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Results for “Health Plan Implementation”

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At least 991 records · Page 55Linked to original sources
PubMed2006

Cultural adaptations to a family life skills program: implementation in rural appalachia.

Numerous parent education programs have been developed to provide parents with the skills and support necessary to effectively improve their parenting abilities. The Strengthening Families Program (SFP) employs a "family skills training" approach for parents and their children (ages 6 to 10). This study focuses on the implementation and outcomes of a culturally adapted SFP in southwestern Virginia, an area known for its Appalachian culture. Two groups were compared (those that received an adapted curricula and those that did not) on retention rates, parental outcomes, child outcomes, and program satisfaction. Retention rates were significantly improved for those participants in the adapted curricula group; however, parent and child outcomes were not affected. Statistically significant improvements for parents were found in effective discipline practices, family cohesion, family conflict, confidence in parenting, and punishment practices; and for both groups of children in increased child social skills and closeness to mothers between pre- and post-test times.

Adult↗
PubMed2002

The DOTS strategy in China: results and lessons after 10 years.

OBJECTIVE: To analyse the five-point tuberculosis (TB) strategy, DOTS, 10 years after its implementation in one-half of China's population, and to suggest lessons for future implementation of the DOTS strategy. METHODS: We analysed trends in case-finding and treatment outcome over time following implementation of the DOTS strategy in each county, using routine reporting data from the Infectious and Endemic Disease Control (IEDC) project (1991 - 2000). We also determined the proportion of counties with different levels of case-finding for the fifth and sixth years of DOTS implementation. FINDINGS: From 1991 to 1995, DOTS expanded rapidly to cover more than 90% of target population and counties. By 2000, 8 million TB suspects had received free diagnostic evaluation: 1.8 million TB cases were diagnosed, free treatment was provided to 1.3 million smear-positive cases, and more than 90% were cured. During DOTS implementation, the percentage of previously treated cases decreased among all smear-positive cases and treatment outcomes improved. Despite these achievements, the detection rate for new smear-positive cases in the project was estimated to be only 54% in 1998, and 41.2% of the counties had a below average or low level of case-finding (with substantial variation between provinces). CONCLUSIONS: The IEDC project demonstrated that it is feasible to rapidly expand DOTS on a large scale. The global target of an 85% cure rate was quickly achieved, and the level of drug-resistance was probably reduced by this project. However, case-detection did not reach the 70% global target, and more research is needed on how to enhance this.

Antitubercular Agents↗
PubMed1997

Implementing assertive community treatment programs in rural settings.

The authors present a controlled evaluation of a rural adaptation of the assertive community treatment (ACT) model for clients with serious and persistent mental illness (SPMI). Four community mental health settings adopted an ACT model, while a fifth site blended ACT principles with those of the Rhinelander model, another approach to case management for persons with SPMI. A broad array of client and system outcomes were evaluated at 6, 12, and 24 months into the intervention. Twelve-month findings alerted us to potential problems in implementing the treatment model in study year 1; the implementation was qualitatively evaluated and weaknesses were addressed at the beginning of the second treatment year. Small, positive findings at 24 months suggested that the mid-study course correction may have had an impact. We present these findings along with descriptive data on the challenges of implementing complex services models. We give particular attention to describing implementation barriers to mental health services provision that are uniquely rural.

Adult↗
PubMed1999

Organizational and technological insight as important factors for successful implementation of IT.

Politicians and hospital management in Sweden and Denmark focus on IT and especially Electronic Patient Record, EPR as a tool for changes that will lead to better economy as well as better quality and service to the patients. These changes are not direct effects of the new medium for patient records but indirect effects due to the possibilities embedded in the new technology. To ensure that the implementation is successful, i.e. leads to changes in organization structure and workflow, we need tools to prepare clinicians and management. The focus of this paper is the individual insight in technology and organization and it proposes a model to assess and categorize the possibilities of individuals and groups to participate in and make an implementation process powerful.

