Thailand stifles AIDS campaign.
Explore the source record for details and available documents.
Acquired Immunodeficiency Syndrome↗
SEARCH · PubMed Health
Results for “Communication Programs--changes”
Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
AIDS education: evolving approaches.
Explore the source record for details and available documents.
Acquired Immunodeficiency Syndrome↗
The University of Rochester experience.
To establish a school-based health center, it is more important than ever to plan for financial support for building a practice. It is difficult to get to and stay at the target enrollment for this population since it is ever-changing group of students. Plan for increased numbers of initial assessments since every year at least one-fourth of the enrollees in the program change. Work closely with primary care providers and make it clear in verbal and written communication that there is no intent to disrupt the relationship with the student. Assess risk of the population and attempt to predict utilization of services (number and type of encounters) and determine costs of care. It is also important to find ways to track hospitalizations, emergency room visits and other unscheduled access to care. Since adolescents frequently seek confidential care, parents and providers may be uninformed regarding the actual cost of management of covered lives in a managed care environment.
Adolescent↗
Understanding and practice: a 7-year follow-up study on implementation of a cardiac rehabilitation program.
The authors explore the perspectives of managers, health care professionals, and patients on a comprehensive cardiac rehabilitation program. Using qualitative methodology, they compare and analyze results from individual interviews and two conceptual modeling seminars held 7 years apart. Professionals and managers understood their own tasks in a professional-centered way that did not include the client's perspective. Patients believed they were not seen in their whole context. Initially, health care organization was fragmented, lacking clear leadership, coordination, and communication between levels of care. However, lack of common understandings of structure, process, and outcome in cardiac rehabilitation services hampered the implementation of program changes.
Attitude of Health Personnel↗
Improving the recognition and management of depression: is there a role for physician education?
BACKGROUND: Many patients who visit primary care physicians suffer from depression, but physicians may miss the diagnosis or undertreat these patients. Improving physicians' communication skills pertaining to diagnosing and managing depression may lead to better outcomes. METHODS: We performed a randomized controlled trial involving 49 primary care physicians to determine the effect of the Depression Education Program on their knowledge of depression and their behavior toward depressed patients. After randomization, physicians in the intervention group completed the Depression Education Program, which consists of 2 4-hour interactive workshops that combine lectures, discussion, audiotape review, and role-playing. Between sessions, physicians audiotaped an interview with one of their patients. Two to 6 weeks following the intervention program, physicians completed a knowledge test and received office visits from 2 unannounced people acting as standardized patients with major depression. These "patients" completed a checklist and scales. Logistic and linear regression were used to control for sex, specialty, and suspicion that the patient was a standardized patient. RESULTS: For both standardized patients, more intervention physicians than control physicians asked about stresses at home, and they also scored higher on the Participatory Decision-Making scale. During the office visits of one of the standardized patients, more intervention physicians asked about at least 5 criteria for major depression (82% and 38%, P = .006), discussed the possibility of depression (96% and 65%, P = .049), scheduled a return visit within 2 weeks (67% and 33%, P = .004), and scored higher than control physicians on the Patient Satisfaction scale (40.3 and 35.5, P = .014). CONCLUSIONS: The Depression Education Program changed physicians' behavior and may be an important component in the efforts to improve the care of depressed patients.
Communication↗
[Influence of changes in physicians' patterns of explanation on patients' compliance].
Although compliance of patients with their physicians' recommendations is necessary for effective treatment of most illnesses, compliance rates in general are low. Physicians usually behave according to the traditional dominance model of the professional-client relationship; they do not encourage their patients to participate, and give little or no explanations of illnesses or of the the treatment process. Interactions between 22 physicians and 139 patients who were on short-term treatment for acute infections were recorded and analyzed according to a method developed to assess form and content of participatory versus dominant modes of explanation. The relation of these data to patients' compliance, expectations and responses to explanations was investigated. After a short workshop in which the physicians learned to use the participatory explanation pattern, the process was repeated for 148 new interactions. As a control, responses of 142 other patients of the same physicians, whose interactions were not recorded so as to examine the influence of the recording itself, were also analyzed. It was found that most physicians used the dominant mode of explanation. However, participation in the workshop program changed in a significant way their explanatory patterns in the direction of more participatory ones. The majority of patients preferred the participatory type of explanation. The main finding was that the more participatory the explanation, the greater the patients' compliance, knowledge and satisfaction with the explanation.
Communication↗
Nurses' interpersonal behaviours and the development of helping skills.
