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At least 19 recordsLinked to original sources

Improving the quality of community health surveys and community health promotion campaigns by feedback from the community: experience from the Wallsend community and health project.

A lifestyle and health risk survey was conducted in two socially disadvantaged Collector's Districts, as the basis for a health promotion intervention in one of the Districts. After community input into the planning, and local advance publicity, 395 people responded to the survey (a response rate of 39%). Three sources of community feedback were used: (i) reasons for refusal to participate; (ii) written comments solicited at a two-month follow-up; (iii) later, in-depth interviews with a subset of respondents. The data from this feedback related both to the process and outcomes of the survey; the latter included increased personal and community awareness of health, as well as lifestyle changes. The data are discussed in terms of their representativeness and the factors influencing participation, the implications of the low response rate, the stages of health behaviour change, and the potential conflict between scientific and human value-systems in community research.

Australia↗

Communities and hospitals: social capital, community accountability, and service provision in U.S. community hospitals.

OBJECTIVES: The study related community social capital to the level of community accountability and provision of community-oriented services in U.S. community hospitals. STUDY SETTING: The sample included 1,383 community hospitals that participated in the 1997 American Hospital Association's (AHA) Hospital Annual and Governance Surveys. DATA SOURCES: (1) The 1997 AHA Annual Hospital Survey, (2) the 1997 AHA Hospital Governance Survey, (3) the DDB Needham Market Facts Survey, (4) the 1996 County Election Data File, and (5) the 1998 Area Resource File. RESEARCH DESIGN: The study used a mix of longitudinal and cross-sectional data. KEY FINDINGS: We identified two distinct indicators of social capital-community participation and voting participation. Community accountability in hospitals was unrelated to either indicator. Hospitals' provision of community-oriented health services was negatively associated with community participation but unrelated with voting participation. The interaction between voting participation and community representation on hospital governance was positively associated with community accountability and provision of community-oriented health services. CONCLUSION: Neither community participation nor voting participation was sufficient to influence hospital behavior. The positive finding associated with the interaction between voting participation and community representation on hospital governance underscored the importance of an active political culture in influencing hospital behavior, without which the installation of community representatives on hospital governance might be more symbolic than actually serving the health concerns of community residents.

Catchment Area, Health↗

Assessment of the impact of community-based medical education of the University of Maiduguri on communities in three local government areas of Borno State, Nigeria: community leaders' perspectives.

BACKGROUND: The community-based training of the University of Maiduguri Medical College was expanded in 1990 to cover three rural local government areas (LGAs) located between 25 and 145 km from the University. This study was conducted between March and May 2000 to assess the impact and level of awareness of the training in the three LGAs in promoting the ideals of Primary Health Care (PHC) and community-based medical education, as perceived by community leaders. METHOD: Focus group discussions (FGDs) were held with community leaders of each of the communities. RESULTS: Consistency in the recollection of what time in the year and for how long the students were in the various communities indicates awareness in all the community leaders. They also indicated that the programme has had a positive impact on their community's health, they would like the students to focus on specific endemic diseases, such as guinea-worm, hypertension, etc, and intensify community outreach programmes, such as home visits and health education. Most participants indicated that their communities participated in the programme by providing accommodation, feeding and other logistics on an ad hoc basis. Community leaders mobilized the communities for health education and other related activities carried out by the students. CONCLUSION: The community-based medical training of the University of Maiduguri has increased community awareness of preventive aspects for various communicable and non-communicable diseases. In addition it has helped to encourage the communities to participate actively in supporting PHC activities.

Community Medicine↗

Flexible community structure correlates with stable community function in methanogenic bioreactor communities perturbed by glucose.

Methanogenic bioreactor communities were used as model ecosystems to evaluate the relationship between functional stability and community structure. Replicated methanogenic bioreactor communities with two different community structures were established. The effect of a substrate loading shock on population dynamics in each microbial community was examined by using morphological analysis, small-subunit (SSU) rRNA oligonucleotide probes, amplified ribosomal DNA (rDNA) restriction analysis (ARDRA), and partial sequencing of SSU rDNA clones. One set of replicated communities, designated the high-spirochete (HS) set, was characterized by good replicability, a high proportion of spiral and short thin rod morphotypes, a dominance of spirochete-related SSU rDNA genes, and a high percentage of Methanosarcina-related SSU rRNA. The second set of communities, designated the low-spirochete (LS) set, was characterized by incomplete replicability, higher morphotype diversity dominated by cocci, a predominance of Streptococcus-related and deeply branching Spirochaetales-related SSU rDNA genes, and a high percentage of Methanosaeta-related SSU rRNA. In the HS communities, glucose perturbation caused a dramatic shift in the relative abundance of fermentative bacteria, with temporary displacement of spirochete-related ribotypes by Eubacterium-related ribotypes, followed by a return to the preperturbation community structure. The LS communities were less perturbed, with Streptococcus-related organisms remaining prevalent after the glucose shock, although changes in the relative abundance of minor members were detected by morphotype analysis. A companion paper demonstrates that the more stable LS communities were less functionally stable than the HS communities (S. A. Hashsham, A. S. Fernandez, S. L. Dollhopf, F. B. Dazzo, R. F. Hickey, J. M. Tiedje, and C. S. Criddle, Appl. Environ. Microbiol. 66:4050-4057, 2000).

