Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Health Plan Implementation”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 397 records · Page 22Linked to original sources
PubMedDate not supplied

[Innovation in the Quebec's community health departments].

Following the reform of the health care system in Quebec at the beginning of the 1970s, 32 Community Health Departments (départements de santé communautaire or DSC) were created; these new organizations were administratively and physically integrated into 32 acute care hospitals throughout the province. Our study investigates to what extent variations in the implementation of DSCs and in the way they have fulfilled their mandate influence the degree of innovation of their practices. The results show that DSCs devoting greater efforts to research activities and to their relationships with other health care establishments and agencies achieve a higher level of innovation in their practices.

Community Health Services↗
PubMed2006

Injecting and HIV prevalence among young heroin users in three Spanish cities and their association with the delayed implementation of harm reduction programmes.

OBJECTIVES: To evaluate changes in the prevalence of HIV infection among young heroin users in three Spanish cities, and their association with harm reduction programmes (HRPs). METHODS: Two cross sectional studies. The 1995 study included 596 users; half were street recruited and half were recruited at drug treatment centres. The 2001-03 study included 981 street recruited users. Face to face interviews were conducted using a structured questionnaire. Samples for HIV testing (saliva in 1995 and dried blood spot in 2001-03) were collected. RESULTS: The proportion who had ever injected (IDUs) decreased in all three cities. HIV prevalence in IDUs decreased by half in Barcelona (44.1% to 20.8%) and Seville (44.2% to 22.2%), but remained constant in Madrid (36.8% and 34.9%). This difference was attributable to a decrease in HIV prevalence in long term IDUs in Barcelona and Seville, but not in Madrid. The crude odds ratio for HIV prevalence in Madrid compared with Barcelona in long term IDUs was 2.3 (95%CI 1.4 to 3.7), increasing to 3.1 (95%CI 1.5 to 6.2) after adjusting for sociodemographic and risk factors. HIV prevalence in short term IDUs was similar in all cities. In 1992 Barcelona already had 20 heroin users in methadone maintenance programmes (MMPs) per 10 000 population aged 15-49 years; Seville reached this rate in 1994, and Madrid, not until 1998. CONCLUSIONS: The prevalence of HIV infection did not decrease in long term injectors in Madrid. The delayed implementation of HRPs, especially MMPs, may be the most plausible hypothesis. This finding should shed light on decision making in countries in a similar epidemiological and sociological situation.

Adolescent↗
PubMed1992

The longevity of Growing Healthy: an analysis of the eight original sites implementing the School Health Curriculum Project.

The status of the Growing Healthy curriculum (School Health Curriculum Project [SHCP]) was examined in the eight sites selected in 1969 by the National Clearinghouse on Smoking and Health to receive funded training and implementation support. A contact person from each site completed and returned a questionnaire pertaining to the district's continued implementation (institutionalization) of the SHCP. Most districts had not continued to implement the program. Reasons for discontinuation included loss of the "program champion" and insufficient administrative leadership. Districts continuing to implement the program generally were smaller in size, and employed a part-time coordinator for the SHCP. Recommendations for institutionalizing future instruction programs include identifying replacement program coordinators and other administrators to ensure continuity and support for the program over time, and conducting process and impact evaluations on program effects.

Curriculum↗
PubMed2002

Experiencing "change" from within: situating the transition to primary health care in a remote Australian context.

The transition to primary health care (PHC) is often described in an idealized manner, which either ignores or obscures the experiences associated with its implementation at the local level. By adopting an anthropological perspective, this article highlights some of these experiences and the context within which they occur for one health care organisation in remote Western Australia. It specifically focuses on problems associated with economic rationalism, managerialism, and the inherently fragmented character of health service organisations. Such issues must be allowed to inform idealized PHC models in order to make them more applicable and attuned to local needs and realities.

Efficiency, Organizational↗
PubMed1999

The impact of knowledge and opinions on the implementation of public policies for mentally ill offenders.

New legislation may not always have its intended effect. Agencies targeted by the legislation must be aware of it, understand its demands, develop procedures to insure implementation, and monitor compliance. This paper reports a study of the extent to which several new state statutes impacted policy, procedures, and services for mentally ill offenders in a large urban Texas county. Key informant-interviews, document reviews and surveys of knowledge and opinions were used to assess implementation, understanding, and acceptance of these new statutes. Results were reported to local constituencies, and used to shape recommendations for local action. Following the study, the community formed a council that has made specific improvements in the system.

