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At least 163 records · Page 9Linked to original sources
PubMed2000

Communities mobilizing for change on alcohol: outcomes from a randomized community trial.

OBJECTIVE: Communities Mobilizing for Change on Alcohol (CMCA) was a randomized 15-community trial of a community organizing intervention designed to reduce the accessibility of alcoholic beverages to youths under the legal drinking age. METHOD: Data were collected at baseline before random assignment of communities to intervention or control condition, and again at follow-up after a 2.5-year intervention. Data collection included in-school surveys of twelfth graders, telephone surveys of 18- to 20-year-olds and alcohol merchants, and direct testing of the propensity of alcohol outlets to sell to young buyers. Analyses were based on mixed-model regression, used the community as the unit of assignment, took into account the nesting of individual respondents or alcohol outlets within each community, and controlled for relevant covariates. RESULTS: Results show that the CMCA intervention significantly and favorably affected both the behavior of 18- to 20-year-olds (effect size = 0.76, p<.01) and the practices of on-sale alcohol establishments (effect size = 1.18, p<.05), may have favorably affected the practices of off-sale alcohol establishments (effect size = 0.32, p = .08), but had little effect on younger adolescents. Alcohol merchants appear to have increased age-identification checking and reduced propensity to sell to minors. Eighteen- to 20-year-olds reduced their propensity to provide alcohol to other teens and were less likely to try to buy alcohol, drink in a bar or consume alcohol. CONCLUSIONS: Community organizing is a useful intervention approach for mobilizing communities for institutional and policy change to improve the health of the population.

Adolescent↗
PubMed2003

The effect of an interdisciplinary community health project on student attitudes toward community health, people who are indigent and homeless, and team leadership skill development.

This study examined whether students' attitudes about community health practice, attitudes toward people who are indigent and homeless, and perceived leadership skills changed after participation in a planned interdisciplinary community health experience with an urban homeless or formerly homeless population. Data were collected from medicine, nursing, occupational therapy, physical therapy, and social work students who participated in the community health experiences and from students in these disciplines who did not participate in this curriculum. The interdisciplinary community health curriculum and practicum experiences, based on the Community Health Empowerment Model (CHEM), were designed and implemented by a coalition of community and academic partners. Students in the CHEM project self-selected into the curriculum and initially showed more positive attitudes about community health and indigent and homeless people than their peers not participating. Despite the CHEM students' positive initial attitudes, data from pretests and posttests revealed a significant positive change in their attitudes toward community health practice at the completion of the curriculum.

Allied Health Personnel↗
PubMed2004

The potential role of community-based registries to complement the limited applicability of clinical trial results to the community setting: heart failure as an example.

BACKGROUND: Clinical trials do not represent community settings, making widespread implementation of evidence-based medicine problematic. New heart failure treatments are an example, as results comparable to those of clinical trials have not been observed in the community. Alternatives to clinical trials could provide useful complementary information. OBJECTIVES AND METHODS: To review the clinical trials and community experiences in heart failure management by searching Pubmed with key words "observational studies," "clinical trials," and "heart failure," to present the preliminary results of a community-based heart failure registry as a complementary database, and to assess the potential value and limitations of the registry approach. RESULTS: Recent advances in the treatment of heart failure led to guidelines using clinical trial evidence as the rationale for transferring newer therapeutic technologies to the community practice setting. Implementation of such guidelines is slow, reflecting concerns over applicability of clinical trial results to the community setting. A community-based registry of beta-blocker treatment for heart failure showed outcomes comparable to those of clinical trials, despite significant differences between physicians and their patients in these settings. CONCLUSION: Registries can complement clinical trials to expedite technology transfer to the community setting.

Adrenergic beta-Antagonists↗
PubMed1981

Community integration of mentally retarded adults: community placement and program success.

