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PubMed1987

Preventive strategies for dealing with violence among blacks.

In regular medicine if a patient goes to a doctor to be treated for a rat bite, the physician cleans the bite, dresses it, gives antibiotics, and gives a tetanus shot. The physician practicing social medicine would give our imaginary patient the same treatment but would go a step further; he would arrange for someone to go into the patient's community and set rat traps. A similar distinction is made between general psychiatry and community psychiatry, and this distinction highlights one of the main principles of the community psychiatrist's mission, community development. Community development being the art of helping a community achieve a social and interpersonal milieu that promotes an optimum level of mental health (Freed, 1972; Freed, 1972). This aspect of community psychiatry takes on an even greater significance when the community being served is a lower socioeconomic, minority community because of the conditions found in such communities that can impair the overall mental health of the community's individuals, families, and groups. This article will illustrate the principle of community development, the role of one psychiatrist in community development, and its importance to deprived minority communities by describing a community psychiatry approach to the problem of black-on-black homicide.

Black or African American↗
PubMed1998

Transforming the curriculum while serving the community: strategies for developing community-based sites.

Developing community-based clinical opportunities for students is a challenge. At San Jose State University (SJSU) School of Nursing, faculty transformed the curriculum by developing community-based experiences directed by faculty and delivered by students during clinical practice. These innovative clinical experiences provide a structure to educate students and enhance the ability to bring health care to underserved people in a community. This article describes the structure and processes for implementing the new experiences and offers strategies to guide other faculty interested in developing community-based experiences.

Community Health Nursing↗
PubMed1999

[The ODEC (Organization for Development and Community Networks) and mental health: from networking to opening in the local community].

The Organisme de développement et d'entraide communautaire (ODEC) is a nonprofit mental health organization that was established in 1987 and offers mutual help and community development services in the Vallée-de-la-Lièvre region in the Outaouais area of Quebec. Starting with an individual accompaniment service for people living with mental health problems, ODEC has succeeded in establishing a significant mutual help network that now involves more than 100 people. This article comes out of an in-depth case study of ODEC. By analysing the major parameters of its journey over more than 10 years, it brings to the fore the impact in the mental health field of providing a network in close association with community involvement.

Community Mental Health Services↗
PubMed1999

Public policy frameworks for improving population health.

Four conceptual frameworks provide bases for constructing comprehensive public policy strategies for improving population health within wealthy (OECD) nations. (1) Determinants of population health. There are five broad categories: genes and biology, medical care, health behaviors, the ecology of all living things, and social/societal characteristics. (2) Complex systems: Linear effects models and multiple independent effects models fail to yield results that explain satisfactorily the dynamics of population health production. A different method (complex systems modeling) is needed to select the most effective interventions to improve population health. (3) An intervention framework for population health improvement. A two-by-five grid seems useful. Most intervention strategies are either ameliorative or fundamentally corrective. The other dimension of the grid captures five general categories of interventions: child development, community development, adult self-actualization, socioeconomic well-being, and modulated hierarchical structuring. (4) Public policy development process: the process has two phases. The initial phase, in which public consensus builds and an authorizing environment evolves, progresses from values and culture to identification of the problem, knowledge development from research and experience, the unfolding of public awareness, and the setting of a national agenda. The later phase, taking policy action, begins with political engagement and progresses to interest group activation, public policy deliberation and adoption, and ultimately regulation and revision. These frameworks will be applied to help understand the 39 recommendations of the Independent Inquiry into Inequalities in Health, the Sir Donald Acheson Report from the United Kingdom, which is the most ambitious attempt to date to develop a comprehensive plan to improve population health.

Adult↗
PubMed2005

Community participation in the treatment development process using community development teams.

Little literature exists about methods for adapting research-based treatments to typical practice settings. This report describes a 2-step process and associated methods used to adapt a school-based treatment program for middle-school youth with attention deficit hyperactivity disorder (ADHD) that operates in a controlled setting to one that can operate in a typical practice setting. Step 1 included a feasibility study that yielded important findings regarding potential obstacles to successful implementation. These data, along with original treatment manuals and literature on treatments for youth with ADHD, were utilized for Step 2--the Community Development Team (CDT) process. Data collected about the CDT process indicate that its strengths outweigh potential limitations. These methods are discussed in the context of successful collaborative procedures for developing and evaluating research-based treatments in practice settings.

Adolescent↗
PubMed1996

Faculty development for community practitioners.

Developing the academic skills of the individuals who will serve as educators and role models in the community is critical to pediatric resident education in community settings. The main focus of any faculty development program must be on teaching, although for a subset of individuals, the development of research skills should also be a consideration. The three key elements that must be considered for an effective faculty development program include: (1) creating a culture of mutual respect between full-time and community faculty; (2) basing the program on sound principles of education theory, especially adult learning theory, using appropriately trained faculty; and (3) establishing ongoing institutional financial and philosophical support. Effectively addressing these elements should create a faculty development program that will help the community practitioner become an effective role model and practitioner- preceptor-educator.

Community Medicine↗
PubMed1982

Effects of chlorpyrifos on field- and laboratory-developed estuarine benthic communities.

