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PubMed1982

Stopping abuse before it occurs: different solutions for different population groups.

This paper reports on a conference at which participants reviewed indepth the literature on child abuse prevention and child development, as it pertains to different cultural and ethnic population groups, and identifies alternative prevention strategies for these different groups. The efficacy of the following interventions are analyzed: perinatal support programs, education for parents, treatment for abused children, early and periodic childhood screening and treatment programs; social skills training for children and young adults; mutual aid programs and neighborhood support groups; family support services such as crisis care; public information about child abuse and community development activities such as employment assistance. The paper concludes that although treatment services for different groups may be quite similar, prevention strategies must take account of the individual and unique values, norms and socialization patterns of different groups.

Adolescent↗
PubMed1995

Empowerment praxis in community coalitions.

Community coalitions address a wide variety of community problems, espousing a community development processes that promotes individual and collective self-determination. They offer a promising venue for the study of empowerment of individuals and organizations. This study utilizes data from members of 35 community coalitions organized for the prevention of alcohol and other drug problems to address the following questions: What individual characteristics are related to the psychological empowerment of coalition members? What organizational characteristics are related to the collective empowering of members? What organization characteristics are related to a coalition being organizationally empowered to succeed in achieving its objectives? At the individual level, psychological empowerment was most strongly related to individuals' participation levels, sense of community, and perceptions of a positive organizational climate. At the group level, the strongest predictors of collective empowering (our operationalization of the empowering organization) were net benefits of participation, commitment, and positive organization climate. Psychological empowerment and positive organizational climate were the two predictors of organizational effectivenes (the empowered organization). Implications and limitations of these findings are discussed.

Adolescent↗
PubMed1996

Psychoanalysis on the beat. Children, police, and urban trauma.

Anna Freud's legacy to child psychoanalysis was her understanding and description of the complexities of development and her ability to apply her findings to the care of children both within and outside of the consulting room. In addition to her approach to consultation with nonanalytic professionals concerned with children's development and well-being, she established a model for generations of child analysts and other analytically oriented clinicians. Both of Ms. Freud's concepts of development and collaboration with other professionals have served as a basis for the implementation of the Child Development-Community Policing Program in New Haven, Connecticut. This collaboration between mental health and police professionals will be described in this paper, with particular emphasis on the application of Ms. Freud's work to attempts to intervene on the behalf of children and families exposed to urban violence.

Adolescent↗
PubMed1998

Psychosocial factors associated with youth involvement in community activities promoting heart health.

This study examined factors that influence youth participation in heart disease prevention activities among 2,609 ninth graders in six inner-city public high schools. Constructs derived from social cognitive, empowerment, and community development theories informed the conceptual framework employed. Study participants were diverse with respect to gender, ethnicity, parent education, acculturation, and academic achievement. Perceived incentive value, self-efficacy, outcome expectancies, sense of community, and perceived policy control were all significantly associated with participation in community activities promoting heart health. In multivariate analyses, perceived incentive value, defined as the extent to which participants valued a heart-healthy environment, was most strongly associated with community participation, accounting for 11.9% of the total variance. These findings have implications for designing school curricula and after-school and community programs targeting adolescents' involvement in health advocacy activities.

Adolescent↗
PubMed1989

Health for today's youth, hope for tomorrow's world.

What is the best way to ensure the highest possible level of health among young people? Sound public policies, supportive environments, community action, and the reorientation of health services all have a part to play. Of particular importance, however, is the direct involvement of youth in the promotion of its own health.

Adolescent↗
PubMed1987

Primary health care in the tropics.

Primary health care (PHC) organization as part of the country's health care system or of a community development system is compared and causes of failure of PHC programmes analyzed. PHC approach has too often forgotten the need for a well-designed suprastructure and/or that the perception in the communities of diseases and health care is strongly dependent on several attitude towards Western medicine. To avoid these blinkers, a good collaboration between health professionals, social scientists and indigenous people is very important during the planning process of PHC programmes.

Community Health Services↗
PubMed1991

Developing services for lesbian and gay adolescents.

The needs of lesbian and gay adolescents for service provision are discussed in this paper. These needs are identified through research investigating milestones in the coming-out process. In addition, the way in which the research results influenced community development initiatives is described. The social context in which the research was conducted is also described.