The extent of community and program success of 166 mentally retarded clients placed into a community-based program was evaluated over a 9-year period. Twenty predictor variables measuring institutional factors, client characteristics, training variables, and community characteristics were related to community or program success. Successful community placement was associated with sensorimotor and work skills, appropriate social-emotional behavior, gender, and family acceptance of community placement and involvement with the interdisciplinary team process. Program success was associated with language and psychomotor skills, education received prior to community placement, community and institution size, and family involvement. Sixteen percent of the clients were reinstitutionalized into either the state mental retardation facility or a mental health facility. Factors associated with successful placement and program progression were discussed as was a model for future deinstitutionalization research.

Adult↗
PubMed1995

Sustaining interventions in community systems: on the relationship between researchers and communities.

Important goals of research-based community interventions include the long-term maintenance of effects and fostering of collaboration between researchers and community leaders. This article reviews the challenges associated with transferring innovations to community systems, changing program delivery from an experimental context controlled by researchers to program delivery controlled by community organizations, and sustaining long-term effects of interventions. It is suggested that researchers who develop and implement community interventions in diverse health areas need to confront several issues: (a) fostering effective long-term relationships between researchers and the communities they study and in which they intervene and (b) designing and implementing interventions that are useful to community systems after the formal phase of research ends.

California↗
PubMedDate not supplied

The community health advisor program and the deep South network for cancer control: health promotion programs for volunteer community health advisors.

The Community Health Advisor program is a proven, community-driven health promotion program that identifies and trains natural helpers who then seek to improve the health of individuals and their communities. This article details the basis of the Community Health Advisor model and describes early pilot programs in the Mississippi Delta. Also described is the formation of the Community Health Advisor Network, which provides technical assistance to Community Health Advisor programs and the proliferation of Community Health Advisor programs nationally. Specifically, details are presented of the modification of the model for the Deep South Network for Cancer Control and of early findings showing a decrease in health disparities in Alabama.

Black or African American↗
PubMed1996

Collaboration between communities and universities: completion of a community needs assessment.

Health care reform can provide opportunities for collaboration between universities and the public at large. An advanced community nursing class within a post-RN program at a university combined resources with a nearby rural community to complete a community health and social needs assessment. The partners in the project included the local hospital, health unit, and the university; funding was secured from the Regional Center for Health Promotion and Community Studies and the two health agency partners also made a financial donation. Community liaisons who were both registered nurses and residents of the community, we instrumental in completing tasks and activities related to the project. The students were taught the various data collection methods and participated in class assignments refining the necessary skills required for the actual assessment. This project benefited the community by providing baseline health status and social needs data in an era of dramatic health care reform while simultaneously affording undergraduate nursing students the opportunity to apply theory to practice.

Alberta↗
PubMedDate not supplied

Outbreak investigations: Community participation and role of community and public health nurses.

Community and public health nurses (C/PHNs) may play a vital role in the investigation of disease outbreaks. C/PHNs possess skills in conducting interviews on sensitive subjects and in collaborating with communities. C/PHNs maintain key links to community providers, symptomatic clients, their families and associates, as well as community institutions where outbreaks occur. This combination of skills makes C/PHNs ideally suited to perform outbreak investigations. There are, however, pressing questions about whether C/PHNs are adequately prepared to contribute to investigation outcomes, to foster participation of affected communities, and to fully apply nursing skills to outbreak investigations to stop the spread of disease. Using one case study, the authors explore investigation outcomes, community participation issues, educational preparation, and public health funding and workforce policies required to achieve these ends successfully. One model of community participation in the steps of outbreak investigation and several Quad Council domains and competencies are proposed for use in practice. Questions regarding the use of emergency preparedness funding and employment of C/PHNs in epidemiology roles are raised.

Caliciviridae Infections↗
PubMed2003

Putting the community back in community health assessment: a process and outcome approach with a review of some major issues for public health professionals.

Community health assessment is a tool for allocating resources in a manner responsive to the community needs and conducive to maximizing community input in decision-making. A process-focused, team approach that draws upon social and behavioral sciences, as well as public health and medical disciplines, is presented--in the context of definitions of community and health and models of community health determinants--as a means of maximizing community involvement in local health issues. Such an approach requires that professionals function less as "experts" than as resources to community members, who are engaged in every step of the process.

