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At least 1,765 records · Page 98Linked to original sources
PubMed1999

Community health report cards. Results of a national survey.

INTRODUCTION: The purpose of this research is to examine the state-of-the-art in community health report card development and use in order to increase their effective integration into community health improvement efforts. METHODS: A mailed survey was sent to 115 "report card" communities nationwide. This list was generated through multiple key informants at the national, regional, and state levels. Seventy-four percent (85/115) were eligible for the study. The report cards returned were inventoried for: quality of their data, comprehensiveness, presentation, appropriateness to target audiences, purpose and sponsorship, relevance to policy development, community involvement, comparability, replicability, and other factors. RESULTS: Of the 85 eligible projects, 65 responded. The report cards varied significantly in all areas. Only one half of communities used pre-existing formats or the experience of others to guide this resource-intensive development process. Data collection was the greatest challenge encountered in development. Local health departments, hospitals, and non-profit civic groups were the community groups most likely to be involved in development. CONCLUSION: There is need for infrastructure, technical assistance, and improved, easy-to-use tools to facilitate the report card development process and the sharing of expertise and experience among involved communities. Greater systematization of the process would enhance the reasonableness and sustainability of the effort. Broad community involvement, including support of the local health department, other community agencies, as well as the local business community, may be key to their success.

Community Health Planning↗
PubMed1991

By how much does dietary salt reduction lower blood pressure? I--Analysis of observational data among populations.

OBJECTIVE: To estimate the quantitative relation between blood pressure and sodium intake. DESIGN: Data were analysed from published reports of blood pressure and sodium intake for 24 different communities (47 000 people) throughout the world. MAIN OUTCOME MEASURE: Difference in blood pressure for a 100 mmol/24 h difference in sodium intake. Allowance was made for differences in blood pressure between economically developed and undeveloped communities to minimise overestimation of the association through confounding with other determinants of blood pressure. RESULTS: Blood pressure was higher on average in the developed communities, but the association with sodium intake was similar in both types of community. A difference in sodium intake of 100 mmol/24 h was associated with an average difference in systolic blood pressure that ranged from 5 mm Hg at age 15-19 years to 10 mm Hg at age 60-69. The differences in diastolic blood pressure were about half as great. The standard deviation of blood pressure increased with sodium intake implying that the association of blood pressure with sodium intake in individuals was related to the initial blood pressure--the higher the blood pressure the greater the expected reduction in blood pressure for the same reduction in sodium intake. For example, at age 60-69 the estimated systolic blood pressure reduction in response to a 100 mmol/24 h reduction in sodium intake was on average 10 mm Hg but varied from 6 mm Hg for those on the fifth blood pressure centile to 15 mm Hg for those on the 95th centile. CONCLUSIONS: The association of blood pressure with sodium intake is substantially larger than is generally appreciated and increases with age and initial blood pressure.

Adolescent↗
PubMed1996

Planning for a community-based hypertension control program in the inner city.

Uncontrolled hypertension is a significant problem among African-Americans residing in inner city environments. To help address the problem, we are developing community-based hypertension control programs in African-American communities located in Milwaukee, Wisconsin and Chicago, Illinois. The Milwaukee program focuses on an entire, diverse inner city area, while the Chicago program is targeted to several more homogeneous African-American neighborhoods. The investigators hypothesize that the success of a hypertension control program will depend on carefully tailoring the educational approaches to the specific characteristics of the target area. Therefore, the study areas that have been selected differ with regard to community size and diversity, community 'stressors' (poverty, unemployment, crime, etc), and types of organizations which are present in the community. This paper describes the background and the rationale for community hypertension control programs in the inner city. The initial approaches to establishing the program by developing interfaces with the community and the gathering of baseline data through household surveys are described.

Community Medicine↗
PubMedDate not supplied

Impact of a community-based program on early childhood development.

To determine the impact of an integrated community-based program in rural villages on early childhood development, a controlled trial was conducted in the Nakhon Sawan province of Thailand. The program involved the cooperation of governmental agencies, nongovernmental agencies, academic institutions, and community organizations. At baseline, 3 control and 3 program villages were similar in terms of nutritional status, developmental performance and parental care. After 2 years of intervention in the program villages, improvements were noted in nutritional status, developmental performance, and intelligence quotient scores, as well as overall utilization of health care resources and parental attitude and involvement.

Child↗
PubMed2000

Applying a prediction rule to identify low-risk patients with community-acquired pneumonia.