Computer Literacy↗
PubMed2005

Assessing the implementation of the chronic care model in quality improvement collaboratives.

OBJECTIVE: To measure organizations' implementation of Chronic Care Model (CCM) interventions for chronic care quality improvement (QI). DATA SOURCES/STUDY SETTING: Monthly reports submitted by 42 organizations participating in three QI collaboratives to improve care for congestive heart failure, diabetes, depression, and asthma, and telephone interviews with key informants in the organizations. STUDY DESIGN: We qualitatively analyzed the implementation activities of intervention organizations as part of a larger effectiveness evaluation of yearlong collaboratives. Key study variables included measures of implementation intensity (quantity and depth of implementation activities) as well as fidelity to the CCM. DATA COLLECTION/EXTRACTION METHODS: We developed a CCM-based scheme to code sites' intervention activities and criteria to rate their depth or likelihood of impact. PRINCIPAL FINDINGS: The sites averaged more than 30 different change efforts each to implement the CCM. The depth ratings for these changes, however, were more modest, ranging from 17 percent to 76 percent of the highest rating possible. The participating organizations significantly differed in the intensity of their implementation efforts (p<.001 in both quantity and depth ratings). Fidelity to the CCM was high. CONCLUSIONS: Collaborative participants were able, with some important variation, to implement large numbers of diverse QI change strategies, with high CCM fidelity and modest depth of implementation. QI collaboratives are a useful method to foster change in real world settings.

Chronic Disease↗
PubMed1999

Clinical governance. The late show.

A survey of 30 trusts in the West Midlands, conducted last summer, found only four ready to implement a plan for evidence-based medicine and clinical governance. Most chief executives had no plans to implement clinical quality systems. Shortage of clinicians' time and poor IT systems were seen as the main barriers to implementation.

Attitude of Health Personnel↗
PubMed1994

Enhancing preventive practice.

Health professionals can play a major role in prevention. They are perceived as a reliable and credible source of health information and they have contact with a large percentage of the population every year. In Canada, a key development for the integration of prevention in clinical practice was the establishment of the Canadian Task Force on the Periodic Health Examination. The Task Force has provided guidance on effective preventive interventions in the clinical setting over the past 15 years. The challenge lies in the implementation of these guidelines. We need to find innovative ways to disseminate and promote them. In this context, the creation of a National Partnership for Quality in Health is an important avenue for the coordination of practice guideline development and implementation in this country. An emerging concern in the delivery of preventive services is the coordination of activities of health professionals within the public health sector, with those of clinical care. In Canada, such a comprehensive and coordinated approach has been put into practice through the Canadian Heart Health Initiative.

Canada↗
PubMed2005

Onchocerciasis control and elimination: coming of age in resource-constrained health systems.

During the past three decades, onchocerciasis control has been successful in reducing blindness and skin disease in Africa and the Americas. In this article, I review the control and elimination of Onchocerca volvulus as a public health problem. The success of onchocerciasis control has been the result of secure financing, generous drug donation, effective partnership between stakeholders, and focused operational and implementation research. The future challenges are to ensure sustainability of existing programmes and to increase the level of integration with other health interventions in resource-deficient health systems.

Animals↗
PubMed2004

[Gender sensitivity in the formulation of Spanish health plans: what it could have been but wasn't].