Community Health Planning↗
PubMed1996

Primary health care, community participation and community-financing: experiences of two middle hill villages in Nepal.

Although community involvement in health related activities is generally acknowledged by international and national health planners to be the key to the successful organization of primary health care, comparatively little is known about its potential and limitations. Drawing on the experiences of two middle hill villages in Nepal, this paper reports on research undertaken to compare and contrast the scope and extent of community participation in the delivery of primary health care in a community run and financed health post and a state run and financed health post. Unlike many other health posts in Nepal these facilities do provide effective curative services, and neither of them suffer from chronic shortage of drugs. However, community-financing did not appear to widen the scope and the extent of participation. Villagers in both communities relied on the health post for the treatment of less than one-third of symptoms, and despite the planners' intentions, community involvement outside participation in benefits was found to be very limited.

Allied Health Personnel↗
PubMed1982

Enhancement of individual and community competence: the older adult as community worker.

This paper presents an evaluation of a primary prevention program designed to enhance individual and community competence in older adult community workers and in community residents with whom they worked. A total of 22 community workers and 97 community residents participated in the study; 30 residents constituted as posttest-only control group. Pre-post changes included increased knowledge of community services among all participants, as well as increased number of community information channels and increased life satisfaction for the workers. Residents, particularly black residents, became more internal, and their increased sense of personal control was related to their increased knowledge of services. Thus, the helper-therapy principle was supported for these older adult, mostly female, community workers, and their helping role had a net empowering effect.

Aged↗
PubMed2003

Microbial community utilization of recalcitrant and simple carbon compounds: impact of oak-woodland plant communities.

Little is known about how the structure of microbial communities impacts carbon cycling or how soil microbial community composition mediates plant effects on C-decomposition processes. We examined the degradation of four (13)C-labeled compounds (starch, xylose, vanillin, and pine litter), quantified rates of associated enzyme activities, and identified microbial groups utilizing the (13)C-labeled substrates in soils under oaks and in adjacent open grasslands. By quantifying increases in non-(13)C-labeled carbon in microbial biomarkers, we were also able to identify functional groups responsible for the metabolism of indigenous soil organic matter. Although microbial community composition differed between oak and grassland soils, the microbial groups responsible for starch, xylose, and vanillin degradation, as defined by (13)C-PLFA, did not differ significantly between oak and grassland soils. Microbial groups responsible for pine litter and SOM-C degradation did differ between the two soils. Enhanced degradation of SOM resulting from substrate addition (priming) was greater in grassland soils, particularly in response to pine litter addition; under these conditions, fungal and Gram+ biomarkers showed more incorporation of SOM-C than did Gram- biomarkers. In contrast, the oak soil microbial community primarily incorporated C from the added substrates. More (13)C (from both simple and recalcitrant sources) was incorporated into the Gram- biomarkers than Gram+ biomarkers despite the fact that the Gram+ group generally comprised a greater portion of the bacterial biomass than did markers for the Gram- group. These experiments begin to identify components of the soil microbial community responsible for decomposition of different types of C-substrates. The results demonstrate that the presence of distinctly different plant communities did not alter the microbial community profile responsible for decomposition of relatively labile C-substrates but did alter the profiles of microbial communities responsible for decomposition of the more recalcitrant substrates, pine litter and indigenous soil organic matter.

Benzaldehydes↗
PubMed2006

Bacterial community structures in MBRs treating municipal wastewater: relationship between community stability and reactor performance.

