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At least 181 records · Page 10Linked to original sources
PubMed2004

How do health workers and community members perceive and practice community participation in the Bamako Initiative programme in Nigeria? A case study of Oji River local government area.

The objective of this study was to assess the perceptions and practices of health workers and households in relation to community participation in the Bamako Initiative programme (BI). The study was conducted in Oji River local government area of South-East Nigeria where the BI program has been operational since 1993. A pre-tested questionnaire was used to collect information from 20 health workers charged with operating the BI in 20 health centres. In addition, focus group discussions were conducted with members of the district and village health committees. Community participation from both health worker and community perspectives seem to have been enhanced by the introduction of BI, despite some constraints. However, the communities were not involved in core areas of community participation, and the health workers seem to be resisting their participation fully. It is concluded the community participation in BI could be improved if expectations were made explicit. This improvement should take into consideration the desires and priorities of the communities and issues impeding participation should be addressed.

Community Networks↗
PubMed1998

How to understand a community--community assessment for the promotion of health-related physical activity.

A definition of the concept of community is given and the principles and the major components of community assessment for health-related physical activity are presented. Definitions of community can include a focus on geographic, social or cultural elements. Basically community assessment deals with a process having two main aspects. The first, quantitative and descriptive aspect consists of a community profile, a wellness profile, a behavioural profile and a service profile. The second, qualitative and analytical aspect deals with organizational capabilities and the community's readiness for change. This information can be used for programme planning, implementation, and evaluation in the process of community development.

Adolescent↗
PubMed2003

Community action against asthma: examining the partnership process of a community-based participatory research project.

BACKGROUND: Community Action Against Asthma (CAAA) is a community-based participatory research (CBPR) project that assesses the effects of outdoor and indoor air quality on exacerbation of asthma in children, and tests household- and neighborhood-level interventions to reduce exposure to environmental asthma triggers. Representatives of community-based organizations, academia, an integrated health system, and the local health department work in partnership on CAAA's Steering Committee (SC) to design and implement the project. OBJECTIVE: To conduct a process evaluation of the CAAA community-academic partnership. DESIGN: In-depth interviews containing open-ended questions were conducted with SC members. Analysis included established methods for qualitative data, including focused coding and constant comparison methods. SETTING: Community setting in Detroit, Michigan. PARTICIPANTS: Twenty-three members of the CAAA SC. MEASUREMENTS: Common themes identified by SC members relating to the partnership's ability to achieve project goals and the successes and challenges facing the partnership itself. MAIN RESULTS: Identified partnership accomplishments included: successful implementation of a complex project, identification of children with previously undiagnosed asthma, and diverse participation and community influence in SC decisions. Challenges included ensuring all partners' influence in decision-making, the need to adjust to "a different way of doing things" in CBPR, constraints and costs of doing CBPR felt by all partners, ongoing need for communication and maintaining trust, and balancing the needs of science and the community through intervention. CONCLUSIONS: CBPR can enhance and facilitate basic research, but care must be given to trust issues, governance issues, organizational culture, and costs of participation for all organizations involved.

Asthma↗
PubMed1998

Community advisory boards: their role in AIDS clinical trials. Terry Beirn Community Programs for Clinical Research on AIDS.

Community-based AIDS research programs were initially federally funded in 1989. Since then, the Terry Beirn Community Programs for Clinical Research on AIDS has mandated that research units develop and maintain community advisory boards to provide advice and communicate community preferences in AIDS research. Seventeen community-based AIDS research units formed community advisory boards (CABs) based on a model developed by the Community Consortium at San Francisco General Hospital. Social workers employed by these AIDS research units surveyed 267 CAB members to ascertain board characteristics and members' perceptions of program activities. Implications for social work and future research are discussed.

Acquired Immunodeficiency Syndrome↗
PubMed2005

Community-directed interventions strategy enhances efficient and effective integration of health care delivery and development activities in rural disadvantaged communities of Uganda.

The community-directed interventions (CDI) strategy achieved a desired coverage of the ultimate treatment goal (UTG) of at least 90% with ivermectin distribution for onchocerciasis control, and filled the gap between the health care services and the communities. However, it was not clear how its primary actors--the community-directed health workers (CDHW) and community-directed health supervisors (CDHS)--would perform if they were given more responsibilities for other health and development activities within their communities. A total of 429 of 636 (67.5%) of the CDHWs who were involved in other health and development activities performed better than those who were involved only in ivermectin distribution, with a drop-out rate of 2.3%. A total of 467 of 864 (54.1%) of CDHSs who were involved in other health and development activities also maintained the desired level of performance. They facilitated updating of household registers (P<0.05), trained and supervised CDHWs, and educated community members about onchocerciasis control (P<0.001). Their drop-out rate was 2.6%. The study showed that the majority of those who dropped out had not been selected by their community members. Therefore, CDI strategy promoted integration of health and development activities with a high potential for sustainability.

