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PubMed1996

Initial community site development for first--and second-year medical students.

BACKGROUND: Many medical schools are planning community-based experiences for preclinical students. As part of a generalist physician initiative, the University of Texas Medical Branch in Galveston placed all 200 first-year medical students in generalists' offices in a new course, called the "Community Continuity Experience." METHODS: Driven by significant time, class size, and geographic constraints, a process managed by the local Area Health Education Center was formulated for identifying and developing potential sites. The final process included identification of candidate generalist sites, departmental participation, and a detailed site assessment. The individual office nurses were the focus of site development activities. RESULTS: Feedback indicated that having office nurses serve as site facilitators was effective, and a key enabling strategy was having a nurse site coordinator serve as a single point of contact for all the sites. The students expressed positive views of the site experience and an interest in assignment, rather than student choice, for site allocation. CONCLUSIONS: Important components of site development for such a new course are development of an accurate database of available generalist community faculty, a methodical site selection process, an early orientation for all involved, and consideration of nonphysician site facilitators during the start-up phase.

Ambulatory Care↗
PubMed2005

Involving the community in cervical cancer prevention programs.

Underutilization of cervical cancer prevention services by women in the high-risk age group of 30-60 years can be attributed to health service factors (such as poor availability, poor accessibility, and poor quality of care provided), to women's lack of information, and to cultural and behavioral barriers. The Alliance for Cervical Cancer Prevention (ACCP) partners have been working to identify effective ways to increase women's voluntary participation in prevention programs by testing strategies of community involvement in developing countries. The ACCP experiences include developing community partnerships to listen to and learn from the community, thereby enhancing appropriateness of services; developing culturally appropriate messages and educational materials; making access to high-quality screening services easier; and identifying effective ways to encourage women and their partners to complete diagnosis and treatment regimens. Cervical cancer prevention programs that use these strategies are more likely to increase demand, ensure follow-through for treatment, and ultimately reduce disease burden.

Ambulatory Care↗
PubMed2005

Computers and the internet: tools for youth empowerment.

BACKGROUND: Youth are often disenfranchised in their communities and may feel they have little voice. Since computers are an important aspect of youth culture, they may offer solutions to increasing youth participation in communities. OBJECTIVE: This qualitative case study investigated the perceptions of 19 (predominantly female) inner-city school youth about their use of computers and the Internet in a school-based community development project. METHODS: Youth working with public health nurses in a school-based community development project communicated with local community members using computer-mediated communication, surveyed peers online, built websites, searched for information online, and prepared project materials using computers and the Internet. Participant observation, semistructured interviews, analysis of online messages, and online- and paper-based surveys were used to gather data about youth's and adults' perceptions and use of the technologies. Constant comparison method and between-method triangulation were used in the analysis to satisfy the existence of themes. RESULTS: Not all youth were interested in working with computers. Some electronic messages from adults were perceived to be critical, and writing to adults was intimidating for some youth. In addition, technical problems were experienced. Despite these barriers, most youth perceived that using computers and the Internet reduced their anxiety concerning communication with adults, increased their control when dealing with adults, raised their perception of their social status, increased participation within the community, supported reflective thought, increased efficiency, and improved their access to resources. CONCLUSIONS: Overall, youth perceived computers and the Internet to be empowering tools, and they should be encouraged to use such technology to support them in community initiatives.

Adolescent↗
PubMed1997

[Participatory action-research in the development of health policies for Izumo City, Japan].

The method of participatory action-research has been introduced in planning and implementing health and welfare projects for the elderly in Izumo City since 1993. Public health researchers have participated in the projects with other related administrative sectors, citizen and non-profit organizations. This study analyzes the establishment and implementation of health policies of Izumo from the following five aspects: policy-making, priority, education, intersectoral cooperation and community development. The participatory action-research method was useful for developing the ability of health-staff to work with citizens; for integrating community care and community development; for using community resources effectively for primary health care; and for developing community-based education of citizens, medical students and health staff. This method can be and should be adopted for strengthening the policy-making ability of public health researchers who learn through cooperation with citizens and non-profit organizations.

Community Participation↗
PubMedDate not supplied

Cysticercosis in an urban black South African community: prevalence and risk factors.