Bacterial community structures in pilot-scale conventional membrane bioreactors (CMBRs) and hybrid MBRs (HMBRs) which were combined with pre-coagulation/sedimentation were analyzed by polymerase chain reaction-denaturing gradient gel electrophoresis (PCR-DGGE) and fluorescence in situ hybridization (FISH) techniques. The results were compared with the community structure in a full-scale activated sludge (AS) process treating the same municipal wastewater. The Dice index (Cs) of similarity analysis of DGGE banding patterns demonstrated that the microbial community in AS was more similar to those in CMBR1 and CMBR2 than HMBR1 and HMBR2. This suggested that influent wastewater composition had a larger impact on bacterial community structures. Long-term community structure changes in the HMBRs and CMBRs were monitored and analyzed over 240 days by Non-metric multidimensional scaling (NMDS) analysis of DGGE banding patterns. The NMDS analysis revealed that both HMBRs and CMBRs had marked changes in community structures during the first about 100 days. Thereafter the perpetual fluctuations of bacterial community structures were observed in both HMBRs and CMBRs, even though the stable MBR performances (the performance was measured as membrane permeability and removal of dissolved organic carbon, DOC) were achieved. These results suggest that not only the stability, but also the adequate dynamics ("flexibility") of the bacterial community structure are important for the stable performance of the MBRs treating complex municipal wastewater.

Bacteria↗
PubMed1999

Community-oriented medical education in Glasgow: developing a community diagnosis exercise.

OBJECTIVES: Recent NHS changes have included an increasing emphasis on primary care settings, and hence community needs assessment. This has led to suggestions that medical education should become more community-oriented if today's medical students are to become effective medical practitioners. Recent curriculum reforms in a number of medical schools frequently involve a more student-centred approach, which encourages students to learn by intellectual discovery and critical thinking. We describe one such exercise in community diagnosis that has been developed in Glasgow's new undergraduate medical curriculum. DESIGN: The exercise has been developed as three teaching sessions, each with specific learning objectives. The first session explores the strengths and weaknesses of routine statistics, and reveals the lack of information regarding individual's and community's health and health care needs. The second session is a community-based rapid participatory appraisal arranged by general practitioners. Students interview patients, carers, and local key informants and health care professionals about their perceptions of health and health needs. In the final campus-based session, students combine and present their findings. Development included two pilot exercises involving detailed evaluation. SETTING: University of Glasgow. SUBJECTS: Medical students. RESULTS: Students valued the contrasting perspectives and information provided by different sources. After completing the three sessions, most students and tutors considered it an interesting, enjoyable and educational experience. CONCLUSIONS: This innovative community-oriented teaching programme gave students some insight into how health, morbidity and mortality are measured, why these might vary between different communities, and how different community members' perspectives might differ regarding perceived health and social needs.

Curriculum↗
PubMed2006

On the front line of primary health care: the profile of community health workers in rural Quechua communities in Peru.

OBJECTIVE: To describe the profile of community health workers--health promoters, traditional birth attendants and traditional healers--in rural Quechua communities from Ayacucho, Peru. METHODS: Basic quantitative and qualitative information was gathered as part of a community health project implemented between 1997 and 2002 in 40 Andean communities with information from questionnaires, personal interviews and group discussions. RESULTS: The majority of current community health workers are men with limited education who are primarily Quechua speakers undertaking their work on a voluntary basis. Health promoters are mostly young, male, high school graduates. There exists a high drop-out rate among these workers. In contrast, traditional healers and traditional birth attendants possess an almost diametrically opposite profile in terms of age, education and drop-out rates, though males still predominate. At the community level the health promoters are the most visible community health workers. CONCLUSION: It is very important to consider and to be aware of the profile of community health workers in order to provide appropriate alternatives when working with these groups as well as with the indigenous population, particularly in terms of culture, language and gender issues.

Journal Article↗
PubMed1995

Community Intervention Trial for Smoking Cessation (COMMIT): I. cohort results from a four-year community intervention.