Commitment of Persons with Psychiatric Disorders↗
PubMed1999

Health promotion research and the diffusion and institutionalization of interventions.

To examine the extent to which health promotion research is providing an empirical basis for the diffusion and institutionalization of effective interventions, we conducted a systematic audit of all articles in 12 public health and health promotion journals for the 1994 calendar year. We identified empirical/non-empirical and health promotion/non-health promotion articles. For each study, the health behaviours or outcomes studied, the target group, gender and setting were categorized. Each study was also categorized as belonging to one of four stages: basic research and development, innovation development, diffusion research, and research into institutionalization or policy implementation. Of all articles coded (n = 1210), 33.9% were identified as non-research, 39.5% were health promotion research and 26.6% were non-health promotion research. The vast majority of studies fell within the basic research and development stage (89.6%), with less than 1% categorized as diffusion research and only 5% as institutionalization or policy implementation research. The published studies reviewed provide a limited empirical basis for diffusion and institutionalization of health promotion programs. These findings suggest a need to more systematically monitor research input (funding) and research output (publications), and to develop a more explicit focus on the relevance of the stages of research innovation and development, the issues and/or behaviours addressed, the target population, and the research setting.

Bibliometrics↗
PubMed1988

From pilot project to national implementation: experiences from the North Karelia Project.

The North Karelia Project started in 1972 as a response to the request of the local people. It was aimed at reducing the exceptionally high mortality and morbidity from cardiovascular diseases in the area. The Project's activities have been directed towards inducing behavioural changes amongst the entire population. Equally, the care of those already sick (such as hypertensives) has also simultaneously been reorganized. The Project has involved the whole of that society, in addition to the health care system, and has collaborated with the food industry, schools and various voluntary organizations. The most recent new activity is a programme to promote marketing of local vegetables and berries to have a substitution for dairy farming, as consumption of dairy products reduce with new dietary habits. The results are encouraging. The individually reported health behavioural changes are reflected by a clear net reduction in biological risk factors (serum cholesterol, blood pressure) compared to the reference community. Also statistics show that mortality from ischaemic heart disease has been reduced more significantly in North Karelia (-22%) than in the rest of Finland (-11%) during the period 1974-1979. The activities tested in North Karelia, and found to be feasible, have been recommended for implementation nationwide in Finland. For instance, anti-smoking activities were first tested in North Karelia before the introduction of national legislation, and experiences obtained in health education have been conveyed to other sectors of the Finnish population through national television in several programmes. The county of North Karelia continues to be a demonstration area in Finland, at present for the Integrated Programme for the Prevention of Noncommunicable Diseases.

Cardiovascular Diseases↗
PubMed2004

Community based schoolchildren's oral health programmes, Kuwait 1985--1998.

AIM: To describe the development of children's oral health programmes in Kuwait and present selected results and expected outcomes based on specific markers. To provide a basis for choosing best outcomes to develop public health policy and implement future programmes. METHOD: Assessment of the health, structural, cost and benefit changes in the oral health sector that resulted from policy decisions and implementation through different approaches in the period 1986--1998. RESULTS: Analysis has provided a basis for selection of appropriate methodologies to be implemented in the country. CONCLUSIONS: The regional programme consisting of full immediate prevention coverage with fluoride lozenges, periodic fluoride rinses, multi-operator care teams, flexible and moveable equipment appears to have provided the best potential within the Kuwait context during this period.

Child↗
PubMedDate not supplied

Organizational characteristics of successful innovative health care programs sustained over time.

Sustaining a successful program over times is critical in today's rapidly changing health care environment. This study sought to identify the characteristics of organizations that implemented innovative health programs for older adults and sustained those programs over time. The Gerontological Health Section of the American Public Health Association created an award in 1998, endowed by the Archstone Foundation, to recognize innovative programs providing health and related social support services to older adults. The 20 award winners were interviewed in Fall 2002, using a structured questionnaire based on the conceptual model for sustainability articulated by Shediac-Rizkallah and Bone. The findings provided insights into the importance of leadership, financing, organizational structure, governance, marketing, and evaluation/research.

Aged↗
PubMed2001

Recent developments in aged care policy in Australia.