Anaerobiosis↗

A community practice model for community psychologists and some examples of the application of community practice skills from the Partnerships for Success initiative in Ohio.

This paper provides an opportunity to consider the concept of community practice from the vantage point of community psychology. The author argues that community psychology has significant potential to change organizations, communities, and other settings to benefit setting occupants. However, it is the author's contention that the full realization of this potential is contingent upon an organized effort to engage in formal community practice. The author defines community practice in terms of four skill sets related to mobilization, planning, implementation, and evaluation. The author also describes settings that might support community practice and discusses implications for training and the field of community psychology in general. Finally, the author illustrates several community practice skills and roles in the context of a local community-based initiative in Ohio called Partnerships for Success.

Evidence-Based Medicine↗

Community based and community focused: nursing education in community health.

Nurses have always cared for individuals, families, groups, and communities in their practice. Recently there has been an increase in the focus on nurses working outside of the hospital, primarily in community-based settings that focus on individuals and families. There is also increasing emphasis on community-focused nursing care with the community as the client. In some nursing programs, nurse educators have tried to adjust to this change by increasing the amount of time that nursing students spend in the community. The focus of this experience ranges from individuals to populations. This article describes a one-semester community health course in a baccalaureate nursing program that gives students both theoretical and practical knowledge in caring for individuals, families, groups, and communities. This allows for practice and understanding of both community-based and community-focused nursing care.

Community Health Nursing↗

Symbolism of community II: the boundary between community mental health professional and community.

OBJECTIVE: To study the symbolism of community as understood and practised within a mental health Crisis and Assessment Service in an Australian city. THEORETICAL APPROACHES: The paper draws on anthropological theories of symbolism, boundary work and social networks. METHOD: Ethnographic fieldwork techniques were employed for data collection. Ethnographic analysis was then applied to these data. RESULTS: In mental health practice, rules of professional behaviour established a boundary that prohibited mental health professionals from social engagement with members of the community they served. Ethical imperatives prevented them from forming interpersonal bonds with their clients. Rules of privacy and confidentiality meant that they could not relate to the client's social network as a whole. CONCLUSIONS: The companion to this paper identified a summarizing symbol, which we designated community, and it specified the social values it represented when appropriated to the task of drawing a boundary between hospital and community. This paper specifies additional social values represented by community when it is appropriated to the task of drawing a boundary between community mental health professionals and the community.

Community Mental Health Services↗

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↗

Community participation in determining the needs of users and carers of rural community care services. Highland Community Care Forum.

In this paper we present the methods and key outcomes of a community led needs assessment exercise. The needs assessment sought to enhance the development of rural community care services by ensuring the views of users and carers were secured and considered in joint planning processes. The research was developed by members of the North and West Sutherland Community Care Forum. A community profiling template was developed and employed in five parish areas of Sutherland. This was drawn from 45 interviews with key informants and 2 community workshops, In addition 54 users and carers were interviewed. The outcomes of the needs assessment exercise identified geographical and cultural factors which present difficulties in developing services as well as posing barriers to user involvement.

Community Health Services↗

Building healthier communities for children and families: applying asset-based community development to community pediatrics.

Social capital is the power of social networks and relationships, which constitute the social environment. Social capital has been associated with many measures of health and development. Asset-based community development (ABCD) provides a framework to increase social capital and build stronger, healthier communities for children. ABCD is a strength-based approach to community building that emphasizes bringing together community assets including individual community members, voluntary associations, and institutions. How pediatricians can apply ABCD to child health is described.

Child↗

Democratic development of standards: the community of communities--a quality network of therapeutic communities.

As the inevitability of regulation and accountability dawned on the British Therapeutic Community movement at the end of the 1990s, a polarised debate took place. The product of that debate is now an action research based system of audit, with its principles and methods based on therapeutic community practice. This paper is written four years after the discussions started, and describes how the "Community of Communities" was conceived, what its methods are, some of the results from it first year of operation, and reflection about the nature of the process itself

Community Mental Health Services↗

The community and orthodontic care. Part II: Community-perceived importance of correcting various dentofacial anomalies. Part III: Community perception of the importance of orthodontic treatment.

