01) and self-efficacy to perform various culinary skills (p = 0.02); and also improved in confidence to continue online learning of culinary skills and consume healthier food. We believe this program might be a viable response to the need for effective and scalable health-related culinary interventions.

  20. The effect of a "surveillance nurse" telephone support intervention in a home care program.

    Science.gov (United States)

    Kelly, Ronald; Godin, Lori

    2015-01-01

    This study is an evaluation of a unique "surveillance nurse" telephone support intervention for community-dwelling elderly individuals in a home care program. A combined propensity-based covariate-matching procedure was used to pair each individual who received the intervention ("treatment" condition, nT = 930) to a similar individual who did not receive the intervention ("control" condition, nC1 = 930) from among a large pool of potential control individuals (nC0 = 4656). The intervention consisted of regularly scheduled telephone calls from a surveillance nurse to proactively assess the individual's well-being, care plan status, use of and need for services (home support, adult day program, physiotherapy, etc.) and home environment (e.g., informal caregiver support). Treatment and control conditions were compared with respect to four service utilization outcomes: (1) rate of survival in the community before institutionalization in an assisted living or nursing home facility or death, (2) rate of emergency room registrations, (3) rate of acute care hospitalizations, and (4) rate of days in hospital, during home care enrollment. Results indicated a beneficial effect of the surveillance nurse intervention on reducing rate of service utilization by increasing the duration of the home care episode.

  1. Project SKI*HI Outreach Programming for Hearing Impaired Infants and Families: Recertification Statement, Questions, Responses, and Approval.

    Science.gov (United States)

    Strong, Carol J.; Clark, Thomas C.

    This program evaluation report presents information on Project SKI*HI, a home-based program for infants and young children with hearing impairments and their families. The program's major goals are early identification of hearing-impaired infants and a home program to facilitate child development. A parent advisor makes weekly home visits to each…

  2. Diferentes estratégias de visita domiciliar e seus efeitos sobre a assistência pré-natal no extremo Sul do Brasil Effects of different home visit strategies on prenatal care in Southern Brazil

    Directory of Open Access Journals (Sweden)

    Juraci A. Cesar

    2008-11-01

    Full Text Available Este estudo do tipo intervenção comunitária controlada unicega não randomizada teve por objetivo avaliar o impacto das visitas realizadas pelos agentes comunitários de saúde e líderes voluntários da Pastoral da Criança sobre o pré-natal de gestantes pobres em Rio Grande, Rio Grande do Sul, Brasil. Aplicaram-se questionários padronizados antes e depois do parto buscando conhecer suas características demográficas, reprodutivas, assistência recebida durante o pré-natal e nível sócio-econômico e condição de moradia. Estas gestantes foram divididas em três grupos, sendo dois grupos-intervenção e um controle. Dentre as 339 gestantes estudadas, 115 pertenciam ao grupo cuja intervenção foi realizada pelos agentes comunitários de saúde, 116 pelos líderes voluntários da pastoral e 108 pertenciam ao grupo controle. Gestantes visitadas pelos agentes comunitários iniciaram o pré-natal mais precocemente, realizaram maior número de consultas, exames clínicos e testes laboratoriais, foram mais comumente orientadas sobre amamentação e suplementadas com sulfato ferroso. A participação de familiares nas consultas de pré-natal foi maior entre gestantes visitadas pelos líderes voluntários. Visitas domiciliares podem melhorar a qualidade do pré-natal entre gestantes pobres e aumentar a participação de familiares, sobretudo do marido, na gestação.This non-randomized community intervention study evaluated the impact of prenatal home visits by community health agents and volunteer leaders from the Children's Mission on prenatal care among poor pregnant women in Rio Grande, Rio Grande do Sul State, Brazil. Previously trained interviewers applied pre-coded questionnaires to the women at home, investigating demographic and reproductive characteristics, socioeconomic status, housing conditions, and prenatal care. Of the 339 pregnant women interviewed, 115 were assigned to the intervention group visited by community health agents

  3. [Home based and group based exercise programs in patients with ankylosing spondylitis: systematic review].

    Science.gov (United States)

    Lopes, S; Costa, S; Mesquita, C; Duarte, J

    2016-01-01

    Ankylosing Spondylitis (AS) is a chronic inflammatory rheumatic disease characterized by inflammation of the joints of the spine and sacroiliac and to a lesser percentage of the peripheral joints. It is a debilitating condition which reduces quality of life in patients with AS. The practice of physical therapy is recommended as non-pharmacological treatment as well as the treatment and prevention of associated deformities. To collect and summarize the available evidence in scientific databases to realize the effectiveness of home based and group based programs in patients with AS. Systematic review, where articles for the study were collected from scientific database PubMed. We have found 65 articles with publication date between January 1, 2004 and January 31, 2014. Inclusion and exclusion criteria were established to make the selection of articles to include in the study. All investigators provided their agreement in presencial meeting for a final selection, and at a later stage, the articles were read in full by the three investigators. The present systematic review includes eight randomized controlled trials. All articles show functional benefits in patients with AS subject to exercise programs in group based and / or home based. From the eight articles, 4 addressed programs conducted in home based context and 4 addressed in group based context programs. There appears to be evidence that the programs carried out based on group are more effective than those home based conducted in patients with AS. It was concluded also be advantageous to carry out home based exercise programs than the absence of any exercise program..

  4. Home based and group based exercise programs in patients with ankylosing spondylitis: systematic review

    Directory of Open Access Journals (Sweden)

    Sofia Lopes

    2016-04-01

    Full Text Available Introduction: Ankylosing Spondylitis (AS is a chronic inflammatory rheumatic disease characterized by inflammation of the joints of the spine and sacroiliac and to a lesser percentage of the peripheral joints. It is a debilitating condition which reduces quality of life in patients with AS. The practice of physical therapy is recommended as non-pharmacological treatment as well as the treatment and prevention of associated deformities. Objective: To collect and summarize the available evidence in scientific databases to realize the effectiveness of home based and group based programs in patients with AS. Methods: Systematic review, where articles for the study were collected from scientific database PubMed. We have found 65 articles with publication date between January 1, 2004 and January 31, 2014. Inclusion and exclusion criteria were established to make the selection of articles to include in the study. All investigators provided their agreement in presencial meeting for a final selection, and at a later stage, the articles were read in full by the three investigators. Results: The present systematic review includes eight randomized controlled trials. All articles show functional benefits in patients with AS subject to exercise programs in group based and / or home based. From the eight articles, 4 addressed programs conducted in home based context and 4 addressed in group based context programs. Conclusion: There appears to be evidence that the programs carried out based on group are more effective than those home based conducted in patients with AS. It was concluded also be advantageous to carry out home based exercise programs than the absence of any exercise program.

  5. Austrian visit

    CERN Multimedia

    2003-01-01

    Hans Hoffmann, Director for Technology Transfer and Scientific Computing, and Maria Rauch-Kallat, Minister of Health and Women's Issues, Austria, signing the visitors' book.Maria Rauch-Kallat, Minister of Health and Women's Issues, Austria, was welcomed by Hans Hoffmann, Director for Technology Transfer and Scientific Computing, on her visit to CERN on 19 May 2003. The theme of the visit was Technology Transfer and spin-offs from CERN for medical applications. Maria Rauch-Kallat toured also the installations of ATLAS.

  6. Polish visit

    CERN Multimedia

    2003-01-01

    On 6 October, Professor Michal Kleiber, Polish Minister of Science and Chairman of the State Committee for Scientific Research, visited CERN and met both the current and designated Director General, Luciano Maiani and Robert Aymar. Professor Kleiber visited the CMS and ATLAS detector assembly halls, the underground cavern for ATLAS, and the LHC superconducting magnet string test hall. Michal Kleiber (left), Polish minister of science and Jan Krolikowski, scientist at Warsaw University and working for CMS, who shows the prototypes of the Muon Trigger board of CMS.

  7. NOTE FROM VISITS SERVICE

    CERN Multimedia

    ETT Division; Division ETT; Service des visites

    2000-01-01

    The Visit Service noticed that for many years countries such as Great Britain, Germany, Spain, Portugal, the Netherlands and the Scandinavian countries visit CERN less than other member countries and that is due to the high price of the trip for the students. To improve the situation the Visit Service plans to create a network of 'Family-Accommodation' ('Famille-Accueil') in Geneva and in France nearbywith the aim to facilitate the trip to foreign students especially from the more distant member countries and to encourage them to visit our unique laboratory. We expect this exchange to be an interesting experience for both the students and the welcoming family ('famille d'accueil'). If you are interested in participating in this family network, please fill in the questionnaire below. The questionnaire is to be returned to the Visit Service, Mrs Christine Fromm, e-mail Christine.Fromm@cern.ch.Name: First name: CERN address: E-mail: Portable phone number: Home address...

  8. European visit

    CERN Multimedia

    2006-01-01

    The European Commissioner for Science and Research, Janez Potočnik, (on the right) visited the CMS assembly hall accompanied by Jim Virdee, Deputy Spokesman of CMS (on the left), and Robert Aymar, Director-General of CERN. The European Commissioner for Science and Research, Janez Potočnik, visited CERN on Tuesday 31 January. He was welcomed by the Director-General, Robert Aymar, who described the missions and current activities of CERN to him, in particular the realisation of the LHC with its three components: accelerator, detectors, storage and processing of data. The European Commissioner then visited the CMS assembly hall, then the hall for testing the LHC magnets and the ATLAS cavern. During this first visit since his appointment at the end of 2004, Janez Potočnik appeared very interested by the operation of CERN, an example of successful scientific co-operation on a European scale. The many projects (30 on average) that CERN and the European Commission carry out jointly for the benefit of res...

  9. Keys to the House: Unlocking Residential Savings With Program Models for Home Energy Upgrades

    Energy Technology Data Exchange (ETDEWEB)

    Grevatt, Jim [Energy Futures Group (United States); Hoffman, Ian [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Hoffmeyer, Dale [US Department of Energy, Washington, DC (United States)

    2017-07-05

    After more than 40 years of effort, energy efficiency program administrators and associated contractors still find it challenging to penetrate the home retrofit market, especially at levels commensurate with state and federal goals for energy savings and emissions reductions. Residential retrofit programs further have not coalesced around a reliably successful model. They still vary in design, implementation and performance, and they remain among the more difficult and costly options for acquiring savings in the residential sector. If programs are to contribute fully to meeting resource and policy objectives, administrators need to understand what program elements are key to acquiring residential savings as cost effectively as possible. To that end, the U.S. Department of Energy (DOE) sponsored a comprehensive review and analysis of home energy upgrade programs with proven track records, focusing on those with robustly verified savings and constituting good examples for replication. The study team reviewed evaluations for the period 2010 to 2014 for 134 programs that are funded by customers of investor-owned utilities. All are programs that promote multi-measure retrofits or major system upgrades. We paid particular attention to useful design and implementation features, costs, and savings for nearly 30 programs with rigorous evaluations of performance. This meta-analysis describes program models and implementation strategies for (1) direct install retrofits; (2) heating, ventilating and air-conditioning (HVAC) replacement and early retirement; and (3) comprehensive, whole-home retrofits. We analyze costs and impacts of these program models, in terms of both energy savings and emissions avoided. These program models can be useful guides as states consider expanding their strategies for acquiring energy savings as a resource and for emissions reductions. We also discuss the challenges of using evaluations to create program models that can be confidently applied in

  10. Occupational Therapy Home Program for Children with Intellectual Disabilities: A Randomized, Controlled Trial

    Science.gov (United States)

    Wuang, Yee-Pay; Ho, Guang-Sheng; Su, Chwen-Yng

    2013-01-01

    This study aimed to investigate the effectiveness of a proposed occupational therapy home program (OTHP) for children with intellectual disabilities (ID). Children with ID were randomly and equally assigned to OTHP or to no OTHP groups. The primary outcome measures were Canadian Occupational Performance, Bruininks-Oseretsky Test of Motor…

  11. Occupational Therapy Home Program for Children with Intellectual Disabilities: A Randomized, Controlled Trial

    Science.gov (United States)

    Wuang, Yee-Pay; Ho, Guang-Sheng; Su, Chwen-Yng

    2013-01-01

    This study aimed to investigate the effectiveness of a proposed occupational therapy home program (OTHP) for children with intellectual disabilities (ID). Children with ID were randomly and equally assigned to OTHP or to no OTHP groups. The primary outcome measures were Canadian Occupational Performance, Bruininks-Oseretsky Test of Motor…

  12. Developing a Home-Based Early Intervention Personnel Training Program in Southeast China

    Science.gov (United States)

    Xie, Huichao; Chen, Ching-I; Chen, Chieh-Yu; Squires, Jane; Li, Wenge; Liu, Tian

    2017-01-01

    China is expected to have a rapid growth in specialized early intervention (EI) services for young children ages birth to 6 and their families. A major barrier in the provision of EI services in China is the shortage of well-trained EI personnel. In 2013, a Home-Based Early Intervention Program (HBEIP) was started at South China Normal University…

  13. Third Grade Effects of the Mother-Child Home Program. Developmental Continuity Consortium Follow-Up Study. Final Report.