Community Health Services↗
PubMedDate not supplied

Reaching into the community. Winners of the 1996 MHA Patric E. Ludwig Community Service Award.

Webster's definitions of community and service form an accurate picture of what MHA seeks to reward with the 1996 MHA Patric E. Ludwig Community Service Award--members who have collaboratively worked with individuals and organizations in their communities to benefit the health and well-being of citizens. The nominees were judged on criteria that focused on true collaboration, leadership efforts, impact on community health status and innovative delivery methods. The winners were chosen from 24 deserving nominations. These four outstanding programs effectively demonstrate the spirit of community service in health care--providers working in concert with local organizations to improve the community's health status. All of the winning programs focused on healthier babies and school-aged youth. Congratulations to the winning programs. They are tangible proof of the important role MHA members play in their communities.

Awards and Prizes↗
PubMed1999

Community networking as a means for identifying people with diabetes in a rural, predominantly bicultural community in New Zealand.

AIMS: To assess the use of community networking to estimate the prevalence of diabetes in a predominantly New Zealand Maori and European community. METHODS: A cross-sectional survey of people with known diabetes identified either through general practice or community networks (others with diabetes, public notices or public meetings) was undertaken. Ascertainment was compared using capture-recapture methods for two independent samples. RESULTS: Overall ascertainment by community networking was greater for Maori than Europeans (40 +/- 3% vs 15 +/- 2%, p < 0.001). Ascertainment using general practice registers was comparable in the two ethnic groups (48 +/- 4% vs 55 +/- 5%, respectively). Women were more likely than men to be contacted through community networking (odds ratio 1.47, 1.05-2.06). CONCLUSION: In closely knit communities, community networking provides an independent source for estimating the prevalence of diabetes.

Community Health Planning↗
PubMedDate not supplied

Community assessment: an RN-BSN partnership with community.

Conducting a community assessment can be a vital aspect of a community health course for a baccalaureate nursing student. This experience can enable the student to use the nursing process in a basic community assessment as well as provide community decision makers with significant data and analysis about community health related needs and potential solutions. This paper describes use of the Community-as-Partner model by Anderson and McFarlane to do a class project to assess a local community.

Community Health Nursing↗
PubMed1994

A shotgun marriage--community health workers and government health services. Qualitative evaluation of a community health worker project in Khayelitsha.

In 1988 the Western Cape Regional Services Council (RSC) initiated a community health worker (CHW) project in Khayelitsha in order to extend its preventive services to people in the community and promote 'community upliftment'. An evaluation of this project was undertaken in 1991 and 1992 in order to examine the potential of this local health authority-run CHW project to be an appropriate primary health care model. Qualitative research methods were used to explore the nature of the work done by the CHWs, whether they were accepted in their communities, and whether the project functioned as part of an integrated health service infrastructure in Khayelitsha. The CHWs were found to provide the basis for a potentially effective, community-responsive service. However, several structural problems mitigated against this service. Relations between the CHWs and nurses in all the formal public health services in the area were superficial and fraught with problems. There were significant differences and conflicting policies between the RSC's CHW project and other neighbouring non-government CHW projects, and these posed various threats to both the RSC and the non-government projects. One of the most serious of these differences was that the RSC project had no structures or plans for community involvement in the running of the project. Before a CHW project is initiated, several critical issues need to be carefully considered and discussed with all the relevant stakeholders. Furthermore, CHWs need to be flexible, and accountable to the communities in which they work. Before employing CHWs, formal public health authorities need to consider carefully whether they are able to meet these criteria.

Community Health Services↗
PubMed1983

Cooperative groups and community hospitals. Measurement of impact in the community hospitals.

The Eastern Cooperative Oncology Group, composed of major cancer treatment centers, has an outreach program which involves community hospitals in ongoing cancer clinical trials. A prevalence survey was carried out in February 1981 among 104 community hospitals and 21 member institutions to determine the characteristics of patients being treated, their staffing, and reasons why patients were not on protocol studies. The survey sampled 25 (50) consecutive patients from community hospitals (member institutions). The purpose of the study was to assess the impact of a community cancer control program. The results of the study demonstrated that 16% of patients surveyed in the affiliated community hospitals were being treated on a research protocol. In addition, a further 35% had their treatment plan influenced by a protocol. Consequently protocols have impacted directly or indirectly on 51% of the patients. The corresponding figures in member institutions were 23% and 38% for a total of 61%. In studying protocol availability, it was found that 66% of all patients were ineligible for any protocol. Of patients eligible for a protocol but not registered on one, 52% were not registered because of physician preference for a specific treatment. The affiliates surveyed were shown to be on average half as large as member institutions in terms of number of beds and staff size. Also, staff/patient ratios are generally smaller in the community hospitals. The median age of patients was considerably lower than SEER incidence data. Also, elderly patients were slightly more prevalent in community hospitals than in member institutions. A clear relationship between disease stage and age in breast cancer patients was noted with the representation of early-stage disease much higher in young women.

