Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Community Development”

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 739 records · Page 41Linked to original sources
PubMedDate not supplied

Community care for adolescents with developmental retardation: problems and proposals.

The quality of community care provision for adolescents with developmental retardation was examined in a health district with a well-developed community service. This paper describes a representative sample of such adolescents living at home, and is based on data from a wider study of the dependency needs of this group. Although many professionals and agencies were involved with each family during the six months prior to the study, their input was poorly co-ordinated and did not focus on the group's special needs. Psychiatric disorder in the adolescent, and relationship difficulties with the primary carer, were the least well catered for, and these results support previous research findings. The paper concludes with proposals for improving the services in the context of current legislation.

Adolescent↗
PubMed1994

An evaluative study of a community health service development.

This paper describes a research study designed to evaluate a community health service development in one health authority in rural England. The study compared two types of primary care teams working towards the same objectives. Surveys of patients and staff in the health authority were conducted about a range of issues, defined by the original aims of the scheme. Measures were made of care received by people over 75 years of age, consumer satisfaction, staff experiences of the multi-disciplinary team, job satisfaction and liaison with social services personnel. Few differences existed between the two forms of care on all of these measures. This paper contains a discussion of the findings alongside an examination of the implications for future health service developments, particularly flagship enterprises such as nursing development units. The importance of well established baseline measurements is emphasized by both the research findings and the discussion.

Aged↗
PubMed2005

A chronic disease outreach program for Aboriginal communities.

BACKGROUND: Our objective is to describe a program to improve awareness and management of hypertension, renal disease, and diabetes in 3 remote Australian Aboriginal communities. METHODS: The program espouses that regular integrated checks for chronic disease and their risk factors are essential elements of regular adult health care. Programs should be run by local health workers, following algorithms for testing and treatment, with backup, usually from a distance, from nurse coordinators. Constant evaluation is essential to develop community health profiles and adapt program structure. RESULTS: Participation ranged from 65% to 100% of adults. Forty-one percent of women and 72% of men were current smokers. Body weight varied markedly by community. Although excessive in all, rates of chronic diseases also differed markedly among communities. Rates increased with age, but the greatest numbers of people with morbidities were middle age and young adults. Multiple morbidities were common by middle age. Hypertension and renal disease were early features, whereas diabetes was a variable and later manifestation of this integrated chronic disease syndrome. Adherence to testing and treatment protocols improved markedly over time. Substantial numbers of new diagnoses were made. Blood pressure improved in people in whom antihypertensive agents were started or increased. Components of a systematic activity plan became more clearly defined with time. Treatment of people in the community with the greatest disease burden posed a large additional workload. Lack of health workers and absenteeism were major impediments to productivity. CONCLUSION: We cannot generalize about body habitus, and chronic disease rates among Aboriginal adults. Pilot data are needed to plan resources based on the chronic disease burden in each community. Systematic screening is useful in identifying high-risk individuals, most at an early treatable stage. Community-based health profiles provide critical information for the development of rational health policy and needs-based health services.

Adult↗
PubMed1996

Comparative biomass spectra and species composition of the zooplankton communities in Golfo Dulce and Golfo de Nicoya, Pacific coast of Costa Rica.

This study is based on a subset of plankton samples obtained during an expedition of the German RV Victor Hensen to the Pacific coast of Costa Rica in 1993/94. It aims at the identification of the main plankton taxa for a general description and comparison of the plankton communities of the gulf systems Golfo de Nicoya (GN) and Golfo Dulce (GD) and the analysis of biomass spectra at inshore and offshore stations at the end of the rainy season and during the dry season. Inshore plankton biomass was significantly higher in GN than GD and exceeded offshore biomass several times, while in the GD area the reverse was found. In the rainy season, inshore biomass spectra of GN and GD were discontinuous with biomass concentrations at small sizes (around 0.06 mg) suggesting little developed communities, with highest production and energy use occurring in the small organisms. From the rainy to the dry season inshore species richness increased in both gulf systems and a shift was observed towards the larger size groups resulting in more continuous biomass spectra. In GN, bivalve larvae, foraminifers, ostracods, mysids and nauplii increase heavily in abundance and some gelatinous specimens occur. In GD, gelatinous zooplankton appears in enormous abundance and dominate the community biomass, followed by large chaetognaths and ostracods. In GD, inshore plankton has neritic and oceanic elements and differs less from the offshore plankton, whereas in GN, inshore plankton in largely neritic. The high abundance of fish eggs and invertebrate larvae suggest that this area is an important spawning ground. While in the rainy season inshore biomass was about 15 times higher in GN compared to GD, this difference was reduced to 3-4 times in the dry season due to the appearance of the large predators mentioned above. The changes from the rainy to the dry season at the offshore stations of both gulf systems are less pronounced in terms of total biomass, shape of the biomass spectra and taxonomic composition of the community. The differences-relatively continuous biomass spectra with an increasing slope and a high total biomass in GD versus flat and shorter spectra due to the absence of large chaetognaths and medusa in the GN-suggest that conditions in the former area allow for a better development of a trophodinamically tightly structured plankton community.

