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PubMed1998

Community-based epidemiology: community involvement in defining social risk.

In traditional epidemiologic research, the concept of risk emerges from a biomedical paradigm which draws heavily upon Cartesian-Newtonian ontological assumptions. Rational assessment of individual risk is based on a culturally conditioned metatheoretical framework that seeks specific causes for specific disease conditions. This leads to the identification of "risk factors" that can be individually modified. Research within this orientation tends to produce interpretations of data which further condition and mold cultural understanding of individual and social risks and the available choices that can be made to modify these risks. Community-based eco-epidemiology balances reductionist tendencies of individual risk-factor analysis against social context and local knowledge gained through community involvement in the research process. The community-based partnership model can contribute to a greater understanding of the interrelatedness of social problems and individual risks on the part of community participants and researchers alike.

Attitude to Health↗
PubMed1984

Blending administrative and community organization practice: the case of community residential facilities.

The authors discuss the management of community programs serving deinstitutionalized populations. They make a case for the concept of "community integration" (re-entry into society), arguing that translating the concept into meaningful practice requires clearer specification of the relevant client communities and calls for a blending of traditional administrative and community organizations skills, with resultant implications for social work education. Illustrations are drawn from the field of mental health and the needs of the chronically mentally ill.

Community Mental Health Services↗
PubMed2005

Gender-specific behavioral health and community release patterns among New Jersey prison inmates: implications for treatment and community reentry.

OBJECTIVES: We describe behavioral health diagnoses and community release patterns among adult male and female inmates in New Jersey prisons and assess their implications for correctional health care and community reentry. METHODS: We used clinical and classification data on a census of "special needs" inmates (those with behavioral health disorders) in New Jersey (n=3189) and a census of all special needs inmates released to New Jersey communities over a 12-month period (n=974). RESULTS: Virtually all adult inmates with special needs had at least 1 Axis I mental disorder, and 68% of these had at least 1 additional Axis I mental disorder, a personality disorder, or addiction problem (67% of all male and 75% of all female special needs inmates). Of those special needs inmates released, 25% returned to the most disadvantaged counties in New Jersey (27% of all male and 18% of all female special needs inmates). CONCLUSIONS: Two types of clustering were found: gender-specific clustering of disorders among inmates and spatial clustering of ex-offenders in impoverished communities. These findings suggest a need for gendered treatment strategies within correctional settings and need for successful reentry strategies.

Adult↗
PubMed2026

Development of a Blockchain-Based Platform to Enable Indigenous Data Sovereignty and Shared Research Participation With Indigenous Communities: Technology Prototyping and Community Engagement Study.

BACKGROUND: Historic and ongoing problematic practices regarding the collection, storage, and use of Indigenous health data have led to the need to ensure principles of Indigenous Data Sovereignty (IDS) are followed in research practices and technology development. OBJECTIVE: This project, a partnership between UC San Diego and the Native BioData Consortium (NativeBio), sought to explore the practical application of blockchain technology and its potential to facilitate Indigenous-led research collaboration. METHODS: This project first undertook purposeful relationship building with NativeBio to form a Community Advisory Board (CAB) for identifying community and technology needs for a blockchain research collaboration platform with an initial focus on genomic data. Over a 2-year project period, a series of public meetings and presentations at Indigenous-led conferences introduced the concept of exploring compatibility between blockchain and IDS principles, followed by iterative prototyping and co-design of a blockchain platform with NativeBio, using Ethereum as the underlying protocol. RESULTS: Direct engagement with NativeBio and the CAB informed the initial design and development of a "b-IDS" proof-of-concept (POC) blockchain platform. The POC consists of three main components: (1) the web front-end layer, (2) the Ethereum network that executes the smart contract and blockchain storage aspects of the framework, and (3) the back-end database that stores off-chain interactions and data for future use with external genomic data repositories. After refinement of the POC, a community-based participatory research (CBPR) use case aligned with IDS principles was identified as a practical workflow and incorporated into the design of the POC for implementation. CONCLUSIONS: The findings from this project demonstrated the potential use of operationalizing IDS through blockchain technology with proactive and sustained engagement with Indigenous partners. Blockchain technology may have certain advantages over other data governance approaches and systems, facilitating timely oversight, shared decision-making and consent structures, and direct involvement of Indigenous communities in technology design, respecting the core principles of IDS and CBPR. Future development of the blockchain-IDS POC will need to incorporate other research practices and ethics frameworks to expand its use to other public health and biomedical research use cases.

