Biomedical subjects

Linda Jo Doctor

Publications and source records attributed to Linda Jo Doctor.

4 recordsLinked to original sources

PubMed2006

Community coalitions to control chronic disease: Allies against asthma as a model and case study.

There is a rich and extensive literature regarding coalitions as vehicles for amassing resources, influence, and energy in pursuit of a health goal. Despite insufficient empirical data regarding outcome, a number of observers have posited the aspects of coalition processes thought to lead to goal attainment. The supplement, which this article is part of, is devoted to an examination of how these elements fitted together (or did not) in the seven areas across the United States where Allies coalitions devoted themselves to achieving asthma control. The aim of this article is to present the theoretical bases for the work of the coalitions. It illustrates and emphasizes how the community context influenced coalition development, how membership was involved in and assessed coalition processes and structures, and the community-wide actions that were instituted and the capacities they were trying to strengthen.

Asthma↗

PubMed2006

Integrating asthma prevention and control: the roles of the coalition.

Activities addressing pediatric asthma are often fragmented. Allies coalitions promoted integration, the alignment of concurrent asthma control activities across and within sectors. Systems integration describes activities from an organizational perspective. Activities included developing a shared vision, promoting consistency in asthma education and self-management support, improving adherence to clinical guidelines, advocating jointly for policy change, and seeking funds collaboratively. Service integration describes activities focused on ensuring seamless, comprehensive services through coordination within and across organizations. Activities included use of community health workers (CHWs) and nurses for care coordination, program cross-referral, and clinical quality improvement. Integration is a sustainable role for coalitions as it requires fewer resources than service delivery and results in institutionalization of system changes. Organizations that seek integration of asthma control may benefit.

Asthma↗

PubMed2006

The coalition process at work: Building care coordination models to control chronic disease.

Asthma is a highly prevalent and frequently misunderstood chronic disease with significant morbidity. Integrating client services at the patient-centered level and using coalitions to build coordinated, linked systems to affect care may improve outcomes. All seven Allies Against Asthma coalitions identified inefficient, inconsistent, and/or fragmented care as issues for their communities. In response, the coalitions employed a collaborative process to identify and address problems related to system fragmentation and to improve coordination of care. Each coalition developed a variety of interventions related to its specific needs and assets, stakeholders, stage of coalition formation, and the dynamic structure of its community. Despite common barriers in forming alliances with busy providers and their staff, organizing administrative structures among interinstitutional cultures, enhancing patient and/or family involvement, interacting with multiple insurers, and contending with health system inertia, the coalitions demonstrated the ability to produce coordinated improvements to existing systems of care.

Asthma↗

PubMed2006

Collaborative design and implementation of a multisite community coalition evaluation.

Evaluation designs assessing community coalitions must balance measures of how coalitions do their work and evidence that the coalitions are making a difference. The Allies cross-site evaluation attempts to determine the combined effects of the seven coalitions' work at the individual, organizational, and community levels. Principal components considered are (a) contextual factors of the coalition community, (b) coalition processes and structure, (c) planning and planning products, (d) implementation actions, (e) activities and collaborations, (f) anticipated intermediate outcomes, and (g) expected asthma related health outcomes. Measurements are quantitative and qualitative, and data generated by these methods are used as ends in themselves and as a way to confirm or inform other measures. Evaluation has been an integral part of the planning and implementation phases of the Allies coalition work, with a priority of involving all of the partners in conceiving of and deciding upon the elements of assessment.

Community Networks↗