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At least 379 records · Page 21Linked to original sources
PubMed1996

Risk factors for intravenous drug use and sharing equipment among young male drug users in Longchuan County, south-west China.

OBJECTIVES: To identify the risk factors for intravenous drug use and sharing of equipment in Longchuan County in south-west China. METHODS: Demographic information and sexual and drug-use-related behavior between 1 January 1991 and 1 August 1994 were collected retrospectively from a cohort of young male drug users aged 18-29 years in 82 villages. RESULTS: A total of 433 drug users were identified. The cumulative incidence of intravenous drug use was 40.0% during the 3.7-year study period. The annual incidence increased from 10% in 1991 to over 30% in 1994. Risk factors for intravenous drug use among drug users, according to the multivariate model, included having had premarital/extramarital sex [odds ratio (OR), 1.5; 95% confidence interval (CI), 1.01-2.3], having a family member who used drugs in 1991 (OR, 1.8; 95% CI, 1.1-2.9), and currently not married (OR, 1.6; 95% CI, 0.98-2.7). Being Buddhist protected against intravenous drug use (OR, 0.4; 95% CI, 0.2-0.9). The population attributable fraction was 30% for not being currently married, 17% for having had premarital/extramarital sex and 14% for having a family member who used drugs. The risk factor for sharing of equipment was being of Jingpo ethnicity (OR, 5.8; 95% CI, 2.5-13.8). The average incidence of sharing equipment was 19.6% per year. The population attributable fraction for sharing equipment was 58.5% for being Jingpo. CONCLUSIONS: The incidence of intravenous drug use and sharing equipment is increasing. Therefore, it is urgent that vigorous, effective intervention programs be initiated in southern Yunnan. Unmarried, sexually promiscuous Jingpo drug users with a family history of drug use should be especially targeted. Given the problems of transport and communication in this remote area of China, intervention programs which use existing social, governmental and community networks should be implemented.

Adolescent↗
PubMedDate not supplied

Achieving recruitment goals through community partnerships: the SENIOR Project.

This article discusses the process of developing collaborative relationships for a community-based health promotion project. A partnership was established among the university, the city where the intervention took place, and the community senior center. A community advisory board was created to identify the strengths, diversity, and needs of each partner. The community advisory board guided the partnership to recruit 1,277 older adults to participate in the intervention study. A sample was deemed representative after comparison with Census 2000 data, with gender and educational attainment being similar.

Aged↗
PubMedDate not supplied

African American community health advisors trained as research partners: recruitment and training.

The African American community has played an influential role in generating change. Grass-roots organizations and concerned individuals can be included in programs designed to increase cancer awareness and cancer early detection practices to ultimately eliminate cancer disparities. The utilization of a formalized Community Health Advisors program can be an infrastructure by which effective cancer prevention and control programs can be conducted in underserved African American communities. The purpose of this article is to outline the steps necessary to develop an infrastructure for recruitment and training of grass-root African Americans to serve as Community Health Advisors trained as Research Partners.

Black or African American↗
PubMedDate not supplied

Community health advisors as research partners: an evaluation of the training and activities.

The feasibility of training large numbers of community health advisors as research partners (CHARPs) was evaluated using talking circles data and cancer activity questionnaires and logs. The talking circles data indicated that the CHARPs (n=108) valued their training and believed they learned necessary research partner skills. A review of contacts (n=7,956) provided evidence that CHARPs (n=883) could work as a team to deliver a variety of services over time to the community. The findings suggested that implementing a large scale intervention with CHARPs has the potential to increase the dissemination of cancer information and to reduce cancer disparities.

Black or African American↗
PubMed2000

Collaboration in disability policies--collaboration between stakeholders of disability policies in the South and in the North.