    Science.gov (United States)

    Levenstein, Phyllis

    This followup study of the effects of the Mother-Child Home Program developed by the Verbal Interaction Project (VIP) measures the school performance of nine groups of 162 third grade children from low income families. The program of 92 home sessions spaced over two school years focused on the mother and child as a socially interactive dyad, and…

  14. 78 FR 6851 - Proposed Information Collection (Patient Satisfaction Survey Michael E. DeBakey Home Care Program...

    Science.gov (United States)

    2013-01-31

    ... AFFAIRS Proposed Information Collection (Patient Satisfaction Survey Michael E. DeBakey Home Care Program....'' SUPPLEMENTARY INFORMATION: Title: Patient Satisfaction Survey Michael E. DeBakey Home Care Program, VA Form 10.... Abstract: VA Form 10-0476 will be used to gather feedback from patients regarding their satisfaction...

  15. 75 FR 62635 - Proposed Information Collection (Patient Satisfaction Survey Michael E. DeBakey Home Care Program...

    Science.gov (United States)

    2010-10-12

    ... AFFAIRS Proposed Information Collection (Patient Satisfaction Survey Michael E. DeBakey Home Care Program... needed to determine patients' satisfaction with services provided by or through the Michael E. DeBakey.... Title: Patient Satisfaction Survey Michael E. DeBakey Home Care Program, VA Form 10-0476. OMB...

  16. 77 FR 69550 - Proposed Information Collection (Patient Satisfaction Survey Michael E. DeBakey Home Care Program...

    Science.gov (United States)

    2012-11-19

    ... AFFAIRS Proposed Information Collection (Patient Satisfaction Survey Michael E. DeBakey Home Care Program.... This notice solicits comments on information needed to determine patients' satisfaction with services... information technology. Title: Patient Satisfaction Survey Michael E. DeBakey Home Care Program, VA Form...

  17. Pilot States Program report: Home energy ratings systems and energy-efficient mortgages

    Energy Technology Data Exchange (ETDEWEB)

    Farhar, B.

    2000-04-04

    This report covers the accomplishments of the home energy ratings systems/energy-efficient mortgages (HERS/EEMs) pilot states from 1993 through 1998, including such indicators as funding, ratings and EEMs achieved, active raters, and training and marketing activities. A brief description of each HERS program's evolution is included, as well as their directors' views of the programs' future prospects. Finally, an analysis is provided of successful HERS program characteristics and factors that appear to contribute to HERS program success.

  18. Home Monitoring Program Reduces Mortality in High-Risk Sociodemographic Single-Ventricle Patients.

    Science.gov (United States)

    Castellanos, Daniel Alexander; Herrington, Cynthia; Adler, Stacey; Haas, Karen; Ram Kumar, S; Kung, Grace C

    2016-12-01

    A clinician-driven home monitoring program can improve interstage outcomes in single-ventricle patients. Sociodemographic factors have been independently associated with mortality in interstage patients. We hypothesized that even in a population with high-risk sociodemographic characteristics, a home monitoring program is effective in reducing interstage mortality. We defined interstage period as the time period between discharge following Norwood palliation and second-stage surgery. We reviewed the charts of patients for the three-year period before (group 1) and after (group 2) implementation of the home monitoring program. Clinical variables around Norwood palliation, during the interstage period, and at the time of second-stage surgery were analyzed. There were 74 patients in group 1 and 52 in group 2. 59 % patients were Hispanic, and 84 % lived in neighborhoods where over 5 % families lived below poverty line. There was no significant difference in pre-Norwood variables, Norwood discharge variables, age at second surgery, or outcomes at second surgery. There were more Sano shunts performed at the Norwood procedure as the source of pulmonary blood flow in group 2 (p value <0.05). There were more unplanned hospital admissions and percutaneous re-interventions in group 2. Patients in group 2 whose admission criteria included desaturation had a 45 % likelihood of having an unplanned re-intervention. Group 2 noted an 80 % relative reduction in interstage mortality (p < 0.01). In a multiple regression analysis, after accounting for ethnicity, socio-economic status, and source of pulmonary blood flow, enrollment in a home monitoring program independently predicted improved interstage survival (p < 0.01). A clinician-driven home monitoring program reduces interstage mortality even when the majority of patients has high-risk sociodemographic characteristics.

  19. Cosmic visits

    CERN Multimedia

    Stefania Pandolfi

    2015-01-01

    On Saturday, 19 September, ESA astronaut Luca Parmitano and Amalia Ercoli Finzi, Principal Investigator of the SD2 experiment on board the ESA Rosetta spacecraft, visited the AMS Control Centre and other CERN installations.   From left to right: Sergio Bertolucci (CERN Director of Research and Computing), Amalia Ercoli Finzi (Emeritus Professor in the Aerospace department of the Polytechnic University of Milan and Principal Investigator of the SD2 experiment on board the ESA Rosetta spacecraft), Maurice Bourquin (AMS-02 Senior Scientist and Honorary Professor in the Nuclear and Corpuscular Physics department of the University of Geneva) and Luca Parmitano (Major in the Italian Air Force and European Space Agency astronaut) in the AMS Payload and Operation Control Centre. They were welcomed in the early morning by Sergio Bertolucci and then headed to the Prévessin site to visit the CERN Control Centre and the Payload and Operation Control Centre (POCC) of the Alpha Magnetic Sp...

  20. Armenian visit

    CERN Multimedia

    2003-01-01

    During his visit to CERN on 4 July 2003, Karen Chshmaritian, Armenian Minister for Trade and Economic Development, toured the ATLAS experimental cavern and assembly hall. From left to right: Aram Kotzinian, from the international organization JINR from Dubna, Marzio Nessi from ATLAS, Karen Chshmaritian, Armenian Minister for Trade and Economic Development, Zohrab Mnatsakanian, Ambassador at the Permanent Mission of the Republic of Armenia to the United Nations in Geneva, Alexandre Sissakian, Vice-Director of JINR and Peter Jenni, ATLAS spokesman.

  1. Randomized intervention trial on preventive home visits to older people: baseline and follow-up characteristics of participants and non-participants

    DEFF Research Database (Denmark)

    Vass, Mikkel; Avlund, Kirsten; Hendriksen, Carsten

    2007-01-01

    of municipality employees) was done at municipality level. In total 5,788 home-dwelling 75- and 80-year-olds living in these municipalities were invited to participate in the study. Written consent was obtained from 4,060 persons (participation rate 71%). RESULTS: During five-year follow-up non-participants had...

  2. ATLAS Virtual Visits

    CERN Document Server

    Goldfarb, Steven; The ATLAS collaboration

    2015-01-01

    ATLAS Virtual Visits is a project initiated in 2011 for the Education & Outreach program of the ATLAS Experiment at CERN. Its goal is to promote public appreciation of the LHC physics program and particle physics, in general, through direct dialogue between ATLAS physicists and remote audiences. A Virtual Visit is an IP-based videoconference, coupled with a public webcast and video recording, between ATLAS physicists and remote locations around the world, that typically include high school or university classrooms, Masterclasses, science fairs, or other special events, usually hosted by collaboration members. Over the past two years, more than 10,000 people, from all of the world’s continents, have actively participated in ATLAS Virtual Visits, with many more enjoying the experience from the publicly available webcasts and recordings. We present an overview of our experience and discuss potential development for the future.

  3. Northwest Energy Efficient Manufactured Housing Program: High Performance Manufactured Home Prototyping and Construction Development

    Energy Technology Data Exchange (ETDEWEB)

    Hewes, Tom [Building America Partnership for Improved Residential Construction (BA-PIRC), Corvallis, OR (United States); Peeks, Brady [Building America Partnership for Improved Residential Construction (BA-PIRC), Corvallis, OR (United States)

    2013-11-01

    The Building America Partnership for Improved Residential Construction, the Bonneville Power Administration (BPA), and Northwest Energy Works (NEW), the current Northwest Energy Efficient Manufactured Housing Program (NEEM) administrator, have been collaborating to conduct research on new specifications that would improve on the energy requirements of a NEEM home. In its role as administrator, NEW administers the technical specs, performs research and engineering analysis, implements ongoing construction quality management procedures, and maintains a central database with home tracking. This project prototyped and assessed the performances of cost-effective high performance building assemblies and mechanical systems that are not commonly deployed in the manufacturing setting. The package of measures is able to reduce energy used for space conditioning, water heating and lighting by 50% over typical manufactured homes produced in the northwest.

  4. Northwest Energy Efficient Manufactured Housing Program: High Performance Manufactured Home Prototyping and Construction Development

    Energy Technology Data Exchange (ETDEWEB)

    Hewes, T.; Peeks, B.

    2013-11-01

    The Building America Partnership for Improved Residential Construction, the Bonneville Power Administration (BPA), and Northwest Energy Works (NEW), the current Northwest Energy Efficient Manufactured Housing Program (NEEM) administrator, have been collaborating to conduct research on new specifications that would improve on the energy requirements of a NEEM home. In its role as administrator, NEW administers the technical specs, performs research and engineering analysis, implements ongoing construction quality management procedures, and maintains a central database with home tracking. This project prototyped and assessed the performances of cost-effective high performance building assemblies and mechanical systems that are not commonly deployed in the manufacturing setting. The package of measures is able to reduce energy used for space conditioning, water heating and lighting by 50 percent over typical manufactured homes produced in the northwest.

  5. Home Performance with ENERGY STAR: Utility Bill Analysis on Homes Participating in Austin Energy's Program

    Energy Technology Data Exchange (ETDEWEB)

    Belzer, D.; Mosey, G.; Dagher, L.; Plympton, P.

