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At least 1,711 records · Page 95Linked to original sources
PubMed1985

Development of community-based health services for adolescents at risk for sociomedical problems.

Community-based service and training programs have been advocated as important for improving access to medical care for the poor as well as enhancing the ambulatory training setting for residents and medical students. In 1981 the Robert Wood Johnson Foundation provided funds to 20 teaching hospitals to support community-based, comprehensive health services to high-risk young people, that is, young people living in communities with high rates of sociomedical problems, such as adolescent pregnancy, drug abuse, alcohol abuse, accidents, homicide, suicide, and depression. In this article, the authors describe the experiences of these institutions in establishing off-campus clinics, concluding that high-risk adolescents need additional services and that teaching hospitals and communities can collaborate to provide these comprehensive services. They discuss issues of maintaining services after foundation grants end and the impact of recent financial restraints on continued support from teaching hospitals for off-campus activities.

Adolescent↗
PubMed2002

Patents and research--an uneasy alliance.

Critics of the patent system have argued that rather than promoting the progress of science and the useful arts, the patent system as it exists in the United States and perhaps elsewhere may actually inhibit such progress. Much of the criticism has been focused on patenting of research tools. The author attempts to evaluate the extent of this effect, and to suggest some possible modifications to the patent system to address its shortcomings. She considers the advantages attributed to the patenting system-providing incentives for finance and development and spurring creativity-with the disadvantages perceived by the academic community, including impediments to the communication of research findings and other transaction costs. Also examined are possible options for mitigating these problems, including legislative restrictions of certain subject matter from patentability, or strengthening the criteria used in review of patent applications, especially non-obviousness and utility. In addition, the author discusses potential "post-patent solutions," such as legislative or other restrictions on licensing.

Cooperative Behavior↗
PubMed1995

Implementation of management innovation at primary care health centers: qualitative assessments.

This article describes the implementation of innovations at health centers participating in The Robert Wood Johnson Foundation Program to Strengthen Primary Care Health Centers. Relatively successful approaches to management innovation are described and common obstacles to innovation are considered. Key issues include poor physician retention, inadequate or inappropriate space, the complexities of automation, difficulty in the recruitment of staff and consultants (particularly in rural areas), and disruptions caused by internal promotions.

Community Health Centers↗
PubMedDate not supplied

The role of the architectural environment in community health: an evidence-based initiative.

This discussion reports the status of a 12-year program administered by a statewide health agency to strategically assess, redevelop, and monitor the architectural and facility management performance of its network of community-based public health care facilities. A protocol, the Strategic Facility Improvement initiative, has directly resulted in significant improvements to the major share of a network of over 100 community clinic and clinical support facilities in the State of Louisiana. The SFI initiative provides oversight with respect to the allocation of public health capital improvement infrastructural resources and has guided completion of 55 facility replacement or renovation projects to date. Its administrative mission, organizational structure, and field methodology is presented as a vehicle to significantly improve the architectural condition of clinical and clinical support environments for underrepresented patient populations. The SFI process is discussed as an evidence-based means to foster greater systemic success in capital improvement efforts within public sector health agencies in the United States and in international contexts.

Architecture↗
PubMedDate not supplied

Building sustainable public health systems change at the state level.

Reforming the public health infrastructure requires substantial system changes at the state level, including the reorganization of state agencies' plans, roles, and relationships with other sectors and communities. Beyond the limited time period of pilot programs and grants, how are these public health system changes to be sustained? Turning Point is an initiative of The Robert Wood Johnson Foundation to transform and strengthen the public health system. The 21 states participating in this initiative developed multisector partnerships to produce public health improvement plans and from these, chose one or more priorities for implementation. Reform efforts to strengthen the public health system occur within complex fiscal and political environments, however, and must cope with both uncertainty and turbulence in the process of implementing change. Turning Point state partners have developed a variety of approaches to the challenge of incorporating effective community collaborations as a permanent strategy for transforming public health systems. A qualitative, descriptive study design was used to analyze the strategies used by Turning Point state partnerships to meet the challenges of sustaining their system improvements. These strategies included: institutionalization within government, establishing "third sector" institutions, cultivating relationships with significant allies, and enhancing communication and visibility among multiple communities.

Community Health Planning↗
PubMed2007

A framework for building organizational capacity integrating planning, monitoring, and evaluation.