Adult↗
PubMed1997

Stress in community care teams: will it affect the sustainability of community care?

The study investigated whether community care is sustainable by examining the levels of stress and burnout that affect community mental health staff. Six teams from around Great Britain were chosen to take part, representing a number of different facets of care: the type of community model, whether it was in an inner city or suburban area and whether the team had been part of a scientific evaluation of care, in which case it may have contained more experienced and more highly trained staff. The results indicated that community care staff experienced high levels of burnout as a result of the work stressors. These levels were higher than those found in any published study of health professionals within hospitals, but are similar to those found in community teams recently. There was no evidence that any particular model of community care produced less burnout, but working in an inner city did seem to produce the highest levels. There did seem to be some benefit from a moderate staff turnover within teams. These results mirror those of other recent studies. Models of community care can only be sustained by reducing their toxicity on the staff who have to make them work. Therefore, levels of stress and burnout should be included in any evaluation of the cost-effectiveness of service models. The alleviation of these high levels through individual and organisational interventions should now be a high priority.

Adult↗
PubMed1991

Community Intervention Trial for Smoking Cessation (COMMIT): opportunities for community psychologists in chronic disease prevention.

Opportunities for participation in chronic disease prevention programs are discussed in the context of a description and analysis of the National Cancer Institute's Community Intervention Trial for Smoking Cessation (COMMIT). COMMIT involves 11 matched pairs of communities with random assignment to the intervention condition within each pair. The 4-year intervention is guided by a partly standardized protocol and embodies a number of community psychology principles. The relative congruence of COMMIT with community psychology principles and methods is discussed with particular emphasis on Kelly's (1988) model of community research. Community psychology's participation in chronic disease prevention trials requires understanding of the programmatic framework of National Institutes of Health prevention research and recognition of the constraints imposed by the framework on community psychology practices.

Community Mental Health Services↗
PubMed2005

Developing a community science research agenda for building community capacity for effective preventive interventions.

Research has shown that prevention programming can improve community health when implemented well. There are examples of successful prevention in local communities, however many continue to face significant challenges, demonstrating a gap between science and practice. Common strategies within the United States to address this gap are available (e.g., trainings), but lack outcomes. Building community capacity to implement high quality prevention can help communities achieve positive health outcomes, thereby narrowing the gap. While there is ample research on the efficacy of evidence-based programs, there is little on how to improve community capacity to improve prevention quality. In order to narrow the gap, a new model of research-one based in Community Science-is suggested that improves the latest theoretical understanding of community capacity and evaluates technologies designed to enhance it. In this article, we describe this model and suggest a research agenda that can lead to improved outcomes at the local level.

Community Mental Health Services↗
PubMed1975

Reduction of prehospital, ambulance and community coronary death rates by the community-wide emergency cardiac care system.

Initiation of quick prehospital cardiopulmonary resuscitation and emergency cardiac care completed the total system needed to provide emergency and convalescent coronary care for a community. Subsequently, annual community rates for coronary death during ambulance transport fell by 62 per cent and for prehospital coronary death by 26 per cent in people under 70 years of age. In cardiac arrest due to acute myocardial infarction, prompt successful prehospital correction of ventricular fibrillation and asystole yielded long-term survival in two thirds of cases. This 66 per cent success rate of prehospital cardiopulmonary resuscitation and emergency cardiac care is identical to contemporary international experience. Precordial thump-version with the fist and precordial fist pacing appeared logical additions to prehospital cardiopulmonary resuscitation and emergency cardiac care technics. Community lives saved yearly were 15.2/100,000 people aged 30 to 69 years and 6.4/100,000 total population. Simultaneously, annual community rates for coronary death as a cause of death and coronary death per 1,000 people fell significantly by 15 and 17 per cent, respectively. Unquantifiable influences included prehospital relief of ischemic chest pain; prehospital correction of acute dysautonomia; prehospital abolition of otherwise prefatal dysrhythmias; similar treatment for acute myocardial infarction in the emergency department, in the inhospital mobile coronary care unit and in the progressive intermediate coronary convalescent unit; and general community education through the media of newspapers, radio and television. The present frequency of coronary death during ambulance transport, 9 to 22 per cent of prehospital coronary deaths in this and other surveys, suggests that the prehospital cardiopulmonary resuscitation and emergency cardiac care component needs improvement in many communities. By reducing prehospital and ambulance coronary death rates, prehospital cardiopulmonary resuscitation and emergency cardiac care for acute myocardial infarction constitutes an essential component of the total system approach to emergency coronary care. Since prehospital cardiopulmonary resuscitation and emergency cardiac care have cheaply and effectively expedited and abbreviated hospitalization for acute myocardial infarction, and lowered community death rates from coronary artery disease, its adoption throughout the United States and the western world seems justified.