Animals↗
PubMed1976

The environment of the malnourished child.

The study of the relation of man to his environment in developing countries emphasizes the inevitable need for societies to recognize the true causes of infection, malnutrition, and poverty. The need is for improvement in the quality of human life in less developed nations, a recommendation easy to prescribe but difficult to accomplish. Although our pool of knowledge is incomplete, it is adequate to suggest ways to diminish infection, increase food production, utilize food more efficiently, improve education, and provide systems of justice to protect the classes most in need. The physical environment in tropical and subtropical regions, and the socioeconomic characteristics of the population inhabiting such regions, favor maintenance and transmission of a variety of viruses, bacteria, and parasites that make agricultural progress and social development difficult, and that contribute to poor fetal growth, nutrient wastage, and deficient postnatal physical growth, accounting for most of the childhood morbidity and mortality. In this regard, infections contribute indirectly to the overall food problem in a similar fashion as pests do in terms of food losses and spoilage. The overall effect could be comparable or greater than that resulting from an inadequate capacity to produce or to purchase the food needed. Thus, my objective has been to stress, within the whole environment, the importance of infection and the need to diminish it. Ways to control and prevent infection are readily known. They have to do with education of the population to improve personal and environmental hygiene. Economic investment is necessary to improve housing and water supply systems, waste disposal, and such preventive measures as immunization programs. Although such measures may appear expensive when first implemented, they have long-lasting effects and many require minimal expenditure once they are established. Large segments of the population stand to benefit, and other development interventions can then be introduced. However, these measures should not be implemented singly. They should be accompanied by community development, family planning, social legislation--in other words, the holistic approach to health and welfare. To do otherwise may aggravate the problem by stimulating demographic growth, perpetuating malnutrition and infection, and maintaining underdevelopment.

Agriculture↗
PubMed1994

Empowering lesbian and gay communities: a call for collaboration with community psychology.

This article traces the history of empowerment efforts in lesbian and gay communities. Despite considerable progress, lesbians and gay men remain marginalized in American society. Their personal, family, and community development is hampered by social and institutional barriers to empowerment. Three powerful disempowering problems of contemporary lesbian and gay communities are detailed: (1) stresses related to coming out; (2) heterosexism; and, (3) difficulties identifying with a community. Four domains are suggested for future collaboration between community psychologists and lesbian/gay communities: (1) anti-lesbian/anti-gay prejudice, discrimination, and violence; (2) mental health and health enhancement; (3) the HIV/AIDS epidemic; and, (4) civil rights. Future collaborations must build on successful-social change strategies already used by activists in lesbian and gay communities.

Civil Rights↗
PubMed2003

Pro-poor health policies in poverty reduction strategies.

Since 1999, the International Monetary Fund and World Bank have required low-income countries soliciting for debt relief and financial support to prepare a Poverty Reduction Strategy Paper (PRSP). The objective of this study is to arrive at a systematic assessment of the extent to which the first batch of interim PRSPs actually addresses the health of the poor and vulnerable. A literature study was used to design and test a semi-quantitative approach to assess the pro-poor focus of health policies in national documents. The approach was applied to the existing interim proposals for 23 Highly Indebted Poor Countries. Results show that a majority of proposals lack country-specific data on the distribution and composition of the burden of disease, a clear identification of health system constraints and an assessment of the impact of health services on the population. More importantly, they make little effort to analyze these issues in relation to the poor. Furthermore, only a small group explicitly includes the interests of the poor in health policy design. Attention to policies aiming at enhancing equity in public health spending is even more limited. Few papers that include expenditure proposals also show pro-poor focused health budgets. We conclude that our systematic assessment of a new international development policy instrument, PRSP, raises strong concerns about the attributed role of health in development and the limited emphasis on the poor, the supposed primary beneficiaries of this instrument. There is a need and an opportunity for the international development community to provide assistance and inputs as poor countries shift their policy thinking from an interim stage to fully developed national policies. This paper presents a menu of analytical and policy options that can be pursued.

