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PubMed1999

WVU--community partnership that provides science and math enrichment for underrepresented high school students.

In response to the need to help West Virginia secondary school students overcome educational and economic barriers and to increase the number of health professionals in the state, the Health Sciences and Technology Academy (hereafter, "the Academy") was established in 1994. The Academy is a partnership between West Virginia University (WVU)--including the Robert C. Byrd Health Sciences Center, Eberly College of Arts and Sciences, and the College of Human Resources and Education--and members of the community, including secondary-school teachers, health care professionals, and other community leaders. The Academy targets students from underrepresented groups (mainly African Americans and financially disadvantaged whites) in grades nine through 12. By November 1997, 290 students (69% girls and 33% African American) from 17 counties were Academy participants. Funding is from the W. K. Kellogg Foundation, Howard Hughes Medical Institute, the National Institutes of Health, the Coca-Cola Foundation, and other sources. Academy programs are an on-campus summer institute and community-based clubs, where students engage in activities for science and math enrichment, leadership development, and health careers awareness. In the Academy's clubs, students carry out extended investigations of problems related to human health and local communities. Most students report that the Academy has increased their interest in health care careers, and almost all who have continued to participate in Academy programs through their senior year have been accepted into college.

Adolescent↗
PubMed2001

An integrated curriculum for MBBS.

OBJECTIVE: To report the formulation and implementation of an organ system based integrated curriculum for MBBS students at Ziauddin Medical University (ZMU) Karachi. STEPS OF INTEGRATION: The Basic Medical Science Faculty (Anatomy, Physiology and Biochemistry) along with representatives from Medicine, Surgery and Community Health Sciences held joint meetings spread over weeks to design a system based integrated curriculum for the first two years of the MBBS class. Objectives of an integrated course were devised and the duties of term coordinator determined. CONCLUSION: Horizontal integration of Basic Science subjects can be achieved, with the subject specialists coordinating the teaching of a system based as opposed to subject based curriculum. The basic sciences can also be integrated with Community Health Sciences to achieve partial vertical integration.

Biological Science Disciplines↗
PubMed1991

Evaluation of public health science in the graduate community health nursing curriculum.

The purpose of this article is to describe and evaluate a unique course in Public Health Science that has recently been implemented in our College of Nursing. This course seeks to provide a synthesis of public health and nursing. The course description as well as the course objectives are outlined. A 22-item questionnaire was developed to obtain demographic information regarding the students enrolled in the course, their community health experience prior to entering the graduate program, their clinical area of specialization, reasons for enrollment in the course, strengths and weaknesses of the course, the degree to which the course met the objectives, and recommendations for future courses in Public Health Science. The findings suggest that the content of Public Health Science has been integrated into the graduate community health nursing program with much success.

Adult↗
PubMed2004

Health sciences research and Aboriginal communities: pathway or pitfall?

OBJECTIVE: To provide health researchers and clinicians with background information and examples regarding Aboriginal health research challenges, in an effort to promote effective collaborative research with Aboriginal communities. METHODS: An interdisciplinary team of experienced Aboriginal-health researchers conducted a thematic analysis of their planning meetings regarding a community-based Aboriginal health research training project and of the text generated by the meetings and supplemented the analysis with a literature review. RESULTS: Four research challenges are identified and addressed: (1) contrasting frameworks of Western science and indigenous knowledge systems; (2) the impact of historic colonialist processes upon the interface between health science research and Aboriginal communities; (3) culturally relevant frameworks and processes for knowledge generation and knowledge transfer; and (4) Aboriginal leadership, governance, and participation. CONCLUSION: Culturally appropriate and community-controlled collaborative research can result in improved health outcomes in Aboriginal communities and contribute new insights and perspectives to the fields of public health and medicine in general.

Attitude to Health↗
PubMed2004

Specialist clinics in remote Australian Aboriginal communities: where rock art meets rocket science.

People in remote Aboriginal communities in the Northern Territory have greater morbidity and mortality than other Australians, but face considerable barriers when accessing hospital-based specialist services. The Specialist Outreach Service, which began in 1997, was a novel policy initiative to improve access by providing a regular multidisciplinary visiting specialist services to remote communities. It led to two interesting juxtapositions: that of 'state of the art' specialist services alongside under-resourced primary care in remote and relatively traditional Aboriginal communities; and that of attempts to develop an evidence base for the effectiveness of outreach, while meeting the short-term evaluative requirements of policy-makers. In this essay, first we describe the development of the service in the Northern Territory and its initial process evaluation. Through a Cochrane systematic review we then summarise the published research on the effectiveness of specialist outreach in improving access to tertiary and hospital-based care. Finally we describe the findings of an observational population-based study of the use of specialist services and the impact of outreach to three remote communities over 11 years. Specialist outreach improves access to specialist care and may lessen the demand for both outpatient and inpatient hospital care. Specialist outreach is, however, dependent on well-functioning primary care. According to the way in which outreach is conducted and the service is organised, it can either support primary care or it can hinder primary care and, as a result, reduce its own effectiveness.