Cysticercosis still represents a significant health problem in developing communities, despite supposed improvements in sanitation and personal hygiene. An ELISA for Cysticercosis antibodies was performed on serum from 230 random adult admissions to Baragwanath Hospital. Seventeen patients were seropositive giving a prevalence of 7.39% for this group of urban black South Africans. Twenty-one patients with documented cerebral cysticercosis were selected in order to evaluate risk factors for cysticercosis. Of the risk factors considered only a history of tapeworm infestation appeared to be significant. Even urbanisation has not resulted in n reduction in the prevalence of Cysticercosis and it appears that the disease continues to be endemic in this developing community.

Black or African American↗
PubMed1989

Nosocomial infections in black South African children.

Nosocomial infections in infants and children were prospectively studied in the general wards of a hospital serving a developing community. Of 1350 admissions in 5 months, 193 (14.3%) developed 302 infections (22.4/100 admissions). The major risk factors were malnutrition, age less than 2 years and prolonged hospitalization. The most common sites of infection were the lower respiratory and gastrointestinal tracts. The most frequently isolated organisms were Staphylococcus aureus and Klebsiella species and the site of most frequent isolation was the lower respiratory tract for which the method most commonly used was endotracheal aspiration. Seventy percent of isolates were resistant in vitro to conventional antibiotics. Thirty-one percent of infections developed while the patient was awaiting a diagnostic procedure or waiting to be sent home. During the study period 60 patients (4.4% of admissions) were admitted with a nosocomial infection acquired elsewhere (31 at this hospital and 29 from other hospitals). Measles and its complications accounted for 28 of these cases and 7 deaths. This study provides information on nosocomial infections in children from a developing community.

Black or African American↗
PubMed2004

Private and public determinants of child nutrition in Nicaragua and Western Honduras.

We present a multivariate regression model of nutritional indicators, including interactions between education levels and overall community development, as well as estimates of community fixed effects, for two data sets: the first one is from a 2001 nationwide household survey in Nicaragua while the second set was collected in the Western regions of Honduras in 2002, as part of an evaluation process for a family entitlement program. Maternal stature, age difference with an older sibling, household size and income are seen as the main determinants of anthropometric development. Within the more homogeneous communities of Western Honduras, woman's education is also related to the child's nutritional status. The importance of individual community variables is much lower and the inclusion of community fixed effects does not alter the other parameters. However, in the Honduran sample, overall community development (assessed through the community fixed effects) has a small but significant and synergistic effect on the impact of child and household variables. The characteristics of this study and the complex design of entitlement programs prevent an adequate evaluation of those interventions within the poverty reduction strategies. The improvement of intra-community targeting seems to be a key orientation for redesign. An improved socio-economic situation, sound population and family policies, and an appropriate preventive public health care still are safe investments towards improvement of child health and nutrition.

Child↗
PubMedDate not supplied

Essential concepts in developing community-university partnerships. CareLink: the Partners in Caring Model.

University and community partnerships are being created to increase community-based educational experiences for nursing students and to assist agencies in facing ever-decreasing resources to pay for health services for clients. Many challenges often burden these partnerships, leading to a less than satisfying experience for all those involved. The Partners in Caring Model described in this article is one approach to forming a successful partnership, proven effective in meeting the educational needs of the University of Connecticut, School of Nursing students, while providing additional resources to the Visiting Nurse Association of Central Connecticut, Inc. Using Anderson and McFarlane's Community as Partner Model as the framework, the essential principles behind the development of this successful partnership are discussed. The Partners in Caring Model demonstrates that community-university partnerships can sustain themselves when the partners have a commitment to care for the population being served, and it is a shared responsibility between education and practice.

Community Networks↗
PubMed2001

Living with support in a home in the community: predictors of behavioral development and household and community activity.