Adolescent↗
PubMedDate not supplied

Effective strategies for reaching high-risk minorities with diabetes.

The NDOP goals of enhancing diabetes awareness by increasing screening activities within select African American neighborhoods and involving residents in health promotion activities were met during the course of the project. The coalition focused on principles suggested for diabetes programs directed at African American communities, including involving a target audience, providing a service, empowering people, and respecting cultural diversity. The focus group mechanism facilitated the input of community members into the program design prior to implementation and insured their involvement throughout the project. The screening and education program fostered empowerment by increasing community residents' control, focusing on their strengths, and identifying personal health goals. Funding support from the New York State Department of Health and the American Association of Diabetes Educators' Research Foundation were both essential in implementing the program. The program was well received. Most of the participant evaluations rated the program as excellent or very good. The program sites, although demographically situated within identified African American communities, produced a greater number of Caucasian and Hispanic participants than expected. Although the older group of African American women constituted 25% of the total population screened, it did not reach the desired number of 300 participants. Future programs need to target sites where older African American women are more likely to be found in greater numbers. Key to the program's success was building strong partnerships with community leaders who served as cultural spokespersons for the initiative to ensure participation from the community. Developing this partnership proved to be more challenging than originally anticipated and required a respectful, persevering approach. Yet once the coalition achieved cohesion, the volunteer members were invaluable in planning and implementing program events. Community members eventually took charge of the coalition and organized programs that have extended beyond the 2-year period of the grant. The coalition continues to expand; members have been added and education programs at churches and community meetings are ongoing. Addressing the problem of diabetes in African American communities requires programs that are innovative, culturally and educationally appropriate, and presented regularly. Such ongoing efforts can increase the knowledge in African American communities and ultimately enhance the health outcomes of community members.

Black or African American↗
PubMed1994

Increasing coordination of the dementia service delivery network: planning for the Community Outreach Education Program.

Dementia is an emerging public health concern because of its prevalence and the cost and extent of care typically needed for people with cognitive disorders. When family members seek assistance in providing care, they frequently encounter a fragmented service delivery network. To increase the coordination of services for people with dementia, the Community Outreach Education Program (COEP) has been designed to provide educational interventions to disseminate information about the diagnosis, assessment, management, and treatment of dementia to health care professionals, service providers, staff of volunteer and community organizations, and family members. This article describes plans for the COEP within the context of a community development perspective.

Aged↗
PubMed1997

St. Thomas Immunization Initiative. A student-run community action project.

The objectives of the St Thomas Immunization Initiative are to provide a clinical community medicine experience for first- and second-year medical students, expose students to a community immunization program, teach students the principles of a community immunization program, and demonstrate a working relationship between the residents of an underserved community and medical students. From 1993 to 1995, first- and second-year students at Tulane University Medical School participated in class projects known as Shots for Tots and the St Thomas Immunization Initiative. Students received instruction about immunizations and administered vaccinations to children and adults in low-income neighborhoods. A total of 754 immunizations were administered to 331 children from 1993 to 1995. Participating students were surveyed and 82% of those who responded to a questionnaire felt that the project benefited the community it served while 79% felt that they personally benefitted from participating in the project. Given their experience, 96% of the students would be more likely to participate in a community development project in the future.

Adult↗
PubMedDate not supplied

Development of educational and training materials on safety and health: targeting Hispanic workers in the construction industry.

The number of Hispanics in the construction work force continues to grow and their fatal and nonfatal occupational injuries are higher than those in any other ethnic group in the United States. Focusing on safety and health for this group may reduce injuries and promote safe workplaces. However, involving hard-to-reach workers is a difficult process because of language and cultural differences within ethnic groups. This article presents findings on effective design, development, and dissemination of safety and health educational materials targeted to Hispanic construction workers. How to utilize a linguistically and culturally sensitive approach is described. The author stresses the need for collaboration among researchers, unions, community development organizations, and advocacy groups in this effort.

Accidents, Occupational↗
PubMed1993

Promoting WID in Jordan.

