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Results for “Program Sustainability”

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At least 199 records · Page 11Linked to original sources
PubMed1996

A village seizes the reins of health care.

The setting-based approach to health promotion and education has been adopted in an Albanian village. The project requires a high degree of self-determination and self-help. External support comes from the International Islamic Relief Organization. Encouraging progress is being made as villagers acquire a wide range of skills, connected not only with the provision of care but also with such matters as fund-raising, health education and relations with public and private bodies.

Albania↗
PubMedDate not supplied

A sustainable behavioral health program integrated with public health primary care.

The need for behavioral healthcare for the poor and indigent is well documented in rural North Carolina, and integrated behavioral healthcare--that is, mental health screening and treatment offered as part of primary care services--has proven a very effective and efficient method to improve patients' health. In 2000, the Buncombe County Health Center (BCHC) began a grant-funded program treating depressed patients in its public health clinics and school health programs. The Health Center used the opportunity to send a team to the Management Academy for Public Health to learn business principles that could be applied to the challenge of sustaining this program as part of its ongoing public health service delivery for the county. Using their business plan from the Management Academy, the BCHC sought funding from various stakeholders, and, through their support, was able to institute a fully integrated behavioral health program in 2004. The BCHC has now joined forces with other partners in the state to address statewide policy changes in support of such programs. These efforts are an example of how a community health center can apply entrepreneurial thinking and strategic business planning to improve healthcare and effect wide-ranging change.

Behavioral Medicine↗
PubMed1995

Enhancing coverage and sustainability of vaccination programs: an explanatory framework with special reference to India.

The article addresses the question in what form and under what conditions vaccination programs can be expected to continue once the 'take off' period is over. This matter is of great importance because of the need to continuously vaccinate new cohorts of children with a high degree of coverage and in an appropriate manner. Using data from India, where vaccination programs are integrated in regular health care delivery, an explanatory framework is presented which, first, analyses the vaccination program in terms of different levels, organizational cultures and inner-level linkages and, second, addresses the relation between the program and its socio-cultural context. The analysis provides starting points for changes that could enhance coverage and sustainability. Such changes include alterations in program design and adjustments in the views of different categories of program staff. The article discusses strategies directed at achieving such changes.

Child↗
PubMedDate not supplied

[Is it possible to sustain health promotion programs in private companies? The case of four Quebec private companies of blue collar workers].

OBJECTIVE: Sustained health promotion programmes in the workplace (HPPW) continues to be a public health challenge. This article presents an evaluation of the implementation and sustainability of such programmes in private blue-collar companies in Quebec to shed light on issues specific to this type of setting. METHOD: A multiple case (4 sites), longitudinal (7 years) and interpretive study method was used. The interpretation framework considered that the implementation and sustainability of HPPW in companies are the result of organizational learning in health promotion, determined by the strategies of individuals in a position of control who shape the decisional processes related to these programmes. RESULTS: After seven years of observation, two of the four sites had continued their HPPW, although these programmes were no longer applied within these companies. The health promotion organizational learning processes in both sites were defined according to targeted organizational purposes set by the decision-makers who supported HPPW. However, these gains were largely lost when HPPW were no longer retained as a component of their organizational development strategy. DISCUSSION: The organizational conditions that are conducive to HPPW are difficult to put together and sustain in companies like those in our study. Businesses implement these programmes mainly for the organizational benefits they expect to reap in the short term, whereas improvement in the health of workers in the longer term is not a priority.

Feasibility Studies↗
PubMed2006

Management matters: sustaining funds for youth development programs.

Drawing on data collected through evaluations of youth development (YD) programs, including those offered in community-and school-based after-school programs, this article describes practices that support program managers' quests for funds that will sustain programs. Designing YD activities to incorporate skills building (including educational) and recreational and fun activities for adolescents can enlarge the resource pool to include funds for educational activities and youth engagement. Strong behavioral management of programs encourages youth attendance and provides a safe environment to develop positive peer and adult relationships, both of which are crucial to YD. Strong attendance, in turn, can keep program costs in line with expectations and reduce the marginal costs for additional participants. Faithful implementation of previously tested program models increases the likelihood that the program will be effective, and positive outcomes are essential to sustained funding.

Adolescent↗
PubMedDate not supplied

Operating a sustainable disease management program for chronic obstructive pulmonary disease.