    2008-01-01

    Home Performance with ENERGY STAR (HPwES) is a jointly managed program of the U.S. Department of Energy (DOE) and the U.S. Environmental Protection Agency (EPA). This program focuses on improving energy efficiency in existing homes via a whole-house approach to assessing and improving a home's energy performance, and helping to protect the environment. As a local sponsor for HPwES, Austin Energy's HPwES program offers a complete home energy assessment and a list of recommendations for efficiency improvements, along with cost estimates. The owner can choose to implement only one or the complete set of energy conservation measures. Austin Energy facilitates the process by providing economic incentives to the homeowner through its HPwES Loan program and its HPwES Rebate program. In 2005, the total number of participants in both programs was approximately 1,400. Both programs are only available for improvements made by a participating HPwES contractor. The individual household billing data - encompassing more than 7,000 households - provided by Austin Energy provides a rich data set to estimate the impacts of its HPwES program. The length of the billing histories is sufficient to develop PRISM-type models of electricity use based on several years of monthly bills before and after the installation of the conservation measures. Individual household savings were estimated from a restricted version of a PRISM-type regression model where the reference temperature to define cooling (or heating degree days) was estimated along with other parameters. Because the statistical quality of the regression models varies across individual households, three separate samples were used to measure the aggregate results. The samples were distinguished on the basis of the statistical significance of the estimated (normalized) cooling consumption. A normalized measure of cooling consumption was based on average temperatures observed over the most recent nine-year period ending in

  6. Evidence for the long term cost effectiveness of home care reablement programs

    Directory of Open Access Journals (Sweden)

    Lewin GF

    2013-10-01

    Full Text Available Gill F Lewin,1,2 Helman S Alfonso,3 Janine J Alan41Faculty of Health Sciences, Curtin University, Perth, WA, Australia; 2Research Department, Silver Chain Group, Perth, WA, Australia; 3School of Population Health, University of Western Australia, Perth, WA, Australia; 4Faculty of Health Sciences, Curtin University, Perth, WA, AustraliaBackground: The objectives of this study were to determine whether older individuals who participated in a reablement (restorative program rather than immediately receiving conventional home care services had a reduced need for ongoing support and lower home care costs over the next 57 months (nearly 5 years.Materials and methods: Data linkage was used to examine retrospectively the service records of older individuals who had received a reablement service versus a conventional home care service to ascertain their use of home care services over time.Results: Individuals who had received a reablement service were less likely to use a personal care service throughout the follow-up period or any other type of home care over the next 3 years. This reduced use of home care services was associated with median cost savings per person of approximately AU $12,500 over nearly 5 years.Conclusion: The inclusion of reablement as the starting point for individuals referred for home care within Australia's reformed aged care system could increase the system's cost effectiveness and ensure that all older Australians have the opportunity to maximize their independence as they age.Keywords: restorative, older adults, community dwelling, service costs

  7. Pakistan Guest Visit HRC

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    Companied by CMEC Beijing representative, Dr. Eng. S.M.Bhutta,a technical advisor of Alternative Energy Development Board (AEDB) in Pakistan, paid a visit to HRC during June 3-5, 2005. Both sides exchanged ideas on micro & small hydropower development, and intended to further strengthen the cooperation in micro & small hydropower fields as to push forward the rural electrification program in Pakistan.

  8. Home-Based Care Program Reduces Disability And Promotes Aging In Place.

    Science.gov (United States)

    Szanton, Sarah L; Leff, Bruce; Wolff, Jennifer L; Roberts, Laken; Gitlin, Laura N

    2016-09-01

    The Community Aging in Place, Advancing Better Living for Elders (CAPABLE) program, funded by the Center for Medicare and Medicaid Innovation, aims to reduce the impact of disability among low-income older adults by addressing individual capacities and the home environment. The program, described in this innovation profile, uses an interprofessional team (an occupational therapist, a registered nurse, and a handyman) to help participants achieve goals they set. For example, it provides assistive devices and makes home repairs and modifications that enable participants to navigate their homes more easily and safely. In the period 2012-15, a demonstration project enrolled 281 adults ages sixty-five and older who were dually eligible for Medicare and Medicaid and who had difficulty performing activities of daily living (ADLs). After completing the five-month program, 75 percent of participants had improved their performance of ADLs. Participants had difficulty with an average of 3.9 out of 8.0 ADLs at baseline, compared to 2.0 after five months. Symptoms of depression and the ability to perform instrumental ADLs such as shopping and managing medications also improved. Health systems are testing CAPABLE on a larger scale. The program has the potential to improve older adults' ability to age in place.

  9. Evaluation of a Home-Based Physical Therapy Program in Ischemic Stroke Patients

    Directory of Open Access Journals (Sweden)

    Elena Sîrbu

    2012-12-01

    Full Text Available The rehabilitation therapy should begin in the acute-care hospital as soon as possible after the stroke and continued after discharging patients from the hospital to their home environment. The purpose of this study was to evaluate the efficiency of a home-based physical therapy program in the improvement of motor function, balance and activities of daily living. Material and methods. Fourteen ischemic first stroke patients (8 women and 6 men, aged from 49 to 84 (mean 69 were recruited from the Neurology Department of the Emergency County Hospital Timişoara. After hospital discharge, they were assigned to a 12-week home physical therapy program in order to improve motor function, balance and activities of daily living (ADL. All patients were assessed before and after the training program with the following tests: (1 Barthel index; (2 Berg Balance Scale; (3 Motricity index; (4 Functional Independence Measure. Results. After 12 weeks of physical therapy, the motricity index showed a significant improvement in the study group which means a better motor outcome (p= 0,08. The mean score of the Barthel index was significantly increased (p=0.02, showing improvement in ADL ability. There was a benefit in reducing disability suggesting a better functional capacity and a higher level of independence (p= 0.03. Finally, our results showed that hemiplegic patients presented a better balance function after completing the rehabilitation program (p= 0,05.Conclusions.The intervention of a 12-week home physical therapy program in stroke survivors provided significantly better outcomes in motor function, balance function and activities of daily living.

  10. Evaluation of the U.S. Department of Energy Challenge Home Program Certification of Production Builders

    Energy Technology Data Exchange (ETDEWEB)

    Kerrigan, P. [Building Science Corporation, Somerville, MA (United States); Loomis, H. [Building Science Corporation, Somerville, MA (United States)

    2014-09-01

    The purpose of this project was to evaluate integrated packages of advanced measures in individual test homes to assess their performance with respect to Building America program goals, specifically compliance with the DOE Challenge Home Program. BSC consulted on the construction of five test houses by three cold climate production builders in three U.S. cities and worked with the builders to develop a design package tailored to the cost-related impacts for each builder. Also, BSC provided support through performance testing of the five test homes. Overall, the builders have concluded that the energy related upgrades (either through the prescriptive or performance path) represent reasonable upgrades. The builders commented that while not every improvement in specification was cost effective (as in a reasonable payback period), many were improvements that could improve the marketability of the homes and serve to attract more energy efficiency discerning prospective homeowners. However, the builders did express reservations on the associated checklists and added certifications. An increase in administrative time was observed with all builders. The checklists and certifications also inherently increase cost due to: adding services to the scope of work for various trades, such as HERS Rater, HVAC contractor; and increased material costs related to the checklists, especially the EPA Indoor airPLUS and EPA WaterSense® Efficient Hot Water Distribution requirement.

  11. Evaluation of the U.S. Department of Energy Challenge Home Program Certification of Production Builders

    Energy Technology Data Exchange (ETDEWEB)

    Kerrigan, P.; Loomis, H.

    2014-09-01

    The purpose of this project was to evaluate integrated packages of advanced measures in individual test homes to assess their performance with respect to Building America Program goals, specifically compliance with the DOE Challenge Home Program. BSC consulted on the construction of five test houses by three Cold Climate production builders in three separate US cities. BSC worked with the builders to develop a design package tailored to the cost-related impacts for each builder. Therefore, the resulting design packages do vary from builder to builder. BSC provided support through this research project on the design, construction and performance testing of the five test homes. Overall, the builders have concluded that the energy related upgrades (either through the prescriptive or performance path) represent reasonable upgrades. The builders commented that while not every improvement in specification was cost effective (as in a reasonable payback period), many were improvements that could improve the marketability of the homes and serve to attract more energy efficiency discerning prospective homeowners. However, the builders did express reservations on the associated checklists and added certifications. An increase in administrative time was observed with all builders. The checklists and certifications also inherently increase cost due to: 1. Adding services to the scope of work for various trades, such as HERS Rater, HVAC contractor; 2. Increased material costs related to the checklists, especially the EPA Indoor airPLUS and EPA WaterSense(R) Efficient Hot Water Distribution requirement.

  12. "Home Practice Is the Program": Parents' Practice of Program Skills as Predictors of Outcomes in the New Beginnings Program Effectiveness Trial.

    Science.gov (United States)

    Berkel, Cady; Sandler, Irwin N; Wolchik, Sharlene A; Brown, C Hendricks; Gallo, Carlos G; Chiapa, Amanda; Mauricio, Anne M; Jones, Sarah

    2016-12-08

    An examination of the content and processes of evidence-based programs is critical for empirically evaluating theories about how programs work, the "action theory" of the program (West et al. in American Journal of Community Psychology, 21, 571-605, 1993). The New Beginnings Program (NBP; Wolchik et al., 2007), a parenting-after-divorce preventive intervention, theorizes that program-induced improvements in parenting across three domains: positive relationship quality, effective discipline, and protecting children from interparental conflict, will reduce the negative outcomes that are common among children from divorced families. The process theory is that home practice of program skills related to these parenting domains is the primary mechanism leading to positive change in parenting. This theory was tested using multi-rater data from 477 parents in the intervention condition of an effectiveness trial of the NBP (Sandler et al. 2016a, 2016b). Four research questions were addressed: Does home practice of skills predict change in the associated parenting outcomes targeted by the program? Is the effect above and beyond the influence of attendance at program sessions? What indicators of home practice (i.e., attempts, fidelity, efficacy, and competence) are most predictive of improvements in parenting? Do these indicators predict parenting improvements in underserved subpopulations (i.e., fathers and Latinos)? Structural Equation Modeling analyses indicated that parent-reported efficacy and provider-rated parent competence of home practice predicted improvements in the targeted parenting domains according to both parent and child reports. Moreover, indicators of home practice predicted improvements in parenting for fathers and Latinos, although patterns of effects varied by parenting outcome.

  13. Spanish Visit

    CERN Multimedia

    2004-01-01

    On 23 January, CERN welcomed a visit by Pedro Morenés Eulate, Spanish Secretary of State for Scientific and Technological Policy. He was taken on a tour of the LHC Superconducting test facility, the CMS magnet assembly hall and the civil engineering works at Point 5. After a brief presentation on the AMS (Alpha Magnetic Spectrometer) experiment, delivered by Sam Ting, and lunch hosted by Director General Robert Aymar, he continued his tour of the ATLAS assembly hall and the ISOLDE experimental hall. Pedro Morenés finished his visit by meeting with the Spanish scientific community working at CERN. From left to right: Juan-Antonio Rubio, CERN, Responsible for the Education & Communication, Technology transfer and Scientific Information groups; Gonzalo León, General Secretary of the Spanish Ministry; Joaquín Pérez-Villanueva y Tovar, Ambassador, Permanent Representative of Spain to the United Nations Office; Robert Aymar, CERN Director General; Maria-José Garcia-Borge, ISOLDE and NTOF, CSIC Madrid Tea...

  14. Effect of home visit on anxiety and depression status of patients with peritoneal dialysis%家庭访视对腹膜透析患者焦虑抑郁状态的影响

    Institute of Scientific and Technical Information of China (English)

    赵小红; 赵红; 张瑞娟

    2014-01-01

    Objective:To explore the effect of home visit on anxiety and depression status of patients with peritoneal dialysis. Methods:60 patients with peritoneal dialysis were randomly divided into the intervention group and the control group(30 cases in each group). The routine follow-up was made in the control group and the home visiting intervention was additionally carried out in the intervention group. The anxiety and depression status of the patients was assessed by using SDS and SAS in the two groups. Results:The anxiety and depres-sion scores of the patients were lower after the intervention than those before the intervention in the two groups and the scores were also lower in the intervention group than the control group(P<0. 01);the incidence of anxiety and depression in any grade was lower in the intervention group than the control group(P<0. 05). Conclusion:The home visit,as an effective follow-up method,can relieve the anxie-ty and depression status of patients with peritoneal dialysis.%目的:探讨家庭访视对腹膜透析( PD)患者焦虑抑郁状态的影响。方法:将60例PD患者随机分为干预组和对照组各30例,对照组采用常规随访,干预组在此基础上实施家庭访视干预。应用自评抑郁量表( SDS)和自评焦虑量表( SAS)评估两组焦虑和抑郁状态。结果:干预后两组患者焦虑、抑郁得分低于干预前,也低于对照组同期水平( P<0.01)。干预组焦虑和抑郁分级后发现,各级的焦虑抑郁发生率均低于对照组( P<0.05)。结论:家庭访视是一种有效的随访方式,能改善PD患者的焦虑抑郁状态,应引起临床护理人员的高度重视。

  15. Effectiveness of a multidimensional home nurse led heart failure disease management program--a French nationwide time-series comparison.