Four studies have been recently undertaken at the Centre for International Child Health on the collaboration between the stakeholders of disability policies, in Southern and Northern countries. Informed by the literature, the authors have explored the roles disabled people's organizations, non-governmental organizations, government and professionals play in the design, provision and evaluation of services for disabled people. They also highlight the different forms participation can take and their most relevant features. The main factors influencing collaboration processes are then classified in three different categories: social factors, ideology-related factors and project-related factors. They are subsequently analysed. The first group encompasses the societal framework in which collaboration may take place, while the identity of the stakeholders is reflected in the ideology-related factors. The nature of the activities undertaken by stakeholders is characterized by the third group of factors. In the conclusion it is suggested that stakeholders, and especially disabled people's counterparts, should increase their awareness of the social model of disability, adopt participatory practices and promote participation at higher levels. However, they should acknowledge that it implies more trust between partners and an alteration of their structures.

Community Networks↗
PubMedDate not supplied

Technology for community health alliances.

A community health alliance brings together divergent interests within a community for the betterment of personal and population health. In this report we describe how a community responsive strategy in Chicago is facilitating the improvement of healthcare by providing local information of what needs to be done, supporting change at the practice level to meet these needs, and initiating community-wide approaches to manage prevalent and important needs without waiting for direct involvement of health professionals.

Chicago↗
PubMed2004

"Don't know enough about it!": awareness and attitudes toward organ donation and transplantation among the black Caribbean and black African population in Lambeth, Southwark, and Lewisham, United Kingdom.

BACKGROUND: The current demand for transplant organs, particularly kidneys, far outweighs the supply in the United Kingdom. This problem is particularly severe for the black African and black Caribbean population, who have been shown to have a disproportionately greater presentation on kidney transplant waiting lists in some regions of the United Kingdom. The situation is clear: There is an urgent need to address the number of black African and black Caribbean patients requiring a kidney transplant, otherwise the human and economic costs will be high. METHODS: An exploratory study was undertaken to assess the current awareness of organ donation and transplantation and to explore attitudes toward these issues in a cross-section of the black African and black Caribbean population in Lambeth, Southwark, and Lewisham. RESULTS: It was found that there was a lack of available information for the black African and black Caribbean communities. This precipitated low levels of awareness about organ donation and transplantation issues. CONCLUSIONS: In an effort to redress this, effective methods for targeting black African and black Caribbean groups are required. From this study, there are indications that appeals for organ donors may be more effectively communicated by using a grass-roots, community-network approach. For this reason, consideration should be given to language and cultural needs, and to the provision of culturally sensitive material and information.

Adolescent↗
PubMed1999

Community-based disaster management during the 1997 Red River Flood in Canada.

This paper examines the relationship between community preparedness and response to natural disaster and their level and pattern of community development. This is done by investigating preparation and response to the 1997 Red River Flood by three rural communities in Manitoba, Canada. The communities were selected because of their different ethnic mix and associated level and pattern of community development. The hypothesis was supported that the level and pattern of community development affect community capacity to respond to flooding. Communities characterised by higher levels of physical, human and social capital were better prepared and more effective responders to the flood. However, where the pattern of community development was characterised by high levels of social capital, decision-making processes were complicated.

Community Networks↗
PubMed1998

Use of focus groups to identify health promotion strategies for the early detection of diabetic retinopathy.

BACKGROUND: People with diabetes do not regularly utilise eye services for the early prevention of vision loss due to diabetic eye disease. A community-based screening program has been initiated in Victoria to address this issue. To encourage people to take preventive eye health care measures, the most effective health promotion strategies were identified. METHODS: Thirty-three health professionals were invited to attend focus groups. A sample of 35 people with diabetes was approached by their GPs or diabetes educators because of their motivation to participate in diabetes activities. Each group consisted of 10 members. Discussion points included the type of education messages available to people with diabetes; use of eye services among the participants with diabetes; and strategies required promoting the screening service. RESULTS: Five focus groups were conducted. The discussions highlighted that a great deal could be achieved by using local community networks to promote the benefits of early detection of diabetic retinopathy and local screening program. The group members recommended that particular attention be directed to general practitioners and their distribution of materials to patients. Key issues for planning and implementing the program were highlighted. The groups urged development of strategies to encourage people with diabetes in rural Victoria to participate in a program for the early detection of diabetic retinopathy.