A series of major reforms implemented through the mid 1980s sought to contain residential care and expand community care in Australia's long-term care system. While this goal has been maintained, a number of new policy initiatives followed the change of federal government in 1996. This article presents a systematic account of current policy objectives, implementation measures, and outcomes in three major policy areas: changing the balance between residential and community care, targeting in community care, and support for family caregivers. This analysis shows that while there have been shifts in emphasis from time to time, concerted policy efforts over the last 20 years have contained the growth of expenditure on long-term care and realized significant change in the service system.

Aged↗
PubMed2002

[Prophylactic examinations of former workers of asbestos processing plants: the Amiantus project].

Prophylactic examinations of the former workers of asbestos plants are performed by virtue of the Law of 19 June 1997 on a prohibition against the use of asbestos-containing products. Periodical examinations allow to detect pathological changes in the pre-symptomatic or early-symptomatic period, which permits to apply an appropriate treatment and slows down considerably the progress of morbid processes. The main objectives of the surveillance and coordination are as follows: (1) to assure good quality of prophylactic examinations through the uniform methods of medical examinations and the detection of pathology resulting from the exposure to asbestos dust, based on international criteria for diagnosing asbestos-related diseases (the Helsinki criteria, 1997); (2) to monitor the respiratory health effects among persons occupationally exposed to asbestos dust; and (3) to keep the database on persons examined and subjected to periodical prophylactic examinations throughout the country. The program of prophylactic examinations of persons occupationally exposed to asbestos dust includes mass screening. For the purpose of this program, a unified strategy of mass screening, including documentation (questionnaires on clinical, radiological and spirometric examinations) and instructions for persons responsible for performing these examinations has been worked out. Each center involved in the implementation of the program has been provided with binding criteria elaborated on the basis of the world standards (the Helsinki criteria, 1977) of clinical, radiological, spirometric and histological examinations aimed at detecting asbestos-related diseases: asbestosis, fibrous mesothelioma and lung cancer. The data obtained will serve as a basis for assessing the morbidity and incidence of asbestos-related diseases among persons occupationally exposed to asbestos dust in asbestos processing plants.

Asbestosis↗
PubMedDate not supplied

The Shanghai case: A qualitative evaluation of community health reform in response to the challenge of population ageing.

Shanghai's health care system is facing a serious challenge of an ageing population, as 14% of its 17 million residents are 65 or older. In 2000, a community health reform was implemented to provide comprehensive and continuous primary care to community residents with a focus on seniors. The study employed the theoretical framework of examining primary care in terms of the constellation of its four unique elements (first contact, comprehensiveness, longitudinality and coordination) and three healthcare components (structure, process and outcome). The study aimed to evaluate the extent to which the reform has achieved its process goals and how the organizational context influenced the level of implementation. In-depth interviews with 25 health providers, 15 seniors and four community leaders were carried out. The study found that the Shanghai community health reform has improved the structure and process of primary care regarding first contact, comprehensiveness and longitunality. However, the reform is constrained by structural barriers on seniors' financial access to resources and the capacity of primary care providers. The previous organization system also constrains the reform in CHCs financing and administration. The Shanghai case illustrates that a broad societal view has to be taken when analysing health reforms, which requires the involvement of multiple sectors including the government, health providers and health consumers.

Aged↗
PubMed2005

The Israeli Long-Term Care Insurance Law: selected issues in providing home care services to the frail elderly.

The paper describes and analyses selected issues related to the provision of home care services to frail elderly people following the Israeli Long-Term Care Insurance Law (1988). The goals and principles of the Law, which mandates the provision of home care services to frail elderly people, are presented. The paper also evaluates its contribution toward enhancing the well-being of elderly clients. Several major dilemmas that arose following implementation of the Law are analysed and evaluated in comparison with other countries that have enacted and implemented similar laws. These dilemmas are community vs institutional care; services in kind vs monetary allowances; service provision through contracting out with nongovernmental agencies; unstable and unskilled labour force; and service quality. Finally, policy implications are discussed, mainly in the following areas: investment in human resources as a condition for achieving high service quality, and the need for coordination between the agencies that provide long-term care services to elderly people.

Activities of Daily Living↗
PubMed2003

An advocacy project to fluoridate toothpastes in Nepal.