Macrobenthic animal communities, developed in sand-filled aquaria in the laboratory and in the field, were exposed to various concentrations of the insecticide chlorpyrifos, and effects on community structure were assessed. Laboratory communities were continuously exposed to the toxicant for 8 wk during colonization by planktonic larvae in unfiltered Santa Rosa Sound, Fla., seawater. Field communities were developed for 8 wk in aquaria placed in Santa Rosa Sound, then removed to the laboratory for exposure to chlorpyrifos for one week. Abundance of arthropods was significantly diminished (alpha = 0.05) by measured concentration of chlorpyrifos greater than or equal to 0.1 microgram/l in water in laboratory communities and by 5.9 microgram/l in water in field communities. Numbers of annelids and chordates in contaminated aquaria were not reduced by the highest concentrations of chlorpyrifos tested, 8.5 microgram/l in laboratory-colonized aquaria and 5.9 microgram/l in field-colonized aquaria. One species of annelid, Cistenides gouldii, was more abundant in field aquaria receiving 1.0 microgram/l or 5.9 microgram/l than in the control and lowest concentration. Molluscan larvae colonizing laboratory aquaria were sensitive to greater than or equal to 0.1 microgram/l; however, later developmental stages characterizing field aquaria were not sensitive to less than or equal to 5.9 microgram/l. Although only 20 of 78 animal species appeared in both laboratory and field communities, sensitivity of animals in these tests and in single species tests could be compared.

Animals↗
PubMedDate not supplied

Developing and establishing online student learning communities.

Developing effective learning communities is an important component of Web-based courses. Learning communities offer a social context for learning that greatly enhances the knowledge acquisition of all involved parties. This article describes the development of an effective learning community among Web-based RN-BSN students. The characteristics of the cohort leading to an effective learning community included supportiveness, open sharing of oneself, and socialization.

Attitude of Health Personnel↗
PubMedDate not supplied

Community mental health teams: development in community care.

This article discusses research undertaken in an area of South Wales on the functioning of community mental health teams, which took place during the closure of two large psychiatric hospitals and the development of the Welsh Office strategy for mental illness. Key findings relate to the lack of clarity of the role of team coordinators, the absence of individual performance review systems, the diversities in referral systems and caseloads. An attempt was made to develop a performance matrix in relation to individual teams.

Community Mental Health Services↗
PubMed1994

A model for community involvement in health (CIH) program development.

Community involvement in health (CIH), a central concept in health development, is a participatory approach to health care that is organized from the perspective of the recipient. Putting CIH into practice represents a learning experience for the community, the health professionals involved and those responsible for the national climate in which this change takes place. The CIH process was operationalized over a two-year period in a black township in South Africa. A community survey identified the health needs and capacities related to the elderly, their families and their support system. Community groups and individuals, in partnership with the researcher, prioritized the needs that had been identified and then implemented four programs related to those needs. A process model was developed that provided the structure for initiating and maintaining these programs. The model helped people who were new to the community organizing to focus on general principles. It was flexible so that programs could be interpreted and implemented in the context of local culture and resources. The model was functional in guiding community nurses, lay community members and employees in health-related programs through the process of starting new programs. This approach empowered participants to move beyond only hoping for change or being puzzled by its elusiveness.

Adult↗
PubMed1997

Community experiments in action: developing community-defined models for reconfiguring health care delivery.

In the United States, health system change occurs as the interaction of politics and policies is played out and pushed forward by individuals and organizations taking action in their local communities and markets. This article provides context and descriptive information about a model of local health care reform that is being tested in twenty-five communities around the nation. We introduce a value-based model of community-responsive health system change, the Community Care Network (CCN) Vision. We briefly describe a national demonstration program that is testing this model between January 1996 and the end of 1998. We offer several ways of looking at the local and regional multisectoral partnerships that are attempting to demonstrate the CCN vision. We look at their composition, the kinds of actions in which they are engaged, several example challenges and responses to them, and we give several examples of schools becoming part of the health system of last resort. Finally, we present some early ideas on how the local actions described here may influence (and be influenced by) the political and policy contexts in which they occur.

Community Networks↗
PubMedDate not supplied

Nurturing grassroots initiatives for health and housing.

This article has discussed the need to support grassroots community development. Grassroots community development requires the development and maintenance of voluntary community organizations (e.g., block, neighborhood, and tenant associations). These organizations have proved effective in the social, physical, and economic development of a community. The challenge facing policy makers and strategists is to develop a system that supports a multitude of community initiatives. This article has discussed such an "enabling system" and structure, functions, and services required as part of this system. The challenge we face is to increase the problem-solving capacity of disenfranchised communities. One of the biggest barriers we face in this mission is the competition and lack of coordination among professional service organizations.

Community Participation↗
PubMed2003

Small water and wastewater systems: pathways to sustainable development?

Globally we are faced with billions of people without access to safe water and adequate sanitation. These are generally located in developing communities. Even in developed communities the current large scale systems for supplying water, collecting wastewater and treating it are not environmentally sustainable, because it is difficult to close the cycle of water and nutrients. This paper discusses the advantages of small scale water and wastewater systems in overcoming the difficulties in providing water and wastewater systems in developing communities and in achieving sustainability in both developed and developing communities. Particular attention is given to technology and technology choice, even though technology alone does not provide the complete answer. Disadvantages of small scale systems and how they may be overcome are discussed.

Conservation of Natural Resources↗