The purpose of this article was to review studies of behavioral development and household and community activity among adults with mental retardation living in community residential services and to distill knowledge about the factors that influence outcome. Research points to behavioral development occurring across the full spectrum of disability but influenced by mental retardation syndrome and the acquisition of pivotal skills. However, engagement in household and community activities has been found to be strongly related to individual adaptive behavior. People with more severe mental retardation are vulnerable to leading lives characterized by underoccupation and lack of community involvement. Moving from institutional to community-based residential services may be accompanied by significant increases in adaptive behavior, but a plateau effect on subsequent development has also been reported. There is substantial evidence to suggest that key aspects of effective teaching technology may be absent in community-based residential environments. Community settings support greater engagement in household and community activities than institutions. Ordinary housing stock and normative architecture and standards of material enrichment are to be preferred. The use of normative housing constrains group living to relatively small scale, but there is little evidence that smaller size within this range is to be preferred to larger size. There is little evidence to suggest that higher staff-to-resident ratios lead to uniformly better outcomes, but staff orientation, working methods, and performance are important influences. Little is known about what precise characteristics of community location give rise to greater community integration. MRDD Research Reviews 7:75-83, 2001.

Adaptation, Psychological↗
PubMed1988

Development of a community health programme.

This formulation of the steps necessary to develop a community health programme is based on Ms Johnston's considerable experience in the "Dana Sehat" programme in Central Java, Indonesia. "Dana Sehat" means health funds and the programme is based on the concept of a community development programme, built upon a health insurance scheme. Further details on the Dana Sehat programme were given in CONTACT 31 "Community Health Care in Rural Java" and in an article by Dr Gunawan Nugroho in the WHO book "Health by the People", 1975. The following outline was first printed in CONTACT 43, February 1976.

Community Health Services↗
PubMed1989

Evaluation of public health impact of schistosomiasis.

Present knowledge on the "importance"/"impact" of schistosomiasis is reviewed. Due to different methological approaches and outcome measures used as well as the substantial inter- and intra-setting variation of the epidemiology, the public health importance of schistosomiasis appears quite inconclusive for any schistosome species and cannot be generalised. In most studies "importance" is mainly understood as the amount of schistosome-related morbidity and mortality. The consequence of these morbidity patterns are however hardly specified in terms of impact on (i) the physical and socioeconomic development of an affected family/household and on (ii) the economic and social consequences for community development. It follows that impact studies mainly considered individuals as unit of analysis and hardly focused on the family/household-level. Consequently, microeconomic studies were so far not undertaken within the concept of household production models and did not distinguish between market and non-market productivity. Standardized ranking of measured schistosome-related morbidity combined with perception patterns of disease, signs, symptoms and of additional health and community development issues could lead to new approaches on how epidemiological data on the transmission and morbidity of schistosomiasis could be linked with information on health and development priorities of a community in order to estimate the relative impact of the disease.

Animals↗
PubMed1986

Rural development and primary health care in less developed countries.

The traditional approach has been to regard health activities as a small component of rural development programmes. Under the Primary Health Care approach health is seen as the lever for rural development. But there are tendencies in the implementation of Primary Health Care in less developed countries towards limiting the range of activities to preventive and curative personal health services and of denuding it of its community development orientation. This paper highlights some of the issues that seem to militate against the establishment of Primary Health Care with its full complement of rural development activities. These activities together with the preventive and curative personal health services undertaken in the framework of community development promise to lead to the achievement of the hitherto elusive goal of improving the socioeconomic and health status of the rural population of less developed countries.

Allied Health Personnel↗
PubMed2006

Developing a community health promotion agenda for a managed care organization.

Coordination and collaboration between organizations interested in promoting the health of the populations they serve can potentially help to ensure that key services are provided as well as augment the efforts beyond that which could be accomplished by each organization alone. Understanding the perspectives of each organization can facilitate development of health promotion initiatives that will be of mutual benefit. In Maryland, when a Medicaid managed care program was initiated, Memoranda of Understanding were signed between each managed care organization (MCO) and each of the 24 local health departments; many stipulated that the parties will coordinate on community health issues. This report describes a telephone survey of the health departments that was performed by one MCO to better understand the interests and expectations of the health departments and discusses a process for developing a community health promotion agenda for an MCO.

Community Health Services↗
PubMed2005

The social impact of land contamination: reflections on the development of a community advocacy and counselling service following the Weston village incident.

Five years ago the village of Weston in Cheshire was affected by one of Britain's largest community-based land contamination incidents. The need for some form of community-based service incorporating social support and advocacy was identified and North Cheshire Health Authority in collaboration with the local community trust developed an advocacy and counselling service within the village. This article presents reflections on this highly complex service by reviewing the Weston incident, its management and possible lessons for public health practitioners dealing with similar incidents.

Community Health Services↗