AIMS: To describe a recent health promotion project undertaken by the United Mission to Nepal Oral Health Programme (UMN OHP) to increase the availability and consumption of affordable, fluoridated toothpaste in Nepal. METHOD: The process of advocating for the fluoridation of toothpastes in Nepal is based on Tearfund's advocacy cycle. RESULTS: The project achieved health promotion outcomes including healthy corporate and public policies and organisational practice and intermediate outcomes such as increased availability and consumption of affordable fluoridated toothpaste. Prior to implementation of the advocacy project in 1997, availability and consumption of fluoridated toothpaste was negligible. By March 2002 total market share of fluoridated toothpaste was approximately 90%. This represents an annual tonnage of 900 tons of fluoridated toothpaste. CONCLUSIONS: The health promotion activity of advocacy for the fluoridation of toothpastes in Nepal achieved measurable gains in health promotion outcomes and intermediate outcomes. Gains in health and social outcomes will take longer to evaluate but based on epidemiological evidence and the experience of other countries increased availability of affordable fluoridated toothpaste will have a significant and ongoing impact on the oral health of the people of Nepal.

Cariostatic Agents↗
PubMedDate not supplied

Using community-partnered participatory research to address health disparities in a Latino community.

Working in collaborative partnership with communities experiencing health disparities has been identified as a successful strategy to address population health disparities. This article illustrates a collaborative outreach program designed to address health disparities in a poor Latino community in Los Angeles County, California, by training community members to function as lay health advisors (LHAs) to provide health education to members of their own community. The study consisted of three phases, each accomplished in a collaborative partnership among researchers, community residents, community-based organizations, and health officials. In Phase 1, a community needs assessment was conducted to identify a community with demonstrated health disparities and agencies within that community willing to become partners in providing health education. In Phase 2, community members were recruited and trained to function as LHAs. Phase 3 consisted of implementation of community outreach and education activities by the LHAs in their community. This article describes how the study changed over time through responding to challenges that arose in the process of conducting the project, the participatory or collaborative methods used, and feedback received. Strategies for successful research using community partners are presented and implications discussed for future research efforts using community-partnered participatory methods for reducing health disparities.

Community Health Workers↗
PubMed2004

Evaluation of HIV/AIDS prevention resources in Liberia: strategy and implications.

The purpose of this preliminary study was to assess the HIV/AIDS prevention needs, services, and resources in Liberia, including the readiness of local providers to conduct HIV/AIDS-related prevention programs based on a set of six key dimensions (prevention needs, knowledge, leadership, environment, risky behaviors, and resources). A valid self-administered qualitative-based health survey, based on a community readiness model, was utilized as the primary data collection source. A cross-sectional design that utilized a convenient sample of key informants such as health coordinators, program directors, and health administrator from both public and private HIV/AIDS-based organizations was used. Furthermore, an extensive review of the National Library of Medicine database of published articles from mid-1980 to 2002 was simultaneously conducted to gauge the extent of scientific publications on HIV/AIDS-related prevention services in Liberia. The findings from this study strongly suggest that Liberia is in a stage of vague awareness, as defined by the Tri-Ethnic Center community readiness framework, regarding HIV/AIDS-related activities, including a significant lack of HIV/AIDS-related resources and scientific publications. Accordingly, there is a critical need to acquire adequate resources and build capacity to implement effective HIV/AIDS-related prevention programming services in order to avert the negative public health consequences associated with HIV/AIDS, including the implementation of relevant evaluation and dissemination strategies. Most importantly, this model has the potential to be utilized in other resource-constraint settings, especially in the developing world, to assess prevention-related resources and programmatic readiness. This is the first published study to evaluate Liberia's HIV/AIDS prevention resources and to systematically document the extent and magnitude of the HIV/AIDS crises in the country.

HIV Infections↗
PubMedDate not supplied

The Health Action Fund: a community-based approach to enhancing health.

This article is based on a program that was developed by the Center for Healthy Communities (CHC), a community-academic partnership in Dayton, Ohio, that continues to act as a force for change in health professions' education and health delivery, stressing the philosophy of "doing with" instead of "doing for" or "doing to." The Health Action Fund is a grassroots health communications and social marketing program that targets community groups who are involved often in health promotion activities developed by large agencies. However, rather than taking the traditional approach to health promotion and prevention where program development and implementation is left to professionals, a different approach was taken that encourages members of neighborhoods, a community group, or a church to identify a problem and then develop a way to address that problem for their group. The program focuses on neighbors helping neighbors where communities take the lead in health promotion and prevention activities. We discuss in detail the project's innovation, challenges and how they have been addressed, qualitative and quantitative improvements made to the program, and how the program serves as a model for other communities.

Community Participation↗