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At least 487 records · Page 27Linked to original sources
PubMed2003

Community participation in externally funded health projects: lessons from Cambodia.

This article provides lessons learned on establishing effective community participation in two externally funded, NGO-implemented health projects working at district level in Cambodia. The first project was implemented in accordance with the Cambodian national guidelines on community participation. The second - using lessons and experiences gained as a result of the first project - worked with Buddhist pagoda volunteers. Primary research was conducted in both settings to assess the effectiveness of the two participation strategies. The article concludes that the success of community participation in externally funded health projects with relatively short implementation timeframes requires engagement with existing community-based organizations and agencies. In Cambodia, where Theravada Buddhism is the dominant religion, pagodas and associated volunteers appear to represent such an organization. Community participation structured around pagoda volunteers - who are held in high esteem within their local communities - is more effective and sustainable than newly (and externally) established community structures with formally elected representatives. Pagodas and associated volunteers in rural Cambodia offer the advantages of effective leadership, local organization, resource mobilization and management. It is recommended that programmes and agencies wishing to adopt community participation strategies in health utilize participatory research to identify the most appropriate local organization to lead such initiatives.

Adolescent↗
PubMed1994

The capacity-building approach to intervention maintenance implemented by the Stanford Five-City Project.

Increasingly, agencies supporting community health promotion interventions require participating communities and evaluators to specify how the intervention will be maintained once agency funding ends. The Stanford Five-City Project (FCP) implemented two different strategies to maintain its heart disease education program, with the second strategy designed to overcome the barriers to implementation that were encountered by the first. This paper provides a practice-oriented description of the initial 'community network' maintenance strategy of the FCP, the barriers that were encountered as this network strategy was implemented, the alternative 'capacity-building' strategy directed at local health educators and the successful implementation of this alternative. Also discussed are the community organization issues underlying the shift in intervention maintenance strategies and the specific components of the capacity-building strategy, including its focus on health educators, and its application of a training of trainers model and cooperative learning methods to provide professional development, technical assistance and other resources to a target group of community health educators. Our experience indicates that capacity-building is a viable method for intervention maintenance and that it may also facilitate efforts to disseminate model health promotion programs to communities lacking experience in community health promotion intervention.

California↗
PubMed1993

Overcoming barriers to health care access for medically underserved children.

The NYCHP was designed to serve the special needs of medically underserved, extremely disadvantaged children in New York City. As a model, and as the flagship program of a national network, the NYCHP demonstrates that it is possible to provide a medical home for children in a variety of challenging situations where access to traditional providers is limited. It is clear, however, that mobile units or other creative ways to overcome barriers to access to care are an insufficient long-term answer. Ultimately, the public sector must take steps to ensure that all American children have regular access to a true medical home regardless of their social or economic situation. In the interim, special initiatives such as the NYCHP must continue to fill the gap.

Academic Medical Centers↗
PubMed1995

Helping community health centers adapt to changing environments: one foundation's response.

The history of community health centers (CHCs) reflects attitudes toward health care delivery in general. Developed as part of the war on poverty, they later survived the more conservative attitudes of the early 1970s to flourish in the late 1970s. In the 1980s, we again witnessed a reduction in the funding available to CHCs. In response to this, The Robert Wood Johnson Foundation (RWJF) established The Program to Strengthen Primary Care Health Centers. The program was designed to help centers to adapt to this environment by becoming more businesslike in their operations and decreasing their dependence on public dollars.

Community Health Centers↗
PubMed1995

The community health center: an enduring model for the past and future.

This article provides insights into the history of community health centers (CHCs) and the role that they play in providing care to the poor. The mission of the CHC has always been to provide comprehensive primary care services to community residents regardless of their ability to pay. Health centers served an estimated 7 million people in 1993. In the near future, centers will be faced with new challenges. For example, the nationwide momentum toward managed care is defining new areas of growth for health centers, including new forms of practice management and contractual arrangements with other providers.

Community Health Centers↗
PubMed1995

Innovations by primary care health centers: lessons for managers and policy makers.

This article highlights results from the evaluation of The Program to Strengthen Primary Care Health Centers, and suggests some directions for public policy. Program participants reported substantial improvements in financial viability, given the relatively small monetary investment. Technical assistance in the development of innovations, however, appears to dampen creativity and ultimately hinder financial gains. Recommendations address improved physician retention, the development of professional expertise, the importance of attention to long-range objectives, the related problems of excess capacity and surplus patient demand, and the integration of primary care health centers into managed care systems and health networks.

Community Health Centers↗
PubMed1995

Reflections from The Robert Wood Johnson Foundation on The Program to Strengthen Primary Care Health Centers.