Part II. A professionally-managed telephone survey was undertaken to assess the community-perceived importance of correcting various dentofacial anomalies. The sample included 505 respondents, aged eighteen and over, from metropolitan and non-metropolitan households across the state of Victoria. The sample distribution had a 95 per cent confidence limit with a 5 per cent margin of error and closely matched the known population distributions for age, sex and geographical location. This article forms part two of a series. It was found that the correction of functional problems such as "difficulty chewing or speaking" was considered to be very important, regardless of age, sex or geographical area. The correction of other factors such as "top teeth which stick out in front", "bottom teeth which stick out in front" or "crooked or crowded front teeth" was also considered to be important. "Spaced front teeth" was the factor considered least important for correction within all groups. It is interesting to note that, for all factors, correction seemed to be considered more important by females and non-metropolitan respondents than by males and metropolitan respondents, In contrast to previous studies in which it has been suggested that patients seek treatment mainly for reasons of aesthetics, the results of this study have shown a definite community recognition of the importance of functional problems as well. Part III. A professionally-managed telephone survey was undertaken to assess the community's perceptions of the importance of having "straight teeth and a nice smile", to assess if a Medicare (the Australian government health benefit scheme) rebate should be provided for orthodontic treatment and to assess whether respondents had any private health insurance that would help cover the cost of orthodontic treatment. The sample included 505 respondents, aged eighteen and over,, from metropolitan and non-metropolitan households across the state of Victoria. The sample distribution had a 95 per cent confidence limit with a 5 per cent margin of error and closely matched the known population distributions for age, sex and geographical location. It was found that a very large percentage of respondents considered the need for "straight teeth and a nice smile" to be very important. This finding is supported by the many studies showing the importance of facial attractiveness to the lives of all people, young and old. Only a small percentage of respondents indicated that they had any private dental health insurance that would help cover the cost of orthodontic treatment. Efforts should be made to inform those responsible for the planning of orthodontic services in both the public and private sectors of the importance of the community's perceptions of aesthetics, and the large amount of published work that reinforces the impact of facial attractiveness on people's lives.

Adolescent↗

Interdisciplinary working between community pharmacists and community nurses: the views of community pharmacists.

Changing roles within primary care have been heralded by the implementation of nurse prescribing and the need to maximize skills within the existing workforce. This paper describes the views of community pharmacists regarding nurse prescribing and interdisciplinary working in primary care. Limited contact was reported between community pharmacists and prescribing nurses which contrasted with the reported frequency of contact with other health professionals. The community pharmacists reported positive views regarding teamworking and nurse prescribing which it is suggested provides a readiness to develop interdisciplinary working which hitherto had foundered on lack of contact and in consequence insufficient understanding of roles and a shared view of primary care.

Attitude of Health Personnel↗

Community interventions for preventing smoking in young people.

BACKGROUND: Decisions to smoke are made within a broad social context. Community interventions use co-ordinated, widespread, multi-component programmes to try and influence behaviour. OBJECTIVES: To determine the effectiveness of community interventions in preventing the uptake of smoking in young people. SEARCH STRATEGY: The Tobacco Addiction group specialised register, Medline and 21 other health, psychology and public policy electronic databases were searched, the bibliographies of identified studies were checked and contact was made with content area specialists. SELECTION CRITERIA: Randomised and non randomised controlled trials that assessed the effectiveness of multi-component community interventions compared to no intervention or to single component or school-based programmes only. Reported outcomes had to include smoking behaviour in young people under the age of 25 years. DATA COLLECTION AND ANALYSIS: Information relating to the characteristics and the content of community interventions, participants, outcomes and methods of the study was extracted by one reviewer and checked by a second. Studies were combined using qualitative narrative synthesis. MAIN RESULTS: Thirteen studies were included in the review, 44 studies did not meet all of the inclusion criteria. All studies used a controlled trial design, with four using random allocation of schools or communities. Of nine studies which compared community interventions to no intervention controls, two, which were part of cardiovascular disease prevention programmes, reported lower smoking prevalence. Of three studies comparing community interventions to school-based programmes only, one found differences in reported smoking prevalence. One study reported a lower rate of increase in prevalence in a community receiving a multi-component intervention compared to a community exposed to a mass media campaign alone. One study reported a significant difference in smoking prevalence between a group receiving a media, school and homework intervention compared to a group receiving the media component only REVIEWER'S CONCLUSIONS: There is some limited support for the effectiveness of community interventions in helping prevent the uptake of smoking in young people.

Adolescent↗