OBJECTIVES: The primary hypothesis of COMMIT (Community Intervention Trial for Smoking Cessation) was that a community-level, multi-channel, 4-year intervention would increase quit rates among cigarette smokers, with heavy smokers (> or = 25 cigarettes per day) of priority. METHODS: One community within each of 11 matched community pairs (10 in the United States, 1 in Canada) was randomly assigned to intervention. Endpoint cohorts totaling 10,019 heavy smokers and 10,328 light-to-moderate smokers were followed by telephone. RESULTS: The mean heavy smoker quit rate (i.e., the fraction of cohort members who had achieved and maintained cessation at the end of the trial) was 0.180 for intervention communities versus 0.187 for comparison communities, a nonsignificant difference (one-sided P = .68 by permutation test; 90% test-based confidence interval (CI) for the difference = -0.031, 0.019). For light-to-moderate smokers, corresponding quit rates were 0.306 and 0.275; this difference was significant (P = .004; 90% CI = 0.014, 0.047). Smokers in intervention communities had greater perceived exposure to smoking control activities, which correlated with outcome only for light-to-moderate smokers. CONCLUSIONS: The impact of this community-based intervention on light-to-moderate smokers, although modest, has public health importance. This intervention did not increase quit rates of heavy smokers; reaching them may require new clinical programs and policy changes.

Adult↗
PubMed2005

Effects of community versus single strain inoculants on the biocontrol of Salmonella and microbial community dynamics in alfalfa sprouts.

Potential biological control inoculants, Pseudomonas fluorescens 2-79 and microbial communities derived from market sprouts or laboratory-grown alfalfa sprouts, were introduced into alfalfa seeds with and without a Salmonella inoculum. We examined their ability to inhibit the growth of this foodborne pathogen and assess the relative effects of the inoculants on the alfalfa microbial community structure and function. Alfalfa seeds contaminated with a Salmonella cocktail were soaked for 2 h in bacterial suspensions from each inoculant tested. Inoculated alfalfa seeds were grown for 7 days and sampled during days 1, 3, and 7. At each sampling, alfalfa sprouts were sonicated for 7 min to recover microflora from the surface, and the resulting suspensions were diluted and plated on selective and nonselective media. Total bacterial counts were obtained using acridine orange staining, and the percentage culturability was calculated. Phenotypic potential of sprout-associated microbial communities inoculated with biocontrol treatments was assessed using community-level physiological profiles based on patterns of use of 95 separate carbon sources in Biolog plates. Community-level physiological profiles were also determined using oxygen-sensitive fluorophore in BD microtiter plates to examine functional patterns in these communities. No significant differences in total and mesophilic aerobe microbial cell density or microbial richness resulting from the introduction of inoculants on alfalfa seeds with and without Salmonella were observed. P. fluorescens 2-79 exhibited the greatest reduction in the growth of Salmonella early during alfalfa growth (4.22 log at day 1), while the market sprout inoculum had the reverse effect, resulting in a maximum log reduction (5.48) of Salmonella on day 7. Community-level physiological profiles analyses revealed that market sprout communities peaked higher and faster compared with the other inoculants tested. These results suggest that different modes of actions of single versus microbial consortia biocontrol treatments may be involved.

Colony Count, Microbial↗
PubMed2004

Preliminary guidelines for the implementation of Community Based Rehabilitation (CBR) approaches in rural, remote and Indigenous communities in Australia.

A forum of health professionals was held in Brisbane, Queensland, Australia, 30-31 August 2003, to discuss the relevance and potential of the Community Based Rehabilitation (CBR) model to rural, remote and Indigenous communities in Australia. The forum identified principles and guidelines for the development of CBR, which are presented here as a focus point for future discussion and action by people with disabilities, rural community members, Indigenous people, policy makers and health professionals. Forum members noted that while considerable strengths were evident in the CBR model, it has yet to make a significant impact on the service system in Australia. While recognising that the Australian context is quite different from many countries in which CBR has traditionally been implemented, they suggested that it may have particular application to remote, rural and Indigenous communities. To facilitate the principles of CBR in these communities, the forum called for recognition of the need for greater community involvement in disability services, the need to develop appropriate training frameworks, and the need to redirect resources to such community models. In keeping with the CBR philosophy, forum members noted that if the model is to be implemented effectively, substantial consumer and community involvement will be instrumental in future steps.

Journal Article↗