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PubMed1998

Taranaki community partnership model.

BACKGROUND: This exercise was undertaken as part of a re-engineering of community health services. 'Community' needed to be defined in order to understand its components, to develop a philosophy and a common understanding to assist in the re-engineering process. AIM: To define community health as it is understood by practitioners in the Taranaki province. METHOD: Workshops were held involving as many community workers as possible. Newsletters kept staff informed of developments. Individual interviews and phone calls also featured. FINDINGS: A community partnership model was developed encompassing the concepts of equity, communication, responsiveness and sustainability. The people working within the model were staff, client and customer. CONCLUSION: This was a worthwhile exercise that resulted in a unique model developed by practitioners for practitioners which gave a feeling of 'belonging' to a fragmented service. It has uses in further research, in education and in the day to day running of community services.

Community Health Nursing↗
PubMed1997

Community-based care: back to the future!

Home- and community-based care are deeply rooted in the United States and worldwide. Public and private organizations have provided formal in-home and community health services for more than a century. Today they are an integral part of the care continuum, ranging from highly technical and professional services to simple forms of non-professional and voluntary support in homes. Because the roles and functions of community workers have expanded and diversified, organizations must successfully recruit, train and support workers with widely differing skills. In health care's new economic era, health has re-emerged as a community rather than individual concern. Non-traditional models of service delivery will be the cornerstone of community-based health care. Providers and policy-makers must find new ways to refocus from treating illness to achieving and maintaining health.

Community Health Services↗
PubMed1995

Por La Vida intervention model for cancer prevention in Latinas.

Our goal was to describe the development and implementation of an intervention on cancer prevention for Latinas in San Diego, Calif. Thirty-six lay community workers ("consejeras") were recruited and trained to conduct educational group sessions. Each consejera recruited approximately 14 peers from the community to participate in the program (total number = 512). Half of the consejeras were randomly assigned to a control group, in which they participated in an equally engaging program entitled "Community Living Skills." Implementation of the intervention was assessed by qualitative and quantitative methods. Preintervention and postintervention self-report information was obtained from project participants on access to health care services, cancer knowledge, preventive measures, and previous cancer-screening examinations. Base-line data suggest that lack of knowledge, costs of cancer-screening tests, and the lack of a regular health care provider are the major obstacles against obtaining cancer-screening tests. Predisposing factors, such as fear and embarrassment, also constitute barriers to getting regular cervical cancer screening. Preliminary analysis indicates that the Por La Vida intervention increases use of cancer-screening tests in comparison to a community living skills control group. Universal access to health care would remove some of the major financial barriers to cancer screening. The Por La Vida program attempts to overcome the substantial barriers by reaching out to low-income Latinas and by providing information regarding the availability, acceptability, and preventive nature of cancer-screening tests.

Adult↗
PubMedDate not supplied

A community-based, culturally sensitive education and group-support intervention for Mexican Americans with NIDDM: a pilot study of efficacy.

The purpose of this study was to determine the feasibility of providing a diabetes patient education and group-support intervention that was directed by a Mexican-American clinical nurse specialist (CNS), dietitian, and community worker; consistent with national standards; and designed for the Mexican-American culture. In a rural Texas-Mexico border community, subjects with diabetes were randomly selected to participate in the intervention, and a family member of each subject participated as a support person. The intervention involved 8 weeks of educational sessions with instruction on nutrition, blood glucose self-monitoring, exercise, and other diabetes self-management topics, and provided group support. Group discussion was facilitated using a series of Spanish-language videotapes that had been developed and previously tested in the target Mexican-American community. Results suggested statistically significant improvements in diabetes knowledge, fasting blood sugar levels, and glycosylated hemoglobin levels. The study documented the feasibility and potential benefits of the intervention.

Aged↗
PubMed1995

Concepts of mental illness and medical pluralism in Harare.