    Science.gov (United States)

    Agrinier, Nelly; Altieri, Christelle; Alla, François; Jay, Nicolas; Dobre, Daniela; Thilly, Nathalie; Zannad, Faiez

    2013-10-09

    The purpose of this study was to assess the effectiveness of a disease management program (DMP) in heart failure (HF) on the incidence of HF hospitalizations and related costs in a real-world population-based setting. Insuffisance CArdiaque en LORraine (ICALOR), a DMP for HF was established in 2006 in the French region of Lorraine. Patients were enrolled after an index HF hospitalization. They received educational and home-visit monitoring programs by HF-trained nurses. General physicians received automatic alerts about patients' significant clinical or biological changes. We used the ICALOR and the national diagnostic related group databases to conduct a comparison of time-series trends in HF hospitalizations in France. The economic impact was obtained using the national scale of costs in France. The median age of the 1222 patients recruited before 2010 was 76 years, and 65% were male. Upon enrollment, patients essentially presented with NYHA class II (n=537, 48%) or class III (n=359, 32%) symptoms. One-year mortality rate was 20.3%. The implementation of the ICALOR program was associated with a reduction in HF hospitalizations in Lorraine estimated by an absolute difference between the number of hospitalizations observed in the Lorraine region and that expected had it been similar to that observed in the whole country of -7.19% in 2010. The estimated annual hospital cost saved by ICALOR was €1,927,648 in 2010. Coordinated DMP of HF might improve outcome cost-effectively when implemented in a real-world population setting, and was associated in Lorraine with a substantial modification of the trend of HF hospitalizations. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  16. Hospital to home: a geriatric educational program on effective discharge planning.

    Science.gov (United States)

    DeCaporale-Ryan, Lauren N; Cornell, Ann; McCann, Robert M; McCormick, Kevin; Speice, Jenny

    2014-01-01

    There has been increased attention on the needs of the burgeoning older adult population, with focus on the limited education and training experiences available in geriatric care. Older adults transitioning between levels of care often require increased attention, and the American Geriatrics Society (AGS) Task Force on the Future of Geriatric Medicine has encouraged greater training opportunities be provided to better understand the needs of this population. The Hospital to Home Program is one model of geriatric training emphasizing many of the AGS recommendations. Through qualitative analyses of 51 internal medicine residents' reflections, the authors report how this educational program is meeting the above need and share how Hospital to Home is enhancing residents' skills in creating a safe discharge for geriatric patients and their families.

  17. Upaya Peningkatan Status Gizi Balita Malnutrisi Akut Berat Melalui Program Home Care

    Directory of Open Access Journals (Sweden)

    Fitri Haryanti

    2014-12-01

    Full Text Available Malnutrisi pada balita masih merupakan permasalahan di Indonesia termasuk di Daerah Istimewa Yogyakarta. Berdasarkan indikator berat badan menurut tinggi badan, 2,6% balita mengalami malnutrisi akut berat. Pada beberapa dekade terakhir, telah terjadi pergeseran paradigma dalam penanganan balita malnutrisi, yang sebelumnya berbasis pendekatan fasilitas kesehatan bergeser menjadi pendekatan berbasis komunitas. Tujuan penelitian ini adalah untuk menganalisis pengaruh program home care terhadap peningkatan status gizi balita malnutrisi pada anak usia 6-60 bulan. Penelitian menggunakan desain kuasi eksperimen dengan pretest dan posttest control group melalui tiga tahap pendampingan yaitu intensif, mandiri, dan penguatan dengan pendekatan asuhan keperawatan. Sampel adalah 56 balita malnutrisi akut di dua wilayah, yaitu 33 balita di Kota Yogyakarta (eksperimen dan 23 balita di Kabupaten Sleman (kontrol dengan teknik pengambilan sampel yaitu purposive sampling. Intervensi home care diberikan selama tiga 3 bulan (Januari sampai Maret 2013. Hasil penelitian menunjukkan setelah program home care, terjadi peningkatan yang signifikan pada status gizi balita (p < 0,05. Pada akhir intervensi, terjadi penurunan kejadian malnutrisi akut berat dari 100% menjadi 56,7% (p < 0,05. Improving Nutritional Status of Children with Severe Acute Malnutrition Through Home Care Program Children undernutrition is still an issue in Indonesia, including in the Special Region of Yogyakarta. Based on weight for height indicator, 2.6% children experience severe acute malnutrition. In the last few decades, there has been a paradigm shift in the management of acute malnutrition from a facility- based to community-centered approach. The purpose of this study was to analyze the effect of home care intervention on the improvement of nutritional status of severe acute malnutrition children aged 6-60 months. This study was designed with quasi-experimental and pretest-posttest control

  18. Effectiveness of a home-based physical therapy program in patients with chronic low back pain

    Directory of Open Access Journals (Sweden)

    Elena SÎRBU

    2017-03-01

    Full Text Available Aim: To demonstrate the effectiveness of a home-based physical therapy program on pain, spine mobility and quality of daily activities in patients with chronic low back pain (CLBP. We also want to show that patients who undergo this program decreased their intake in analgesic and anti-inflammatory drugs. Methods: 18 patients with chronic low back pain were assessed with the following tests: VAS pain scale, Schober’s test and Rolland-Morris questionnaire. Acetaminophen and non-steroidal anti-inflammatory drugs (NSAID consumption was recorded. Over a period of six months all subjects participated in a 45 minutes home-based physical therapy program, three times per week. Before starting this intervention all patients were instructed and exercises were demonstrated in front of them by a physical therapist. Moreover, they received written brochures in order to exercise correctly at home. Follow-up examinations took place at baseline and six months later. Results: We obtained significant differences between pre- and post-intervention assessments of pain (p=0.001, lumbar flexion (p=0.0001 and functional status (p=0.0005 in our group. Moreover, the number of patients who were taken analgesics decreased from 7 (39% to 5 patients (28%. Likewise the number of patients who were taken anti-inflammatory drugs decreased from 11 (61% to 8 (44%. Conclusion: The home-based rehabilitation program was effective in improving the ranges of active lumbar flexion and in decreasing the physical disability caused by low back pain, as well as in reducing the levels of pain. We note that a larger number of patients have given up to the intake of NSAIDs comparative to those who have given up to analgesics.

  19. Impact of a home-based social welfare program on care for palliative patients in the Basque Country (SAIATU Program

    Directory of Open Access Journals (Sweden)

    Molina Emilio Herrera

    2013-01-01

    Full Text Available Abstract Background SAIATU is a program of specially trained in-home social assistance and companionship which, since February 2011, has provided support to end-of-life patients, enabling the delivery of better clinical care by healthcare professionals in Osakidetza (Basque Health Service, in Guipúzcoa (Autonomous Community of the Basque Country. In January 2012, a retrospective observational study was carried out, with the aim of describing the characteristics of the service and determining if the new social service and the associated socio-health co-ordination had produced any effect on the use of healthcare resources by end-of-life patients. The results of a comparison of a cohort of cases and controls demonstrated evidence that the program could reduce the use of hospital resources and promote the continuation of living at home, increasing the home-based activity of primary care professionals. The objective of this study is to analyse whether a program of social intervention in palliative care (SAIATU results in a reduction in the consumption of healthcare resources and cost by end-of-life patients and promotes a shift towards a more community-based model of care. Method/design Comparative prospective cohort study, with randomised selection of patients, which will systematically measure patient characteristics and their consumption of resources in the last 30 days of life, with and without the intervention of a social support team trained to provide in-home end-of-life care. For a sample of approximately 150 patients, data regarding the consumption of public healthcare resources, SAIATU activity, home hospitalisation teams, and palliative care will be recorded. Such data will also include information dealing with the socio-demographic and clinical characteristics of the patients and attending carers, as well as particular characteristics of patient outcomes (Karnofsky Index, and of the outcomes of palliative care received (Palliative

  20. Process evaluation to explore internal and external validity of the "Act in Case of Depression" care program in nursing homes.

    NARCIS (Netherlands)

    Leontjevas, R.; Gerritsen, D.L.; Koopmans, R.T.C.M.; Smalbrugge, M.; Vernooij-Dassen, M.J.F.J.

    2012-01-01

    BACKGROUND: A multidisciplinary, evidence-based care program to improve the management of depression in nursing home residents was implemented and tested using a stepped-wedge design in 23 nursing homes (NHs): "Act in case of Depression" (AiD). OBJECTIVE: Before effect analyses, to evaluate AiD proc

  1. The Effect of a Physical Activity Program on the Total Number of Primary Care Visits in Inactive Patients: A 15-Month Randomized Controlled Trial.

    Directory of Open Access Journals (Sweden)

    Maria Giné-Garriga

    Full Text Available Effective promotion of exercise could result in substantial savings in healthcare cost expenses in terms of direct medical costs, such as the number of medical appointments. However, this is hampered by our limited knowledge of how to achieve sustained increases in physical activity.To assess the effectiveness of a Primary Health Care (PHC based physical activity program in reducing the total number of visits to the healthcare center among inactive patients, over a 15-month period.Randomized controlled trial.Three hundred and sixty-two (n = 362 inactive patients suffering from at least one chronic condition were included. One hundred and eighty-three patients (n = 183; mean (SD; 68.3 (8.8 years; 118 women were randomly allocated to the physical activity program (IG. One hundred and seventy-nine patients (n = 179; 67.2 (9.1 years; 106 women were allocated to the control group (CG. The IG went through a three-month standardized physical activity program led by physical activity specialists and linked to community resources.The total number of medical appointments to the PHC, during twelve months before and after the program, was registered. Self-reported health status (SF-12 version 2 was assessed at baseline (month 0, at the end of the intervention (month 3, and at 12 months follow-up after the end of the intervention (month 15.The IG had a significantly reduced number of visits during the 12 months after the intervention: 14.8 (8.5. The CG remained about the same: 18.2 (11.1 (P = .002.Our findings indicate that a 3-month physical activity program linked to community resources is a short-duration, effective and sustainable intervention in inactive patients to decrease rates of PHC visits.ClinicalTrials.gov NCT00714831.

  2. Effect of 3-Months Home-Based Exercise Program on Changes of Cognitive Functioning in Older Adults Living in Old People’s Home

    Directory of Open Access Journals (Sweden)

    Nemček Dagmar

    2016-05-01

    Full Text Available The aim of the study was to determine the effect of regular participation in home-based exercise programme on cognitive functioning changes in institutionalised older adults. Two groups of participants were recruited for the study: experimental (n = 17 in mean age 76 ± 5.6 years, who participated in home-based exercise program and control (n = 14 in mean age 80 ± 4.2 years. The standardised Stroop Color-Word Test-Victoria version (VST was used to measure the level of cognitive functions. Group differences were analyzed with Mann-Whitney U-test for independent samples and for differences between pre-measurements and post-measurements on experimental and control group we used non-parametric Wilcoxon Signed - Rank Test. The level of significance was α < 0.05. Application of 3-months home-based exercise program significantly improved the cognitive functions only in one (Word condition; p<0.01 from three VST conditions in institutionalised older adults. That’s why we recommend longer participation in home-based exercise program, at least 6- months, with combination of various types of cognitive interventions, like concepts of cognitive training, cognitive rehabilitation, and cognitive stimulation to improve cognitive functioning in older adults living in old peoples’ homes.

  3. Cost-effectiveness of In-Home Cognitive Behavioral Therapy for low-income depressed mothers participating in early childhood prevention programs.

