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PubMed2002

The Beacon Project--a community-based health improvement project.

Inequality and socioeconomic deprivation remain powerful determinants of the nation's health. The Beacon Project, led by two primary health care visitors, was initiated to tackle the rapidly declining health and social needs of a community in Cornwall, southwest England. Significant improvements in conditions and a general sense of wellbeing on the estate, together with the improvements in social outcomes was observed over a period of four years.

Community Health Planning↗
PubMed2002

Do we need a new law or regulation? The public health decision process.

New laws or regulations may not be a practical response to a public health threat. While in some instances legislation or regulation may be the only alternative to protecting the public's health, in many situations public health authorities and their legal counsel must consider alternative approaches to abating threats. This article provides an overview of the alternatives available to the public health official by providing discussion of a "legal tool box" available to public health officials. It also presents scenarios, with commentary, that serve as the basis for illustration of other means of intervention.

Community Health Planning↗
PubMedDate not supplied

[Assessment and prospects of the community's participation at the Ziguinchor regional hospital centre (Senegal)].

At the Ziguinchor regional hospital centre (RHC), the populations participate in the health effort by paying care services and medicines. The financial assessment of the participation of the community at the Ziguinchor RHC, from January 1,1998 to June 30, 2000, did not give good results. CFAF 263,066,092 of receipts have been generated, especially through the sale of medicines (38.85%) and via the obstetrical and gynecological clinic services (13.30%). The expenditures went up to CFAF 267,120,718; 41.87% were given to the staff, and 25.39% were used to buy medicines. Globally, expenditures exceeded receipts. At the beginning of January 1998, CFAF 7,600,524 were left to the Health Committee's budget. At the end of June 2000, there only remained CFAF 3,365,898. The decrease in the budget was expected because the RHC Health Committee board, set since 1984, never been renewed. Its management never followed the present recommendations. The board members, who were arbitrarily elected, didn't respect their commitment and were just represented by the treasurer. The latter had only a financial executive role. The board's decisions, which should have had the agreement of its president, were taken unilaterally by the direction of the RHC. Consequently, expenses evolved in keeping with gains, completely ignoring the use of the state budget. For a successful start of the RHC in the hospital reform, ten recommendations have been put across. The objective is to improve the organization of the Health Committee in order to better answer the population health problems.

Community Health Planning↗
PubMed2001

Ten best readings on community participation and health.

This article reviews, in the opinion of the author, the 10 most influential reading on community participation and health development. The introduction notes that some of the articles do not address health directly but still do bring crucial interpretations to the topic. All articles view community participation as an intervention by which the lives of people, particularly the poor and marginalised can be improved. In addition, they all address the issue of the value of participation to equity and sustainability. The article considers the readings under four heading: concepts and theory; advocacy; critiques and case studies. It highlights the important contributions each reading makes to the understanding of participation in the wider context of health and health development. In conclusion, the article argues that participation has not met the objectives of planners and professionals, in good part, because it is questionable as to whether viewing participation as an intervention enables them to make correct assessments of its contribution to development. The bottom line is that participation is always about power and control, an issue planners and professionals do not want explicitly to address.

Community Health Planning↗
PubMed2003

The health care safety net: money matters but savvy leadership counts.

The nation's health care safety net--heavily reliant on external funding and support--is uniquely vulnerable to shifting and often adverse market and policy conditions. While adequate funding is essential to ensuring safety net providers can care for low-income people, the Center for Studying Health System Change (HSC) has identified a number of other factors key to building and maintaining viable community safety nets. Throughout the four rounds of HSC's Community Tracking Study (CTS) site visits, researchers have found that strong political and organizational leadership, community support, collaboration and business acumen have helped safety net providers build capacity and improve care coordination for low-income and uninsured people. These characteristics and business strategies have strengthened many community safety nets, better preparing them to weather current economic problems and providing a road map for the potentially tougher times ahead.

Capital Financing↗
PubMed2003

Assessing community needs.

A needs assessment can be an invaluable tool when you are developing a new program or expanding a program you already offer. However, the process for conducting a community needs assessment can be complicated. In this brief we walk you through this process, including defining your purpose, selecting an approach, collecting data and then using that data.

