COMMUNITY STUDY FOR PUBLIC HEALTH AND OTHER AGENCY WORKERS. A THEORY ABOUT ORIGIN AND DEVELOPMENT OF COMMUNITIES IN THE UNITED STATES.
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Humans↗
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Results for “Community Development”
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Population control and community economic development in southern Jiangsu.
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Asia↗
MAPP in Chicago: a model for public health systems development and community building.
The Chicago Department of Public Health's (CDPH's) community planning efforts came from a city-wide strategic plan that called for the establishment of a city-wide network of community partnerships that focus on community needs and resource assessment and program development. Using Mobilizing for Action through Planning and Partnerships as a framework for planning at the community level, the CDPH supports five community coalitions through the Chicago Center for Community Partnerships. The overall goal of the Center is to increase community capacity, build new partnerships, provide coalitions with access to decision makers, and inform the role of local public health agencies in supporting this type of work. Bringing together a wide spectrum of stakeholders, coalition members work to conduct assessments and develop and implement strategies. While coalitions demonstrate outcomes related to specific strategies, they also exhibit infrastructure-level results, with increased levels of community organizing, leveraging of existing resources, and new systems for information dissemination. Simultaneously, the CDPH has gained new partners in public health, increased collaboration, and more information about communities. These outcomes are contingent on certain elements of success: (1) committed leadership; (2) commitment to a new way of doing business; (3) prepared public health workforces; and (4) community readiness.
Chicago↗
Tracheoesophageal speech in a developing world community.
OBJECTIVES: To determine the tracheoesophageal speech results in a Third World medical practice; to examine the impact of socioeconomic status, literacy, and proximity to specialist services on tracheoesophageal speech; to assess whether these factors should affect patient selection for fistula speech; and to determine guidelines for voice prosthesis selection. DESIGN: Retrospective analysis. SETTING: Groote Schuur Hospital, Cape Town, South Africa, which serves a Third World community. PATIENTS: Ninety-seven consecutive patients who underwent total laryngectomy between January 1, 1996, and October 1, 1998. Patients who undergo total laryngectomy routinely have a primary tracheoesophageal fistula created for speech. MAIN OUTCOME MEASURES: Speech outcomes after total laryngectomy; tracheoesophageal speech in relation to social class, literacy, and proximity to specialist services; and experience with removable and indwelling valves. RESULTS: Fifty-nine (81%) of 73 patients acquired useful speech. Speech outcome was not affected by employment status or proximity to specialist services. Although speech was affected by literacy and housing, several illiterate shack dwellers acquired good speech. Average device life of removable prostheses was 16 weeks (>4 months in 35% [64/183]). Indwelling prostheses had an average life of 28 weeks. CONCLUSIONS: Tracheoesophageal speech results in a Third World community equate with those in the Developed World. All patients who undergo laryngectomy and have adequate manual dexterity and cognitive function should be given a trial of fistula speech. Removable voice prostheses can successfully be used as indwelling prostheses.
Adult↗
[Work in community health is about to change].
Changes in Ontario's political, social and economic environments have necessitated an unprecedented transformation in the health care system. The change in focus from the individual to the community now includes core units such as families, groups and communities. Visiting nurses, public health nurses and community health nurses have worked in Community Health Centres (CHCs) since 1970. However, the role of nurses working in these centres has not been clearly defined in the literature. Nor is there is a general consensus on their title. Nurse practitioners, primary care nurses or community health nurses are all used. As well, there is no existing educational program in Ontario that trains this type of nurse. This article discusses and gives examples of nurses working in community health, whose primary clinical expertise is in using community based and community development program strategies to plan health programs. These programs are specifically developed to address the health needs of the communities they serve--in this case, Toronto's francophone community. Also demonstrated are new approaches to nursing care within a community setting. From health promotion to disease prevention, from community development to research, the practice of community health nursing is complex and exciting.
Community Health Nursing↗
At the interface of health and community care: developing linkages between aged care services in a rural context.
