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At least 19 recordsLinked to original sources
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↗
PubMed1987

Uncleanliness among persons seen by community health workers.

Community nurses and other community workers often encounter persons who live in conditions of extreme uncleanliness, but not much attention has been paid to the causes of this behavior. The author surveyed 12 community health centers in Sydney, Australia, to obtain data on specific aspects of personal and home cleanliness for persons under their care. Of the 83 subjects identified as living in unclean conditions, 15 were age 60 or younger. Almost two-thirds had some degree of memory impairment, and 40 percent were or had been heavy drinkers. However, 12 subjects did not have obvious physical or mental disorders, and the author suggests that eccentric personality factors may account for their living conditions. He believes uncleanliness should not be labeled as part of a syndrome, but that it is a sign that may lead to recognition of a causative disorder. He recommends further study of the problem.

Aged↗
PubMed1997

Community health workers: who they are and what they do.

Community health workers (CHWs) are community members who serve as frontline health care professionals. They generally work with the underserved and are indigenous to the community in which they work-ethnically, linguistically, socioeconomically, and experientially. This article presents the results of a survey of 197 systematically selected health care providers in eight Bay Area counties. The authors found that 25% of the health care providers in these eight counties hire CHWs. The hiring projections indicate that opportunities are expanding for these frontline professionals; the majority of growth is in public health departments and community-based organizations. The majority of CHWs are women (66%) of color (77%) with a high school degree or less (58%). A total of 44% earn an annual salary of $20,00 to $25,000; 30% make more than $25,001. AIDS and maternal and child health are the two major content foci of CHW work.

California↗
PubMed2006

Measuring return on investment of outreach by community health workers.

Community health workers (CHWs) are effective in improving access to health care, promoting client knowledge and behavior change, and contributing to improved health status of individuals. However, few outreach programs have evaluated the financial impact of CHWs on health care systems and policies. A longitudinal repeated measures design was used to assess the return on investment (ROI) of outreach by CHWs employed by Denver Health Community Voices. Service utilization, charges and reimbursements for 590 underserved men were analyzed 9 months before and after interaction with a CHW. Primary and specialty care visits increased and urgent care, inpatient, and outpatient behavioral health care utilization decreased, resulting in a reduction of monthly uncompensated costs by $14,244. Program costs were $6,229 per month and the ROI was 2.28:1.00, a savings of $95,941 annually. These data provide evidence of economic contributions that CHWs make to a public safety net system and inform policy making regarding program sustainability.

Colorado↗
PubMed1994

Adults with acquired hearing loss: identification and referral patterns of community health workers.

Community health workers in one health region of New South Wales were surveyed about their criteria and referral patterns to identify and assist adults with acquired hearing losses. Reported or observed communication problems were the most commonly used criteria for identifying hearing loss, suggesting that a failure model was being utilised. Given that the literature has previously demonstrated reluctance on the part of individuals with acquired hearing loss to report their hearing difficulties, the implications of these results are discussed. Clients suspected of having acquired hearing losses were usually referred to their doctors for further investigation and treatment. Other hearing help services were not systematically utilised. Alternative strategies for identifying and managing acquired hearing loss at the community level are needed.

Community Health Workers↗
PubMed1998

Promoting health, promoting women: the construction of female and professional identities in the discourse of community health workers.

Community health worker (CHW) programs are implemented in the third world and among racial minorities in the U.S. by public health professionals with the goal of improving people's access to basic health services. There is a shared view that women's roles as mothers make them effective CHWs because most health practices are located within the realm of the family. The objective of this paper is to inquire how and what concepts of woman are constructed and promoted in CHW programs. Viewing CHW as a discourse, I examine literature on CHWs using a critical feminist perspective and insights from narrative and rhetorical analyses. I argue that CHW positions women living in the third world and non-white Hispanic women in the U.S. as the "other" woman. The natural attributes of this other woman include mother, care giver, oppressed, child-like, and victim of patriarchy, religion, poverty, and diseases. These attributes are used to define categories of the female such as "the third world woman" and "Hispanic woman". These categories, in turn, define two unnamed opposite categories: "the first world woman" and "the public health professional". I conclude that CHW is a colonizing discourse and that public health professionals and feminists need to practice reflexivity.

Caregivers↗
PubMed1998

Stress and job satisfaction among social workers, community nurses and community psychiatric nurses: implications for the care management model.

The introduction in April 1993 of new arrangements for assessment and care management following the NHS and Community Care Act 1990 (Department of Health 1990a) heralded a period of major transition for front-line workers in the health and social services. Policy expectations for the development of the purchaser/provider split and the 'new managerialism' have posed unprecedented ideological, organizational and professional challenges. Two years after the full implementation of the reforms a postal survey of the experiences of care managers about policy and practice changes was undertaken in Wales. This paper focuses on the stresses and satisfactions of care management practice among three distinct groups of front-line workers: social workers, community nurses and community psychiatric nurses. The results of multiple regression analyses, corroborated by qualitative data, implicate an increased workload in general and administrative work in particular, combined with reduced opportunities for client contact, as the main sources of stress. Being able to control or shape those factors impinging on the experience of stress and job satisfaction appears to lie at the heart of the dilemma. Practice and policy implications are considered.

Journal Article↗
PubMed1989

Hookworm and roundworm infections in farm-worker communities in the large-scale agricultural sector in Zimbabwe.