Australia↗
PubMed2003

Working Pasteur's Quadrant: harnessing science and action for community change.

Community psychology in general and the field of prevention in particular has unquestioningly accepted the assumption that the research process should proceed in a linear fashion from a search for basic knowledge to application in the community context. This ignores the compelling insight offered by Stokes (1997) that the drive for new knowledge and the pursuit of application can be combined in a single effort. If research in community psychology pursues the drive for application without an equal commitment to the development of knowledge about underlying community processes of social cooperation and change, it will become a field less capable of innovative and enduring contributions to community well-being and effectiveness Opportunities abound in community psychology for the simultaneous pursuit of new knowledge and more effective practice. We offer the example of a community leadership development program to promote collective efficacy as a case in point.

Community Mental Health Services↗
PubMed2005

The California active aging community grant program: translating science into practice to promote physical activity in older adults.

BACKGROUND: Attempts to study the translation of evidence-based physical activity interventions in community settings are scarce. PURPOSE: This project was an investigation of whether 13 diverse local lead agencies could effectively implement a choice-based, telephone-assisted physical activity promotion program for older adults based on intervention models proven efficacious in research settings. METHODS: At baseline, participants developed their own physical activity programs through an individualized planning session based on preference, health status, readiness to change, and available community resources. Thereafter, participants received regular telephone calls over a 1-year period from a trained staff member or volunteer support buddy. Additional program components consisted of health education workshops, newsletters, and group-based physical activities. Self-report data on caloric expenditure due to all and moderate or greater intensity physical activities were collected from 447 participants (M age = 68 +/- 8.6 years). RESULTS: A significant increase (p < or = .0001) from baseline to midintervention and intervention endpoint was observed for total weekly caloric expenditure (Mdn change = 644-707 kcal/week) and moderate or greater weekly caloric expenditure (Mdn change = 149-265 kcal/week), as well as for weekly physical activity duration and frequency. These changes were observed in participants across all sites. CONCLUSIONS: The increases in weekly caloric expenditure were commensurate with findings from several previous randomized clinical trials. The utilization of community agency staff and volunteers receiving basic training to implement essential program components proved feasible. Very favorable levels of program satisfaction expressed by community staff, volunteer support buddies, and participants, combined with the significant increases in physical activity, warrant further dissemination of the intervention model.

Aged↗
PubMed2005

Medical education and training: responding to community needs.

At its inception in 1987, the Aga Khan University introduced the idea of community-based medical education in Pakistan, at a time when this model was being introduced and adapted internationally. Human resource development has been a major objective in the Department of Community Health Sciences (CHS). CHS has contributed to developing a medical curriculum that addresses the health needs of the community at large. This paper narrates the department's experience in working directly with under-served communities, leading to the development of specialized courses and degree programs. CHS emphasizes operational research and development of managerial skills among front-line public health professionals, in both the public and private sectors. Training is provided by people from diverse backgrounds, such as public health, community development, social sciences, law, epidemiology, economy, biostatistics, demography, theater, and film. The lessons we have learned show that the mode of training depends on the overall objectives of the program, the clients and the setting. However, in the spirit of the participatory approach, the recipients of the training must be involved during all stages so as to ensure the sustainability of the training program. Training must focus on the communities at the grass roots level or community based organizations, where the communities identify their own capacity and needs. Wide dissemination of training materials, courses and manuals is also useful to replicate successful experience.

Community Health Services↗
PubMed1997

Promoting community-based maternal and child health services: a university-health department partnership.

OBJECTIVES: Funded by the Federal Maternal and Child Health Bureau, a partnership between the Johns Hopkins University School of Public Health, Department of Maternal and Child Health (JHU), and the Baltimore City Health Department (BCHD) identifies maternal and child health problems, and develops appropriate interventions. This paper presents the organization and activities of the JHU/BCHD Maternal and Child Community Health Science Consortium as a result of overcoming traditional barriers to collaborative efforts, and discusses what role the Consortium has had in its own collaborative success. METHOD: A review of the literature uncovered a number of barriers to productive interaction. A number of factors contributing to overcoming the barriers was also revealed. The organization and activities of the work of the JHU/BCHD Maternal and Child Community Health Science Consortium has been applied to these barriers and associated factors, and discussed in context of implications for future collaborative efforts. RESULTS: The Consortium has developed a fully integrated administrative structure bridging both the BCHD and JHU. The mission of the Consortium has been translated into four categories of work, each one designed to complement, extend, and augment the other. The infrastructure established in Baltimore, as a direct result of this partnership, has served to overcome traditional barriers to productive academic/agency collaboration, while promoting organizational productivity. This outcome is a result of overcoming the recognized barriers to collaboration. CONCLUSIONS: Health agencies and university public health programs must link resources and collaborate to address public health issues. Commitment to a collaborative approach to the public's health will determine its future.