Blockchain↗
PubMedDate not supplied

Health of the chronically mentally ill who rejoin the community: a community assessment.

This article describes findings from a community assessment project on 25 chronically mentally ill individuals who rejoined the community following discharge from psychiatric hospitals. The focus was to identify health concerns or problems and health promotion patterns using Healthy People 2000 as a guiding framework. Findings suggest that most participants found relocation to the community easy. Stress, depression, and abuse were mental health problems reported by participants. Physical health problems included high tobacco use, low exercise level, poor oral health, high-risk sexual behavior, and limited contact with physicians and dentists. Health promotion activities were good sleeping behavior, limited use of alcohol and drugs, and a strong interest in participating in health promotion programs including exercise, stress management, and smoking cessation programs. Interventions to promote the health of the chronically mentally ill and implications for community mental health nurses are discussed.

Adult↗
PubMed2000

Community-identified alcohol issues in the Mexican American community: research design and utilization.

This article describes a community-based study, Alcohol Outlet Density and Mexican American Youth Violence, funded by the California Wellness Foundation--Violence Prevention Initiative to the prevention Research Center in Berkeley, California. The study was conducted in three northern California cities in 1993-1996. The focus is on the inclusionary planning process in designing and implementing the study. Community members were an integral part in the identification of study questions. As a result, the findings of the study are relevant to community activists in advocating alcohol-related policies. The need for more utilization-based community studies is emphasized.

Advertising↗
PubMed1982

Utilizing a community data base system with community health nursing students.

The instrument to "go out and study the community" can be awesome and confusing to both students and nurses. The use of the data base management system as described in this paper makes the task a less formidable one. It also systematically classifies data about a community into a usable form so that nursing diagnoses can be identified appropriately. We strongly believe that the concept of community-as-client must become a part of the philosophy of every community health nurse. We see the data base management system as one method of incorporating this philosophy.

Community Health Nursing↗
PubMed1998

Transforming the curriculum while serving the community: strategies for developing community-based sites.

Developing community-based clinical opportunities for students is a challenge. At San Jose State University (SJSU) School of Nursing, faculty transformed the curriculum by developing community-based experiences directed by faculty and delivered by students during clinical practice. These innovative clinical experiences provide a structure to educate students and enhance the ability to bring health care to underserved people in a community. This article describes the structure and processes for implementing the new experiences and offers strategies to guide other faculty interested in developing community-based experiences.

Community Health Nursing↗
PubMedDate not supplied

Daily time use as a measure of community adjustment for persons served by assertive community treatment teams.

PURPOSE: The purpose of the study was to examine daily time use of clients of Assertive Community Treatment (ACT) as a measure of their community adjustment and well-being. The actual daily time use of ACT clients in the four categories of personal care, productivity, leisure, and sleep were compared to the data for Canadian population norms. METHOD: Daily time use data were collected from 27 adult clients from two Assertive Community Treatment Teams in southeastern Ontario using recall time diaries of two weekdays. The data were coded using the Statistics Canada (1999) coding scheme. Descriptive statistics were used to determine time in the major categories of time use and z scores were used to compare the study sample to the adult Canadian population. The percentages of time spent in specific subcategories of activity were also compared. RESULTS: The results indicated an imbalance in occupation with time use dominated by leisure and sleep activities. Study participants spent significantly more time in passive leisure compared to active leisure and socialization. CONCLUSION: The activity patterns of ACT clients were not consistent with those associated with community adjustment, health, and well-being. Occupational therapists working in ACT are in a good position to contribute to the literature regarding occupational performance and mental illness and to lead ACT teams in discussions and practices that may promote health through activity.

