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PubMed2006

Literacy for the community, by the community.

Literacy is a significant challenge in the U.S. and its territories, especially in low income communities where use of English language is non-standard. Wedeveloped the Actual Community Empowerment (ACE) Reading program for students at risk in such communities. ACE is a small-group tutoring program to support fluency, word recognition and decoding, and comprehension at the best pace of learning for individual, struggling readers. It has several variations (e.g., for different ages, different uses of technology), depending on local needs and resources. The program has been successfully implemented in 40 locations from Philadelphia to Pohnpei, with a 95% success rate for significant reading improvement. ACE tutors are community paraprofessionals or school students with backgrounds similar to the children who receive tutoring. In the first major section of this paper, the ACE Reading Program is described and empirical research demonstrating the benefits of the program for students' literacy is reviewed. The second major section presents preliminary qualitative research evidence that paraprofessional tutors progress through recognizable stages toward increased professionalism. Recommendations for future research are provided.

Adolescent↗
PubMed1991

Community action for health promotion: a strategy to empower individuals and communities.

Health status is directly affected by environmental conditions and by personal health-related behaviors, and it is indirectly affected by environmental conditions that themselves influence health behaviors. A comprehensive approach to health promotion, therefore, should encourage individuals to adopt and maintain personal behaviors that would prevent disease and promote health; discourage health-damaging personal behaviors by individuals and facilitate people engaging in health-promoting behaviors; and eliminate health hazards from the physical and social environment and make that environment more health-promoting. This comprehensive approach would require social and community action to change environmental conditions as well as efforts to change individual behavior. A model of health promotion interventions is developed within which community action plays a central role. The author then presents a model of community organization to influence public policy to achieve health promotion goals. The community organization model, previously tested in comparative case-study research, is illustrated with examples drawn from appropriate health promotion programs.

Community Health Services↗
PubMedDate not supplied

Revitalized commitment to community. A community benefit plan helps a hospital be a good neighbor.

Three years ago St. John Hospital and Medical Center, Detroit, made a commitment to strengthen its community relationships and reaffirm its mission of serving those in need by following the Catholic Health Association's Social Accountability Budget. While implementing the program, administrators were surprised to learn the hospital was already participating in many community programs for which it received little or no reimbursement. They also discovered that the hospital had no formal, written charity care policy even though St. John provided more than $14 million in uncompensated care annually. To learn what the needs of the surrounding community were, the hospital went to the clergy, who overwhelmingly identified the needs of the elderly as the number-one priority. A close second was supporting the basic family unit. Other concerns included basic family needs, safe neighborhoods and schools, and teen pregnancy. Although the hospital realized it could not do all that was needed, it felt obliged to be a leader in seeing that the needs were met and drew up a community benefit plan that documented the problems and the solutions. The hospital did what it could and worked with other organizations to address needs such as housing for the elderly, affordable and accessible healthcare, neighborhood improvement and safety, and family services.

Catholicism↗
PubMed1994

Community benefit reporting is worthwhile. A central Iowa healthcare provider annually distributes a report to its community.

To document our impact on the community's health, Mercy Health Center of Central Iowa has created a "Community Benefits Report"--a 14-page report listing all charitable projects among eight distinct subsidiaries of Mercy Health Center. The Mercy report lists all the charitable works provided to the community in the past year by Mercy Hospital Medical Center, the Mercy Clinic System, the Clark Street House of Mercy, the Bishop Drumm Care Center, and a few smaller affiliate hospitals in rural Iowa. Mercy's community benefits report serves not only as a summary, but as the blueprint for the work Mercy leaders are planning. This documentation helps in many ways, including identifying the needs of Des Moines and central Iowa and showing Mercy's role in meeting those needs.

Annual Reports as Topic↗
PubMed2001

Medical education through community experience: community projects at the University of South Dakota School of Medicine.

Community projects are a requirement of third-year medical students at three South Dakota clinical campuses. Students identify a community issue, design and implement either a service or research project, and present the project to faculty and peers. Topics include cardiovascular and other disease risk factors, nutrition education, firearm safety and many others. These projects answer a need to advance an understanding of population health, promote community involvement among student physicians, and improve the health of the community.