This study investigates the interpersonal behaviours of general nurses and evaluates the effectiveness of a nine-week program in developing helping skills. Ninety-nine nurses undertaking tertiary studies were administered the FIRO-B Scale, which assesses six dimensions of interpersonal behaviours, before and after the skills program. Changes in interpersonal behaviours were examined for the total sample and for six clinical subgroups based on the nurse's area of clinical practice. Nurses' FIRO-B scores at pre-test were also compared with results from a sample of occupational therapy students. The results of this study showed that nurses, when compared with occupational therapists, had less desire to belong and a stronger need to influence or control interpersonal relationships. When clinical subgroups of nurses were contrasted, significant differences in the need for inclusion and affection were identified. Evaluation of the communication skills program demonstrated some significant improvements in helping attitudes for the sample as a whole, but no differences when specific nursing subgroups were examined. Findings from this study are discussed in relation to the helping role of nurses, methodological limitations, and directions for future investigation.
Adult↗
Discharge planning in an acute hospital.
To improve discharge planning on an acute medical ward, a nursing "team system" was initiated with clear delineation of responsibility for discharge planning. The head nurse supervised the nurses' actions and supported their communication with attending physicians. To assess the efficacy of this approach, chart reviews and interviews of 60 consecutive patients were performed before and after the implementation of the plan. A plan was labeled adequate if the following criteria were met: all treatable diagnoses were recognized; appropriate treatment regimens were instituted for each diagnosis; the patient's abilities were sufficient for him to function in the proposed environment; and plans were made for follow-up care. Patient knowledge was stated to be adequate if the patient was aware of his diagnosis, treatment regimen and plans for follow-up care. In addition, the patient was questioned concerning his satisfaction with the plans for further care. Seventy-five percent of the patients admitted to this ward required discharge planning. Of those requiring discharge planning, the plan was judged adequate in 55% prior to the program change and in 83% following that change. Eighty percent of the patients required some teaching during their hospital stay. Of these, by the time of discharge, knowledge was adequate in 53% prior to the program change and 51% subsequent to the change. Initially 68% of the patients were very satisfied with the discharge plans but this figure rose to 86% following the program change.
Aftercare↗
Bipolar disorder and family communication: effects of a psychoeducational treatment program.
Family psychoeducational programs are efficacious adjuncts to pharmacotherapy for patients with schizophrenic and bipolar disorders, but little is known about what these programs change about families. The authors assessed changes in face-to-face interactional behavior over 1 year among families of bipolar patients who received a 9-month family-focused psychoeducational therapy (FFT; n = 22) or crisis management with naturalistic follow-up (CMNF; n = 22), both administered with maintenance pharmacotherapy. Members of families who received FFT showed more positive nonverbal interactional behavior during a 1-year posttreatment problem-solving assessment than families who received CMNF, although no corresponding decreases were seen in negative interactional behaviors. The positive effect of family treatment on patients' symptom trajectories over 1 year was partially mediated by increases in patients' positive nonverbal interactional behaviors during this same interval.
Adolescent↗
Impact evaluation of the "not me, not now" abstinence-oriented, adolescent pregnancy prevention communications program, Monroe County, New York.
"Not Me, Not Now" is an abstinence oriented, adolescent pregnancy prevention integrated communications program developed by Monroe County, NY. The evaluation utilized a cross-sectional time series approach in the analysis of items from several waves of youth surveys administered to two different age groups: (1) a survey of 7th and 8th graders on awareness, attitudes and intended behavior, and (2) the Youth Risk Behavior Survey administered to 9th through 12th graders. The trends found in the surveys demonstrated high levels of awareness of the program, changing attitudes and intended behaviors consistent with the program's messages. Analysis of pregnancy rates for 15-17 year-olds in the county were compared to reductions found in similar geographic areas. Pregnancy rates in Monroe County declined faster than in comparison areas. The authors conclude that there is a strong likelihood that the program had independent effect on the outcome of pregnancies in the population exposed to the program.
Adolescent↗
The Canadian Red Cross plasmapheresis donor safety program: changes in plasma proteins after long-term plasmapheresis.