This paper explores issues concerning the development of linkages across the interface between acute and community aged care services in a small regional Australian city. It addresses a participatory action research project that took place over a 2 year period involving an Aged Care Assessment Team (ACAT). Aged Care Assessment Teams are multidisciplinary teams whose members mediate between hospitals and the aged care system in the community and have a key role in developing networks and linkages between various service providers in the field. In an age of economic rationalist-inspired reform agendas in health and community care, rural infrastructures have been compromised to such a degree that the role of rural ACAT in developing linkages between sectors has never been more important. This paper takes up this issue and addresses the project findings, which highlight a field characterised by ineffective linkages within and between the various sectors, a lack of understanding of the operation of the rural aged care system among nurses working in regional hospitals, and the efficacy of ACAT working collaboratively with nurses to create new and more effective linkages in aged care.
Aged↗
Toward a synergism of rural development and community psychology.
It is a common experience that all social intervention programs planned and executed for social amelioration have not met with success. The major thesis of this article is that parallel growth of two subfields: rural development and community psychology, may not be coincidental, and the recent trends in Indian psychology readily lead themselves to a union between the two. The attempts to intervene in two different communities (heterogeneous and homogeneous) have proved an eye-opener for future interventions.
Community Mental Health Services↗
An integrated approach to modeling resource utilization for rural communities in developing countries.
Resource consumption in developing countries has been the focus of a considerable amount of research. What has been understudied however, has been the feedback affects of resource consumption on resource availability to both households and communities. Heavy reliance on natural resources and intensive smallholder agriculture common to many rural communities in developing countries has forced people to fulfill short-term needs to the detriment of long-term ecological and livelihood sustainability. This paper introduces a conceptual framework to examine how individuals and households fulfill daily caloric needs and the aggregate effects on resource availability and consumption. Data were collected from a large number of published case studies of rural land-use dynamics, growth and yield models, and human livelihoods were reviewed from scientific journals, reports published by NGOs, and government reports. Using inputs defined by the user, the model tracks annual fuelwood and agricultural land use based on meeting individual energy demands. A case-study-based analysis was patterned after smallholder agriculturalists at the family and community level. Three scenarios are presented in this paper using data from Uganda to illustrate the application of this model.
Adult↗
Becoming 'indispensable': developing innovative community pharmacy practices.
OBJECTIVE: To describe common characteristics of successful innovative community pharmacy practices. DATA SOURCES: Four pharmacists who are successfully incorporating pharmaceutical care services into their pharmacy practices were identified for inclusion by key informants. Sites considered for inclusion were within 300 miles of the University of Minnesota College of Pharmacy. The four innovative community pharmacy practices were located in Maquoketa, Iowa, and in Bemidji, Anoka, and Minneapolis, Minn. Published articles identified through a Medline search-using the terms pharmaceutical care, Medicaid, Medicare, pharmacist, pharmacy, and collaborative practice-provided information to prepare for pharmacist interviews. STUDY SELECTION: By the authors. DATA EXTRACTION: Previsit telephone interviews with each pharmacist, combined with literature selected by the authors, were used to identify common characteristics of successful practices. Structured, on-site empirical observation was then performed to devise a tool for pharmacists to use for the development of innovative community pharmacy practices. The tool was then validated by two additional practitioners. DATA SYNTHESIS: Components of successful innovative community pharmacy practices include philosophy of practice, patient care process, management system, and clinical knowledge. A checklist tool is presented to be used in conjunction with the narrative description of the four components. CONCLUSION: Advanced pharmacy services delivered within pharmaceutical care practices can be a successful business opportunity for community pharmacists. Community pharmacists motivated to develop an innovative practice and provide pharmaceutical care services can use the checklist tool during practice implementation.
Attitude of Health Personnel↗
Research priorities for the reduction of perinatal and neonatal morbidity and mortality in developing country communities.