The Focus Group Discussions (FGD) described in this paper are the first step of a study aiming to develop an 'emic' case-finding instrument. In keeping with the realities of primary care in Zimbabwe, nine FGD were held with 76 care providers including 30 village community workers, 22 traditional and faith healers (collectively referred to as traditional healers in this paper), 15 relatives of patients and 9 community psychiatric nurses. In addition to the general facets of concepts of mental illness, three 'etic' case vignettes were also presented. A change in behaviour or ability to care for oneself emerged as the central definition of mental illness. Both the head and the heart were regarded as playing an important role in the mediation of emotions. The types of mental illness described were intimately related to beliefs about spiritual causation. Angered ancestral spirits, evil spirits and witchcraft were seen as potent causes of mental illness. Families not only bore the burden of caring for the patient and all financial expenses involved, but were also ostracized and isolated. Both biomedical and traditional healers could help mentally ill persons by resolving different issues relating to the same illness episode. All case vignettes were recognized by the care providers in their communities though many felt that the descriptions did not reflect 'illnesses' but social problems and that accordingly, the treatment for these was social, rather than medical. The data enabled us to develop screening criteria for mental illness to be used by traditional healers and primary care nurses in the next stage of the study in which patients selected by these care providers on the grounds of suspicion of suffering from mental illness will be interviewed to elicit their explanatory models of illness and phenomenology.

Activities of Daily Living↗
PubMed2000

Community-based education in nutrition and cancer: the Por La Vida Cuidándome curriculum.

The Por La Vida (PLV) intervention model relies on community lay health advisors trained to conduct education sessions among members of their existing social networks. PLV Cuidándome was funded by the NCI to develop, implement, and evaluate the PLV model with respect to nutrition and cancer prevention, as well as early detection of breast and cervical cancers. The target population is the Latino community, for which substantial barriers to health care access exist. This article presents the curriculum that guides the sessions and describes its development, which was based on semi-structured interviews with Latina lay-health community workers to explore relevant attitudes and behaviors. Also key to the process was the work of the educational materials committee, whose members offered community representation as well as expertise in nutritional sciences, educational technologies, and community-based health promotion interventions and research. The 12-session curriculum's goal was to increase both the variety and the quality of fruits and/or vegetables consumed. It included information about consumption of fiber and fat in the importance of balance between energy intake and physical activity. The program has been well received. An ongoing study examines how it enhances nutrition and cancer prevention.

Community Health Services↗
PubMed1995

Occupational conditions and workers' sense of community: variations by gender and race.

The literature is reviewed to define a sense of community in the workplace and to identify factors that may foster it. A model is developed and estimated with survey data from a culturally diverse sample of men and women performing lower-level jobs at a medium-sized manufacturing firm. Results of regression analyses are reported that correct for sample selection bias resulting from the lower response rates of minority workers. Findings suggest that well-designed jobs and supportive workplace relationships and policies are important in explaining workers' sense of community, defined as workers' perceptions of mutual commitment between employee and employer. Informal sources of support play a larger role in explaining men's sense of community, while formal sources of support are more important in explaining women's sense of community. Findings further suggest that African American workers, especially women, have a difficult time experiencing a sense of community at work.

Black or African American↗
PubMed2005

Knowledge, attitude and practice of family planning amongst community health extension workers in Kaduna State, Nigeria.

A self-administered opportunistic questionnaire was given to 232 community health extension workers (Chews) in Kaduna state, Nigeria. Seventy-eight were male and 154 female. All could recall at least one modern method of family planning. The oral contraceptive pill (OCP) (85.8%), injectable contraceptives (85.3%), and the intra-uterine contraceptive device (IUCD) (56.0%), were most widely known about. Emergency contraception was not known about. A high percentage of female Chews have practised family planning: 115 (74.7%) have used at least one method and this is more among the married women. Methods ever used included injectable contraceptive (57.4%), OCP (47.0%), and IUCD (22.6%). Fifty percent of females were current users. Non-current users were likely to be between the ages of 25 - 29 years especially when not married, and 35 - 39 years when married. Reasons for the non-use of family planning by female Chews were side effects, not being married, not being sexually active and religious beliefs.

