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PubMed1997

Evaluating a statewide partnership for reducing risks for chronic diseases.

We describe a case study evaluation of Kansas LEAN, a statewide partnership with the mission of reducing risks for chronic diseases through dietary and exercise modification. We used a case study design to examine five primary questions related to process and outcome: (a) were the goals of the partnership important to constituents? (process), (b) were constituents satisfied with the partnership (process), (c) were community or systems changes (new or modified programs, policies, or practices) facilitated by partnership efforts (outcome)?, (d) were these changes important to the partnership's mission (outcome)?, and (e) what critical events helped facilitate community changes (outcome)? several measurement instruments--a monitoring and feedback system, constituent surveys, and semistructured interviews--were used to address key evaluation questions. Kansas LEAN is a strong statewide partnership with involvement from key representatives throughout Kansas. It is an ongoing, comprehensive health promotion program that plans and implements multiple components, in a variety of settings, to create awareness, behavior change, and a supportive environment. Kansas LEAN has facilitated several important community or systems changes related to its mission. We conclude with a discussion of the challenges of evaluating partnerships that seek to reduce risks for chronic diseases.

Acute Disease↗

PubMedDate not supplied

Intrahospital transport of the critically ill adult: a research review and implications.

Transporting the critically ill adult from the relative stability of the critical care environment to a testing site or new area is a nursing responsibility. Yet current research about the risks and benefits of intrahospital transport is at times conflicting. This article provides an analysis of available research on the critical elements involved in intrahospital transport and suggests recommendations for clinical practice.

Algorithms↗

PubMed2000

Creating clinical experiences in a social work agency on aging.

This article describes the growth of a relationship between the fields of social work and nursing that developed into a positive learning experience for senior nursing students. It highlights the growing awareness, complicated by the scarcity of clinical sites, of the importance of including content in curricula related to community-dwelling older adults. The author was able to prepare student assignments from a social work agency on aging. The outcomes of this process included meeting the objectives of community health nursing and a new awareness by nursing students of the collaborative roles of nursing and social work in the community.

Aged↗

PubMed2002

Interventions to prevent HIV-related stigma and discrimination: findings and recommendations for public health practice.

Stigma and discrimination exist in many forms, undermining individual and community health. Interventions to combat stigma and discrimination are essential to prevent the spread of human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS). Health departments, and others, can benefit by mounting specific interventions against these threats to public health. In New York State, interventions against HIV-related stigma and discrimination are integral components of the comprehensive approach to HIV prevention. For maximum impact, multiple interventions are employed at both policy and program levels. This article summarizes the need for interventions, discusses practical examples from actual experience, and presents the synergy of multiple interventions in a logic model.

Attitude to Health↗

PubMed2003

Addressing urban health in Detroit, New York City, and Seattle through community-based participatory research partnerships.

OBJECTIVE: This study describes key activities integral to the development of 3 community-based participatory research (CBPR) partnerships. METHODS: We compared findings from individual case studies conducted at 3 urban research centers (URCs) to identify crosscutting adaptations of a CBPR approach in the first 4 years of the partnerships' development. RESULTS: Activities critical in partnership development include sharing decision-making, defining principles of collaboration, establishing research priorities, and securing funding. Intermediate outcomes were sustained CBPR partnerships, trust within the partnerships, public health research programs, and increased capacity to conduct CBPR. Challenges included the time needed for meaningful collaboration, concerns regarding sustainable funding, and issues related to institutional racism. CONCLUSIONS: The URC experiences suggest that CBPR can be successfully implemented in diverse settings.

Community Health Planning↗

PubMed2006

Hard gains through soft contracts: productive engagement of private providers in tuberculosis control.

Over the past decade, there has been a rapid increase in the number of initiatives involving "for-profit" private health care providers in national tuberculosis (TB) control efforts. We reviewed 15 such initiatives with respect to contractual arrangements, quality of care and success achieved in TB control. In seven initiatives, the National TB Programme (NTP) interacted directly with for-profit providers; while in the remaining eight, the NTP collaborated with for-profit providers through intermediary not-for-profit nongovernmental organizations. All but one of the initiatives used relational "drugs-for-performance contracts" to engage for-profit providers, i.e. drugs were provided free of charge by the NTP emphasizing that providers dispense them free of charge to patients and follow national guidelines for diagnosis and treatment. We found that 90% (range 61-96%) of new smear-positive pulmonary TB cases were successfully treated across all initiatives and TB case detection rates increased between 10% and 36%. We conclude that for-profit providers can be effectively involved in TB control through informal, but well defined drugs-for-performance contracts. The contracting party should be able to reach a common understanding concerning goals and role division with for-profit providers and monitor them for content and quality. Relational drugs-for-performance contracts minimize the need for handling the legal and financial aspects of classical contracting. We opine that further analysis is required to assess if such "soft" contracts are sufficient to scale up private for-profit provider involvement in TB control and other priority health interventions.