Clinical Clerkship↗
PubMed2003

American Academy of Pediatrics Community Access to Child Health (CATCH) Program: a model for supporting community pediatricians.

Advocacy on behalf of children who are medically underserved and the pediatricians who care for them has been a long-standing core commitment of the Royal College of Paediatrics and Child Health and the American Academy of Pediatrics. Although different in etiology, barriers to adequate health care exist in both nations. In the United States, almost 18 million children have either no health insurance or inadequate coverage, whereas in the United Kingdom, parents can, in most cases, readily enroll their youngsters in a universal health insurance program that is not dependent on employers or employment.(1) However, despite universal access to health care in the United Kingdom, as in the United States, there are infants and children who do not regularly use or otherwise connect to available health care delivery systems. Many of these families are not participants in other social systems (eg, church, school, voting, employment, property ownership/rental) and therefore are not known to governments, agencies, authorities, or health care professionals. Both nations have citizens living in extreme poverty with its associated environmental and health hazards and tendencies to health risk behaviors. Both the Royal College of Paediatrics and Child Health and the American Academy of Pediatrics have strategies and programs to address these issues and to support pediatricians who work in their communities to improve the lives of children. The following describes the American Academy of Pediatrics Community Access to Child Health infrastructure that supports practicing community pediatricians in these efforts and opportunities to develop collaborative international endeavors to advance the practice of community pediatrics.

Child↗
PubMed2005

Texas' community health workforce: from state health promotion policy to community-level practice.

BACKGROUND: Imagine yourself in Texas as a newly arrived immigrant who does not speak English. What would you do if your child became ill? How would you find a doctor? When you find one, will the doctor speak your native language or understand your culture? In a state of approximately 22 million people, many Texas residents, marginalized by poverty and cultural traditions, find themselves in this situation. To help them, some communities across Texas offer the services of promotores, or community health workers, who provide health education and assist with navigating the health care system. CONTEXT: In 1999, Texas became the first state in the nation to recognize these workers and their contributions to keeping Texans healthy. This paper examines a state health promotion policy that culminated in a training and certification program for promotores and the impact of this program on the lay health education workforce in Texas. METHODS: In 1999, the Texas legislature established the 15-member Promotor(a) Program Development Committee to study issues involved in developing a statewide training and certification program. During its 2-year term, the committee met all six of its objectives toward establishing and maintaining a promotor(a) certification program. CONSEQUENCES: By the end of December 2005, it is estimated that there will be more than 700 certified promotores in Texas. State certification brings community health workers into the public health mainstream as never before. INTERPRETATION: Promotores, a community health safety net and a natural extension of the health and human services agencies, improve health at the neighborhood level. Certification brings renewed commitment to serving others and a distinction to those who have been the unsung heroes of public health for decades.

Community Health Services↗
PubMed1988

Use of community analysis methods in community-wide intervention programs.

Successful implementation of large scale health intervention programs aimed at heart disease or cancer prevention require prior analysis and understanding of community structure, organization and influence networks. Systematic sociological analysis facilitates the health program entry process. Survey results are used to build acceptance, participation and to design educational programs. Specific methods used to assess the community's social configuration, organizational resources, and leadership patterns are described. Local leader identification process and participation in community advisory boards is presented. Approaches to the study of community are reviewed in the context of the Minnesota Heart Health Project, a ten year research and demonstration program to reduce risk of cardiovascular disease in three U.S.A. cities.

Cardiovascular Diseases↗
PubMed1997

Detection and management of pneumonia by community health workers--a community intervention study in Rehri village, Pakistan.