Adult↗
PubMed1992

Adopting the primary health care approach in malaria control in Malaysia: lessons in community participation.

The Primary Health Care approach in Malaysia was first tried out in Sarawak, East Malaysia in 1982. In 1984, the Vector Borne Disease Control Program, Kelantan decided to adopt the Primary Health Care approach as an additional strategy in its effort to control malaria in the state, which then experienced an increase in malaria cases. Much effort was directed at creating the awareness and stimulating the interest of health staff and communities to adopt the strategy. Kelantan was made the model state. The paper gives an outline of the process involved and some characteristics of PHC workers. A study was carried out among health workers, community members and health staff on their knowledge and involvement in PHC in three states, including Kelantan. In view of the overall success of this approach, and the weaknesses which have been identified possible solutions have been suggested and should be acted upon.

Communicable Disease Control↗
PubMed1971

An unusual social experiment to help youth in crisis (Ankh).

This paper describes the setting up and operation of a Crisis Intervention Service in a semi-rural community serving a population of 75,000 within a 20-mile radius. It was established in response to the mounting problem of drug abuse by youth in the community. Workers in the service were drawn from within the peer group being served, and the service has been deliberately client-orientated. It has developed as a community project. Significant features behind its success are described. Evaluation on a cost-effectiveness basis shows considerable saving in both financial and professional time terms, which should interest any organization, medical, social or political, concerned with these matters.

Adolescent↗
PubMed1995

Has there been a failure to prepare and support parish-based clergy in their role as frontline community mental health workers: a review.

Addresses the issue that parish-based clergy, functioning as frontline community mental health workers, often do so with inadequate training and limited support from the mental health community. Claims that although a clergyperson is as likely to have a severely mentally distressed person seek her or his assistance as is a mental health specialist, there is inadequate research on the function of clergy in the mental health network or the psychological dynamics of religion. Suggests that clergy can serve most effectively in the mental health network as skilled facilitators, identifying the needs of persons, and connecting them to a larger circle of specialized helpers. Argues that the mental health and religious communities share many common values and goals and need to work together more effectively for the best interest of those they are called to serve.

Aged↗
PubMed2003

An outbreak of severe acute respiratory syndrome among hospital workers in a community hospital in Hong Kong.

BACKGROUND: During outbreaks, hospital workers are at high risk for nosocomial infection with severe acute respiratory syndrome (SARS)-associated coronavirus. OBJECTIVE: To examine how hospital workers became infected and whether they transmit the virus to their families. DESIGN: Retrospective descriptive study. SETTING: 529-bed community hospital in Hong Kong. PATIENTS: 40 hospital workers infected with SARS-associated coronavirus over a 6-week period (25 March through 5 May 2003). MEASUREMENTS: Percentage of infected hospital workers according to job category. RESULTS: The cumulative incidence was highest among health care assistants, followed by physicians and nurses (8%, 5%, and 4%, respectively). Most hospital workers were infected from direct contact with patients with SARS, who primarily were in general wards and had unsuspected infection. At the time of contact, all hospital workers had used masks but not necessarily other protective devices. Affected hospital workers did not infect their families. CONCLUSION: Before isolation of all patients with clinically confirmed or suspected SARS, routine use of several protective devices, and training of staff in infection control, many health care workers were infected with SARS from patients with unsuspected cases.

Adult↗
PubMed1976

Social workers' orientations toward community mental health concepts.

Relations between ideological priorities in social work and community mental health were examined by a Likert-type questionnaire containing statements representing Caplan's Conceptual Models in Community Mental Health. Seventy social workers were sampled, with equal subsamples representing the five largest fields of practice in social work. This sample appeared to be highly representative of the national social work population by fields of personal service. By analyses of variance and correlation, significant differences were found between levels of approval for respective models by the total sample, but no significant differences were found by fields of practice, or any other professional or demographic attribute. This indicates a consensual integrity in the social work profession's community mental health orientation, and strong mutuality between social work and community mental health value orientations.