Community Health Planning↗
PubMed2004

Community-based prevention of substance abuse.

Substance abuse is pervasive in a number of countries throughout the world, placing an enormous burden and strain on their healthcare systems. The relationship between crime and illicit drug use increases the significance of the problem facing countries worldwide. Jamaica has not only become a trans-shipment point for cocaine from South America, but recent Drug Enforcement Agency figures show Jamaica being responsible for 30% of cocaine trafficking into the United States of America. Though all segments of society are involved, disadvantaged groups are disproportionately affected. Substance use and abuse among adolescents is of particular concern. Supply reduction approaches have not been effective enough in reducing the prevalence of substance use and abuse in many countries throughout the world. Substance abuse prevention research over 25 years has led to the identification of a number of factors differentiating substance abusers from others. The presence of risk factors and the absence of protective facts contribute to an increase potential for drug abuse. The impact that these factors have is also determined by the level of psychological and social development of an individual. The presence of risk factors as well as the absence of protective factors leads to increased "exposure opportunity", exposure to a potential substance of abuse being closely associated with the potential for initial drug use, transition from initiation to regular use and subsequently dependence. One method of reducing "exposure opportunity" is community prevention. The basic aim of community prevention programmes is to decrease the rate of drug use in a population by enhancing protective factors and reversing or reducing risk factors.

Community Health Planning↗
PubMed2005

Community health advisors effectively promote cancer screening.

Cancer is the second leading cause of death in the United States. Across many cancers, racial and ethnic minorities bear an unequal burden of disease (e.g., lower 5-year survival rates). Concerted efforts to reach minority communities and address these disparities are needed. Community Health Advisors (CHAs) are trusted natural helpers from within the community who provide emotional support, advice, and tangible aid to members of their social network. Their understanding of community culture allows them to provide culturally appropriate, informal, and spontaneous assistance to community members. Using various approaches and across a number of racial/ethnic groups, CHA interventions have demonstrated success in increasing cancer screening. This paper highlights some of those intervention programs and concludes with considerations for future projects.

Breast Neoplasms↗
PubMed2006

The African American Wellness Village in Portland, Ore.

More than 80% of African Americans in Oregon reside in the Portland metropolitan area; African Americans comprise 1.7% of the state's population. Although relatively small, the African American population in the state experiences substantial health disparities. The African American Health Coalition, Inc was developed to implement initiatives that would reduce these disparities and to promote increased communication and trust between the African American community and local institutions and organizations. One of these initiatives is an annual Wellness Week featuring an African American Wellness Village. The Wellness Village uses a model of cultural sensitivity to provide access to free health screenings, links between health care organizations and African American community members, and health education and information. The African American Health Coalition, Inc obtained a Racial and Ethnic Approaches to Community Health (REACH) 2010 grant to sustain this programming. The Wellness Village is supported by five major sponsors; annual attendance has ranged from 700 to 900 participants. The African American Health Coalition's evaluation of the event indicates that more than 50% of respondents identify the Wellness Village as the only place that they receive health screenings. Participants with access to screenings elsewhere report that a culturally sensitive environment that inspires trust is the reason they prefer the screenings offered at the Wellness Village. Culturally sensitive health fairs such as the Wellness Village may play an important role in bringing preventive health screenings to African American communities. Collaboration between black and white health care providers is critical in this effort. Partnerships must be built at multiple levels, including institutions to provide financial resources and in-kind donations, community members to assist with outreach and recruitment, and health care professionals to conduct screenings and services.

Black or African American↗
PubMedDate not supplied

Rehabilitation services in Papua New Guinea.