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is one of our nation's most rapidly growing chronic health conditions. It is estimated that over 16 million individuals are diagnosed with COPD (Friedman & Hilleman, 2001). In addition, another 16 million are misdiagnosed as asthma or not diagnosed at all. COPD is a condition that affects the working-age as well as the elderly. Despite the high mortality rate, COPD is a treatable and modifiable condition. Disease management programs (DMPs) for asthma are a common initiative within many health insurance plans and integrated delivery networks. Similar initiatives are not as common for COPD. This article will highlight the National Jewish Medical and Research Center's COPD DMP interventions and outcomes. OBJECTIVE: To outline interventions and operational strategies critical in developing and operating a sustainable and effective disease management program for COPD. CONCLUSIONS: Disease Management is an effective model for managing individuals with COPD. Applying a case management model that includes (1) risk-identification and stratification; (2) education and empowerment regarding self-monitoring and management; (3) lifestyle modification; (4) communication and collaboration amongst patients, healthcare providers, and case managers to enhance the treatment plan; (5) providing after-hours support; and (6) monitoring care outcomes is crucial. Applying these interventions in a credible manner will improve the quality of life and quality of care delivered to individuals with mild, moderate, severe, and very severe COPD. Additionally, these interventions can significantly reduce utilization events.

Aged↗
PubMed1991

Observations on the initiation of sustained ventricular tachycardia by programmed stimulation.

We analyzed the initiation of sustained monomorphic ventricular tachycardia (VT) by programmed ventricular stimulation (PVS) in 50 consecutive patients who had clinical VT or aborted sudden cardiac death with remote myocardial infarction. In 25 of 50 patients, the first induced QRS complex of VT was morphologically identical to the succeeding QRS complexes of VT (type I). In 25 other patients, the first VT beat had a different morphology (type II). Type I had a significantly longer VT cycle length than type II (333 +/- 65 msec and 293 +/- 66 msec, P = 0.036). Type II VT initiation required more aggressive stimulation protocol than type I (type I: type II; number of extrastimulus required for induction 2.5 +/- 0.9 : 3.0 +/- 0.6, P = 0.026; shortest extrastimuli coupling interval 244 +/- 28 msec : 220 +/- 23 msec, P = 0.002). The interval between the last extrastimulus and the onset of the first VT beat was 408 +/- 88 msec in type I and 336 +/- 75 msec in type II (P = 0.004). Furthermore, there was good correlation between the VT cycle length and the interval from last extrastimulus to the onset of nonpaced beat in type I but not in type II.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed2004

A grey multi-objective programming approach for sustainable land-use in the Miyun Reservoir basin, China.

Miyun Reservoir is the most important water source to Beijing City. Land-use of the basin plays a great role in the protection of water resources. Hence a sustainable land-use planning is required to optimize land-use structure and protect water resources in the basin. Based on the complete land-use system analysis in Miyun, a grey multi-objective programming to basin land-use(GMOPBLU) model was developed and applied to land-use planning. Two alternatives were produced and analyzed by means of interactive adjustment and scenario analysis. The results showed the GMOPBLU model is a valuable approach for basin land-use planning.

China↗
PubMed1993

Guidelines for a research and development (R&D) program for high sustained G.

This article is a contribution to the workshop on "Operational Requirements in the Prevention of G-Induced Loss of Consciousness (G-LOC) in High Performance Aircraft"; it focuses on the "operational" side of the requirements to prevent G-LOC. There are two types of requirements for prevention of G-LOC; a) pre-G-LOC detection devices that monitor physiologic changes of the pilot before G-LOC occurs, and b) the more generic personal G protection systems that increase G tolerance. Recently there have been major advances in G-protection research and development (R&D) systems (soon to become operational) that significantly improve G-level and G-duration tolerances. We do not know the extent of the impact of these new systems on G-LOC, but it could be substantial. These near-term operational anti-G systems are: 1. Positive pressure breathing (PPB) systems assisted by chest counterpressure that are activated by an increase in G levels; i.e., the higher G level, the greater the pressures applied to the aircrew member (Morgan et al., 1992). This PPB system is known as PBG. PBG has been flight tested with the standard operational anti-G suit. This test program known as Combat Edge significantly reduces pilot fatigue and extends G-duration tolerance. In limited operational testing of F-16 and F-15 aircraft, PBG has received substantial pilot acceptance. 2. An improved anti-G suit that provides uniform pressure of the lower body that includes the operational anti-G suit abdominal bladder. This new anti-G suit concept increases both G-level and G-duration tolerances (Krutz et al., 1990; Morgan et al., 1992). Flight tested as the Advanced Tactical Anti-G Suit (ATAGS), it is comfortable and preferred by pilots over the standard operational anti-G suit. 3. The combination of Combat Edge and ATAGS, the most advanced anti-G system in the final stages of development (Morgan et al., 1992). This anti-G equipment has been tested in the laboratory on the centrifuge. Experimental subjects are able to tolerate 8 to 9G "relaxed" or with a minimal anti-G straining maneuver (AGSM) (Morgan, 1992). Accleration scientists believe that once these systems become operational on high performance aircraft that the incidence of G-LOC will be significantly reduced, particularly G-LOC associated with fatigue.