Given the modest amount of resources provided by the Foundation through The Program to Strengthen Primary Care Health Centers, the grantees undertook a high level of activity. Perhaps centers were aided by the momentum and focus of the Program in addition to financial resources. Such grants seem to move longer-range projects onto the daily agendas of managers. It might be worthwhile to convert some portion of federal community health center funding to support financial and managerial innovations. Generally, positive evaluation findings should encourage centers to explore some of the demonstrated initiatives. Evolution and innovation are considered key to the survival of primary care health centers.

Community Health Centers↗
PubMedDate not supplied

Creating community-based access to primary healthcare for the uninsured through strategic alliances and restructuring local health department programs.

In 2003, the Wilkes County Health Department joined with county healthcare providers to develop the HealthCare Connection, a coordinated and continuous system of low-cost quality care for uninsured and low-income working poor. Through this program, local providers of primary and specialty care donate specialty care or ancillary services not provided by the Health Department, which provides case management for the program. Basing their methods on business models learned through the UNC Management Academy for Public Health, planners investigated the best practices for extending healthcare coverage to the underinsured and uninsured, analyzed operational costs, discovered underutilized local resources, and built capacity within the organization. The HealthCare Connection is an example of how a rural community can join together in a common business practice to improve healthcare access for uninsured and/or low-income adults.

Case Management↗
PubMed2007

The evolution of the CDC HIV prevention capacity-building assistance initiative.

As the HIV/AIDS epidemic neared the end of its first decade in the late 1980s, the US Centers for Disease Control and Prevention (CDC) recognized the disparate impact on racial and ethnic minority communities. In response, a program was initiated to build capacity to prevent the further spread of HIV and other STDs in these communities. Since that time, the program has expanded in scope, intensity of efforts, and funding. Today, the CDC's Capacity Building Assistance (CBA) Initiative serves communities across the nation by building community, organizational, and HIV prevention program/intervention capacity designed to reduce the number of new HIV infections among at-risk populations. This article focuses on the history and evolution of these efforts, lessons learned, and how these were used to develop the current, more responsive system. A conceptual framework is presented that describes the taxonomy of CBA services designed to (1) enhance organizational infrastructure; (2) enhance HIV prevention interventions; (3) strengthen community capacity; and (4) strengthen community planning. It includes language and definitions, approaches and mechanisms for delivering capacity-building services, and a Web-based request-and-referral system that serves as the foundation for tracking, monitoring, and ensuring the delivery of appropriate, efficient, and culturally competent CBA.

Centers for Disease Control and Prevention, U.S.↗
PubMedDate not supplied

The evolution of the community health nurse practitioner in Korea.

Community health nursing in Korea has undergone dramatic changes since 1980. These changes arose through the efforts of Mo Im Kim, an internationally known leader in Korean nursing, and colleagues who successfully worked to establish a national community health nurse practitioner program. This article will review these changes with the aim of describing the evolutionary process that culminated in a community health care system that is meeting the needs of Korean citizens who live in rural and isolated areas. The authors believe that the evolution of the community health nurse practitioner in Korea provides a paradigm that can serve as a model for other countries. Health care in Korea is organized differently than that in the United States. However, the plan, process, and political activism can be used for community and public health nursing change in the United States. The information contained in this article is based upon interviews with Mo Im Kim and 20 of her colleagues and associates. Interviewees were selected using a "snowball" sampling technique. Additional data were derived from various professional and personal documents of these individuals. The first author conducted the interviews in both Korea and in the United States.

Community Health Nursing↗
PubMed1998

Interorganizational collaboration: a cautionary note for tribal health nurses.

As the Indian Health Service restructures and more Indian tribes assume control for their health care services, more collaborative initiatives between Indian tribal health and other organizations may be anticipated. This paper addresses the topic of interorganizational collaboration and tribal health care. There are unique issues related to Indian tribal healthcare, and this paper provides a cautionary note to public health nurses who work with and for Indian tribes. Interorganizational collaboration and tribal health care will of be interest not only to the public health nurses working for a tribe, but also to the county and state public health nurses who may be entering into a collaborative effort with a tribal health care agency.

Community Health Nursing↗
PubMed1998

Determinants of the quality of life of rural families.

Drawing from human ecology theory, the purpose of this study was to examine socioeconomic-demographic determinants of the quality of life of rural families. In the study, computer-aided telephone interviewing via random digit dialing procedures were used to collect data in the spring of 1996. The participants included 510 rural (both farm and nonfarm) respondents. Quality of life was measured by five subscales: finances; home, family, and friends; household; community; and environment. The results of the regression analyses indicated that the independent variables--gender, race, marital status, employment status, residence, age, family income, and household size, differentially affected the quality of life subscales. Among the independent variables, household size--not a commonly used determinant in quality of life studies--was the most important predictor of subjective well-being. The findings of this study lend support for the dimensional, rather than global, measurement of subjective well-being.

Adult↗