    Science.gov (United States)

    Ammerman, Robert T; Mallow, Peter J; Rizzo, John A; Putnam, Frank W; Van Ginkel, Judith B

    2017-01-15

    To determine the cost-effectiveness of In-Home Cognitive Behavioral Therapy (IH-CBT) for low-income mothers enrolled in a home visiting program. A cost-utility analysis was conducted using results from a clinical trial of IH-CBT and standard of care for depression derived from the literature. A probabilistic, patient-level Markov model was developed to determine Quality Adjusted Life Years (QALYs). Costs were determined using the Medical Expenditure Panel Survey. A three-year time horizon and payer perspective were used. Sensitivity analyses were employed to determine robustness of the model. IH-CBT was cost-effective relative to standard of care. IH-CBT was expected to be cost-effective at a three-year time horizon 99.5%, 99.7%, and 99.9% of the time for willingness-to-pay thresholds of US$25,000, US$50,000, and US$100,000, respectively. Patterns were upheld at one-year and five-year time horizons. Over the three-year time horizon, mothers receiving IH-CBT were expected to have 345.6 fewer days of depression relative to those receiving standard home visiting and treatment in the community. IH-CBT is a more cost-effective treatment for low-income, depressed mothers than current standards of practice. These findings add to the growing literature demonstrating the cost-effectiveness of CBT for depression, and expand it to cover new mothers. From a payer perspective, IH-CBT is a sound option for treatment of depressed, low-income mothers. Limitations include a restricted time horizon and estimating of standard of care costs. Copyright © 2016 Elsevier B.V. All rights reserved.

  4. Serotonin transporter gene (SLC6A4) polymorphism and susceptibility to a home-visiting maternal-infant attachment intervention delivered by community health workers in South Africa: Reanalysis of a randomized controlled trial

    Science.gov (United States)

    Moser, Dirk; Skeen, Sarah; Cooper, Peter; Murray, Lynne; Moran, Greg

    2017-01-01

    Background Clear recognition of the damaging effects of poverty on early childhood development has fueled an interest in interventions aimed at mitigating these harmful consequences. Psychosocial interventions aimed at alleviating the negative impacts of poverty on children are frequently shown to be of benefit, but effect sizes are typically small to moderate. However, averaging outcomes over an entire sample, as is typically done, could underestimate efficacy because weaker effects on less susceptible individuals would dilute estimation of effects on those more disposed to respond. This study investigates whether a genetic polymorphism of the serotonin transporter gene moderates susceptibility to a psychosocial intervention. Methods and findings We reanalyzed data from a randomized controlled trial of a home-visiting program delivered by community health workers in a black, isiXhosa-speaking population in Khayelitsha, South Africa. The intervention, designed to enhance maternal-infant attachment, began in the third trimester and continued until 6 mo postpartum. Implemented between April 1999 and February 2003, the intervention comprised 16 home visits delivered to 220 mother–infant dyads by specially trained community health workers. A control group of 229 mother–infant dyads did not receive the intervention. Security of maternal-infant attachment was the main outcome measured at infant age 18 mo. Compared to controls, infants in the intervention group were significantly more likely to be securely attached to their primary caregiver (odds ratio [OR] = 1.7, p = 0.029, 95% CI [1.06, 2.76], d = 0.29). After the trial, 162 intervention and 172 control group children were reenrolled in a follow-up study at 13 y of age (December 2012–June 2014). At this time, DNA collected from 279 children (134 intervention and 145 control) was genotyped for a common serotonin transporter polymorphism. There were both genetic data and attachment security data for 220 children

  5. Integrative psychotherapeutic nursing home program to reduce multiple psychiatric symptoms of cognitively impaired patients and caregiver burden: randomized controlled trial

    NARCIS (Netherlands)

    Bakker, T.J.; Duivenvoorden, H.J.; Lee, J. van der; Olde Rikkert, M.G.M.; Beekman, A.T.; Ribbe, M.W.

    2011-01-01

    OBJECTIVE: To test the effectiveness of an integrative psychotherapeutic nursing home program (integrative reactivation and rehabilitation [IRR]) to reduce multiple neuropsychiatry symptoms (MNPS) of cognitively impaired patients and caregiver burden (CB). DESIGN: Randomized controlled trial. SETTIN

  6. Visita domiciliária: um olhar da enfermagem psiquiátrica La visita a domicilio: una mirada de la enfermería psiquiátrica Home visit: the perspective of the psychiatric nursing

    Directory of Open Access Journals (Sweden)

    Renata Curi Labate

    2004-10-01

    Full Text Available A visita domiciliária é tema de interesse em diversas áreas da enfermagem. Em psiquiatria, com a implantação de serviços psiquiátricos na comunidade, a necessidade de realizar visita domiciliaria tornou-se evidente. Por um período de um ano estivemos envolvidos com esta atividade, solicitando-a ou realizando-a para pacientes atendidos no Núcleo de Saúde Mental. O objetivo deste trabalho é relatar esta experiência, destacando os seguintes aspectos: O Espaço Público e o Privado da família e a articulação entre visitadores e os recursos da comunidade. A visita domiciliaria aproxima a equipe do contexto do doente e favorece a articulação entre o doente, sua família, o serviço de saúde e os recursos da comunidade.La visita domiciliaria es tema de interés en diversas áreas de enfermería. En psiquiatría, con la implantación de servicios psiquiátricos en la comunidad, la necesidad para las visitas ha llegado a ser evidente. Durante un año hemos estado involucrados en esta actividad, realizándola o solicitándola para pacientes atendidos en el Núcleo de Salud Mental. El objetivo de este trabajo es describir nuestra experiencia, detallando los siguientes aspectos: La Vida Pública y Privada de la Familia y la colaboración entre los profesionales y los recursos en la comunidad. Las visitas domiciliarias reúnen al equipo desde el contexto del enfermo y favorece la articulación entre el enfermo, su familia, el servicio de salud y los recursos de la comunidad.The home visit is a matter of concern in diverse areas of nursing. With the implementation of psychiatric services in the community, the need for visits has become evident. For one year, we were involved with this activity, requesting it or providing it for patients assisted in the Núcleo de Saúde Mental (Mental Health Center. The aim of this paper is to describe our experience, detailing the following aspects: the public and private life of the family and the

  7. Home healthcare services in Taiwan: a nationwide study among the older population

    Directory of Open Access Journals (Sweden)

    Lai Hsiu-Yun

    2010-09-01

    Full Text Available Abstract Background Home healthcare services are important in aging societies worldwide. The present nationwide study of health insurance data examined the utilization and delivery patterns, including diagnostic indications, for home healthcare services used by seniors in Taiwan. Methods Patients ≥65 years of age who received home healthcare services during 2004 under the Taiwanese National Health Insurance Program were identified and reimbursement claims were analyzed. Age, gender, disease diagnoses, distribution of facilities providing home healthcare services, and patterns of professional visits, including physician and skilled nursing visits, were also explored. Results Among 2,104,978 beneficiaries ≥65 years of age, 19,483 (0.9% patients received 127,753 home healthcare visits during 2004 with a mean number of 6.0 ± 4.8 visits per person. The highest prevalence of home healthcare services was in the 75-84 year age group in both sexes. Females received more home healthcare services than males in all age groups. Cerebrovascular disease was the most frequent diagnosis in these patients (50.7%. More than half of home healthcare visits and around half of the professional home visits were provided by community home nursing care institutions. The majority of the home skilled nursing services were tube replacements, including nasogastric tubes, Foley catheter, tracheostomy, nephrostomy or cystostomy tubes (95%. Conclusions Nine out of 1,000 older patients in Taiwan received home healthcare services during 2004, which was much lower than the rate of disabled older people in Taiwan. Females used home healthcare services more frequently than males and the majority of skilled nursing services were tube replacements. The rate of tube replacement of home healthcare patients in Taiwan deserves to be paid more attention.

  8. Greenbelt Homes Pilot Energy Efficiency Program Phase 1 Summary: Existing Conditions and Baseline Energy Use

    Energy Technology Data Exchange (ETDEWEB)

    Wiehagen, J.; Del Bianco, M.; Wood, A.

    2013-02-01

    A multi-year pilot energy efficiency retrofit project has been undertaken by Greenbelt Homes, Inc, (GHI) a 1,566 co-operative of circa 1930 and '40 homes. The three predominate construction methods of the townhomes in the community are materials common to the area and climate zone including 8" CMU block, wood frame with brick veneer and wood frame with vinyl siding. GHI has established a pilot project that will serve as a basis for decision making for the roll out of a decade-long community upgrade program that will incorporate energy efficiency to the building envelope and equipment with the modernization of other systems like plumbing, mechanical equipment, and cladding.

  9. Greenbelt Homes Pilot Energy Efficiency Program Phase 1 Summary. Existing Conditions and Baseline Energy Use

    Energy Technology Data Exchange (ETDEWEB)

    Wiehagen, J. [NAHB Research Center, Upper Marlboro, MD (United States); Del Bianco, M. [NAHB Research Center, Upper Marlboro, MD (United States); Wood, A. [NAHB Research Center, Upper Marlboro, MD (United States)

    2013-02-01

    A multi-year pilot energy efficiency retrofit project has been undertaken by Greenbelt Homes, Inc, (GHI) a 1,566 co-operative of circa 1930 and '40 homes. The three predominate construction methods of the townhomes in the community are materials common to the area and climate zone including 8” CMU block, wood frame with brick veneer and wood frame with vinyl siding. GHI has established a pilot project that will serve as a basis for decision making for the roll out of a decade-long community upgrade program that will incorporate energy efficiency to the building envelope and equipment with the modernization of other systems like plumbing, mechanical equipment, and cladding.

  10. Older persons' experiences of a home-based exercise program with behavioral change support.

    Science.gov (United States)

    Arkkukangas, Marina; Sundler, Annelie J; Söderlund, Anne; Eriksson, Staffan; Johansson, Ann-Christin

    2017-08-16

    It is a challenge to promote exercise among older persons. Knowledge is needed regarding the maintenance of exercise aiming at preventing falls and promoting health and well-being in older persons. This descriptive study used a qualitative inductive approach to describe older persons' experiences of a fall-preventive, home-based exercise program with support for behavioral change. Semi-structured interviews were conducted with 12 elderly persons aged 75 years or older, and a qualitative content analysis was performed. Four categories emerged: facilitators of performing exercise in everyday life, the importance of support, perceived gains from exercise, and the existential aspects of exercise. With support from physiotherapists (PTs), home-based exercise can be adapted to individual circumstances in a meaningful way. Including exercises in everyday life and daily routines could support the experience of being stronger, result in better physical functioning, and give hope for an extended active life in old age.

  11. Visitation by wild and managed bees (Hymenoptera: Apoidea) to eastern U.S. native plants for use in conservation programs.

    Science.gov (United States)

    Tuell, Julianna K; Fiedler, Anna K; Landis, Douglas; Isaacs, Rufus

    2008-06-01

    Addition of floral resources to agricultural field margins has been shown to increase abundance of beneficial insects in crop fields, but most plants recommended for this use are non-native annuals. Native perennial plants with different bloom periods can provide floral resources for bees throughout the growing season for use in pollinator conservation projects. To identify the most suitable plants for this use, we examined the relative attractiveness to wild and managed bees of 43 eastern U.S. native perennial plants, grown in a common garden setting. Floral characteristics were evaluated for their ability to predict bee abundance and taxa richness. Of the wild bees collected, the most common species (62%) was Bombus impatiens Cresson. Five other wild bee species were present between 3 and 6% of the total: Lasioglossum admirandum (Sandhouse), Hylaeus affinis (Smith), Agapostemon virescens (F.), Halictus ligatus Say, and Ceratina calcarata/dupla Robertson/Say. The remaining wild bee species were present at plant species were visited at least once by wild bees; 9 were highly attractive, and 20 were moderately attractive. Honey bees visited 24 of the 43 plant species at least once. Floral area was the only measured factor accounting for variation in abundance and richness of wild bees but did not explain variation in honey bee abundance. Results of this study can be used to guide selection of flowering plants to provide season-long forage for conservation of wild bees.