Diabetic Retinopathy↗
PubMed1999

Factors associated with participation in resident action groups in metropolitan Sydney: a cross-sectional survey.

OBJECTIVE: To explore the characteristics of participants in resident action groups in metropolitan Sydney. METHODS: A stratified random sample of participants in 50 groups registered with local councils were surveyed in 1997. Demographic, social/psychological, cost/benefit, group process and group potency variables and four measures of amount of participation were examined. RESULTS: An increase in the hours of participation per month was associated with a decrease in the self-reported costs of participation, an increase in the self-reported benefits of participation and an increase in group potency. Involvement in a greater number of activities was associated with a decrease in the self-reported costs and an increase in the self-reported benefits associated with participation, increased satisfaction with group processes, a decrease in group potency and an increase in the number of members known prior to group membership. Length of group membership was positively associated with age and more positive expectations of the group's future success. An increase in the proportion of meetings attended was associated with self-reported satisfaction with group processes. CONCLUSIONS AND IMPLICATIONS: An important principle of public health is community participation. The results of this study indicate that the greatest potential for increasing individual participation may be in efforts to reduce the costs associated with participation, increase the benefits associated with participation and increase the satisfaction of group members with group processes.

Adult↗
PubMed1997

Community caring: an ethnographic study within an organizational culture.

American society is demanding that health care organizations design a health care system that is more responsive to the needs of their communities. In their efforts to respond, organizations are challenged to better understand organizational dynamics, community needs, and community relationships. The purpose of this study was to explore and understand the meaning of caring for the community from the perspective of care providers in a hospital-based ambulatory program. Using a focused ethnographic design, the study was conducted in a community hospital close to a large metropolitan city. Research methods included open-ended interviews, participant observations, and examination of documents. Analysis of data revealed five major themes related to the experience of caring for the community. Themes reflected different perspectives of communities, reciprocal relationships and teams, education and prevention, shared values, and understanding community needs. At the same time, an overarching theme related to wellness, growth, and empowerment emerged. Results provided knowledge that may help increase understanding of organizational culture that impacts the development of healthy communities. Findings may also help facilitate organizational change toward the development of new models of care that are integrated with the community.

Anthropology, Cultural↗
PubMed2001

Successful implementation of community water fluoridation via the community diagnosis process.

OBJECTIVES: This paper describes the community diagnosis process and how it was used to implement community water fluoridation in Tennessee. METHODS: Public health dental staff developed a survey instrument to collect community-specific data on the oral health status of schoolchildren. Key survey findings were presented to county health councils who were determining and prioritizing the health needs of their communities. RESULTS: Community-specific data showed higher caries levels in children without access to an optimally fluoridated community water supply. Presentation of local survey findings to county health councils resulted in fluoridation being a high-priority health issue in several counties. With health council support, opposition to fluoridation by utility district officials was overcome when decision makers were challenged with local survey findings. The community diagnosis process resulted in the successful fluoridation of six community water systems serving a total of 33,000 residents. CONCLUSIONS: The community diagnosis approach was successful in implementing community water fluoridation in geographic areas historically opposed to this public health measure. The success of these fluoridation initiatives was attributed to: (1) current, community-specific assessments of children's oral health; (2) identification of communities with disparate oral health needs, problems, and resources; and (3) effective presentation of community-specific oral health survey data to community leaders, stakeholders, and decision makers.

Attitude to Health↗
PubMed2001

A community participatory oral health promotion program in an inner-city Latino community.