This community based, case management intervention study was done to assess the effectiveness of Community Health Workers (CHWs) in case detection and management of pneumonia in children under five years of age. Twenty-two volunteers (school teachers and students) were selected as CHWs from Rehri village, in Sindh, Pakistan and trained on World Health Organization (WHO) recommended National/Acute Respiratory Tract Infection (ARI) guidelines at the Department of Paediatrics, Dow Medical College, Civil Hospital, Karachi. The CHWs had no prior health education. The intervention was the use of CHWs to detect and manage pneumonia in children under five years of age in Rehri village. Two medical officers supervised the post-training activities of CHWs in the village during the study period. Between December, 1992 and May, 1993, 442 episodes of pneumonia (very severe disease 10, severe pneumonia 54 and simple pneumonia 378) were detected and managed by trained CHWs. The medical officers agreed with the CHWs for classification and treatment in 356 (81%) cases. This study suggests that in areas where there is a shortage of trained health care professionals, educated community members such as school teachers can be trained to detect and manage pneumonia in their community.

Case Management↗
PubMed1996

An ecological assessment of community-based interventions for prevention and health promotion: approaches to measuring community coalitions.

Presented an ecological assessment of a community coalition to prevent alcohol, tobacco, and other drug abuse, and related risks. Ecological assessment is defined as occurring at multiple social levels and along a continuum of stages of coalition readiness. The assessment is aided by the triangulation, or combining of assessment methods and strategies. Measures used to assess the coalition's formation, implementation of community initiatives, and production of community impacts are described, along with the triangulation strategies used to enhance the assessment findings.

Alcoholism↗
PubMed1988

The role of community psychology in the community.

Community Psychology's future place in community activism is assessed relative to its unique independent origins in academia, its tradition of empirical research and strict methodology, and its strong commitment to the elimination of its own existence. These attributes, which define the discipline in the mental health field, are contrasted with the singular traits of other community mental health professions. This paper is a discussion of the history, present weaknesses, and ultimate salvation of Community Psychology.

Community Participation↗
PubMed1992

Community involvement towards community objectives.

The World Health Organisation "Health for all children by the year 2000" declaration presents an exciting yet timely challenge. If these aims are to be achieved, the role of the health worker must be broadened. There must be a recognition that families will determine the true health of their children--physical, mental and social. Families must be able to identify and realise their aspirations, to satisfy their needs and to cope with and adapt to their environments. Only by advocacy, by forming a partnership with families, and by empowering families to exercise greater control over their health and their environment, will health workers begin to see positive change in the community. There is a need to collect and collate data from the community in order that the true needs of families are met. New outcome measures which address "quality of life" must be developed; these will accord closely with the WHO aims, and will enable communities to set the high standards that must be achieved for our children. "Health", interpreted in its broadest meaning, should lead to health professionals concentrating on the promotion of a healthy lifestyle and the attainment of "quality of life". There must be a move away from the "medical model" of care to the empowerment of parents who are responsible for the care for their children and the need to work towards better community resources.

Child↗
PubMed2006

Realities and myths of safety issues for community researchers working in a marginalized African American community.

Community psychologists often conduct research in collaboration with marginalized communities in which safety is an issue. However, we rarely talk about what specific safety issues we experience and how we deal with them. Our story describes the realities and myths of neighborhood safety that were experienced in a low-income African American neighborhood of Chicago, while collaborating on a project designed to increase access to the Internet to obtain health information. We examine both the challenges experienced and our responses in the context of a community intervention planned, implemented, and evaluated by a partnership team composed of various stakeholders. Critical lessons such as the importance of building on community strengths and the need to be aware of our own biases are discussed.

Black or African American↗
PubMed1986

Organizational and community approaches to community-wide prevention of heart disease: the first two years of the Pawtucket Heart Health Program.

The Pawtucket Heart Health program (PHHP) is a federally funded research and demonstration project for the primary prevention of coronary heart disease (CHD) in a community. This article presents a discussion of the first 26 months of this intervention, divided into its three phases. PHHP staff initially approached the intervention city through local organizations to accomplish risk-factor behavior change in the population. After 11 months, PHHP complemented its programs in organizations with activities open to all city residents, in order to accelerate participation by the population. Seven months into this phase, it was decided that community activities should be the major focus of the intervention approach to assure a level of participation adequate to make a measurable impact. The third has shown the greatest percentage of public participation, demonstrating the complementary nature of organization and community interventions and of the translation of social learning theory into principles for primary prevention in a community.