Ambulances↗
PubMed2003

Community outreach as an iterative dialogue among scientists and communities in the Texas gulf coast region.

In response to significant environmental health challenges in Southeast Texas, a National Institute for Environmental Health Sciences Center at the University of Texas Medical Branch at Galveston was created to promote and conduct inter-disciplinary research in the areas of: (1) the molecular biology of DNA repair, replication and mutagenesis, (2) asthma pathogenesis in response to oxidative stress and viral exposures, and (3) environmental toxicant biotransformation. In addition, the NIEHS Center maintains close ties with neighboring communities through an active Community Outreach & Education Program (COEP) that develops and disseminates translational materials for use in environmental health awareness outreach, toxicology consultation, K-12 curriculum enrichment and in developing site-specific Community Partnership projects. The COEP core service divisions include: Environmental Arts & Sciences, Asthma Outreach & Education, Theater Outreach & Education, and Public Forum & Toxics Assistance. Public Forums focus on the use of Augusto Boal's Forum Theater dramaturgy to include the voices and local knowledge of communities within the process of Participatory Research. Forums create the preconditions for significant partnerships that link the hazardous risk perceptions and environmental health needs of communities with the expertise of NIEHS Center investigators and translational services provided through COEP outreach programs. The Forum process also creates leadership cores within environmentally challenged communities that facilitate the ongoing translational process and maintain the vital linkage between the health needs of communities and the analytic tools and the field and clinical technologies of the environmental sciences.

Community-Institutional Relations↗
PubMed2004

Readiness, functioning, and perceived effectiveness in community prevention coalitions: a study of communities that care.

This paper examined whether community readiness, prevention knowledge, coalition functioning, and barriers are linked to perceived effectiveness of community prevention coalitions. Interviews were conducted with 203 key leaders in Communities That Care (CTC) prevention boards in 21 Pennsylvania communities. Community-level means for the reliable self-report measures were utilized separately and in combination with research staff ratings, state technical assistant staff ratings, and other data. The results indicated that the strong link between readiness and perceived effectiveness was mediated by internal coalition functioning. The extent of CTC linkage with outside community entities was not linked to perceived effectiveness. The study concludes that community readiness is an important condition for success of a prevention coalition, and exerts effects mainly through the quality of the coalition's internal functioning. Member turnover and infighting appear to be important factors related to internal functioning. Linkage with outside entities may be more important for coalition models where the coalition is more dependent on local institutions for resources.

Adult↗
PubMed2002

Perceived stigma and community integration among clients of assertive community treatment.

Facilitating the integration of persons with psychiatric disabilities is an important goal of community programs. In addition to limitations such as inadequate housing, poverty, and unemployment, a common barrier to community adjustment identified by people with psychiatric disabilities is their perception of being stigmatized. This study examined the relationships between perceived stigma and community integration in 95 clients of assertive community treatment (ACT) teams, using sequential multiple regression procedures. Findings indicate that despite their physical presence in the community and the intensive support they receive, ACT clients believe other community members will reject them. Moreover, this perception appears to interfere with their sense of belonging, particularly among those who also perceive less social support and who have greater psychosocial skill deficits. In the context of the present study, global self-esteem did not mediate this relationship. In addition to community focused antistigma campaigns, stigma-related issues should also be addressed with ACT clients themselves.

Adolescent↗
PubMed1999

Attitudes towards community medicine: a comparison of students from traditional and community-oriented medical schools.

OBJECTIVE: To compare the attitudes towards community medicine of first and final year students from two Australian medical schools. METHOD: In 1995, medical students from Newcastle University (a problem-based, community-oriented curriculum) and Adelaide University (a more traditional lecture-based curriculum) were asked to complete the Attitudes to Community Medicine questionnaire. This is a valid and reliable 35 item survey assessing six key domains of community medicine. The two medical schools differ in their methods of selection and curriculum delivery, and also in curriculum content. RESULTS: Response rates averaged 95% for first year and 81% for final year students. Students selected into both medical schools were found to have positive attitudes with respect to most aspects of community medicine. However, those entering Newcastle had more positive attitudes toward community medicine overall than their Adelaide counterparts. They also scored more positively on subscales relating to holistic care and evaluation of health care interventions. Students who were older and female scored more positively on some subscales, but correction for age and gender did not change the conclusions about medical school differences. CONCLUSION: This study suggests that selection criteria, and probably curriculum style and emphasis, have an influence on the attitudes that medical students possess and later develop toward community medicine.

Adult↗