BACKGROUND: HIV prevention organizations are increasingly adopting more intensive and evidence-based strategies with the goal of protecting targeted populations from HIV infection or transmission. Thus, capacity building has moved to the forefront as a set of activities necessary to enable HIV prevention organizations to plan, implement, monitor, and evaluate prevention programs and services. Cost-effective approaches to the provision of capacity building assistance traditionally use strategies that compromise efficaciousness and more intensive approaches can be cost prohibitive. In addition, traditional approaches treat program planning and implementation and program monitoring and evaluation as two separate entities, even though they are interdependent aspects of an efficient and effective service delivery system. OBJECTIVE: This article describes a framework for building sustainable organizational capacity that combines high- and low-intensity approaches; integrates program planning, monitoring, and evaluation; and focuses on building understanding of the value of appropriate organizational change. METHODS: The described framework was used over a 3-year period with 52 community-based organizations funded by the Centers for Disease Control and Prevention (CDC) and organizations funded by CDC-funded health departments. RESULTS AND CONCLUSIONS: The article includes lessons learned, recommendations for building long-term sustainability, organizational change at various levels, and the need to develop standardized indicators to measure changes in organizational capacity.

Centers for Disease Control and Prevention, U.S.↗
PubMed2001

Disaster mitigation and preparedness: the case of NGOs in the Philippines.

The Philippines is very vulnerable to natural disasters because of its natural setting, as well as its socio-economic, political and environmental context--especially its widespread poverty. The Philippines has a well-established institutional and legal framework for disaster management, including built-in mechanisms for participation of the people and NGOs in decision-making and programme implementation. The nature and extent of collaboration with government in disaster preparedness and mitigation issues varies greatly according to their roots, either in past confrontation and political struggles or traditional charity activities. The growing NGO involvement in disaster management has been influenced by this history. Some agencies work well with local government and there is an increasing trend for collaborative work in disaster mitigation and preparedness. Some NGOs, however, retain critical positions. These organisations tend to engage more in advocacy and legal support for communities facing increased risk because of development projects and environmental destruction. Entry points into disaster mitigation and preparedness vary as well. Development-oriented agencies are drawn into these issues when the community members with whom they work face disaster. Relief organisations, too, realise the need for community mobilisation, and are thus drawn towards development roles.

Community Participation↗
PubMed1995

Rehabilitation planning for flood affected areas of Thailand: experience from Phipun District.

Floods are common in Thailand. A flood in the southern part of the country in 1988 was of unprecedented magnitude. Several villages and vast tracts of agricultural land were covered with mud slides washed away from deforested hills. Rehabilitation of the affected areas, a task which required complex planning, was a challenge for the District Development Committee (DDC), which is the local level planning body. The Committee encountered several problems, including inability to use the existing data base and lack of accurate information, human resources, adequate funds and coordination among agencies. Unable to cope with the new challenges, the DDC resorted to conventional planning which failed to address the problems caused by the flood. Guidelines should be formulated to strengthen district level planning for rehabilitation after a disaster.

Community Participation↗
PubMed2003

The role of federally funded health centers in serving the rural population.

CONTEXT: Federally funded health centers attempt to improve rural health by reducing and eliminating access barriers to primary care services. PURPOSE: This study compares rural health center patients with people in the general rural population for indicators of access to preventive services and health outcomes. METHODS: Data from the annual reporting system for federally funded health centers, the 1999 Uniform Data System, and published national census data were used to provide sociodemographic comparisons. Selected health status indicators, preventive services utilization, and health outcomes were obtained from a survey of health center patients, and the results were compared with the National Health Interview Survey and National Vital Statistics. FINDINGS: Unlike the nation's rural population, the majority of rural health center patients are of minority race/ethnicity, live at or below poverty, and are either uninsured or on Medicaid. Despite having higher prevalence of traditional access barriers than the general rural population, rural health center patients are significantly more likely to receive certain preventive services and also to experience lower rates of low birthweight, particularly for African American infants. However, rural health center patients are not more likely to have received influenza vaccination or up-to-date mammogram screening. CONCLUSIONS: Health centers provide access to essential preventive care for many of the most vulnerable rural residents. A national strategy to expand the rural health center network will likely help to ensure improved health for the considerable proportion of rural residents who still lack access to appropriate services.

Adolescent↗