[Characteristics of community participation in urban primary health care programs].
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The achievement of significant levels of influence on six program decision areas by communities served by health care program is investigated using Guttman scale analysis in a sample of 50 Children and Youth comprehensive health care projects in the United States to determine whether such achievement occurs in an ordered or a random sequence. Evidence presented indicates that the achievement of relative levels of community influence is orderly for initial levels of influence; higher levels of community influence apparently do not follow the same order. Implications of these findings for planning and predicting the development of personal health service programs are discussed.
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Many universities are establishing programs to bring health professions students, faculty, and communities together to address the communities' needs using public health models and tools. Such partnerships provide students with the opportunity to put into practice what they learn in the classroom, work together in interdisciplinary teams, and provide communities with access to preventive care and health education. The authors describe the experience of the partnership developed between a Washington, D.C., elementary school and a group of students from the schools of medicine, nursing, and public health and health services of the George Washington University and George Mason University. Working with both an academic preceptor and a community preceptor, the students assessed the schoolchildren's immunization status; prepared informational packets for parents; and organized and conducted an immunization fair at the elementary school. The authors describe how the program was implemented, the results of the program, and lessons learned.
A conceptual model was developed for a community-based intervention study in a Black township in South Africa. The model shows a useful way to structure the complex role public health nurses play as they meet community health needs using a community's priorities and building toward community involvement in health and self-care. The model was applied over a 2-year period in an under-developed community of 100,00 people where the unemployment rate was over 50%, fewer than 10% of the homes had electricity, and only one-third had access to the sewage removal system. Over half of older adults interviewed were illiterate. The residents, in collaboration with the nurse researcher, gathered data, prioritized needs, and chose projects to produce solutions. The model guided activities for community empowerment through a deliberate transfer of information and expertise from the nurse to members of the community. Conceptual models or paradigms are useful to focus nursing strategies, to guide professional nursing practice, and to support interdisciplinary goals for cooperative efforts. The principles are also applicable in the United States and other developed countries as more effective ways to achieve health goals are sought.
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