Child↗
PubMed2005

Successful coupling of community attachment of health science students with relief work for drought victims.

CONTEXT: Recurrent drought is a major disaster affecting many countries. As a result of poor rain fall a major drought was forecast for Ethiopia in 2003. The country appealed for support to avert drought-related health problems. University of Gondar decided to respond to the appeal by sending students and staff to selected drought-affected areas. OBJECTIVES: To illustrate how an institution has turned the response to a natural disaster into a service-learning educational opportunity while maintaining equilibrium between the two. METHODS: The drought relief response of the institute was twined with the regular team-training programme and academic schedule of senior health science students and 190 of them were transferred to deployment sites. FINDINGS: Students provided support for the national effort of reducing drought-related morbidity and mortality by participating in multifaceted public health and relief activities, and fulfilled their regular learning objectives at the same time. DISCUSSION: This project demonstrated the use of a natural disaster as a learning method to expose students to a more realistic array of health problems and human conditions. It also demonstrated the feasibility of addressing social responsibility, while fulfilling academic responsibility through community-based approach. CONCLUSION: Service-learning is a valuable learning method. Balancing the service and teaching objectives and maintaining the quality of both can be attained through careful twining of the objectives of both components.

Community-Institutional Relations↗
PubMed2001

Predictability of medical students' performance at the Aga Khan University from admission test scores, interview ratings and systems of education.

INTRODUCTION: Performance in an admission test and carefully conducted, structured interview provides a uniform basis for the assessment of applicants prepared in different systems of education for admission to an institute of higher professional learning. We studied the predictability of the system of education followed by the students prior to entrance into the Medical College, the admission test scores, and interview ratings on performance after five trimesters at the Aga Khan University Medical College. METHOD: A cohort of 374 medical students who were admitted during 1989--1994, were considered. The associations between the admission test score, interview ratings, system of education, and the scores obtained for anatomy, physiology, biochemistry and community health sciences examinations held after five trimesters were analysed using appropriate statistical procedures. RESULTS: Interview ratings were associated with the scores in Physiology but not other subjects. The chief finding of this study was the association between the system of education and performance in both the admission test and the examination after five trimesters. Students who followed the British school curricula for 13 years scored significantly higher than those who followed the 12 years of the Pakistani system. When controlled for the admission test score, the difference in mean scores of the two groups was still evident for two subjects; community health sciences and physiology. CONCLUSION: We believe that the evidence indicates differences in learning methods inculcated by the system of education prior to entry into the Medical College, notwithstanding the 1-year difference in duration of education.

Analysis of Variance↗
PubMed1996

Critical appraisal by reading for medical students--a case study from Pakistan.

Doctors read literature to keep abreast of medical advances. A recommendation from the 1993 World Summit for Medical Education is that medical schools should teach medical students to critically appraise scientific reports. The Department of Community Health Sciences of Aga Khan University Medical College teaches basic research methods to medical students. This is now supplemented with "Critical Reading". Critical reading was first taught to 67 third year students between October, 1993 and May, 1994. A "validity check-list for critical readers" was introduced in a two week orientation consisting of three one-hour classroom sessions and four one-hour small group sessions. Thereafter, small groups met monthly to critique clinical epidemiological reports relevant to current organ system teaching. The students reading attitudes and critical appraisal skills were assessed through continuous assessment and a written final examination with questionnaire. All but three students passed the final examination (mean score (74%, standard deviation 12%). Sixty-four of 67 (96%) completed questionnaires. All (73% strongly) agreed that critical reading skills were essential, but only 30% strongly agreed that they had, indeed, mastered the skills. Ninety-seven percent (56% strongly) disagreed that year three was too early to start critical reading. Clinical teaching staff expressed interest in learning these skills. Students benefited from and enjoyed this first critical reading course. It strengthened ties between clinical and community health sciences teaching staff. The critical reading skills of the clinical teaching staff is being addressed in seminars to strengthen institutional research capacity.

Education, Medical, Undergraduate↗