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PubMed2004

Developing and using the Guide to Community Preventive Services: lessons learned about evidence-based public health.

The Guide to Community Preventive Services (Community Guide) is being developed under the leadership of the independent, nonfederal Task Force on Community Preventive Services. The Task Force makes recommendations for the use of public health programs and policies based on scientific evidence about what practices have worked to improve health. The Community Guide thoroughly searches scientific literature for topic-relevant studies, evaluates their quality according to established criteria, and makes recommendations based on the overall strength of the body of evidence and the size and variability of reported effects. In addition, the Community Guide identifies promising interventions that have not been adequately researched, thus helping to inform the public health research agenda. The continuously updated and expanded body of recommendations and research agenda formulated by this rigorous process have been published on the Internet and in various publications since 1999 and constitute a highly valued and objective evidence-based resource for guiding current and future public health activities. More remains to be learned, however, on how best to disseminate Community Guide findings to key target audiences and encourage their use to inform practice, policy, and additional research.

Centers for Disease Control and Prevention, U.S.↗
PubMed2002

Making health data maps: a case study of a community/university research collaboration.

This paper presents the main findings from a collaborative community/university research project in Canada. The goal of the project was to improve access to community health information, and in so doing, enhance our knowledge of the development of community health information resources and community/university collaboration. The project built on a rich history of community/university collaboration in Southeast Toronto (SETO), and employed an interdisciplinary applied research and action design. Specific project objectives were to: (1) develop via active community/university collaboration a geographic information system (GIS) for ready access to routinely collected health data, and to study logistical, conceptual and technical problems encountered during system development; and (2) to document and analyze issues that can emerge in the process of community/university research collaboration. System development involved iteration through community user assessment of need, development or refinement of the GIS, and assessment of the GIS by community users. Collaborative process assessment entailed analysis of archival material, interviews with investigators and participant observation. Over the course of the project, a system was successfully developed, and favorably assessed by users. System development problems fell into four main areas: maintaining user involvement in system development, understanding and integrating data, bringing disparate data sources together, and making use of assembled data. Major themes emerging from the community/university collaborative research process included separate community and university cultures, time as an important issue for all involved, and the impact of uncertainty and ambiguity on the collaborative process.

Access to Information↗
PubMed2006

Developing an interdisciplinary, community-based education program for health professions students: the Rochester experience.

To successfully meet the nation's changing health needs, future health professionals must learn skills in applied health promotion and disease prevention. To achieve these goals, the Center for Rochester's Health (the Center), a collaboration of the Monroe County Department of Public Health and the University of Rochester School of Medicine and Dentistry and School of Nursing, all located in Rochester, New York, developed an innovative education program that gives interdisciplinary teams of students opportunities to partner with community agencies engaged in research-oriented health improvement initiatives. The Center started this course in 1998, under the auspices of a national initiative supported by the Health Resources and Services Administration and the Institute for Healthcare Improvement. The authors discuss the challenges related to the implementation and institutionalization of this interdisciplinary population-based education program. They describe their experiences over a seven-year period, from 1998 to 2005, including the various factors that enabled them to make necessary changes in the program activities and the ways in which the Center was able to bring departments together to consider new course directions for engaging students in the community health improvement process. They discuss the different stages of program development, including the early years of program planning and later curriculum changes that involved the development of an online population health curriculum. The authors conclude that by understanding changes in the education goals of various health professions schools and by adapting education programs to meet the needs of students from these schools, program planners will have more opportunities to sustain community-based education programs.

Academic Medical Centers↗
PubMed1988

Decree No. 2007 establishing departments in the General Directorate of Adult Education, 29 September 1988.

This Decree sets forth the departments of the General Directorate of Adult Education of Colombia and their functions. Among the departments is the Department of Community Cultural Development and Literacy. Its duties include proposing strategies for the execution of plans and programs of community cultural development and literacy and participating in the orientation of the design and application of curricula relevant for informal programs of literacy and basic social training.

Americas↗
PubMedDate not supplied

A community partnership model for developing a Center for Cancer Nursing Education and Research.