Aerospace Medicine↗
PubMedDate not supplied

Establishing, funding, and sustaining a university outreach program in oral health.

The Surgeon General's report of May 2000, Oral Health in America, suggests that there are two Americas in terms of oral health: those who have excellent oral health, and those who are unable to access care and have disparate amounts of dental disease. Since the majority of dental schools are located in urban settings, dental educators need to establish, fund, and sustain outreach programs while sensitizing students to the needs of the underserved. This paper describes the process that Case Western Reserve University School of Dental Medicine used to develop an outreach program to address the needs of underserved children in Cleveland, Ohio.

Adolescent↗
PubMed2005

Sustaining remote-area programs: retinal camera use by Aboriginal health workers and nurses in a Kimberley partnership.

OBJECTIVE: To describe how a novel program of diabetic retinopathy screening was conceived, refined and sustained in a remote region over 10 years, and to evaluate its activities and outcomes. DESIGN: Program description; analysis of regional screening database; audit of electronic client registers of Aboriginal community controlled health services (ACCHSs). SETTING AND PARTICIPANTS: 1318 Aboriginal and 271 non-Aboriginal individuals who underwent retinal screening in the 5 years to September 2004 in the Kimberley region of north-west Australia; 11 758 regular local Aboriginal clients of Kimberley ACCHSs as at January 2005. MAIN OUTCOME MEASURES: Characteristics of clients and camera operators, prevalence of retinopathy, photograph quality, screening intervals and coverage. RESULTS: Among Aboriginal clients, 21% had diabetic retinopathy: 19% with non-proliferative retinopathy, 1.2% with proliferative retinopathy, and 2.8% with maculopathy. Corresponding figures for non-Aboriginal clients were 11%, 11%, 0 and 0.4%, respectively. Photograph quality was generally high, and better for non-Aboriginal clients, younger Aboriginal clients and from 2002 (when mydriatic use became universal). Quality was not related to operator qualifications, certification or experience. Of 718 regular Aboriginal clients with diabetes on local ACCHS databases, 48% had a record of retinal screening within the previous 18 months, and 65% within the previous 30 months. CONCLUSIONS: Screening for diabetic retinopathy performed locally by Aboriginal health workers and nurses with fundus cameras can be successfully sustained with regional support. Formal certification appears unnecessary. Data sharing across services, client recall and point-of-care prompts generated by electronic information systems, together with policies making primary care providers responsible for care coordination, support appropriate timely screening.

Aged↗
PubMedDate not supplied

Goal-oriented evaluation as a program management tool.

Health promotion programs, like all human services activities, must be well managed in order to be effective. In an age of reduced financial resources to support new programs and sustain old ones, all program directors must be concerned with the efficiency with which available resources are used to meet program goals and objectives. In times such as these, competition is high for those resources that are available. Programs that can demonstrate both effectiveness in meeting their goals and operational efficiency in doing so are more likely to be successful in the competition for these scarce resources. In this article, practical suggestions for the use and presentation of evaluation data in the analysis of program effectiveness and efficiency are presented. The methodology is based on the contention that program evaluation should be useful to program directors as an integral part of their management of program resources in relation to program goals.

Efficiency↗
PubMed1991

Discussing life-sustaining treatment. A teaching program for residents.

Ideally, physicians and patients should discuss patient preferences for life-sustaining treatment before the onset of cognitive impairment or a life-threatening illness; however, these conversations often do not occur. We developed an educational program in which residents practiced discussing advance directives with volunteer simulated outpatients and then received feedback from the patient, an observing resident, and a faculty member. Residents found the training sessions to be realistic, relevant, and useful. Resident self-ratings improved significantly on eight items representing knowledge, skills, and attitudes about discussing advance directives with patients. Resident learning occurred in four major areas: technical knowledge about advance directives; introducing the topic to patients; giving patients information; and eliciting patients' values and feelings. We conclude that residents need and want training in this area and that simulated patients act as a catalyst for their learning.

Advance Directives↗
PubMed2004

Current and future challenges in school-based prevention: the researcher perspective.

During the next decade we will see broad dissemination of a growing number of empirically validated school-based prevention programs. The processes of effectiveness research, broad program diffusion, and program integration at the school and community level will become a central focus of research activity. The paper presents six future directions for research in the field of school-based prevention and health promotion. The directions include developing new programs and models, developing standards and accountability systems related to school success, moving from efficacy to effectiveness research, understanding factors influencing program integration, broad dissemination of programs and policies, and the sustainability of programs, policies, and community partnerships. These future directions are driven by three significant research-to-service challenges faced both by practitioners and researchers that involve systems integration across developmental stages, levels of care, and institutional structures.

Humans↗