Advertising↗
PubMed1990

The relative influence of the community and the health system on work performance: a case study of community health workers in Colombia.

A central component of the primary health care approach in developing countries has been the development and utilization of community-based health workers (CHWs) within the national health system. While the use of these front line workers has the potential to positively influence health behavior and health status in rural communities, there continues to be challenges to effective implementation of CHW programs. Reports of high turnover rates, absenteeism, poor quality of work, and low morale among CHWs have often been associated with weak organizational and managerial capacity of government health systems. However, no systematic research has examined the contribution of work-related factors to CHW job performance. The research reported in this paper examines the relative influence of reward and feedback factors associated with the community compared to those associated with the health system on the performance of CHWs. The data are drawn from a broader study of health promoters (CHWs) conducted in two departments (provinces) in Colombia in 1986. The research was based on a theoretical model of worker performance that focuses on job related sources of rewards and feedback. A survey research design was employed to obtain information from a random sample of rural health promoters (N = 179) and their auxiliary nurse supervisors about CHW performance and contributing factors. The findings indicate that feedback and rewards from the community have a greater influence on work performance (defined as degree of perceived goal attainment on job tasks) than do those stemming from the health system.(ABSTRACT TRUNCATED AT 250 WORDS)

Colombia↗
PubMed2005

Mobilizing communities: an overview of the Community Coalition Partnership Programs for the Prevention of Teen Pregnancy.

The Community Coalition Partnership Programs for the Prevention of Teen Pregnancy (CCPP) was a seven-year (1995-2002) demonstration program funded by the Centers for Disease Control and Prevention (CDC) Division of Reproductive Health conducted in 13 U.S cities. The purpose of the CCPP was to demonstrate whether community partners could mobilize and organize community resources in support of comprehensive, effective, and sustainable programs for the prevention of initial and subsequent pregnancies. This article provides a descriptive overview of the program origins, intentions, and efforts over its planning and implementation phases, including specific program requirements, needs and assets assessments, intervention focus, CDC support for evaluation efforts, implementation challenges, and ideas for translation and dissemination. CDC hopes that the experiences gained from this effort lead to a greater understanding of how to mobilize community coalitions as an intervention to prevent teen pregnancy and address other public health needs.

Adolescent↗
PubMed2000

A survey of community gardens in upstate New York: implications for health promotion and community development.

Twenty community garden programs in upstate New York (representing 63 gardens) were surveyed to identify characteristics that may be useful to facilitate neighborhood development and health promotion. The most commonly expressed reasons for participating in gardens were access to fresh foods, to enjoy nature, and health benefits. Gardens in low-income neighborhoods (46%) were four times as likely as non low-income gardens to lead to other issues in the neighborhood being addressed; reportedly due to organizing facilitated through the community gardens. Additional research on community gardening can improve our understanding of the interaction of social and physical environments and community health, and effective strategies for empowerment, development, and health promotion.

Agriculture↗
PubMed2006

The changing prevalence of drug-resistant Escherichia coli clonal groups in a community: evidence for community outbreaks of urinary tract infections.

A multidrug-resistant clonal group (CgA) of Escherichia coli was shown to cause half of all trimethoprim-sulphamethoxazole (TMP-SMZ)-resistant urinary tract infections (UTIs) in a college community between October 1999 and January 2000. This second study was conducted to determine the fate of CgA. Urine E. coli isolates from women with UTI, collected between October 2000 and January 2001, were tested for antibiotic susceptibility, O serogroup, ERIC2 PCR and DNA macrorestriction patterns using pulsed-field gel electrophoresis. The proportion of UTIs caused by CgA declined by 38% (P<0.001) but the prevalence of resistance to TMP-SMZ did not change. Six additional clonal groups were identified and these were responsible for 32% of TMP-SMZ-resistant UTIs. The temporal decline in the proportion of UTIs caused by CgA provides evidence that CgA caused a community outbreak of UTI. The fluctuation and occurrence of other E. coli clonal groups in this community suggest that a proportion of community-acquired UTIs may be caused by E. coli disseminated from one or more point sources.

Adolescent↗