It is now accepted that in developing countries community-based rehabilitation (CBR) is the most effective way to meet the needs of the disabled. The proportion of the population of Papua New Guinea (PNG) having access to CBR is not known. The purpose of this project was to clarify the extent of rehabilitation services in PNG. It was hoped that by establishing the extent of services, communication and cooperation between them would increase, leading to more efficient and effective use of the limited resources (human and otherwise) available for rehabilitation in PNG. A questionnaire was sent to all known existing rehabilitation services, all provincial health departments, provincial hospitals and church health services. A 47% response rate was achieved. Results showed that most provinces have some form of rehabilitation available but rehabilitation is not spread equally throughout PNG. Most of the services are based in the urban centres and the rural population is badly served except in the Highlands Region and the Sepik provinces, which appear to be more comprehensively served by CBR. The services that do exist are hampered by lack of human and material resources and difficulty accessing clients due to transport difficulties. There needs to be a greater movement of rehabilitation into the community with government backing. The greatest effort is being made by Callan Services for Disabled Persons based in Wewak with its group of Special Education Resource Centres that also carry out CBR. CBR would appear to be an appropriate way to address the needs of the disabled PNG population, but in order to be successful it requires greater backing and more trained personnel.

Community Health Planning↗
PubMed2006

Community ophthalmology--an approach including tentative strategic interventions in brief.

Community ophthalmology is based mainly on the principles of primary healthcare approach with active community involvement and participation, focus on prevention, equity of distribution of resources, involvement of correct and recent technological procedures and integrated multisectoral approach. In our country National Programme for Control of Blindness was launched in 1976. Community ophthalmology programme can play definitely a great role there.

Blindness↗
PubMed2006

[Longitudinal analysis of factors associated with participation in community-based mass screening for the frail elderly in need of care].

PURPOSE: To examine factors associated with participation in a community based comprehensive health check to screen frail elderly before they become in need of long-term care. METHODS: All residents aged 70 years and over living in Kusatsu, Gumma prefecture were surveyed for their sociodemographics, and physical, mental and social functioning through in-person interview in the years 2001 and 2003. In the following years--in 2002 and 2004, respectively--mass screenings were conducted to detect early signs of need for care among the elderly. Using the baseline interview information as explanatory variables, we performed multiple logistic regression analysis in order to examine the social determinants of participation in the mass-screening. RESULTS: For the first mass-screening, having high blood pressure and poor subjective health decreased the likelihood of attending the screening by 34% and 65% respectively. In contrast, one point increases in IADL, mobility and social-role score increased the probability of attendance by 27%, 26% and 26% respectively. After the screening was re-conducted, the factors influencing attendance appeared to have changed. With a third mass-screening, while the IADL and mobility score still had significant effects, elderly having excellent subjective health were less likely to go by some 48%. It was also found that not having visual impairment had a significantly positive effect on attendance. CONCLUSION: If local government conducts community-based mass screening aiming to screen the frail elderly in need of care, it is likely that there are high risk elderly among the non-participants. It is very important to follow up those non-participants using an attendance roll and provide appropriate advice. It is also worth discussing mass screening that focuses more on health promotion than on "screening" itself.

Activities of Daily Living↗
PubMed2006

Local health departments and the challenge of chronic disease: lessons from California.

The essential role local health departments have played in the control of infectious diseases has not been matched with an equivalent contribution in prevention of chronic diseases. Local health departments have attempted to define and build that capacity, but they have been confronted with budget cuts and competing public health priorities, most notably bioterrorism preparedness. This article is based on interviews with local health officials and describes some of the common ways local health departments in California have forged ahead to develop the capacity to engage in comprehensive approaches to chronic disease prevention in spite of the challenges. Additionally, the article highlights future considerations that need to be addressed if these promising trends in chronic disease prevention are to become more widespread.

California↗
PubMed1995

Surveying disabilities in Mafraq District in Jordan in view of approaching community based rehabilitation.

Disabilities in Mafraq District in Jordan were identified using active case detection. The identified disabilities were characterized by type, sex and age of the disabled as well as other variables pertaining to the reproductive history of their mothers and certain socioeconomic variables pertaining to their families. The results indicated an unmet need regarding services addressing the disabled and that they belong to poor families with high prevalence of illiteracy. The results also showed that the prevalence of consanguineous marriages as well as pregnancy at the two extremes of women's reproductive life is associated with congenital disability. The results were availed to the responsible authorities to facilitate embarking on Community Based Rehabilitation (CBR) in the district.

Adolescent↗