The Canadian Red Cross Blood Services have been harvesting plasma from whole blood by plasmapheresis procedure for the last 10 years. To date, we have performed approximately 230,000 procedures. To determine whether this procedure is a health hazard to an individual, a donor safety program was established in 1979 at the National Reference Laboratory. Serum levels of total protein, albumin, and immunoglobulins are monitored at intervals set by the Bureau of Biologics, Health and Welfare Canada. In this communication, we present a 10-year evaluation of this program. A comparison of the protein concentration distributions between first-time and long-term plasmapheresis donors showed no significant differences. Therefore, we have demonstrated that the donors are not at risk as the result of changes in the measured plasma protein levels following plasmapheresis procedure as performed over the last 10 years at The Canadian Red Cross Blood Services.
Blood Donors↗
Anticipation versus results: an approach to improved program forecasting.
Health planners may be an integral part of the decision-making process when new programs are designed and legislation and regulations are drafted. The appropriateness of the resultant program design will depend on the quality of the guidance provided by the planners. In many cases, this guidance is primarily determined by the philosophical beliefs, subjective system insights, and communication skills of the individual--supported by a little data. Pressures of the moment and limitations in existing impact prediction techniques may restrict the use of more systematic methods of planning. This historical approach has produced numerous planning failures, when success is measured by comparing anticipated and actual outcomes. Planned changes have often been accompanied by significant, unpredicted side effects that reduce the political credibility of decision-makers and produce programs that are criticized by the public that they are intended to serve. Thus, the need seems to exist for new approaches to the analysis of the potential impact of program changes. Planning, decision-making and implementation processes for health programs should be studied in order to enable planners to provide improved guidance to decision-makers. One conceptual approach to the performance of such studies is explored here.
Forecasting↗
A feedback model for applied research on tobacco control.
Although the health communication program feedback cycle is frequently referenced, the steps for moving between or within the sections of the model in a public health environment are rarely described. We detail the process by which the Texas Tobacco Research Consortium implemented the stage of "assessing effectiveness and making refinement" and expanded it to include a program assessment feedback model. Tools were developed to move the consortium through five stages of the expanded program assessment feedback model: 1) formulate research questions using logic models to identify key evaluation items, 2) format data displays from multiple data sources to address research questions, 3) use a facilitated group process to present and review research findings, 4) prepare group recommendations, and 5) involve local partners to translate recommendations into practice. The process allowed us to sift through a large volume of information and prepare data-based program recommendations. A Web-based reporting system provided timely access to community-based program activity data and process indicators that, when linked to logic models, provided actionable items for program improvement. Partnerships among researchers and state and local practitioners created the conditions for implementing the recommendations. Program changes included revisions to program materials, target audiences, and evaluation instruments for a community-based tobacco-cessation campaign. The systematic approach allowed translation of research into practice and should be applicable to other areas of population-based health promotion.
Health Education↗
Outreach programs and their effects within the Cancer Information Service network.
Outreach programs have been part of the Cancer Information Service (CIS) program since its outset. The scope of work of the first two CIS contracts gave broad responsibilities to the local offices for public and professional education, responsibilities that were carried out in a diverse fashion with little national direction. As the National Cancer Institute (NCI) Office of Cancer Communications matured and became more directed, the CIS local offices began successfully to implement programs with the Office of Cancer Communications and through intermediary groups. The Partners in Prevention (PIP) effort, launched by NCI in 1984, was the first major national community education program in which all the CIS offices participated. Shortly after the inception of PIP, however, the outreach personnel were deleted from the CIS contracts, due to budget restrictions. When the outreach component was reinstituted in 1990, the structure of the program changed to a catalytic role, working with local media and intermediary organizations to bring the NCI program messages and materials to targeted audiences and memberships. Under the reconfigured CIS network, the outreach program will serve as a resource to both those community institutions that are funded by NCI and those that are not and will be proactive in intermediary development. This paper details the chronology of the program and presents some of the research issues that need to be addressed in the future.
Humans↗
The effect of operations research on program changes in Bangladesh.
This article is based on the ten-year experience of an operations research project in Bangladesh. It assesses how, and under what circumstances, research-based advice and results of pilot projects contribute to change in large-scale public programs. It discusses project research on issues facing the national family planning program: recruitment and training of field-workers; delivery of injectable contraceptives; management information; field-workers' use of service registers; field supervision; satellite clinics; and contraceptive user fees. These issues are used to illustrate the advantages and disadvantages of a long-term institutionalized project, and to describe the diversity of means for communication with policymakers. The analysis shows that research, policy decision, and implementation can occur in any sequence. Policy advice that disrupts long-standing power relationships and organizational culture takes a great deal of effort to implement. Operations research can produce useful changes in organizational behavior, even when large-scale problems remain.
Bangladesh↗