This article describes a partnership model used to establish the Center for Cancer Nursing Education and Research at the University of Louisville (U of L) School of Nursing. The model was used to bring together area nursing education programs, institutions providing cancer nursing care, and related community groups. The need for the project was directly related to the high cancer morbidity and mortality in the community. The U of L's strategic agenda and strong commitment to cancer prevention and care provided a growth opportunity for the recognition of nurses' role in cancer care. Nurses are positioned to influence cancer care across the continuum from prevention to end of life, and building the capacity for cancer nursing is essential to building a system of cancer care. This article describes an innovative partnership model used to stimulate a community-wide focus on cancer nursing. The organizational structure, development of partner relationships, description of project activities, and outcomes are presented along with a discussion of the said model's benefits and potential for replication.

Community-Institutional Relations↗
PubMed2006

Primary and community care workforce planning and development.

AIM: This article reports a study that provided primary and community care managers with information, allowing them to: (a) evaluate the size and mix of their workforce; and (b) develop knowledgeable and skilled teams to meet the demands of growing and changing services. BACKGROUND: Primary and community care services are growing in the United Kingdom, but workforce planning and development, despite their wide-ranging cost and quality implications, have not received the same attention. Indeed, most primary and community care workforce planning and development issues are universal. Demand 1-1 side workforce planning is concerned not only with the number, but also with staff mix; but how these autonomous and isolated practitioners spend their time is unique. The other side of the equation, workforce supply, raises many recruitment and retention challenges for managers in many countries. Any country's main workforce planning methods apply equally well to primary care, but each is flawed. A second, main problem is that the methods lead to fragmented services, whereas modern workforce planning methods should be multidisciplinary. Consequently, it has never been more important for managers to have data and algorithms to develop appropriate care teams. METHOD: A large and versatile workforce database, profiling 304 English primary care trusts using demographic, socio-economic, mortality, morbidity, staffing and performance workforce-related variables, compiled in 2002 and updated yearly, is described. Data were supplemented with a systematic literature review leading to a 340-item annotated bibliography; and qualitative interviews with managers. RESULTS: Workforce size and mix are historical and irrational at best. Moreover, the number of variables that influence staffing is growing, thereby complicating workforce planning. CONCLUSION: Evaluating and adjusting the size and mix of teams using empirically determined community demand and performance variables based on the area's socio-economic characteristics is feasible.

Community Health Nursing↗
PubMed1996

Establishing and using a community inter-agency client monitoring system to develop addictions treatment programs.

The Substance Abuse Monitor is a comprehensive community-based addictions information system that forms the basis for an innovative approach to community needs assessment. This paper describes: (1) the conditions that created the need and support for the monitoring system; (2) the community development strategy that was employed to secure the commitment of agencies to the project; (3) the specifics of the needs assessment procedures; (4) some of the theoretical, clinical and methodological issues on which the procedures are based; (5) the practical applications of the system; and (6) the limitations of the system. The establishment of the database was based upon the idea that there would be benefits at several levels: the community, the participating agencies, the individual counsellors and the clients. The realization of these benefits requires that the information collected and the results generated must be capable of addressing specific service delivery problems with practical and tangible solutions. It is argued that the project has been successful in generating such solutions, and has considerable potential as an ongoing needs assessment tool.

Adult↗
PubMedDate not supplied

A critique of contemporary community health promotion approaches: based on a qualitative review of six programs in Maine.

