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PubMed1986

The accident department and Age Concern.

Accident and Emergency Departments are increasingly becoming major providers of primary health care to the elderly. The attendance of an elderly person at an Accident Department may be associated with loss of independence and this may lead to admission to hospital. Such admissions, may sometimes, be avoided by the provision of immediate social support in the community. For five years, we have worked with the Age Concern after-care officer who is able to provide such assistance by liaison with the Social Services. To provide longer-term help, she works closely with the community-based Age Concern network. The Community and Social Services, as well as the Hospital-based services, have benefited from her presence.

Age Factors↗
PubMed2001

Linking personal and public health information: a vision for community-centered health information systems.

As health care in the U.S. and worldwide has shifted from a centralized, institution-based model to a distributed process occurring largely in the communities, Integrated Advanced Information Management Systems (IAIMS) initiatives must also move toward addressing the challenges of integrating health information at the community level. The Wisconsin IAIMS initiative strives to create such a solution, anchoring its efforts in a regional health information technology architecture by partnering with Wisconsin-area communities as the foundation that will ensure the establishment of the appropriate collaborations to gain adequate investment and generate sustainable solutions for health information integration.

Community Networks↗
PubMedDate not supplied

Buckle-up and smile for life: uncommon partners find common ground to collaborate and eliminate disparities. Part 1.

Disparities in health and lack of access to oral health are well-documented common concerns. Health education and health promotion increase awareness about the importance of prevention and the relationship of oral health to overall health. The benefits of collaboration and coalition building to enhance community outreach are well established. In order to combat and correct the problems of disparities and access, many more collaborative efforts must be put in place. Meaningful impact on the health of a community can be made by collaborations of both traditional and non-traditional partners. Grassroots efforts that mobilize coalitions around a specific cause and target specific populations can achieve far greater results than any one entity acting alone. Well-coordinated community projects that represent a collaboration of efforts can galvanize the resources, mobilize volunteers and engender public support that will achieve a positive outcome for a common good. The integration of oral health messages with other public health messages and partnership with a very non-traditional entity was an approach that was adopted by the National Dental Association (NDA). This paper describes the unique partnership between the NDA and the Department of Transportation-National Highway Traffic Safety Administration ([DOT-NHTSA], the funding agency) and the development and launch of a pilot program: "Buckle-Up and Smile for Life". Sections of the paper include: background information on the problems of disparity and access; the impact of community education and the benefits of collaboration; evolution of the unique partnership, including background information on disparities in seat belt usage among African Americans; a description on how the pilot program was structured and implemented; and future plans. The objective of this article is to encourage other oral health organizations to form alliances with the NDA (and other organizations committed to public health) to go into underserved communities to deliver the oral health message. Involvement and participation on all levels, with diverse and non-traditional partners will make a difference. The National Dental Association applauds the commitment of the American Dental Assistants Association to form alliances that address the issues of access and disparities. Groups working together for a common good are linked together by one common notion: Caring Counts.

Adolescent↗
PubMed2002

Environmental uncertainty and collaboration among California nonprofit hospitals.

Meeting the health needs of a community involves developing relationships with a wide range of partners. The purpose of this study was to determine the effect of environmental uncertainty on the level of interorganizational relations among nonprofit hospitals with the intent of providing community benefit. Findings indicate that nonprofit hospitals in California are collaborating to provide community benefit. Significant relationships were found between select hospital characteristics, perceived environmental uncertainty, and components of interorganizational relations.

California↗
PubMed2004

Community-wide information systems design: concepts and an illustration.

Models for community-wide information systems design help insure the development of a health information infrastructure that supports life-long, community-centric, patient focused care. Collaborating with community health planning groups provides a reasonable starting point for such endeavors. We review existing approaches to community-based information systems design, draw design principles from the experiences of past innovations, and describe our team's experience in partnering with a community health planning group to establish a community-wide design approach to information systems design. Key themes include (1) partnerships; (2) brokering and integrating existing initiatives; and (3) creating business models for sustainability

Community Health Planning↗
PubMedDate not supplied

Sun Health uses seafaring theme effectively in report to community.

A seafaring theme seems unusual for a system based in Sun City, Ariz., but Sun Health uses it to good advantage in its 2002 Report to the Community. The title, Stay the Course, refers to the fact the system plans to stay afloat after four consecutive years of operational losses. Now completing its 15th year, Sun Health tells readers how it hopes to navigate around the reefs and find clear waters.

Annual Reports as Topic↗
PubMedDate not supplied

From tragedy to triumph: a segue to community building for children and families.