Activities of Daily Living↗
PubMedDate not supplied

Practical tools for qualitative community-oriented primary care community assessment.

BACKGROUND AND OBJECTIVES: The evolution of managed care is creating a need for feasible methods for clinical practices to perform community assessments. Since some types of clinically useful data are best obtained through a qualitative community assessment, practical methods of carrying out this type of assessment are needed. Such practical methods are also important for community-oriented primary care, an attractive model for the marriage of population perspectives and clinical primary care. METHODS: Using methods suitable for busy clinical practices, qualitative data useful for clinical purposes were collected either by mail surveys, telephone surveys, or during focus group discussions in a low-income community. Characteristics of data obtained through each method, together with the costs, advantages, and disadvantages of each approach, were examined. RESULTS: All three methods revealed similar themes in their responses, though the range and emotional content of the responses varied by approach. Clinically useful data were obtained, although the potential for sampling and response biases must be considered. Costs, primarily related to professional time, varied by as much as 50% among the methods examined; telephone surveys were the least expensive per enrolled subject. CONCLUSIONS: The methods tested are potentially feasible in busy practices. However, practices should clarify their objectives and resources prior to using these methods.

Adult↗
PubMed1998

The role of the community pharmacist as an oral health adviser--an exploratory study of community pharmacists in Johannesburg, South Africa.

The aim of this study was to examine to what extent community pharmacists are currently acting as dental advisers, and to determine whether they would be willing to extend this role in the future. The data were collected by means of a random survey of community pharmacists in Johannesburg, and included: incidence and nature of dental enquiries; dental knowledge with respect to preventive measures; willingness to engage in promotion of oral health and prevention of oral disease. The results reveal an anomaly. On one hand community pharmacists seemed to be handling a substantial amount and range of inquiries related to oral health and dental disease, and were willing to fulfil a meaningful role as oral health advisers. On the other hand, however, they have received very little education on these matters and seemed to operate in isolation from dentists and other health professionals, which raises doubts about their ability to play a meaningful role in primary health care. Nevertheless, it is quite feasible for community pharmacists to play the role as envisaged, provided additional training and networking with dentists, oral hygienists, dental therapists and other relevant health professionals takes place.

Community Pharmacy Services↗
PubMed1998

[Community nutrition strategy project: an innovation in community health].

The strategy of the community nutrition project is based on the utilization of the community development structures to deliver the nutrition services. These structures, represented in Senegal by youth associations, women groups, GIEs and NGOs, are part of the decentralization process, and as such play an important role in health and health development activities in poor urban districts. The Community Nutrition Project (CNP), funded for five years by the World Bank, German Cooperation (KFW), World Food Program (WFP) and the Senegalese government aims to halt further deterioration in the nutrition status of the most vulnerable groups in the poorest urban districts of Senegal. All nutrition services and particularly the IEC services have been entirely contracted out the first year to 76 GIEs involving 323 unemployed persons, operating as micro-enterprises "MIC" and 17 "GIEs" of unemployed physicians, pharmacists, and social workers for a total of 34 persons, organized as "maître d'Oeuvre communautaires "MOC", in charge of the supervision tasks. Each community nutrition center recruits and monitors every six months 460 to 600 beneficiaries composed of women at six months of pregnancy, lactating mother of children under 6 months, and a group of children aged from 6 to 35 months old. An average of 87% of registered children in the nutrition centers are weekly or monthly weighted. Thus the proportion of malnourished children in cohort of children followed from January to July 1996 has decreased from 70% to 25% within six months. The malnutrition rate has been reduced up to 65% after six months.

Adult↗
PubMed2002

Community data--where does the value lie? Assessing confidence limits of community collected water quality data.