Although post-neonatal and child mortality rates have declined dramatically in many developing countries in recent decades, neonatal mortality rates have remained relatively unchanged. Neonatal mortality now accounts for approximately two-thirds of the 8 million deaths in children less than 1 year of age, and nearly four-tenths of all deaths in children less than 5 years of age. Worldwide, 98% of all neonatal deaths occur in developing countries, mostly at home, and largely attributable to infections, birth asphyxia and injuries, and consequences of prematurity, low birth weight and congenital anomalies. We review principal determinants of neonatal morbidity and mortality during the antenatal, intrapartum and postpartum periods, and propose priority community-based research activities to develop, test and adapt inexpensive, practical and sustainable interventions during these periods to reduce perinatal and neonatal morbidity and mortality in developing countries.
Cause of Death↗
Long-term reductions in mortality among children under age 5 in rural Haiti: effects of a comprehensive health system in an impoverished setting.
OBJECTIVES: Evidence regarding the long-term impact of health and other community development programs on under-5 mortality (the risk of death from birth until the fifth birthday) is limited. We compared mortality in a population served by health and other community development programs at the Hôpital Albert Schweitzer (HAS) with national mortality rates among children younger than 5 years for Haiti between 1958 and 1999. METHODS: We collected information on births and deaths in the HAS service area between 1995 and 1999 and assembled previously published under-5 mortality rates at HAS. Published national rates for Haiti served as a comparison. RESULTS: In the early 1970s, the under-5 mortality rate at HAS declined to a level three fourths lower than that in Haiti nationwide. More recently, HAS rates have remained at one half those for Haiti nationwide. Child survival interventions in the HAS service area were substantially higher than in Haiti nationwide although socioeconomic characteristics and levels of childhood malnutrition were similar in both areas. CONCLUSIONS: HAS's programs have been responsible for long-term sustained reduction in mortality among children aged less than 5 years. Integrated systems for health and other community development programs could be an effective strategy for achieving the United Nations Millennium Goal to reduce under-5 mortality two thirds by 2015.
Benchmarking↗
Elderly migration and development in small communities.
"This paper develops a conceptual model of the process of community change [in the United States] in response to elderly inmigration. Analysis of intra-regional variation in elderly migration patterns in Appalachia, and synthesis of an emergent literature on the benefits and costs of attracting elderly migrants, serve as a backdrop for case studies, based on field observations and interviews, of three contrasting Appalachian communities at different stages of development as retirement destinations."
Adult↗
Developing community-specific recommendations for first-line treatment of acute otitis media: is high-dose amoxicillin necessary?
OBJECTIVES: National recommendations are to use high-dose amoxicillin (80-90 mg/kg per day) to treat uncomplicated acute otitis media (AOM) in children who are at high risk for infection with nonsusceptible Streptococcus pneumoniae (NSSP). However, high-dose treatment may not be necessary if the local prevalence of NSSP is low. The objective of this study was to estimate the local prevalence of NSSP in children with acute upper respiratory illnesses and to develop community-specific recommendations for first-line empiric treatment of AOM. METHODS: We conducted a cross-sectional prevalence study in the offices of 7 community pediatricians in St Louis, Missouri. S pneumoniae was isolated from nasopharyngeal swabs collected from children who were younger than 7 years and had AOM, nonspecific upper respiratory infection, cough, acute sinusitis, or pharyngitis. Children were excluded from the study when they had received an antibiotic in the previous 4-week period. Parents and providers completed a brief questionnaire to assess risk factors for carriage of NSSP. On the basis of National Clinical Chemistry Laboratory Standards, isolates with a penicillin minimum inhibitory concentration > or =0.12 microg/mL were considered to be nonsusceptible to penicillin (NSSP), and isolates with a penicillin minimum inhibitory concentration >2 microg/mL were categorized as nonsusceptible to standard-dose amoxicillin (35-45 mg/kg per day; NSSP-A). RESULTS: S pneumoniae was isolated from the nasopharynx of 85 (40%) of 212 study patients (95% confidence interval [CI]: 33%-47%); 41 (48%) of 85 isolates were NSSP (95% CI: 37%-59%), and 6 (7%) were NSSP-A (95% CI: 1.5%-13%). Among the 212 study patients, the prevalence of NSSP was 19% (95% CI: 14%-25%), and the prevalence of NSSP-A was 3% (95% CI: 0.6%-5%). Carriage of NSSP was increased in child care attendees compared with nonattendees (29% vs 14%; odds ratio: 2.6; 95% CI: 1.3-5.2). CONCLUSIONS: In our community, although the prevalence of NSSP among isolates of S pneumoniae identified from the nasopharynx of symptomatic children is high (48%), the probability of NSSP-A infection among symptomatic children is <5%. Our data support a recommendation to treat most children who have uncomplicated AOM with standard-dose amoxicillin. Children who attend child care or have recently received an antibiotic may require treatment with high-dose amoxicillin. Other communities may benefit from a similar assessment of the prevalence of NSSP and NSSP-A.