Delivery of Health Care↗
PubMed2006

The novella approach to inform women living on low income about early breast cancer detection.

Economically disadvantaged women have a greater likelihood of later-stage breast cancer diagnosis when compared to women with higher levels of income. Later-stage diagnosis decreases the chances of survival. The purpose of this article is to describe a project whereby breast cancer survivors, living on lower incomes, created novellas (stories) using artistic media to reach their peers with a message about the importance of early breast cancer detection. The recruitment and engagement of breast cancer survivors in a 2-year community development project that used participatory, women-driven approaches are discussed, and the reciprocal learning between health care providers, community partners, and women living on low income is shared. Recommendations for health promotion practice are presented.

Adult↗
PubMed2005

'Micro' public health--the reality.

The first paper in this series itemised the research undertaken to discover the unexpressed needs of the village population. Community Participatory Appraisal methodology ensured that local people had the opportunity to express their opinions and health needs. Interviews were analysed and data offered to a focus group for ratification. This information was then used to create a questionnaire. The World Health Organization Quality of Life questionnaire (brief form) and Antonovsky's 'Orientation to Life' questionnaire were added to ensure as many aspects affecting the health of the population were covered. The questionnaire indicated the importance for planning purposes. The role of health visitors has recently returned to the broader remit outlined in 1977 by the Council for the Education of Health Visitors and framed in the four principles of health visiting. In the 1980s the medical model of health visiting prevailed and individual health promotion dominated. During the 1990s this expanded to encompass 'family public health' looking at the impact of a variety of attributes, for example; poverty, relationships, lifestyle and community. Now government is urging health visitors to work with populations; to determine health needs and collaborate with agencies to effect changes. Implementation of the research findings, detailed in this, the second paper, records the steps taken to accomplish 'micro' population public health and the success of this new way of working. Health visitors need to equip themselves with a variety of new ways of working, including community development, in order to maximise the health of their population.

Adolescent↗
PubMed1990

Recent trends in the development of alcohol and drug treatment services in Ontario.

This article summarizes the major trends in the development of alcohol and drug treatment services in Ontario since 1979. These trends are contrasted to the objectives of a province-wide Addiction Research Foundation (ARF) community development program designed to establish or expand addiction services within this same time period. Data were obtained from all treatment services in the province by surveys undertaken in 1980, 1983 and 1986. Across the period of analysis, there have been rapid increases in the number of addiction programs, their total cost and the total treatment caseload. Some specific changes have been quite consistent with ARF objectives: a stabilization in the use of hospital beds for addictions treatment, an increase in community-based versus hospital-based treatment resources, an increase in the province-wide capacity for comprehensive client assessment and a larger representation of women in addictions programs. Other ARF objectives have yet to be achieved. In particular, a major increase in nonresidential treatment alternatives and an increase in the proportion of treated cases from special populations such as youth or the elderly are still required. Suggestions are made concerning future program development.

Adult↗
PubMed2003

Action research: a hospital responds to domestic violence.

Using action-research methods and the principles of community development, a small working group initiated an organization-wide process to sensitize the Sunnybrook and Women's College hospital community to the relationship between violence and women's health. In this article, we explore the process by which the initiative was successfully introduced into the newly merged hospital. We describe critical factors for the initiative's success and offer some suggestions on how to maximize opportunities for organizational change.

Community Health Planning↗
PubMedDate not supplied

Addressing the challenges of underdevelopment in environmental and occupational health in southern Africa.

Since 1996, the University of Michigan's Fogarty International Center training and research program in Environmental and Occupational Health (EOH) in Southern Africa has contributed to capacity development in the 14 countries of the Southern African Development Community. Methods include training citizens from the region in master's, doctoral, and short-term focused programs; assisting the development of graduate programs in EOH at institutions, developing resources for distance-based degree programs; direct support ofjunior and mid-level researchers, and organizing regional short courses and regional conferences. Substantial EOH resources now present in South Africa are leveraged to assist capacity development in the rest of the region. The program's successes appear to be due to strong regional leadership and oversight structures, a strategy of developing EOH resource centers in several countries, and close collaboration with other regional and international EOH programs.

Africa, Southern↗
PubMed1982

Training counseling skills: an experimental analysis and social validation.

A community development perspective suggests the value of using local resources to solve local problems. Two low-income staff of a community service center served as nonprofessional counselors after receiving a training program consisting of written instructions, practice, and performance feedback. The effects of the 40-hour training program were positive for both counseling and problem-solving skills. There was also evidence of generalization of counseling performance across clients, problems, and time. In addition, expert judges' ratings of performance were obtained as a measure of social validity. These findings suggest that the training procedures are effective in enhancing the counseling and problem-solving skills of low-income nonprofessionals.