Founded in 1977, the Queen Alia Fund (QAF) has been promoting social development in Jordan for 15 years by providing social services, and educational and vocational training at the grassroots. The fund, which is the country's principal nongovernmental organization (NGO), operates a network of over 40 community development centers. Under its women's programs, the fund targets such areas as literacy, health, skill training, family planning (FP) and the environment. Princess Basma Bint Talal, chairperson, QAF, introduced the activities of the fund and expressed concern for population issues in Jordan during a meeting with JOICFP Deputy Executive Director Yasuo Kon on October 13 in Tokyo. "Jordan has a very high birthrate and rapid population expansion," she said. "This places very big burdens on services; so we are now very concerned with trying to relieve this situation." Noting that FP is a very sensitive issue in Jordan. Princess Basma said that a program for birth spacing had recently been adopted nationally. She added that both JOICFP and QAF shared many mutual priorities in their approaches including a shared emphasis on health education activities. "We'd very much like to see a fostering and promoting of relations between Japanese and Jordanian NGOs, particularly in this field, and we would be delighted if we could explore the possibility of further cooperation through some of the services we offer in Jordan in this regard," she said.

Asia↗
PubMedDate not supplied

[Starting points for the Italian actualization derived from the experience of community medicine in developing countries].

The Authors have studied the salient features of Community Medicine from three different aspects: 1) the theory of primary health care, as defined by the WHO, as a fundamental element in Community Medicine; 2) the characteristics it assumes in health planning in developing countries, where it is designed to meet the special local requirements; 3) the situation in Italy, where local medical care is regarded as a favoured sphere for projects, but where different planning and policies are required. From this study we have selected a number of ideas gathered during our experience in developing countries, which are suitable for adoption in Italy: the setting up of health care systems on global, capillary and participatory lines, aimed jointly at prevention, diagnosis and therapy: the use of scientific methodologies which are both thorough and accurate, and which are available for user countries; adequate personnel training; coordination between medical care and the working world; all this with the aim of enabling each and every individual to lead a socially and economically productive life, by ensuring the greatest possible physical and mental well being.

Community Medicine↗
PubMed2005

Effects of selected pharmaceuticals on riverine biofilm communities.

Although pharmaceutical and therapeutic products are widely found in the natural environment, there is limited understanding of their ecological effects. Here we used rotating annular bioreactors to assess the impact of 10 microg.L(-1) of the selected pharmaceuticals ibuprofen, carbamazepine, furosemide, and caffeine on riverine biofilms. After 8 weeks of development, community structure was assessed using in situ microscopic analyses, fluor-conjugated lectin binding, standard plate counts, fluorescent in situ hybridization, carbon utilization spectra, and stable carbon isotope analyses. The biofilm communities varied markedly in architecture although only caffeine treated biofilms were significantly thicker. Cyanobacteria were suppressed by all 4 compounds, whereas the nitrogen containing caffeine, furosemide, and carbamazepine increased algal biomass. Ibuprofen and carbamazepine reduced bacterial biomass, while caffeine and furosemide increased it. Exopolymer content and composition of the biofilms was also influenced. Significant positive and negative effects were observed in carbon utilization spectra. In situ hybridization analyses indicated all treatments significantly decreased the gamma-proteobacterial populations and increased beta-proteobacteria. Ibuprofen in particular increased the alpha-proteobacteria, beta-proteobacteria, cytophaga-flavobacteria, and SRB385 probe positive populations. Caffeine and carbamazepine additions resulted in significant increases in the high GC354c and low GC69a probe positive cells. Live-dead analyses of the biofilms indicated that all treatments influenced the ratio of live-to-dead cells with controls having a ratio of 2.4, carbamazepine and ibuprofen being 3.2 and 3.5, respectively, and furosemide and caffeine being 1.9 and 1.7, respectively. Stable isotope analyses of the biofilms indicated delta 13C values shifted to more negative values relative to control biofilms. This shift may be consistent with proportional loss of cyanobacteria and relative increase in algal biomass rather than incorporation of pharmaceutical carbon into microbial biofilm. Thus, at 10 microg.L(-1) levels pharmaceuticals exhibit both nutrient-like and toxic effects on riverine microbial communities.