Surveys were carried out to assess the prevalences and intensities of hookworm and roundworm infections in 15 farm-worker communities in Zimbabwe with poor living conditions. Examination of 1635 faecal samples showed that hookworms (Necator americanus and Ancylostoma duodenale) were the commonest helminths (61.7% of infections). They were followed by Ascaris lumbricoides and Trichuris trichiura at less than 3%. There were striking differences in prevalences and intensities of infection of the different helminthic parasites among the 15 communities surveyed. In general, differences between males and females were not statistically significant. Age-prevalence and age-intensity profiles for hookworms showed that infection increased with age, with a peak in the adult age groups. A. lumbricoides prevalence was relatively high in children but declined to a very low plateau in adults. There were no significant relationships between number of households per latrine at each community and the prevalence and intensity of infection by hookworms and prevalence of roundworms. The relevance of the above findings is discussed in relation to the control of morbidity and transmission of the helminths.

Adolescent↗
PubMedDate not supplied

Promoting infant health through home visiting by a nurse-managed community worker team.

This article describes the Resources, Education and Care in the Home program (REACH-Futures), an infant mortality reduction initiative in the inner city of Chicago built on the World Health Organization (WHO) primary health care model and over a decade of experience administering programs to reduce infant mortality through home visits. The program uses a nurse-managed team, which includes community residents selected, trained, and integrated as health advocates. Service participants were predominately African American families. All participants were low-income and resided in inner-city neighborhoods with high unemployment, high teen birth rates, violent crime, and deteriorated neighborhoods. Outcomes for the first 666 participants are compared to a previous home-visiting program that used only nurses. Participant retention rates were equivalent overall and significantly higher in the first months of the REACH-Futures program. There were two infant deaths during the course of the study, a lower death rate than the previous program or the city. Infant health problems and developmental levels were equivalent to the prior program and significantly more infants were fully immunized at 12 months. The authors conclude that the use of community workers as a part of the home-visiting team is as effective as the nurse-only team in meeting the needs of families at high risk of poor infant outcomes. This approach is of national interest because of its potential to achieve the desired outcomes in a cost-effective manner.

Adult↗
PubMedDate not supplied

Increasing the effectiveness of community workers through training of spouses: a family planning experiment in Guatemala.

As community-based distribution (CBD) systems for the delivery of contraceptive methods are implemented in developing countries around the world, there is growing interest in making these programs more effective. Previous research on the CBD program in Guatemala indicated the importance of the role of the spouse: those community volunteers (called "distributors") who received assistance from their spouses were more effective in selling contraceptives than those who did not. The current experiment was designed to test the effect of providing the spouses of distributors with a formal 3-day training course on family planning and contraceptives. "Effect" was operationally measured in terms of the level of contraceptive sales. To this end sales data were compared for the experimental group (33 distributors whose spouses received the training) and the control group (33 distributors whose spouses wanted to attend the training but could not because their primary occupation did not allow them to be absent) for periods of 6 months prior to and 6 months following the training. The results indicate that sales among the experimental group increased significantly, whereas no such increase was found among the controls. This suggests a strategy for increasing the effectiveness of community volunteer workers that has received relatively little attention in the literature to date.

Community Health Services↗
PubMed1997

A pre-intervention survey to determine understanding of HIV and AIDS in farm worker communities in Zimbabwe.

A cumulative total of 41,298 AIDS cases have been reported in Zimbabwe as of March 1995. Of concern is the growing evidence of high levels of seroprevalence among rural farm workers. A pre-intervention survey was conducted by interview in one district to examine behavioral factors likely to place farm workers in marginalized rural communities at risk for sexually transmitted diseases (STD) and HIV infection. Seven hundred seventy commercial farm workers from 17 randomly selected commercial farm participated in the study. We found that farm worker communities, which are characterized by educationally disadvantaged women when compared with men (p < .001), have had little exposure to AIDS prevention activities. Beliefs that AIDS is brought about by divine or ancestral retribution were upheld by less education women (p < .001). A significant association was found with respect to perceived risk to HIV and low self-efficacy among uneducated women who articulated helplessness and an inability to protect themselves from HIV infection. Among more educated men, we found acknowledgment about multipartnering and that changes in behavior are more likely to develop as a result of changes in normative values (p = .075). Condom use among men, which is probably the most effective barrier against STD infection, was shown to be associated with age (p < .01) and education (p < .01). The study concludes with recommendations for an appropriate intervention.

Adolescent↗
PubMed1997

Detection and management of pneumonia by community health workers--a community intervention study in Rehri village, Pakistan.

This community based, case management intervention study was done to assess the effectiveness of Community Health Workers (CHWs) in case detection and management of pneumonia in children under five years of age. Twenty-two volunteers (school teachers and students) were selected as CHWs from Rehri village, in Sindh, Pakistan and trained on World Health Organization (WHO) recommended National/Acute Respiratory Tract Infection (ARI) guidelines at the Department of Paediatrics, Dow Medical College, Civil Hospital, Karachi. The CHWs had no prior health education. The intervention was the use of CHWs to detect and manage pneumonia in children under five years of age in Rehri village. Two medical officers supervised the post-training activities of CHWs in the village during the study period. Between December, 1992 and May, 1993, 442 episodes of pneumonia (very severe disease 10, severe pneumonia 54 and simple pneumonia 378) were detected and managed by trained CHWs. The medical officers agreed with the CHWs for classification and treatment in 356 (81%) cases. This study suggests that in areas where there is a shortage of trained health care professionals, educated community members such as school teachers can be trained to detect and manage pneumonia in their community.

Case Management↗
PubMed2004

A focus of lymphatic filariasis in a tea garden worker community of central Assam.

A survey for lymphatic filariasis was conducted among tea garden workers of central Assam. Of the 656 night blood samples examined, 31 were found positive for Wuchereria bancrofti parasite (microfilaria rate 4.7%). Microfilaria rate was higher in male (7.3%) than females (2.1%). Culex quinquefasciatus was incriminated as vector mosquito.

Agriculture↗