  12. Concepções da equipe de saúde da família sobre as visitas domiciliares Concepciones del equipo de salud de la familia sobre das visitas domiciliarias Conceptions of the family health team about home visits

    Directory of Open Access Journals (Sweden)

    Karen Namie Sakata

    2007-12-01

    Full Text Available Entendendo as visitas domiciliares enquanto tecnologia de interação no cuidado à saúde da família, o objetivo foi compreender as concepções da equipe de Saúde da Família sobre as visitas. Utilizou-se abordagem qualitativa e a entrevista semi-estruturada foi o instrumento de coleta de dados. Foram entrevistados dezenove profissionais de duas equipes de Saúde de Família de um município do interior paulista. Os resultados mostraram que as visitas são atividades potenciais para o cuidado à família, mais humano e acolhedor, permitindo o vínculo, laços de confiança e conhecer o usuário no seu ambiente familiar. Apreende-se que as visitas ora são compreendidas como acompanhamento da saúde, ora como fiscalização. Dificuldades existiram como pouco tempo disponível e impotência da equipe frente aos problemas.Entendiendo las visitas domiciliarias como tecnología de interacción en el cuidado a la salud de la familia, la finalidad fue comprender las concepciones del equipo de Salud de la Familia sobre las visitas. Se utilizó una aproximación cualitativa y la entrevista semiestructurada fue el instrumento de recolecta de datos. Se entrevistaron a diecinueve profesionales de dos equipos de Salud de la Familia de un municipio del interior paulista. Los resultados mostraron que las visitas son actividades potenciales para el cuidado a la familia, más humano y acogedor, permitiendo el vínculo, lazos de confianza y conocer al usuario en su ambiente familiar. Se aprehende que las visitas ora son comprendidas como acompañamiento de la salud, ora como fiscalización. Dificultades existieron, tales como poco tiempo disponible e impotencia del equipo ante los problemas.Connsidering home visits as a technology for interaction in family health care, this study aimed to understand how the Family Health team conceives these visits. A qualitative approach was used and data were collected through semistructured interviews. We interviewed

  13. A Randomised Controlled Trial of Two Early Intervention Programs for Young Children with Autism: Centre-Based with Parent Program and Home-Based

    Science.gov (United States)

    Roberts, Jacqueline; Williams, Katrina; Carter, Mark; Evans, David; Parmenter, Trevor; Silove, Natalie; Clark, Trevor; Warren, Anthony

    2011-01-01

    This study compares outcomes of early intervention programs for young children with autism; an individualised home-based program (HB), a small group centre-based program for children combined with a parent training and support group (CB) and a non-treatment comparison group (WL). Outcome measures of interest include social and communication skill…

  14. [Results of a physical therapy program in nursing home residents: A randomized clinical trial].

    Science.gov (United States)

    Casilda-López, Jesús; Torres-Sánchez, Irene; Garzón-Moreno, Victor Manuel; Cabrera-Martos, Irene; Valenza, Marie Carmen

    2015-01-01

    The maintenance of the physical functionality is a key factor in the care of the elderly. Inactive people have a higher risk of death due to diseases associated with inactivity. In addition, the maintenance of optimal levels of physical and mental activity has been suggested as a protective factor against the development and progression of chronic illnesses and disability. The objective of this study is to assess the effectiveness of an 8-week exercise program with elastic bands, on exercise capacity, walking and balance in nursing home residents. A nursing home sample was divided into two groups, intervention group (n=26) and control group (n=25). The intervention group was included in an 8-week physical activity program using elastic bands, twice a week, while the control group was took part in a walking programme. Outcome measurements were descriptive variables (anthropometric characteristics, quality of life, fatigue, fear of movement) and fundamental variables (exercise capacity, walking and balance). A significant improvement in balance and walking speed was observed after the programme. Additionally, exercise capacity improved significantly (P≤.001), and the patients showed an improvement in perceived dyspnea after the physical activity programme in the intervention group. The exercise program was safe and effective in improving dyspnea, exercise capacity, walking, and balance in elderly. Copyright © 2014 SEGG. Published by Elsevier Espana. All rights reserved.

  15. Greenbelt Homes Pilot Program: Summary of Building Envelope Retrofits, Planned HVAC Equipment Upgrades, and Energy Savings

    Energy Technology Data Exchange (ETDEWEB)

    Wiehagen, J. [Partnership for Home Innovation, Upper Marlboro, MD (United States); Del Bianco, M. [Partnership for Home Innovation, Upper Marlboro, MD (United States); Mallay, D. [Partnership for Home Innovation, Upper Marlboro, MD (United States)

    2015-05-01

    In the fall of 2010, a multiyear pilot energy efficiency retrofit project was undertaken by Greenbelt Homes, Inc, (GHI) a 1,566 home cooperative of circa 1930 and 1940 homes in Greenbelt, Maryland. GHI established this pilot project to serve as a basis for decision making for the rollout of a decade-long community-wide upgrade program that will incorporate energy efficiency improvements to the building envelope and mechanical equipment. It presents a unique opportunity to evaluate and prioritize the wide-range of benefits of high-performance retrofits based on member experience with and acceptance of the retrofit measures implemented during the pilot project. Addressing the complex interactions between benefits, trade-offs, construction methods, project management implications, realistic upfront costs, financing, and other considerations, serves as a case study for energy retrofit projects to include high-performance technologies based on the long-term value to the homeowner. The pilot project focused on identifying the added costs and energy savings benefits of improvements.

  16. Home infusion program for Fabry disease: experience with agalsidase alfa in Argentina

    Directory of Open Access Journals (Sweden)

    Isaac Kisinovsky

    2013-02-01

    Full Text Available Fabry disease is an X-linked lysosomal storage disorder caused by inherited deficiency of the enzyme α-galactosidase A. Enzyme replacement treatment using agalsidase alfa significantly reduces pain, improves cardiac function and quality of life, and slows renal deterioration. Nevertheless, it is a life-long treatment which requires regular intravenous infusions and entails a great burden for patients. Our objective was to evaluate retrospectively the safety and tolerability of the home infusion of agalsidase alfa in patients with Fabry disease in Argentina. We evaluated all the patients with Fabry disease who received home infusion with agalsidase alfa 0.2 mg/kg between January 2005 and June 2011. The program included 87 patients; 51 males (mean age: 30 years and 36 females (mean age: 34 years. A total of 5229 infusions (mean: 59 per patient; range: 1-150 were administered. A total of 5 adverse reactions were seen in 5 patients (5.7% of patients and 0.9% of the total number of infusions. All were mild in severity and resolved by reducing the rate of infusion and by using antihistaminics. All these 5 patients were positive for IgG antibodies, but none of them presented IgE antibodies and none suffered an anaphylactic shock. In our group 18 patients were switched from agalsidase beta to agalsidase alfa without complications. Home infusion with agalsidase alfa is safe, well tolerated and is associated to high compliance.

  17. The Home Independence Program with non-health professionals as care managers: an evaluation

    Directory of Open Access Journals (Sweden)

    Lewin G

    2016-06-01

    Full Text Available Gill Lewin,1 Karyn Concanen,2 David Youens3 1School of Nursing, Midwifery and Paramedicine, Curtin University, Perth, WA, Australia; 2Silver Chain Group, Osborne Park, WA, Australia; 3Faculty of Health Science, Curtin University, Perth, WA, Australia Abstract: The Home Independence Program (HIP, an Australian restorative home care/reablement service for older adults, has been shown to be effective in reducing functional dependency and increasing functional mobility, confidence in everyday activities, and quality of life. These gains were found to translate into a reduced need for ongoing care services and reduced health and aged care costs over time. Despite these positive outcomes, few Australian home care agencies have adopted the service model – a key reason being that few Australian providers employ health professionals, who act as care managers under the HIP service model. A call for proposals from Health Workforce Australia for projects to expand the scope of practice of health/aged care staff then provided the opportunity to develop, implement, and evaluate a service delivery model, in which nonprofessionals replaced the health professionals as Care Managers in the HIP service. Seventy older people who received the HIP Coordinator (HIPC service participated in the outcomes evaluation. On a range of personal outcome measures, the group showed statistically significant improvement at 3 and 12 months compared to baseline. On each outcome, the improvement observed was larger than that observed in a previous trial in which the service was delivered by health professionals. However, differences in the timing of data collection between the two studies mean that a direct comparison cannot be made. Clients in both studies showed a similarly reduced need for ongoing home care services at both follow-up points. The outcomes achieved by HIPC, with non-health professionals as Care Managers, were positive and can be considered to compare favorably

  18. The Study of Patients' Adherence with COPD Therapy by Home Visit%家庭访视对慢性阻塞性肺病患者治疗依从性的影响

    Institute of Scientific and Technical Information of China (English)

    胡波; 苗秀欣; 朱秀丽; 修麓璐; 赵京明

    2013-01-01

    目的 探讨家庭访视对慢性阻塞性肺病患者治疗依从性的影响.方法 将70名COPD患者分为观察组和对照组各35例,对照组行常规治疗指导和定期复诊;观察组在常规治疗指导、定期复诊的基础上行家庭访视,历时24周.两组干预前后以及干预后3个月应用六分钟步行距离(six minute walking distance,6-MWD)测验、中文版西雅图阻塞性肺疾病问卷(SOLDQ)以及治疗依从性指标进行测量;应用SPSS统计学软件进行数据分析.结果 干预后两组比较,6-MWD、呼吸困难量表(MRC)测定及治疗依从性指标差异具有统计学意义(P<0.01),干预后3个月测定,两组差异仍具有统计学意义(P<0.05).结论 定期家庭访视,能显著提高慢性阻塞性肺病患者的治疗依从性、提高运动耐力和生活质量,成效至少可维持3个月.%Objective To study the patients adherence with therapy of chronic obstructive pulmonary disease by home visit. Methods Seventy patients with COPD were divided into observation group and control group, with 35 cases in each group. The control group received conventional treatment guidelines, which included regular reexamination, observation group received home visit based on the conventional treatment of guidance and regular reexamination, which lasted 24 weeks. Before and after 3 months of intervention,two groups were surveyed by six minute walking distance (six minute walking distance,6-MWD) test,the Chinese version of the Seattle obstructive pulmonary disease questionnaire (SOLDQ) and therapy adherence index measurement. The outcomes were analyzed applying SPSS statistical software. Results After intervention, two groups showed significant differences ( P < 0.01) in MWD, MRC determination and therapy adherence index, however the difference between the two groups was significant after 3 months ( P < 0. 05 ). Conclusion The therapy adherence and exercise tolerance and quality of life can be significantly

  19. How effective are programs at managing transition from hospital to home? A case study of the Australian transition care program

    Directory of Open Access Journals (Sweden)

    Gray Leonard C

    2012-03-01

    Full Text Available Abstract Background An increasing demand for acute care services due in part to rising proportions of older people and increasing rates of chronic diseases has led to new models of post-acute care for older people that offer coordinated discharge, ongoing support and often a focus on functional restoration. Overall, review of the literature suggests there is considerable uncertainty around the effectiveness and resource implications of the various model configurations and delivery approaches. In this paper, we review the current evidence on the efficacy of such programs, using the Australian Transition Care Program as a case study. Discussion The Australian Transition Care Program was established at the interface of the acute and aged care sectors with particular emphasis on transitions between acute and community care. The program is intended to enable a significant proportion of care recipients to return home, rather than prematurely enter residential aged care, optimize their functional capacity, and reduce inappropriate extended lengths of hospital stay for older people. Broadly, the model is configured and targeted in accordance with programs reported in the international literature to be effective. Early evaluations suggest good acceptance of the program by hospitals, patients and staff. Ultimately, however, the program's place in the array of post-acute services should be determined by its demonstrated efficacy relative to other services which cater for similar patient groups. Summary Currently there is a lack of robust evaluation to provide convincing evidence of efficacy, either from a patient outcome or cost reduction perspective. As the program expands and matures, there will be opportunity to scrutinise the systematic effects, with lessons for both Australian and international policy makers and clinical leaders.

  20. The Effects of a Life Review Program on Disorientation, Social Interaction and Self-Esteem of Nursing Home Residents.

