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Connecting our resources: Louisiana's approach to community health network development.

Louisiana's rural community health systems are in crisis because of pressures fueled by the rising costs of health care, sustained poor health status, state budget shortfalls and changes in priorities, and a sliding rural economy. The development of community health networks is providing new infrastructure and capacity for communities to reprioritize, formulate innovative partnerships, and leverage new resources. Successful elements of Louisiana's network development experience include community commitment to engage in study and action; the availability of capable and motivated technical assistance; an approach that involves open-engagement, community-driven decision-making; and data-driven problem definition, prioritization, and solutions. Louisiana's experiences illustrate the benefits of developing networks along with, or as a result of, a community health plan. When a community owns its health improvement plan, it is more likely to support the new network as a structure for implementation. Broad-scale participation is also a principle of success. When social service agencies are included along with health agencies, more comprehensive strategies result, and they bring additional resources, resulting in more holistic solutions. The cases of 2 networks are presented as illustrations. One involves the facilitation of a community planning process for an existing network. The plan helped to expand the network's community connections and support and provided the content for a successful application for a Health Resources and Services Administration Community Access Program grant. In the second case, a new network was developed, and it leveraged federal funds from the federal Office of Rural Health Policy's Network Development Grant Program.

Community Health Planning↗

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↗

Tuberculosis: finding a community solution.

The Tuberculosis Surveillance Project set out to gain community and health care worker support for and participation in the development and implementation of a tuberculosis control program which would address the high incidence of tuberculosis in Innu and Inuit communities in Labrador. The underlying principle of this project is that a tuberculosis control program must have the support of both the communities and the health care workers if it is to succeed. A three-person tuberculosis steering committee, with representation from the Innu Nation, the Labrador Inuit Association, and the Labrador Health Services Board, supervised initial tuberculosis data collection and analysis and workshop planning. Community Health Representatives, community physicians, and community nurses participated in a workshop to develop a tuberculosis protocol for the region. In addition, community tuberculosis control strategies were developed in workshops in each community in an effort to ensure community and health care worker support for the protocol and tuberculosis control in its broadest sense. This project illustrates how partnerships between communities and health care workers can be achieved. Future tuberculosis incidence rates will be used to evaluate the effectiveness of the partnership.

Adolescent↗

Community participation in international health: practical recommendations for donor and recipient organizations.

This article discusses the need for donor agencies and recipient organizations to involve target communities in the conceptualization, development, monitoring, and implementation of health services and programs in international health. This paper assumes that most donor organizations are based in industrialized countries. Given that resources are finite in both developing and developed countries, the article briefly reviews the current trend of declining public funds for health systems and an increasing role for privately funded health services worldwide. The article calls for community-based international health services that reflect the priorities of target populations, and it also discusses practical steps to involve local populations in community-based health planning and management in international health.

Community Health Planning↗

How to promote effective African American partnerships for community-based HIV/AIDS planning: lessons learned from the Atlanta Regional Minority Health Network.

Coalitions differ from partnerships in that they are often more diverse in their organizational components. Such diversity may lend the advantages of resource conservation and greater credibility but may pose fundamental challenges as well. Using group communication tactics and group maintenance strategies such as positive communication and intentional relationship-building can strengthen the performance of a group. The purpose of this paper is to describe the communication enhancement and conflict prevention methods which the Atlanta Regional Minority Health Network found essential to the successful functioning of the coalition of HIV prevention stakeholders.

Acquired Immunodeficiency Syndrome↗

Health impact assessment for the sustainable futures of Salford.

BACKGROUND: The Salford Health Investment for Tomorrow and the Local Improvement Finance Trust proposals for the comprehensive redevelopment of Salford Royal Hospital and the provision of four integrated primary health and social centres in the City of Salford are a response to the challenge of the NHS Plan to modernize delivery and service provision. The scale of the proposed developments will have a major effect on the quality of life in Salford. This health impact assessment was undertaken to determine how these proposals could be amended to ensure that the impacts are optimised so that potential benefits to Salford's communities are realised to maximise their health and wellbeing. METHOD: This involved a comprehensive prospective health impact assessment and a series of interviews with key stakeholders, community organisations, and local people to identify and prioritize potential positive and negative impacts of the proposals. RESULTS AND CONCLUSIONS: The assessment pointed to a wide range of positive and negative impacts that provided the basis of a set of recommendations, which were linked directly to the themes of the Salford Community Plan. These related to setting employment, education, and training opportunities to maximise health and wellbeing and improve quality of life for all communities in Salford within the framework of the plan. In presenting the findings of the health impact assessment and discussing the recommendations, the paper presents a unique approach in health impact assessment reporting by offering perspectives from the assessor and the project's steering group.

Community Health Planning↗

The community hospital as a focus for health planning.

A community hospital focus for health planning has been developed by a Department of Community Medicine in a "non-teaching" voluntary hospital. Results of three years of planning experience have included: descriptions of service area populations and utilizer populations; implementation of neighborhood based health centers with transportation and outreach programs; integration of emergency services with other ambulatory care resources; and proposals for geriatric day-care, ambulatory surgery, and patient education. Working relationships have been developed between the hospital Department and local planning bodies, among them the Comprehensive Health Planning agency, the County Health Services Department, consumer groups, voluntary agencies and a University Health Services Center.

Aged↗

Health maintenance organizations; reestablishment of compliance by Kaiser Foundation Health Plan, Inc.: Public Health Service. Notice, continued regulation of health maintenance organizations.

On December 4, 1981, the Office of Health Maintenance Organizations (OHMO) notified Kaiser Foundation Health Plan, Inc. that Kaiser-Georgetown Community Health Plan, Inc.), (formerly Georgetown University Community Health Plan, Inc.), 4200 Wisconsin Avenue, NW., Suite 300, Washington, D.C., a federally qualified health maintenance organization (HMO), had successfully reestablished compliance with its assurance to the Secretary that it would maintain a fiscally sound operation. This determination took effect on December 1, 1981.

District of Columbia↗