In 2000, more than 60 nonprofit agencies, health care providers, government officials, and community advocates in Tarrant County, Texas, came together to work for systemic change in the mental health care system. The coalition, known as the Mental Health Connection, began working toward a "No Wrong Door" approach to mental health services, which required aggressive coordination between federal, private, and nonprofit resources. The result is a five- to six-year plan for implementation of a new systems of care model for children with severe emotional disturbances and their families. The Mental Health Connection also focuses on legislative advocacy to bring about necessary policy changes at the local, state, and federal levels. Finally, the coalition focuses on developing sustainable revenue streams that will allow the new systems to remain in place once the group accomplishes the initial mission of the Mental Health Connection.

Child↗
PubMed2005

"Smallball" evaluation: a prescription for studying community-based information interventions.

OBJECTIVES: This paper argues that focused evaluation studies of community-based informational interventions conducted over the life-cycle of the project ("smallball" studies) are more informative and useful than randomized experiments conducted only at the project's conclusion ("powerball" studies). METHOD: Based on two contrasting strategies in baseball, smallball and powerball studies are compared and contrasted, emphasizing how the distinctive features of community-based interventions lend advantage to smallball approaches. RESULTS: Smallball evaluations have several important advantages over powerball evaluations: before system development, they ensure that information resources address real community needs; during deployment, they ensure that the systems are suited to the capabilities of the users and to community constraints; and, after deployment, they enable as much as possible to be learned about the effects of the intervention in environments where randomized studies are usually impossible. IMPLICATIONS: Many in informatics see powerball studies as the only legitimate form of evaluation and so expect powerball studies to be done. These expectations should be revised in favor of smallball studies.

Community Health Planning↗
PubMed2005

Community outreach: from measuring the difference to making a difference with health information.

BACKGROUND: Community-based outreach seeks to move libraries beyond their traditional institutional boundaries to improve both access to and effectiveness of health information. The evaluation of such outreach needs to involve the community in assessing the program's process and outcomes. PURPOSE: Evaluation of community-based library outreach programs benefits from a participatory approach. To explain this premise of the paper, three components of evaluation theory are paired with relevant participatory strategies. CONCEPTS: The first component of evaluation theory is also a standard of program evaluation: use. Evaluation is intended to be useful for stakeholders to make decisions. A useful evaluation is credible, timely, and of adequate scope. Participatory approaches to increase use of evaluation findings include engaging end users early in planning the program itself and in deciding on the outcomes of the evaluation. A second component of evaluation theory seeks to understand what is being evaluated, such as specific aspects of outreach programs. A transparent understanding of the ways outreach achieves intended goals, its activities and linkages, and the context in which it operates precedes any attempt to measure it. Participatory approaches to evaluating outreach include having end users, such as health practitioners in other community-based organizations, identify what components of the outreach program are most important to their work. A third component of evaluation theory is concerned with the process by which value is placed on outreach. What will count as outreach success or failure? Who decides? Participatory approaches to valuing include assuring end-user representation in the formulation of evaluation questions and in the interpretation of evaluation results. CONCLUSIONS: The evaluation of community-based outreach is a complex process that is not made easier by a participatory approach. Nevertheless, a participatory approach is more likely to make the evaluation findings useful, ensure that program knowledge is shared, and make outreach valuing transparent.

Community Health Planning↗
PubMed2005

Using evaluation to adapt health information outreach to the complex environments of community-based organizations.

OBJECTIVE: After arguing that most community-based organizations (CBOs) function as complex adaptive systems, this white paper describes the evaluation goals, questions, indicators, and methods most important at different stages of community-based health information outreach. MAIN POINTS: This paper presents the basic characteristics of complex adaptive systems and argues that the typical CBO can be considered this type of system. It then presents evaluation as a tool for helping outreach teams adapt their outreach efforts to the CBO environment and thus maximize success. Finally, it describes the goals, questions, indicators, and methods most important or helpful at each stage of evaluation (community assessment, needs assessment and planning, process evaluation, and outcomes assessment). LITERATURE: Literature from complex adaptive systems as applied to health care, business, and evaluation settings is presented. Evaluation models and applications, particularly those based on participatory approaches, are presented as methods for maximizing the effectiveness of evaluation in dynamic CBO environments. CONCLUSION: If one accepts that CBOs function as complex adaptive systems-characterized by dynamic relationships among many agents, influences, and forces-then effective evaluation at the stages of community assessment, needs assessment and planning, process evaluation, and outcomes assessment is critical to outreach success.

Community Health Planning↗