STUDY OBJECTIVES: To study the validity of a recently developed community-acquired pneumonia (CAP) severity prediction rule in estimating mortality, to determine its utility in decision making regarding hospitalization, and to assess factors influencing this decision. DESIGN: Retrospective chart review. SETTING: Two sites of the University Health Network, the Toronto General and Toronto Western Hospitals, tertiary-care teaching institutions with a sizable primary-care and secondary-care source of referrals, and a total of 900 beds. PATIENTS: Consecutive patients with CAP admitted between February and June 1996. MEASUREMENTS AND RESULTS: A single trained medical records extractor assembled data to compare our population to that used in developing the CAP prediction rule, in terms of mortality and to assess reasons for hospitalization. Two hundred fifty-five eligible patients were admitted, and 244 charts (96%) were available. Our patients tended to be older, with nearly four times as many residents of chronic care institutions (39% compared with 10%), and had a higher risk class distribution than the published cohort. Risk class-specific mortality was similar in four of five classes. Of the 71 patients in the low-risk classes, 67 had additional reasons for admission; 18 of which were psychosocial (homelessness, substance abuse, or inadequate home supports). CONCLUSIONS: The CAP severity prediction rule estimates mortality well. Admission of low-risk patients was linked to psychosocial and other medical reasons not captured by this rule. The rule can be very useful in assessing the need for hospitalization; however, there remains a significant percentage of patients with a low severity score who may require hospitalization for psychosocial and economic considerations.

Adult↗
PubMed2006

The Deep South Network for cancer control. Building a community infrastructure to reduce cancer health disparities.

Given the recent advances in cancer treatment, cancer disparity between whites and African-Americans continues as an unacceptable health problem. African-Americans face a considerable disparity with regard to cancer incidence, survival, and mortality when compared with the majority white population. On the basis of prior research findings, the Deep South Network (DSN) chose to address cancer disparities by using the Community Health Advisor (CHA) model, the Empowerment Theory developed by Paulo Freire, and the Community Development Theory to build a community and coalition infrastructure. The CHA model and empowerment theory were used to develop a motivated volunteer, grassroots community infrastructure of Community Health Advisors as Research Partners (CHARPs), while the coalition-building model was used to build partnerships within communities and at a statewide level. With 883 volunteers trained as CHARPs spreading cancer awareness messages, both African-Americans and whites showed an increase in breast and cervical cancer screening utilization in Mississippi and Alabama. In Mississippi, taking into account the increase for the state as a whole, the proportion that might be attributable to the CHARP intervention was 23% of the increase in pap smears and 117% of the increase in mammograms. The DSN has been effective in raising cancer awareness, improving both education and outreach to its target populations, and increasing the use of cancer screening services. The National Cancer Institute has funded the Network for an additional 5 years. The goal of eliminating cancer health disparities will be pursued in the targeted rural and urban counties in Mississippi and Alabama using Community-Based Participatory Research. Cancer 2006. (c) 2006 American Cancer Society.

Black or African American↗
PubMed1986

Primary health care for whom? Village perspectives from Nepal.

Over the last decade, many developing nations have embraced Primary Health Care (PHC) within their national health plans. PHC, in contrast to earlier approaches to national health development, emphasizes community participation and basic health care for the poorer segments of society. The research reported here finds that in the enthusiasm for the PHC concept in Nepal, important sociocultural processes have been overlooked. This paper describes the relationship between certain sociocultural factors and PHC activities in rural Central Nepal. It reveals a contradiction between the stated PHC intentions to address local interests and promote community participation on the one hand, and the actual approach taken on the other hand. Specifically it argues that PHC is encountering problems in Nepal for three reasons: (1) PHC fails to appreciate villagers' values and their own perceived needs. In particular, PHC is organized primarily to provide health education, whereas villagers value modern curative services and feel little need for new health knowledge. (2) PHC views rural Nepali culture only pejoratively as a barrier to health education. Alternatively, local cultural beliefs and practices should be viewed as resources to facilitate dissemination and acceptance of modern health knowledge. (3) In attempting to incorporate Nepal's traditional medical practitioners into the program, PHC has mistakenly assumed that rural clients passively believe in and obey traditional practitioners. In fact, clients play active roles and are themselves in control of the therapeutic process. Thus, instead of attempting to recruit traditional practitioners to do its work, PHC should recognize the precedent for community participation in Nepal's traditional medical system and develop the respect for villagers' own ideas and values that traditional practitioners already possess.