Acute Disease↗
Community health developments in Australia.
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Australia↗
Facing the challenge of practice development in community nursing.
The large number of job titles associated with practice development within nursing can cause confusion as to the exact role of the person working within the development sphere. However, there is a recognized need for these development roles in the absence of clinical managerial positions and within the climate of continuing changes in the NHS. This article explores the skills required for practice development and is, in part, a reflective account of the work achieved over a 2-year period. The authors argue for clarity of purpose and continuing commitment from within the organization in order for these roles to achieve some degree of recognition, with specific reference to a community health care setting.
Community Health Nursing↗
Developing a community board for a mental health center.
Federally funded community mental health centers are required to have governing boards made up of community residents to ensure that services are meeting the community's needs. Sound View-Throgs Neck Community Mental Health Center in Bronx, New York, met that requirement by developing three local advisory boards, one for each subcatchment area served by an outpatient clinic. Later a central community board with 12 members, four from each of the local advisory boards, was formed. The central board has several standing committees that parallel the organization of the center, including community, hospital, and rehabilitation services; research and development; and administration. Board members and center staff meet regularly. They have found that they must act as partners and learn to share power, privileges, and knowledge.
Catchment Area, Health↗
A framework for the development of community health agency partnerships.
The purpose of the study reported in this paper was to generate substantive theory regarding the development of effective partnerships among community agencies working with vulnerable populations. Ethnographic interviews were conducted and analyzed by applying the constant comparative method of qualitative analysis. This information was supplemented with data from the participants in two workshops, three manuscript reviewers, and relevant literature. Analysis of the data resulted in the emergence of a framework that outlines elements of partnerships. This framework furnishes the foundation for discussions of partnership configuration and partnership development. The results of this study provide basic guidelines for the formation of effective partnerships, and show that there is no single way to develop and structure such collaborative initiatives. Further studies are required in other substantive areas to advance the emergence of a formal theory of partnerships.
Adult↗
Connecting our resources: Louisiana's approach to community health network development.
Louisiana's rural community health systems are in crisis because of pressures fueled by the rising costs of health care, sustained poor health status, state budget shortfalls and changes in priorities, and a sliding rural economy. The development of community health networks is providing new infrastructure and capacity for communities to reprioritize, formulate innovative partnerships, and leverage new resources. Successful elements of Louisiana's network development experience include community commitment to engage in study and action; the availability of capable and motivated technical assistance; an approach that involves open-engagement, community-driven decision-making; and data-driven problem definition, prioritization, and solutions. Louisiana's experiences illustrate the benefits of developing networks along with, or as a result of, a community health plan. When a community owns its health improvement plan, it is more likely to support the new network as a structure for implementation. Broad-scale participation is also a principle of success. When social service agencies are included along with health agencies, more comprehensive strategies result, and they bring additional resources, resulting in more holistic solutions. The cases of 2 networks are presented as illustrations. One involves the facilitation of a community planning process for an existing network. The plan helped to expand the network's community connections and support and provided the content for a successful application for a Health Resources and Services Administration Community Access Program grant. In the second case, a new network was developed, and it leveraged federal funds from the federal Office of Rural Health Policy's Network Development Grant Program.
Community Health Planning↗