Bacteria↗
PubMed2002

Emotional intelligence and the good community.

Suggests various ways in which the concept of emotional intelligence (EI) can inform community research and action. Begins by defining EI and reviewing the growing body of research on its contribution to educational, health, and occupational outcomes. Next distinguishes between EI and the related concept of emotional and social competence. Then considers the connection between EI and several topics of interest to community action researchers including prevention and wellness promotion, implementation and dissemination of innovative programs, community development, and the value of diversity. Concludes by suggesting that the ecological perspective can help inform research and practice relating to EI.

Community Participation↗
PubMed1998

Oncology services: the Department of Defense perspective.

The Department of Defense (DoD) military health system has responsibility for providing medical care for more than 8 million beneficiaries. This article discusses initiatives related to both the providing and purchasing of oncology services. A description of health care coverage under TRICARE, the Department's managed care program, which utilizes military treatment facilities and civilian health care providers, is provided. Participation in clinical trials by the DoD beneficiaries, oncology services in military treatment facilities, quality management programs, cancer research, and the development of new technologies to enhance early cancer detection are presented. Access to research trials and new technologies is necessary for a comprehensive approach to cancer care. Clinical trials have been the vehicle by which the oncology community developed most of its formal clinical evidence for the efficacy of various treatment approaches. The Department participates in clinical trials through cooperative group membership or affiliation. Through an interagency agreement with the National Cancer Institute, DoD beneficiaries have available the option of participating in NCI-sponsored clinical trials through the direct military care system or through civilian care with reimbursement for approved protocols nationwide. The DoD has been actively involved in breast cancer research since 1992 and prostate and ovarian cancer research since 1997. The goals of the cancer research programs are to expedite and facilitate breakthroughs in research, support innovative, and exploratory ideas with a vision to foster new directions, address neglected issues, and bring new investigators into the research arena. The program incorporates the consumer perspective by involving consumers in the decision-making process. The DoD health care system trains experts in the management of cancer patients and provides a multidisciplinary approach to care through the direct military health care system or through network providers as part of the TRICARE system. Although cost containment is key, the delivery of high quality health care that is easily accessible is a primary goal of the military health system. Provision of a comprehensive benefits package that includes a spectrum of care and employing outcomes measurements to evaluate care that is appropriate for the patient's disease is essential.

Clinical Trials as Topic↗
PubMed2004

Geospatial information technology: an adjunct to service-based outreach and education.

This exemplar highlights how geospatial information technology was effective in supporting academic practice, faculty outreach, and education initiatives at the University of Mississippi School of Nursing. Using this cutting-edge technology created a community-based prototype for fully integrating point-of-service research, practice, and academics into a cohesive strategy to influence change within the health care delivery system. This exemplar discusses ways this knowledge benefits practice and curriculum development; informs critical decision making affecting the people we serve; underscores the vital role nurses play in linking this technology to practice; and develops community residents as partners in their own health and that of the community.

Community Health Nursing↗
PubMed2003

Integrated environmental impact assessment: a Canadian example.

The Canadian federal process for environmental impact assessment (EIA) integrates health, social, and environmental aspects into either a screening, comprehensive study, or a review by a public panel, depending on the expected severity of potential adverse environmental effects. In this example, a Public Review Panel considered a proposed diamond mining project in Canada's northern territories, where 50% of the population are Aboriginals. The Panel specifically instructed the project proposer to determine how to incorporate traditional knowledge into the gathering of baseline information, preparing impact prediction, and planning mitigation and monitoring. Traditional knowledge is defined as the knowledge, innovations and practices of indigenous and/or local communities developed from experience gained over the centuries and adapted to local culture and environment. The mining company was asked to consider in its EIA: health, demographics, social and cultural patterns; services and infrastructure; local, regional and territorial economy; land and resource use; employment, education and training; government; and other matters. Cooperative efforts between government, industry and the community led to a project that coordinated the concerns of all interested stakeholders and the needs of present and future generations, thereby meeting the goals of sustainable development. The mitigation measures that were implemented take into account: income and social status, social support networks, education, employment and working conditions, physical environments, personal health practices and coping skills, and health services.

American Indian or Alaska Native↗