Attitude to Health↗
PubMed1993

Changes in trophic structure of a freshwater protozoan community subjected to cadmium.

The development of protozoan communities in laboratory microecosystems has been studied in order to observe the effect of cadmium on the trophic structure and dynamics of these communities. The effect of cadmium was evident on the species richness, density, and biomass. The most sensitive parameters seem to be biomass and species richness. In the controls, the trophic structure of the community was defined for bacterivore-detritivore, photautotroph, algivore, and in low proportion for nonselective species. In the fractions with cadmium there was a decrease in diversity in each trophic group; the bacterivore-detritivore and photosynthetic species were the most affected. Also, there was an appearance of saprotroph species. Species belonging to the control and others exclusively pertaining to microecosystems with cadmium were observed.

Animals↗
PubMed1986

Residential facilities for the mentally ill: needs assessment and community planning.

The planning and development of community-based facilities for the mentally ill have been hindered by many factors, one of which is the lack of an acceptable methodology for determining the housing needs of this population. This paper describes a consumer-oriented needs assessment strategy that provides a basis for planning residential facilities for the mentally ill. Survey results provided detailed descriptions of the population in need of residential programs, the types of facilities needed, the total volume of need for each, and the distribution of need. Implications for program planning are discussed as well as the advantages and disadvantages in utilizing this approach for establishing a basis for residential facilities planning for the mentally ill.

Adolescent↗
PubMed1974

Disturbance, patch formation, and community structure.

A model is developed to relate community structure to level of environmental disturbance in systems in which the effects of disturbance are localized in space and time. In general these disturbances create a pattern of spatio-temporal heterogeneity by renewing a limiting resource, thereby permitting utilization by species that are not dominant competitors. The proposed model predicts the frequency distribution of these renewed areas, with regard to size and age (colonization stage). The model thus allows one to relate overall system pattern to the local biology within these areas, to compare various areas with different levels of disturbance, and to predict the effects of new disturbance.

Ecology↗
PubMed1991

Factors associated with success among southern Cheyenne and Arapaho Indians.

Researchers in applied social science are seeking ways of approaching the facilitation of community-based development at the grass-roots level. Much research to date has focused on negative social aspects in communities, such as substance abuse and high numbers of school drop-outs. An innovative approach was developed that involved looking instead at successful individuals in communities. Individuals identified as successful were interviewed about the factors they associated with their own success. The experience of supportive parenting during their childhoods and moderation in alcohol and other substance use as adults were strongly correlated with success in life. The interview process provided an effective springboard for discussions and the development of intervention strategies at the community level.

Achievement↗
PubMed1984

Community medicine for clinicians in Canada: a recommendation for postgraduate training.

A large gap presently exists between the predominantly biologic expertise of the medical profession and the complex mixture of biologic, behavioural and epidemiologic components of health problems today. Furthermore, the development of community medicine in Canada has been relatively separate from that of the clinical disciplines. To enable clinicians to acquire the knowledge and skills to manage these health problems, much more community-oriented research, applied behavioural science and clinical epidemiology is needed within the clinical sector of medicine. I have proposed a definition of clinical community medicine and presented a strategy for training clinicians in community medicine skills that calls for administrators of clinical postgraduate programs to develop training in clinical community medicine. Residency programs in community medicine cannot be expected to provide such training given their nonclinical priorities, which focus mainly on the training of public health physicians.

Canada↗
PubMed1999

Advanced practice community health nursing in community nursing centers: a holistic approach to the community as client.

Community nursing centers are unique arenas for advanced practice community health nursing. These innovative nurse-managed delivery models are grounded in a holistic approach to the community-as-client. They provide the public with direct access to a range of advanced practice professional nursing services that are not otherwise available. Community Nursing Centers are collaborative with other health professions and organizations. They aim to meet the assessed needs of underserved populations using extant resources to achieve optimal health for all members of the community. This article discusses the underlying conceptual basis for development of community nursing centers and provides a case study example.

Community Health Centers↗
PubMedDate not supplied

The determinants of community health nursing in Taiwan: past, present, and future aspects.

There are many determinants that influence the development of community health nursing in Taiwan. Political reality and policy, economic development, social changes, universality of education, systematization of healthcare, and disease changes are among the main factors. The author individually describes these influences in reference to past and current situations. Then, the author discusses the future prospects of these influences on community health nursing in Taiwan.

Community Health Nursing↗