Antitubercular Agents↗

PubMed1997

North-South health research collaboration: challenges in institutional interaction.

North-South health development cooperation often includes research financed largely by external donors. The cooperation varies between projects and programmes with regard to subject area, mix of disciplines involved, research methods, training components and project management arrangements. A variety of problems is encountered, but they are rarely described and discussed in published project reports. We authors conducted a study of a small number of European health researchers collaborating with researchers from the Third World. We focused upon projects involving both biomedical and social science researchers, and apart from a literature review three methods were applied: self-administered questionnaires to European researchers, semistructured interviews with five IHCAR researchers, and written summaries by the three authors, each on one recent or ongoing collaborative project of their choice. Most collaborative projects were initiated from the North and are monodisciplinary or partly interdisciplinary in the sense that researchers did independent data collection preceded by joint planning and followed by joint analysis and write-up. There may be disagreements concerning remuneration such as allowances in relation to fieldwork and training. Socio-cultural misunderstanding and conflict was reportedly rare, and no serious problems were reported regarding authorship and publishing. It is concluded that collaborative research is a complex and poorly understood process with considerable potential and worth pursuing despite the problems. Difficulties related to logistics and finance are easily and freely discussed, while there is little evidence that transdisciplinary research is conducted or even discussed. We recommend that published and unpublished reports on collaborative research projects include more detailed accounts of the North-South collaborative arrangements and their management, ethical and financial aspects.

Cooperative Behavior↗

PubMedDate not supplied

The local Red Cross in time of disaster: characteristics and conditions of organizational effectiveness during the Loma Prieta earthquake and central Texas floods.

This discussion demonstrates that three interrelated activities should improve volunteer organizations' disaster capabilities. These factors include improved disaster planning, learning from related experiences, and improving interorganizational networks. These three activities can dramatically improve the local chapter's emergency response. Networking ought to be the first priority. Through the development of both formal and informal contacts, planning and experience potential become enhances. Without the support and involvement of volunteer organizations, an effective community-wide disaster response would be difficult, if not impossible.

California↗

PubMed1992

Federal, state, and local partnerships in providing primary care: one urban health department's endeavor with a state university medical center.

We describe how the federal government, the City of Chicago, and the State of Illinois worked together to increase the availability and accessibility of health care services on Chicago's underserved west side by reopening a bankrupt, federally-funded community health center. The federal government made the building available to the City which then contracted with a state university medical center to be the provider of services. This partnering has allowed the Chicago Department of Health to offer services in a previously underserved area. The University has gained an opportunity for community-based primary care teaching, as well as community relations. Patients have increased access to a wide variety of specialty and inpatient care. If public health providers are to be successful in this financial climate, they must look to new partners and new ways of delivering services to increase availability of services at a time when they are greatly needed.

Academic Medical Centers↗

PubMed1982

Planning for disaster: a new community outreach program for mental health centers.

Disaster victims typically do not request services from the mental health system. Victims must be contacted through innovative outreach programs linked to the disaster relief network. Advance planning for disaster programs by mental health centers is highly desirable, but barriers may be encountered related to (a) external support, (b) information on victim needs, (c) intervention methods, (d) linkage with disaster agencies, or (d) planning guidelines. Advice and information are offered on how to overcome each potential barrier. A model disaster plan is outlined that is consistent with NIMH guidelines for disaster preparedness planning, and with three criteria considered essential for an effective plan.

Community Mental Health Centers↗

PubMed1991

How nonprofit human service organizations manage their funding sources: key findings and policy implications.

Major findings and policy implications on how nonprofit social service organizations manage their funding relations are summarized. Data from in-depth case studies of six medium-sized social service organizations with distinctive funding profiles yielded findings on the major contingencies associated with controlling fees, the volatility of donations, and the driving force of public funding relationships for funders (public and private), nonprofit managers, and the role of nonprofit organizations.

Data Collection↗

PubMedDate not supplied

Partnering with public health: a model for baccalaureate nursing education.

This article discusses the implementation of a one-year project developed to increase and improve the quality of public health nursing experiences for baccalaureate nursing students at one state-assisted university. The partnership model involved collaboration with public health departments, the academic nursing programs, and community agencies and leaders. The project led to the development of increased student skills related to interdisciplinary team work, program development, and cultural competency skills. A needs assessment questionnaire of the public health department partner staff supported a need to develop public health work force skills. The project provided opportunities for nursing faculty development. The project results support the need for service-academic partnerships to develop the public health nursing workforce.

Cultural Characteristics↗

PubMed1989

Interorganizational collaboration and dissemination of health promotion for older Americans.