    Science.gov (United States)

    Tabourne, Carla E. S.

    1995-01-01

    Examined the effects on veteran and novice participants of a life review program for nursing home residents with Alzheimers disease or severe cognitive dysfunction. Results confirm the impact of the Life Review Program on level of disorientation, social interaction, and life review. Evidence suggests that life improvements may be stored in memory…

  1. Evaluation of an Intensive In-Home Services Program Aimed at Parents with Substance Abuse Issues Reported for Child Maltreatment.

    Science.gov (United States)

    Dore, Martha Morrison

    This paper discusses the results of a study that investigated the effectiveness of a demonstration program designed to provide in-home intervention with parents and children in families with substance abuse issues. The goals of the program were to prevent further child abuse or neglect, prevent family breakdown and child placement, and facilitate…

  2. Development of a wheelchair skills home program for older adults using a participatory action design approach.

    Science.gov (United States)

    Giesbrecht, Edward M; Miller, William C; Mitchell, Ian M; Woodgate, Roberta L

    2014-01-01

    Restricted mobility is the most common impairment among older adults and a manual wheelchair is often prescribed to address these limitations. However, limited access to rehabilitation services results in older adults typically receiving little or no mobility training when they receive a wheelchair. As an alternative and novel approach, we developed a therapist-monitored wheelchair skills home training program delivered via a computer tablet. To optimize efficacy and adherence, principles of self-efficacy and adult learning theory were foundational in the program design. A participatory action design approach was used to engage older adult wheelchair users, care providers, and prescribing clinicians in an iterative design and development process. A series of prototypes were fabricated and revised, based on feedback from eight stakeholder focus groups, until a final version was ready for evaluation in a clinical trial. Stakeholder contributions affirmed and enhanced the foundational theoretical principles and provided validation of the final product for the target population.

  3. Development of a Wheelchair Skills Home Program for Older Adults Using a Participatory Action Design Approach

    Directory of Open Access Journals (Sweden)

    Edward M. Giesbrecht

    2014-01-01

    Full Text Available Restricted mobility is the most common impairment among older adults and a manual wheelchair is often prescribed to address these limitations. However, limited access to rehabilitation services results in older adults typically receiving little or no mobility training when they receive a wheelchair. As an alternative and novel approach, we developed a therapist-monitored wheelchair skills home training program delivered via a computer tablet. To optimize efficacy and adherence, principles of self-efficacy and adult learning theory were foundational in the program design. A participatory action design approach was used to engage older adult wheelchair users, care providers, and prescribing clinicians in an iterative design and development process. A series of prototypes were fabricated and revised, based on feedback from eight stakeholder focus groups, until a final version was ready for evaluation in a clinical trial. Stakeholder contributions affirmed and enhanced the foundational theoretical principles and provided validation of the final product for the target population.

  4. 社区护士主导的全科团队家访服务对高龄居家老人心理状况的影响%Influence of community nurse-led multidisciplinary team home visiting services on psychological state of old age of home elderly

    Institute of Scientific and Technical Information of China (English)

    易景娜; 陈利群; 贾守梅; 陆敏敏; 荀雪琴

    2012-01-01

    Objective:To probe into the influence of community nurse - led multidisciplinary team home visiting service on psychological state such as depression and loneliness of community advanced age of old people at home. Methods: A total of 144 old people at home whose cognition was clear and whose age was over 80 years old were randomly divided into intervention group(n = 74) and control group(n = 70) by throwing coins. The intervention group patients received the nurse - led multidisciplinary team home visiting. The control group cases received routine community health service. The changes of depression and loneliness indexes were observed respectively before intervention, at three months after intervention and six months after intervention. Results: There was statistical significant difference in depression and loneliness score of advanced age of old people at home between both groups(P0. 05). Conclusion: The nurse-led multi-disciplinary home visiting service can improve the adverse psychological conditions such as depression and loneliness of advanced age of old people at home,and the team mode is operational and practical.%[目的]探讨以社区护士为主导的全科团队家访服务对社区高龄居家老人抑郁、孤独等心理状况的影响.[方法]采用投掷硬币法将144名认知清楚的80岁以上居家老人按照居住地随机分为干预组(74例)和对照组(70例),干预组接受社区护士为主导的全科团队家访服务,对照组接受常规社区卫生服务.采用重复测量方差分析两组干预前、干预3个月、6个月时抑郁、孤独指标的变化.[结果]两组高龄居家老人抑郁、孤独得分比较差异有统计学意义(P<0.001);两组抑郁、孤独各时间点的单独处理效应显示干预组在干预3个月、6个月时各领域得分均较干预前降低(P<0.001),而对照组无明显变化(P>0.05).[结论]社区护士为主导的全科团队家访服务可明显改善高龄居家老人的抑郁

  5. Needs and preference assessment for an in-home nutrition education program using social marketing theory.

    Science.gov (United States)

    Francis, Sarah L; Taylor, Martha L; Strickland, Amy Williams

    2004-01-01

    Nutrition education programs for elder caregivers (CG) and their elder care recipients (CR) are important in preventing malnutrition. Using Social Marketing Theory, this study assessed the needs and preferences for nutrition education in elder CGs and their CRs in Guilford County, NC. Thirty-two pairs of community-residing elder CGs/CRs and three focus groups (FGs) participated. Health and diet questionnaires were administered to all CGs/CRs during in-home interviews. CGs/CRs and FGs evaluated nutrition education materials. Questionnaires were analyzed using SPSS v9. Ethnograph v5.0 was used to code the interviews regarding the education materials. The CGs were middle age (58.9 years), overweight (BMI = 28.8) Caucasian women. The CRs were old (79.4 years), overweight (BMI = 26.0) Caucasian women. Identified malnutrition risk factors of CGs and CRs included inadequate fluid and dietary intake, polypharmacy, and chronic disease. Identified nutrition needs and education preferences of CGs/CRs were similar. Perceived nutrition education preferences of the FGs did not reflect the interests of the CGs/CRs. This information is being used to revise the education materials and develop an in-home nutrition education program for CGs and CRs in Guilford County, NC.

  6. Identifying Feasible Physical Activity Programs for Long-Term Care Homes in the Ontario Context

    Science.gov (United States)

    Shakeel, Saad; Newhouse, Ian; Malik, Ali; Heckman, George

    2015-01-01

    Background Structured exercise programs for frail institutionalized seniors have shown improvement in physical, functional, and psychological health of this population. However, the ‘feasibility’ of implementation of such programs in real settings is seldom discussed. The purpose of this systematic review was to gauge feasibility of exercise and falls prevention programs from the perspective of long-term care homes in Ontario, given the recent changes in funding for publically funded physiotherapy services. Method Six electronic databases were searched by two independent researchers for randomized controlled trials that targeted long-term care residents and included exercise as an independent component of the intervention. Results A total of 39 studies were included in this review. A majority of these interventions were led by physiotherapist(s), carried out three times per week for 30–45 minutes per session. However, a few group-based interventions that were led by long-term care staff, volunteers, or trained non-exercise specialists were identified that also required minimal equipment. Conclusion This systematic review has identified ‘feasible’ physical activity and falls prevention programs that required minimal investment in staff and equipment, and demonstrated positive outcomes. Implementation of such programs represents cost-effective means of providing long-term care residents with meaningful gains in physical, psychological, and social health. PMID:26180563

  7. HOME Plus: Program design and implementation of a family-focused, community-based intervention to promote the frequency and healthfulness of family meals, reduce children's sedentary behavior, and prevent obesity.

    Science.gov (United States)

    Flattum, Colleen; Draxten, Michelle; Horning, Melissa; Fulkerson, Jayne A; Neumark-Sztainer, Dianne; Garwick, Ann; Kubik, Martha Y; Story, Mary

    2015-04-29

    Involvement in meal preparation and eating meals with one's family are associated with better dietary quality and healthy body weight for youth. Given the poor dietary quality of many youth, potential benefits of family meals for better nutritional intake and great variation in family meals, development and evaluation of interventions aimed at improving and increasing family meals are needed. This paper presents the design of key intervention components and process evaluation of a community-based program (Healthy Home Offerings via the Mealtime Environment (HOME) Plus) to prevent obesity. The HOME Plus intervention was part of a two-arm (intervention versus attention-only control) randomized-controlled trial. Ten monthly, two-hour sessions and five motivational/goal-setting telephone calls to promote healthy eating and increasing family meals were delivered in community-based settings in the Minneapolis/St. Paul, MN metropolitan area. The present study included 81 families (8-12 year old children and their parents) in the intervention condition. Process surveys were administered at the end of each intervention session and at a home visit after the intervention period. Chi-squares and t-tests were used for process survey analysis. The HOME Plus program was successfully implemented and families were highly satisfied. Parents and children reported that the most enjoyable component was cooking with their families, learning how to eat more healthfully, and trying new recipes/foods and cooking tips. Average session attendance across the ten months was high for families (68%) and more than half completed their home activities. Findings support the value of a community-based, family-focused intervention program to promote family meals, limit screen time, and prevent obesity. NCT01538615.

  8. Effectiveness of a lifestyle exercise program for older people receiving a restorative home care service: a pragmatic randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Burton E

    2013-12-01

    Full Text Available Elissa Burton,1,2 Gill Lewin,1,2 Lindy Clemson,3 Duncan Boldy41Faculty of Health Sciences, Curtin University, Perth, WA, Australia; 2Research Department, Silver Chain, Perth, WA, Australia; 3Health and Work Research Unit, The University of Sydney, Sydney, NSW, Australia; 4School of Nursing and Midwifery, Curtin University, Perth, WA, AustraliaBackground: Restorative home care services are short-term and aimed at maximizing a person’s ability to live independently. They are multidimensional and often include an exercise program to improve strength, mobility, and balance. The aim of this study was to determine whether a lifestyle exercise program would be undertaken more often and result in greater functional gains than the current structured exercise program delivered as part of a restorative home care service for older adults.Methods: A pragmatic randomized controlled trial was conducted in an organization with an established restorative home care service. Individuals who were to have an exercise program as part of their service were randomized to receive either a lifestyle and functional exercise program called LiFE (as this was a new program, the intervention or the structured exercise program currently being used in the service (control. Exercise data collected by the individuals throughout and pre and post intervention testing was used to measure balance, strength, mobility, falls efficacy, vitality, function, and disability.Results: There was no difference between the groups in the amounts of exercise undertaken during the 8-week intervention period. Outcome measurement indicated that the LiFE program was as effective, and on 40% of the measures, more effective, than the structured exercise program.Conclusion: Organizations delivering restorative home care services that include an exercise component should consider whether LiFE rather than the exercise program they are currently using could help their clients achieve better outcomes

  9. 45 CFR 1306.20 - Program staffing patterns.

    Science.gov (United States)

    2010-10-01

    ..., DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, HEAD START...-based program options must employ home visitors responsible for home visits and group socialization... delegate agencies offering the family child care program option must ensure that in each family child...

  10. An Integrated Model of Care: A Visit to The SPARK Center, a Program of Boston Medical Center

    Science.gov (United States)

    Griest, Christa

    2010-01-01

    This article features The SPARK Center, a program of Boston Medical Center, located in Mattapan, Massachusetts. The Center has pioneered a whole-child approach to address the multi-dimensional needs of Boston's most at-risk children, recognizing that vulnerable children need more than educational supports to flourish. The Center's integrated model…

  11. Evaluation of the Enhanced Assessment Grants (EAGs) SimScientists Program: Site Visit Findings. CRESST Report 791

    Science.gov (United States)

    Herman, Joan; Dai, Yunyun; Htut, Aye Mon; Martinez, Marcela; Rivera, Nichole

    2011-01-01

    This evaluation report addresses the implementation, utility, and feasibility of SimScientists' simulation-based assessments for middle school science classrooms, with particular attention to the use of accommodations available in the program. Data were collected from a convenience sample of five schools and eight teachers across three states…

  12. Psychological Evaluation of Animal-assisted Intervention (AAI) Programs Involving Visiting Dogs and Cats for Alcohol Dependents: A Pilot Study.