PURPOSE: This article reports on a process evaluation of three Planned Approach to Community Health (PATCH) projects and three Community Chronic Disease Prevention Programs (CCDPP) that operated in the State of Maine. PATCH and CCDPP are similar approaches to community health promotion developed and disseminated by the Centers for Disease Control. The evaluators studied how the Planned Approach to Community Health and the Community Chronic Disease Prevention Program models worked as community health strategies across the six field sites. RESEARCH METHODS USED: Qualitative methods were used in a cross-case comparison of the six field sites. In studying each site, the evaluators focused on six stages common to both the Planned Approach to Community Health and the Community Chronic Disease Prevention program models: Stage 1: conducting a community needs assessment; Stage 2: analyzing needs assessment data; Stage 3: setting priorities for the project based on the data; Stage 4: implementing activities; Stage 5: producing process outcomes; and Stage 6: institutionalizing the project. The analysis focused on how each of the six communities traversed these stages. SUMMARY OF FINDINGS: Eight recommendations for refining Planned Approach to Community Health and Community Chronic Disease Prevention strategies resulted from the study: 1) do a community capacity assessment prior to initiating a community needs assessment; 2) do not overly rely on Behavioral Risk Factor Surveys; 3) analyze needs assessment data rapidly for community consumption; 4) allow flexibility and community input in determining priority health objectives; 5) provide technical assistance throughout a project, not just in the beginning; 6) fund at least one full-time local coordinator and extensive capacity building; 7) emphasize multiple interventions around one chronic condition at a time; and 8) emphasize program institutionalization. CONCLUSIONS: Community development approaches like Planned Approach to Community Health and Community Chronic Disease Prevention are promising health promotion strategies. To be optimally effective, however, these strategies need refinement based on systematic study in field settings. Because this study was limited to six sites in Maine, some of these findings may have limited generalizability.

Chronic Disease↗
PubMed1992

A call to the international nursing community: put AIDS in developing countries on the agenda.

In some African countries 10%-15% of the middle class may due during the 1990s and at the present time the human infrastructure is being eroded by HIV. Over 90% of home and community care is being supervised by nursing and midwifery personnel in some developing countries. What will happen if these carers become ill or die? Peter Kerr provided a micro view of HIV disease in developing countries in 'Health care crisis in Africa', August ANJ. In this article he discusses the macro implications for developing countries as they encounter the consequences of what is likely to be the most devastating epidemic of this century.

Acquired Immunodeficiency Syndrome↗
PubMed1985

The community residential treatment service: developing a continuum of prosthetic environments for the chronically disabled.

Among the many issues regarding the care of chronic mental patients, none is more pressing than the need for administrative and clinical models designed to organize and systematize the efforts of diverse community service providers. This paper describes the functioning of the Community Residential Treatment Service of the South Beach Psychiatric Center, a large-scale project of a state facility created to respond to this tissue. By blending sophisticated clinical and administrative technology, programs operated by the state, voluntary, and proprietary health care sectors have been integrated to form a balanced service delivery system. This system provides a broad continuum of inpatient and outpatient residential settings developed in accordance with social learning principles. The components of the system, with the Community Residential Treatment Service as the major integrative force, are linked together by detailed contracts as well as common behavioral clinical and behavioral administrative language. The treatment successes f this system have been significant enough to suggest that a positive synergistic effect is generated by this programming combination.

Community Mental Health Services↗
PubMedDate not supplied

Taking a "leap of faith": acceptance and value of a cancer program-sponsored spiritual event.

Investigations of spiritual interventions for cancer patients are disproportionately few compared to the reported importance of religion to Americans. We report on the implementation and evaluation of a spiritual, community-based intervention developed with interdenominational community clergy. Approximately 1200 people attended a total of 3 gatherings: 2 at Roman Catholic and another at a Protestant Church. Respondents to questionnaires evaluating attendee characteristics and satisfaction (n = 209) were predominantly women (85%); 50% were patients and 45% were aged 60 years and older. Men were more likely to be currently under treatment for cancer, while women were more likely to be past patients or friends. Fewer than 2% felt anger or anxiety; attendees felt the service was very (90%) or somewhat (9.5%) helpful and expressed appreciation for cancer program clinician attendance and for hospital sponsorship of the event. Components in order of preference were prayer, music, Scripture, and litany. Logistic regression models reveal that music was most appreciated by previously treated patients, and prayer by currently treated patients. Secular healthcare systems can offer a religious service that comforts and links attendees to a broader community, including clergy and cancer program clinicians. Surveys can identify service components that appeal to differing groups and can facilitate service development.

Adolescent↗