This article describes how a successful health promotion program for older adults was adapted and disseminated through collaboration of the American Association of Retired Persons, the American Red Cross, and the Dartmouth Institute for Better Health. The details of this effort are presented in three sections: the conceptual framework used to build the collaborative relationship, the outcomes, and an analysis of these experiences as they relate to the diffusion of innovations in organizations. The problems encountered are discussed as well as the need for more time to elapse before judging the ultimate success of the diffusion of the program.

Academies and Institutes↗

PubMedDate not supplied

Evaluating the effectiveness of a multi-component intervention to improve health in an inner-city Havana community.

The ecosystem approach to human health was applied to guide an evaluation of the effectiveness of a multi-component intervention to improve quality of life and health in an inner-city Havana community. A pre- versus post-intervention analysis was carried out in the study community of Cayo Hueso, and Colon, a concurrent comparison community. A household survey of 1,703 individuals was conducted in 30 neighborhoods, equally divided between the two areas. Greater improvements in housing, local infrastructure, and exposure to risk were perceived to have occurred in the targeted community, more so from the perspective of benefit to the community rather than with regard to the residents' own households. Improvements in some lifestyle-related risk factors and self-rated health in the most vulnerable subgroups (elderly and adolescents) were also achieved. Overall, the Cayo Hueso Plan was considered highly successful in improving the quality of life amid difficult circumstances. Its lessons are being embraced by other communities.

Adult↗

PubMedDate not supplied

Partnerships in health care: creating a strong value chain.

The health care climate is one of stormy relations between various entities. Employers, managed care organizations, hospitals, and physicians battle over premiums, inpatient rates, fee schedules, and percent of premium dollars. Patients are angry at health plans over problems with access, choice, and quality of care. Employers dicker with managed care organizations over prices, benefits, and access. Hospitals struggle to maintain operations, as occupancy rates decline and the shift to ambulatory care continues. Physicians strive to assure their patients get quality care while they try to maintain stable incomes. Businesses, faced with similar challenges in the competitive marketplace, have formed partnerships for mutual benefit. Successful partnerships are based upon trust and the concept of "win-win." Communication, ongoing evaluation, long-term relations, and shared values are also essential. In Japan, the keiretsu contains the elements of a bonafide partnership. Examples in U.S. businesses abound. In health care, partnerships will improve quality and access. When health care purchasers and providers link together, these partnerships create a new value chain that has patients as the focal point.

Cooperative Behavior↗

PubMed2006

Outcomes research collaborations between third-party payers, academia, and pharmaceutical manufacturers: What can we learn from clinical research?

Research collaborations between academic researchers, regulatory agencies, and pharmaceutical manufacturers have made the drug development process more efficient and have frequently supported the successful documentation of quality, safety, and efficacy of pharmaceuticals (the so-called three hurdles). Over recent years issues of drug cost, access, and utilization have moved to center stage, giving rise to a "fourth hurdle approval" process by third-party payers. This requires new forms of collaborative research among new players. This contribution highlights the need for a "triangular" relationship in the field of outcomes research between scientists in academia, third-party payer institutions, and pharmaceutical manufacturers. We discuss, and illustrate by case studies, how successful models of collaboration from the drug development process might be relevant to research activities related to the fourth hurdle. Case studies which may provide useful models for collaborative outcomes research include the "International Conference on Harmonization" process, the voluntary consultation procedures established by drug regulatory agencies, and the Quebec experience in database sharing.

Biomedical Research↗

PubMed2002

Evaluation of the organization and financing of the Danish health care system.

The organization and financing of the Danish health care system was evaluated within a framework of a SWOT analysis (analysis of strengths, weaknesses, opportunities and threats) by a panel of five members with a background in health economics. The evaluation was based on the reading of an extensive range of documents and literature on the Danish health care system, and a 1-week visit to health care authorities, providers and key persons. The present paper describes the main findings of one of the panel members. A quality assessment approach is combined with the principles of a SWOT analysis to assess the main features of the Danish health care system. In addition, a public health perspective has been used in judging the coherence of the subsystems of the health systems. It is concluded that the macro-efficiency of the health care system could be increased by improving the cooperation between the subsystems. The relatively high mortality rates suggest that greater input into health education programs could significantly improve the health status of the Danish population. Finally, it is suggested that the steering power of the public board be strengthened by transferring ownership of health care institutions to other hands (privatization).

Community Participation↗

PubMedDate not supplied

Ohio hospital PR pros collaborate on crisis communications plan.

Two member hospitals of the Akron Regional Hospital Association (ARHA), Ohio, experienced crisis situations which severely strained their public relations resources. These events were the genesis for the development of a comprehensive plan for sharing public relations resources among 11 member hospitals. The plan details procedures for sharing help in the event of a crisis or specific hospital media event. It identifies three potential situations in which it can be implemented: internal disaster, external disaster, or a specific incident unique to one of the hospitals. No occasion has yet arisen to implement the plan.

Communication↗