Waterwatch is a national community-based monitoring network that aims to involve community groups and individuals in the protection and management of waterways. Waterwatch Victoria has the dual objectives of catchment education and water quality monitoring. The educational outcomes are evident, with the Waterwatch programme facilitating over 9,000 students to monitor more than 2,000 sites in waterways in 2000. This paper aims to assess the scientific value of community-collected data, through examining differences between Waterwatch data and professionally collected data. The study looked at all aspects of volunteer data collection, including data confidence protocols, equipment, and data analysis. All professional data was collated by the Victorian Water Quality Monitoring Network (VWQMN). The parameters examined in this study were turbidity, electrical conductivity (EC), pH and total phosphorus. The level of agreement between community-collected data and professional data varied temporally and spatially. Waterwatch data for EC and pH appeared to be very similar to professionally collected data. Equipment used by Waterwatch volunteers for turbidity and total phosphorus appeared to be limited in accuracy to moderate ranges. Overall the VWQMN professionally collected data showed less variance, suggesting greater variability, potentially due to inaccuracies, in volunteer collected data

Community-Institutional Relations↗
PubMed1992

Community work project in Gazankulu: a community-based training experience.

Speech Pathology and Audiology students at the University of the Witwatersrand participated in a field trip to learn about rural community work. In collaboration with rehabilitation workers at Tintswalo Hospital, Gazankulu, projects in pre-school language stimulation, aphasia assessment and intervention, and hearing screening were undertaken. Projects adhered to community work principles. These were successful in terms of both providing a service to the community and teaching students principles and practice of community work.

Audiology↗
PubMed1991

Balance of care for the dying between hospitals and the community: perceptions of general practitioners, hospital consultants, community nurses and relatives.

A survey was made of the general practitioners, hospital consultants and community nurses who had cared for a random sample of people dying in 1987. Their views and experiences of the balance of care between hospital and the community are reported. All three groups wanted more people to be looked after in their homes rather than in hospital if adequate care could be arranged at home. But they perceived inadequacies in home help and district nursing services and many wanted other community services expanded or introduced. The main shortcomings of the hospital service were seen as inadequate numbers of hospice beds, difficulty obtaining admission for people needing long term care, discharge too early and some over-treatment of people who were dying. There was some evidence from relatives that pain control was better in hospital than at home, and the district nurses also reported that pain was not controlled satisfactorily for patients dying at home as often as it could be. It is concluded that inadequacies in community services may discourage some people from taking on the care of their relatives at home.

Adult↗
PubMedDate not supplied

[The "community meeting" in a therapeutic community (author's transl)].

This article explores the aim, structure, direction modalities, the role and intervention of the staff in a 'community meeting'. Problems related to large group phenomena, course, contents and dynamics of that meeting are also studied. We conclude that 'community meeting' is a difficult but indispensable meeting in a therapeutic community. It is the place where the different therapeutic activities of the community can be integrated and where a therapeutic culture can be developed.

Humans↗
PubMedDate not supplied

Community risk perception: a case study in a rural community hosting a waste site used by a large municipality.

Using a model of risk perception which divides the community into attitudinal and behavioural subgroups based on awareness, concern and action in relation to a waste management facility, we conducted a survey in a community with an operating landfill and a ten-year history of controversy over the unsuccessful siting of a hazardous waste facility (HWF). The purpose of the survey was to study community attitudes to waste management in general, attitudes specific to landfills and HWFs, and to identify factors which shape community attitudes in both cases. Levels of concern and activism were lower for the landfill; activism and concern were more likely among younger subjects and those with children. In the case of the HWF, greater concern and activism were more likely among married people and those without a university education. Gender differences in relation to environmental "concern" were not found for either the landfill or the HWF siting attempts.

Adult↗
PubMed1995

Teleform scannable data entry: an efficient method to update a community-based medical record? Community care coordination network Database Group.

Community-based multi-disciplinary care of chronically ill individuals frequently requires the efforts of several agencies and organizations. The Community Care Coordination Network (CCCN) is an effort to establish a community-based clinical database and electronic communication system to facilitate the exchange of pertinent patient data among primary care, community-based and hospital-based providers. In developing a primary care based electronic record, a method is needed to update records from the field or remote sites and agencies and yet maintain data quality. Scannable data entry with fixed fields, optical character recognition and verification was compared to traditional keyboard data entry to determine the relative efficiency of each method in updating the CCCN database.

Chronic Disease↗