Attitude of Health Personnel↗
PubMed1997

Perceptions of children and community members concerning the circumstances of orphans in rural Zimbabwe.

Focus group discussions and interviews were held with 40 orphans, 25 caretakers and 33 other community workers from a rural area near Mutare, Zimbabwe. Orphan concerns included feeling different from other children, stress, stigmatization, exploitation, schooling, lack of visits and neglect of support responsibilities by relatives. Many community members, while recognizing their limitations due to poverty, were already actively helping orphans and caretakers. Extended family networks are the primary resource for orphans, though some relatives exploit orphans or fail to fulfil their responsibilities. Interventions are suggested which support community coping mechanisms by strengthening the capacities of families to care for orphans. Outside organizations can develop partnerships with community groups, helping them to respond to the impact of AIDS, by building upon existing concern for orphan families. They can help affected communities to develop orphan support activities which encourage caring responses by community leaders and relatives and which discourage property-grabbing and orphan neglect. Material support channelled through community groups to destitute families at critical times can strengthen family coping mechanisms. Income-generating activities should build upon communities' existing capabilities and benefit the most vulnerable orphan households. Some communities are responding to the AIDS disaster by adaptations to cope with devastating changes taking place in their communities.

Acquired Immunodeficiency Syndrome↗
PubMed2006

Issues with prescribed medications in Aboriginal communities: Aboriginal health workers' perspectives.

INTRODUCTION: The health of Indigenous Australians remains appalling. The causes of this situation are multi-factorial, however one contributing factor is poor medication compliance within Aboriginal populations. Anecdotal evidence provided by Aboriginal health workers in western New South Wales (NSW), Australia, has suggested that there are problems associated with the use of prescribed medications within the Aboriginal community. Aboriginal health workers form a core component of the Aboriginal health service sector and they have an in-depth knowledge of the community and its healthcare provision, as well as a familiarity with clinic patients and families. As such they are an important group whose opinions and beliefs about medication use in the Aboriginal population should be investigated. While there have been studies on the issues of prescribing in Aboriginal communities and access to medications, limited investigation into the use of prescribed medicines in Aboriginal communities and the role of the pharmacist in that process, has taken place. Therefore, this research aimed to identify the type of and reasons for inappropriate use of prescribed medications within Aboriginal communities serviced by the Mid Western Area Health Service (since incorporated into the Greater West Area Health Service) as perceived by the Aboriginal health workers in the area, and to explore strategies in conjunction with those Aboriginal health workers to address identified issues. METHODS: Qualitative, in-depth interviews were held with 11 Aboriginal health workers employed in Community Health Centres and hospitals in the Mid Western Area Health service of NSW. The interviews were audiotaped and transcribed verbatim. The transcripts were content analysed for emerging themes. The interviews explored the beliefs, perceptions and experiences of the Aboriginal health workers regarding prescribed medication use, the role of the pharmacist, and identification of future strategies to improve medication use in local Aboriginal communities. RESULTS: The Aboriginal health workers reported a general lack of access to medications and frequent inappropriate use of medications due to limited understanding, literacy and information all of which lead to non-compliance with instructions. Medication sharing was common in their communities. They reported that many Aboriginal people were uncomfortable seeking medicines advice, and the consumer medicine information provided was often difficult to understand, culturally inappropriate and unlikely to be utilised. Strategies suggested to improve pharmacist services and access to the services were a more 'Aboriginal friendly' environment, relationship development between pharmacists and Aboriginal health workers, cultural awareness programs for pharmacists and their staff, provision of disease state management services and medicine education programs by pharmacists for Aboriginal health workers. CONCLUSION: Medication misunderstandings and non-compliance within the Aboriginal community frequently occur. Suggestions to improve access, understanding and compliance, along with the education and training of Aboriginal health workers may provide tools for self-determination. Pharmacists may be well positioned to provide Aboriginal health workers with medicines information and patient education skills, and encourage the effective use of medicines within the Aboriginal community.

Attitude of Health Personnel↗