    Science.gov (United States)

    Ohtani, Nobuyo; Narita, Shin; Yoshihara, Eiji; Ohta, Mitsuaki; Iwahashi, Kazuhiko

    2015-12-01

    The purpose of this study was to develop an evaluation method for animal-assisted intervention (AAI) programs involving Mood Check List-Short form.2 (MCL-S.2) and the State-Trait Anxiety Inventory (STAI) for psychiatric daycare of Japanese alcohol. dependents. A total of 36 alcohol dependents completed the study and questionnaires assessing their state. A single session of AAI reduced both subjective and physiological measures of state anxiety (A-State); and this program induced a significant reduction in the anxiety after an AAI program session with the dogs and cats involved in the intervention (p = 0.001). The Wilcoxon t-test showed that there were also significant differences in the "anxiety", "pleasantness", and "relaxation". scores for MCL-S.2 among the alcohol dependents, before and after AAI; a significantly decreased "anxiety" score (p = 0.006), and increased "pleasantness" (p = 0.002) and "relaxation" (p=0.012) scores for MCL-S.2 after AAI. The results of this study indicated that alcohol dependents who experienced a group AAI session-program exhibited significant improvements in their feeling; decreased anxiety, and increased pleasantness and relaxation.

  13. The Implementation of IGE and Related Home-School-Community Relations Programs and Activities: Seven Case Studies. Theoretical Paper No. 64.

    Science.gov (United States)

    Miles, William R.; And Others

    Each of the seven case studies in this report describes the school and community, the implementation of Individually Guided Education (IGE) programs, and home-school-community relations programs and activities, and analyzes the home-school-community relations programs and activities. The selection of the seven schools was primarily based on the…

  14. [The effect of crisis intervention by the visiting nurse with cancer patients].

    Science.gov (United States)

    Kim, C J; Yoo, J S; Park, J W

    1989-04-01

    This study was undertaken at Yonsei University Medical Center to identify the crisis responses and nursing problems of patients who had been diagnosed with cancer, and changing patterns of grieving over time periods, and to analyse the effectiveness of follow up care through home visiting nursing. This study was carried out in three stages. The 1st study data were collected from a total of 205 patients who had been diagnosed with cancer from Sept. 1 to Dec. 31, 1987 using a cross-sectional method. The 2nd study data were collected three times from 30 patients with cancer at 4 weeks intervals from March 1 to June 31, 1988 using a longitudinal method. The 3rd study data were collected from two different groups from March 1 to June 31, 1988. One was an experimental group who was visited by nurses and the other one was a control group not visited by nurses. The subjects of the 3rd study consisted of 60 patients with cancer and a Quasi-experimental research design was used. The results were as follows: 1. The patients did not experience one stage at a time among the five stages of grieving, denial, anger, bargaining, depression and acceptance, as identified by Kübler Ross. They experienced a combination of stages, especially of the bargaining and the depression stages. This stages did not change with the passing of time. 2. The patients expressed more physical and socioeconomical problems than emotional problems. And they used more problem coping methods than emotional coping methods. 3. Follow up care through home visiting nursing positively influenced the patient's quality of life, especially their physical well-being and symptom control. The patients responded positively to the home visiting nursing, stating that it was helpful to them. It was concluded that the development of a home visiting nursing program is needed for the effective home care of patients with cancer.

  15. Misoprostol for Prevention of Postpartum Hemorrhage at Home Birth in Afghanistan: Program Expansion Experience

    Science.gov (United States)

    Ansari, Nasratullah; Zainullah, Partamin; Kim, Young‐Mi; Tappis, Hannah

    2016-01-01

    Introduction Afghanistan has a maternal mortality ratio of 400 per 100,000 live births. Hemorrhage is the leading cause of maternal death. Two‐thirds of births occur at home. A pilot program conducted from 2005 to 2007 demonstrated the effectiveness of using community health workers for advance distribution of misoprostol to pregnant women for self‐administration immediately following birth to prevent postpartum hemorrhage. The Ministry of Public Health requested an expansion of the pilot to study implementation on a larger scale before adopting the intervention as national policy. The purpose of this before‐and‐after study was to determine the effectiveness of advance distribution of misoprostol for self‐administration across 20 districts in Afghanistan and identify any adverse events that occurred during expansion. Methods Cross‐sectional household surveys were conducted pre‐ (n = 408) and postintervention (n = 408) to assess the effect of the program on uterotonic use among women who had recently given birth. Maternal death audits and verbal autopsies were conducted to investigate peripartum maternal deaths that occurred during implementation in the 20 districts. Results Uterotonic use among women in the sample increased from 50.3% preintervention to 74.3% postintervention. Because of a large‐scale investment in Afghanistan in training and deployment of community midwives, it was assumed that all women who gave birth in facilities received a uterotonic. A significant difference in uterotonic use at home births was observed among women who lived farthest from a health facility (> 90 minutes self‐reported travel time) compared to women who lived closer (88.5% vs 38.9%; P maternal deaths were identified among those women who used misoprostol. Discussion The results of this study build on the findings of the pilot program and provide evidence on the effectiveness, primarily measured by uterotonic use, of an expansion of advance distribution of

  16. Effects of intergenerational Montessori-based activities programming on engagement of nursing home residents with dementia

    Directory of Open Access Journals (Sweden)

    Michelle M Lee

    2007-10-01

    Full Text Available Michelle M Lee1, Cameron J Camp2, Megan L Malone21Midwestern University, Department of Behavioral Medicine, Downers Grove, IL , USA; 2Myers Research Institute of Menorah Park Center for Senior Living, Beachwood, OH, USA Abstract: Fourteen nursing home residents on a dementia special care unit at a skilled nursing facility took part in one-to-one intergenerational programming (IGP with 15 preschool children from the facility’s on-site child care center. Montessori-based activities served as the interface for interactions between dyads. The amount of time residents demonstrated positive and negative forms of engagement during IGP and standard activities programming was assessed through direct observation using a tool developed for this purpose – the Myers Research Institute Engagement Scale (MRI-ES. These residents with dementia displayed the ability to successfully take part in IGP. Most successfully presented “lessons” to the children in their dyads, similar to the way that Montessori teachers present lessons to children, while persons with more severe cognitive impairment took part in IGP through other methods such as parallel play. Taking part in IGP was consistently related with higher levels of positive engagement and lower levels of negative forms of engagement in these residents with dementia than levels seen in standard activities programming on the unit. Implications of using this form of IGP, and directions for future research, are discussed.Keywords: Montessori-based activities, intergenerational programming, engagement, dementia

  17. Evaluation of bluetooth low power for physiological monitoring in a home based cardiac rehabilitation program.

    Science.gov (United States)

    Martin, Timothy; Ding, Hang; D'Souza, Matthew; Karunanithi, Mohan

    2012-01-01

    Cardiovascular disease (CVD) is the leading cause of mortality in Australia, and places large burdens on the healthcare system. To assist patients with CVDs in recovering from cardiac events and mediating cardiac risk factors, a home based cardiac rehabilitation program, known as the Care Assessment Platform (CAP), was developed. In the CAP program, patients are required to manually enter health information into their mobile phones on a daily basis. The manual operation is often subject to human errors and is inconvenient for some elderly patients. To improve this, an automated wireless solution has been desired. The objectives of this paper are to investigate the feasibility of implementing the newly released Bluetooth 4.0 (BT4.0) for the CAP program, and practically evaluate BT4.0 communications between a developed mobile application and some emulated healthcare devices. The study demonstrated that BT4.0 addresses usability, interoperability and security for healthcare applications, reduces the power consumption in wireless communication, and improves the flexibility of interface for software development. This evaluation study provides an essential mobile BT4.0 framework to incorporate a large range of healthcare devices for clinical assessment and intervention in the CAP program, and hence it is useful for similar development and research work of other mobile healthcare solutions.

  18. Home Fire Safety Practices and Smoke Detector Program Awareness in an Urban Pediatric Emergency Department Population.

    Science.gov (United States)

    Wood, Rachel Lynn; Teach, Stephen J; Rucker, Alexandra; Lall, Ambika; Chamberlain, James M; Ryan, Leticia Manning

    2016-11-01

    Risk factors for residential fire death (young age, minority race/ethnicity, and low socioeconomic status) are common among urban pediatric emergency department (ED) patients. Community-based resources are available in our region to provide free smoke detector installation. The objective of our study was to describe awareness of these resources and home fire safety practices in this vulnerable population. In this cross-sectional study, a brief survey was administered to a convenience sample of caregivers accompanying patients 19 years of age or younger in an urban pediatric ED in Washington, DC. Survey contents focused on participant knowledge of available community-based resources and risk factors for residential fire injury. Five hundred eleven eligible caregivers were approached, and 401 (78.5%) agreed to participate. Patients accompanying the caregivers were 48% male, 77% African American, and had a mean (SD) age of 6.5 (5.9) years. Of study participants, 256 (63.8%) lived with children younger than 5 years. When asked about available community-based resources for smoke detectors, 240 (59.9%) were unaware of these programs, 319 (79.6%) were interested in participating, and 221 (55.1%) enrolled. Presence of a home smoke detector was reported by 396 respondents (98.7%); however, 346 (86.3%) reported testing these less often than monthly. Two hundred fifty-six 256 (63.8%) lacked a carbon monoxide detector, and 202 (50.4%) had no fire escape plan. Sixty-five (16%) reported indoor smoking, and 92 (22.9%) reported space heater use. In this urban pediatric ED population, there is limited awareness of community-based resources but high rates of interest in participating once informed. Whereas the self-reported prevalence of home smoke detectors is high in our study population, other fire safety practices are suboptimal.

  19. Nursing home staff training in dementia care: a systematic review of evaluated programs.

    Science.gov (United States)

    Kuske, Bettina; Hanns, Stephanie; Luck, Tobias; Angermeyer, Matthias C; Behrens, Johann; Riedel-Heller, Steffi G

    2007-10-01

    We reviewed studies of in-service interventions for caregivers of persons with dementia in nursing homes published between 1990 and 2004. The aim was to obtain an overview of the evaluated interventions and to characterize their methodological quality. A thorough literature search was conducted, including searching electronic databases for selected intervention studies and previous reviews. Selected studies were summarized and compared along certain categories, and methodological quality was assessed. A total of 21 studies were identified, mostly published in the United States. Most were of poor methodological quality. Although nearly all reported positive effects, their results must be interpreted cautiously due to methodological weaknesses. Extensive interventions with ongoing support successfully demonstrated sustained implementation of new knowledge. Owing to methodological weaknesses and a lack of follow-up evaluations, little or no evidence existed for the efficacy or, particularly, the transfer of knowledge in simpler interventions when reinforcing and enabling factors were not present. On an international and, particularly, on a national level a lack of evaluated in-service training programs for caregivers in homes for people with dementia is apparent. Methodological weakness is common. This study highlights the need for well-defined methodologically improved studies, providing conclusive evidence of the effects of intervention types to help improve the quality of dementia care.

  20. Assessment of home-based behavior modification programs for autistic children: reliability and validity of the behavioral summarized evaluation.

    Science.gov (United States)

    Oneal, Brent J; Reeb, Roger N; Korte, John R; Butter, Eliot J

    2006-01-01

    Since the publication of Lovaas' (1987) impressive findings, there has been a proliferation of home-based behavior modification programs for autistic children. Parents and other paraprofessionals often play key roles in the implementation and monitoring of these programs. The Behavioral Summarized Evaluation (BSE) was developed for professionals and paraprofessionals to use in assessing the severity of autistic symptoms over the course of treatment. This paper examined the psychometric properties of the BSE (inter-item consistency, factorial composition, convergent validity, and sensitivity to parents' perceptions of symptom change over time) when used by parents of autistic youngsters undergoing home-based intervention. Recommendations for future research are presented.