AIM: To systematically examine gender sensitivity in the policies formulated in the health plans of the various Autonomous Communities in Spain in which these plans are available. We defined gender sensitivity as the extent to which the health plans took gender into account as a relation category and developed interventions to ameliorate gender-related inequalities. MATERIAL AND METHODS: A questionnaire with a structure similar to that of the health plans, which were based on the World Health Organization's proposal, was designed. The questionnaire consisted of an introductory section, which we called the symbolic content, and described the general objectives and values of the health plan. In the other section, which we called the operative content of the health plan, the specific objectives and the interventions to achieve them were expressed in concrete terms. A gender sensitivity symbolic index and gender sensitivity operative index were constructed. RESULTS: Thirteen health plans were analyzed. Those of the Basque Country, the Valencian Community and the Canary Islands showed high symbolic content, which did not always match their subsequent operative implementation. The health plans of the Basque Country, Catalonia and Galicia showed the greatest operative gender sensitivity. CONCLUSIONS: Gender sensitivity in health plans varies widely among Autonomous Communities. Some channels for action would be to set up partnerships and networks for health professionals and collectives in order to raise awareness of the problem and build on the experience of the Autonomous Communities whose initiatives are carried out with the greatest gender sensitivity.

Health Planning↗
PubMed2006

Using complexity theory to build interventions that improve health care delivery in primary care.

Previous observational research confirms abundant variation in primary care practice. While variation is sometimes viewed as problematic, its presence may also be highly informative in uncovering ways to enhance health care delivery when it represents unique adaptations to the values and needs of people within the practice and interactions with the local community and health care system. We describe a theoretical perspective for use in developing interventions to improve care that acknowledges the uniqueness of primary care practices and encourages flexibility in the form of intervention implementation, while maintaining fidelity to its essential functions.

Community Health Services↗
PubMed1976

Comparative analysis of community health planning: transition from CHPs to HSAs.

With the implementation of the National Health Planning and Resources Development Act, comprehensive health planning is moving into a new phase. In search of lessons to guide future planning efforts on the part of the Health Systems Agencies (HSAs) established by the act, this paper reviews organizational and operational characteristics of ten relatively "successful" local comprehensive health planning agencies. Several problems are delineated that HSAs will likely share with their predecessors and strategies for confronting these problems are suggested.

Community Participation↗
PubMed1994

Planning in the health sector: for whom, by whom?

To state that there are vested interests in health planning is to state the obvious. One can identify numerous actors ranging from international agencies, government officials, pharmaceutical companies, health personnel and community and citizen's groups which would like to stake a claim on the direction and nature of planning and implementing health policy. We argue that the role of specific actors can only be seen in the broader social, economic and ideological framework which, consequently, determines the working of the model of health care. Probably the most important factor influencing health planning is the influence of international donors, governments and agencies. The present ideological tilt towards the market, privatization, less government and more liberalization, has had important repercussions on health planning and delivery. Furthermore, the debt crisis, and the stabilization and structural adjustment programmes being followed by a very large number of underdeveloped countries, are transforming health systems. Essentially, vested interests in health planning within countries, need to be seen in the light of recent ideological and economic changes, and international relations of aid, power and domination.

Government↗
PubMed1997

The role of private-for-profit managed behavioral health in the public sector.

Managed behavioral health, once largely confined to private sector employees, has been growing rapidly in the public sector. Throughout the country, behavioral health services, particularly for Medicaid enrollees, are coming under the management of private-for-profit firms. The authors discuss these developments, and the controversies that have come about as a result. Several public/private models of managed behavioral health services are identified.

California↗
PubMed2005

A developmental conceptualization of return to work.

INTRODUCTION: Although return to work (RTW) is a phenomenon that has been researched for many years, our ability to understand and improve outcomes is still limited. As an avenue for advancing the field, this paper presents an alternative way of thinking about RTW. METHOD: The conceptualization was constructed based on a review of the literature and the comments of RTW and workers' compensation researchers. RESULTS: RTW is presented as an evolving process, comprising four key phases: i.e., "off work," "work re-entry," "retention," and "advancement." In addition, multiple phase-specific outcomes that may be used to evaluate RTW success are advanced. CONCLUSION: Broadening thinking about RTW to take into consideration the complexities of its developmental nature holds promise for understanding and improving RTW, as it not only clarifies the importance of incremental milestones, but also facilitates intervention choice and evaluation.

Community Participation↗