OBJECTIVES: This paper reports the planning, implementation, process evaluation, and refinement of an oral health community participatory project in Mount Pleasant, an inner-city Latino neighborhood of Washington, DC. The main goal was to explore the feasibility of implementing such a project. METHODS: The PRECEDE-PROCEED model was used to guide the planning and process evaluation of this project, in conjunction with community organizational methods. A steering committee, which met periodically, was formed to assist in program planning, implementation, and evaluation. The needs assessment of the community identified extensive dental health problems among children and deficiencies in their parents' oral health knowledge, opinions, and practices. In response, culturally appropriate health education and promotion activities were planned and implemented in collaboration with local community organizations, volunteers, and local practitioners. Process evaluation was used to provide feedback into the refinement of the community approach, which included record keeping and an inventory approach to activities completed and resources used. The overall impact and usefulness of this program were assessed informally using an anonymous open-ended questionnaire directed to members of the steering committee, and an outreach survey using a convenience sample at a local Latino health fair. RESULTS: The implementation of such a community participatory approach was feasible and useful for building upon existing local resources and addressing oral health concerns in a community not reached by traditional dental care and health promotion initiatives. Individuals in this community showed a substantial interest in oral health matters and participated in a variety of oral health prevention activities. The community approach adhered to community-based research principles.

Attitude to Health↗
PubMed2004

Prevention of mother to child transmission of HIV: evaluation of a pilot programme in a district hospital in rural Zimbabwe.

PROBLEM: Zimbabwe has one of the highest rates of HIV seroprevalence in the world. In 2001 only 4% of women and children in need of services for prevention of mother to child transmission of HIV were receiving them. DESIGN: Pilot implementation of the first programme for prevention of mother to child transmission of HIV in rural Zimbabwe. SETTING: 120 bed district hospital in Buhera district (285,000 inhabitants), Manicaland, Zimbabwe. KEY MEASURES FOR IMPROVEMENT: Programme uptake indicators monitored for 18 months; impact of policy evaluated by assessing up-scaling of programme. STRATEGIES FOR CHANGE: Voluntary counselling and testing services for HIV were provided in the hospital antenatal clinic. Women identified as HIV positive and informed of their serostatus and their newborn were offered a single dose antiretroviral treatment of nevirapine; mother-child pairs were followed up through routine health services. Nursing staff and social workers were trained, and community mobilisation was conducted. EFFECTS OF CHANGE: No services for prevention of mother to child transmission of HIV were available at baseline. Within 18 months, 2298 pregnant women had received pretest counselling, and the acceptance of HIV testing reached 93.0%. Of all 2137 women who had an HIV test, 1588 (74.3%) returned to collect their result; 326 of the 437 HIV positive women diagnosed had post-test counselling, and 104 (24%) mother-child pairs received nevirapine prophylaxis. LESSONS LEARNT: Minimum staffing, an enhanced training programme, and involvement of district health authorities are needed for the implementation and successful integration of services for prevention of mother to child transmission of HIV. Voluntary counselling and testing services are important entry points for HIV prevention and care and for referral to community networks and medical HIV care services. A district approach is critical to extend programmes for prevention of mother to child transmission of HIV in rural settings. The lessons learnt from this pilot programme have contributed to the design of the national expansion strategy for prevention of mother to child transmission of HIV in Zimbabwe.

Ambulatory Care↗
PubMed1997

Childhood accidents: epidemiology, trends, and prevention.

Accidents are the most common cause of death in children over one year of age. Prevention remains a high priority. We have reviewed the current epidemiology of childhood accidents and their prevention, and made recommendations for the future. In 1992, 559 children died in United Kingdom as a result of an accidents--240 from road traffic accidents and 100 from burns and scalds. Every year 50 children drown. Accidents cause significant disability to children. Many children, up to one in four of the population in urban areas, attend accident and emergency departments, and 5-10% of these are admitted to hospital. Accident risk factors include low social class, psychosocial stress, an unsafe environment, and child developmental disorders. Research has shown that prevention is best achieved by making the child's environment safer, often through legislation. Insufficient resources have been put into both research into childhood injuries and preventive work in communities. Collaboration between health authorities, NHS trusts, local authorities and community networks is vital if success is to be achieved. A national safety agenda for children would focus the attention that this problem deserves.

Accident Prevention↗