Allied Health Personnel↗
PubMedDate not supplied

Advancing community health through community health partnerships.

Improving a community's health is a key goal of health services organizations. Effectively pursuing that goal requires health services organizations to create partnerships with other organizations to help identify community health needs and to create and carry out programs that bring together community members and needed health services. Drawing on community systems concepts and a recent study of community health partnership efforts in three cities, this article provides a framework for such partnerships. Types of partnerships described include: Community action partnerships, in which the partnership forms to address a specific problem or pursue a specific opportunity. Community organization partnerships, in which a set of organizations in a similar service sector agree to collaborate for mutually agreed upon goals; and Community development partnerships, in which a partnership attempts to increase participation by people and organizations in collaborative activities that advance the community on multiple fronts or that contribute to community assets and services in multiple areas. The article also describes how the pressures to create large integrated delivery systems can affect creation of partnerships to improve community health. Increasingly, healthcare leaders are being held accountable for the health of communities they serve. When creating partnerships for community health and carrying out health-improvement activities, leaders should be aware of and respond to four key dimensions of accountability: political accountability, commercial accountability, clinical/patient accountability, and community accountability.

Catchment Area, Health↗
PubMedDate not supplied

Reaching out: a community initiative for disadvantaged pregnant women.

A major challenge for public health services is to reach disadvantaged pregnant women with a relevant program that assists them to reduce modifiable risk factors. A community development approach was used to initiate an outreach program aimed at urban natives and other high-risk pregnant women. Community involvement in program planning, the use of native and non-native community health workers, the provision of social support and the tangible health benefits of the program contributed to its success in attracting women for service.

Adolescent↗
PubMed1987

Preparation of community health nursing leaders for social action.

Indiana University School of Nursing graduate Department of Community Health Nursing has been preparing community health nurses for primary health care practice, as defined by the World Health Organization since 1978. The faculty are committed to preparing community health nursing leaders for social action aimed at improving the health of the community in both the Department's major in the master's programme and its new major in the doctoral programme. The core curricula for these majors in both programmes are presented. The master's curricula is based on integrating public health principles with those of community development. The doctoral major builds on this base of primary health care practice with a curriculum focused on the contribution of community health nursing to public and health policy. The graduates of the master's programme are prepared to work with community groups as a social force in promoting the health of the community. The graduates of the new doctoral major entitled "Health Policy and the Health of the Community" are being prepared as community health nursing leaders with expertise in health care policy and the legislative process with a focus on issues related to nursing and community health. These graduates will be able to function within the broader community, including national and international settings. Based on experiences in graduate education in community health nursing recommendations are made for the response graduate nursing education must make in order to prepare appropriate leaders who can work toward the goal of improving the community's health.

Community Health Nursing↗
PubMed2001

Children. The unwitting target of environmental injustices.

Children have little control over where they live, what they eat, the financial circumstances of their families, or the developmental activities and behaviors that make them vulnerable to environmental contaminants. Minority and poor families disproportionately live in communities with landfills, hazardous waste facilities, incinerators, industrial plants, and old housing with poor indoor air quality and lead-based paint. Residents of these communities are also more likely than are more affluent communities to consume fish on a regular basis from local waters, many of which have banned fishing. Consequently, these children and their families are exposed more frequently than are children in other communities to potentially dangerous chemicals that can affect health. Data indicate that poor and minority children have higher rates of asthma, elevated blood lead levels, learning disabilities, and hyperactivity than do non-minority and more affluent children. When a group of people is exposed unfairly and inequitably to toxins in their communities, workplaces, and schools, a phenomenon called environmental discrimination or environmental racism exists. Environmental justice is a US governmental remedy that requires the application of fair strategies and processes in the resolution of inequality related to environmental contamination. The US response resulted in the establishment of offices of Environmental Justice within the EPA and ATSDR and passage of important legislation and policies, such as the Community Planning and Right-to-Know Act of 1986, Executive Order 12898 (Federal Actions to Address Environmental Justice in Minority Populations), and Executive Order 13045, a parallel order to protect low-income and minority children from actual and potential environmental hazards. Communities and advocacy groups play an important role in promoting healthier environments for children. Frequently, low-income and minority communities are perceived as less powerful, less organized, and ill equipped to defend against actual and potential sources of environmental contamination. Health care professionals are in a strategic position to assist with community development, organizing, and empowerment through educational programming, networking, and supporting other activities that bring attention to the plight of environmentally vulnerable communities.

Child↗