Journal articles on the topic 'Community service programmes'
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Huang, Yuan-Han, Linlin Ma, Luke A. Sabljak, and Zachary A. Puhala. "Development of sustainable community paramedicine programmes: a case study in Pennsylvania." Emergency Medicine Journal 35, no. 6 (April 17, 2018): 372–78. http://dx.doi.org/10.1136/emermed-2017-207211.
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BackgroundCommunity paramedicine (CP) models have been applied across rural and urban communities in support of healthcare delivery systems for nearly two decades. However, there is still insufficient information regarding the development of sustainable CP programmes. This study explores the strategies used by active CP programmes and investigates their operational statuses, community demographics, financial models and challenges for programme development.MethodsA series of interviews was conducted with four CP programmes in Pennsylvania, USA, which are affiliated with a local government, a health system, an ambulance service and an emergency medical service, respectively. Each CP programme uses its own model with unique goals, as well as providing corresponding services/care based on the demands from their communities.ResultsThree CP programmes in the study were mainly aimed at reducing healthcare resource utilisation (ie, reduce readmissions or ED utilisation), but one of the programmes developed a sustainable model aiding newborn care in the community. Establishing a solid reimbursement mechanism and working closely with collaborators are two major strategies for developing sustainable CP programmes. Complete data collection and a programme evaluation process will also be important to demonstrate the value of its CP models to potential collaborators and policy-makers. However, the cost-effectiveness of a CP model is still not easy to identify due to the separate programmes being developed without uniform goals.ConclusionThe challenges and solutions from the four programmes under study can provide a road map for the development of CP programmes for other communities.
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Thompson, Catherine. "Lessons from an Australian community dialectical behaviour therapy programme for borderline personality disorder." International Psychiatry 5, no. 1 (January 2008): 15–16. http://dx.doi.org/10.1192/s1749367600005427.
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In 2003, the National Institute for Mental Health in England (NIMHE) published guidelines for the development of services for people with personality disorders (NIMHE, 2003), prompting community mental health teams (CMHTs) to reassess their service provision for this patient group. The guidelines did not recommend any particular treatment approach, but CMHTs were encouraged to develop specialist programmes. For many CMHTs the focus has been on borderline personality disorder, as it is one of the most prevalent personality disorders seen in adult mental health services and has high costs for both the patient and the service (Moran, 2002). The evidence base for which treatment may be most effective within the community remains small, however, and this has left many CMHTs unclear regarding a suitable programme. Here I will outline a CMHT-based dialectical behaviour therapy (DBT) programme operating in Western Australia and reflect on why I feel it is an option that CMHTs in the UK looking to develop their service should consider.
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McKenzie, Chloe, and Emma Tarpey. "Exploring forensic service users’ experience of participating in a community life skills and work-readiness programme." Journal of Forensic Practice 22, no. 1 (November 11, 2019): 1–11. http://dx.doi.org/10.1108/jfp-05-2019-0020.
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Purpose The purpose of this paper is to provide insight into the experiences of individuals with a criminal history of participating in a community life skills and work-readiness programme. Design/methodology/approach Semi-structured interviews were conducted with seven individuals that have a criminal history who were participating, or had previously participated, in a community life skills and work-readiness programme. This data was analysed by interpretative phenomenological analysis. Findings Four superordinate themes emerged, these were: “need to change”, “changing identity”, “giving back to the community” and “a sense of belonging”. These themes are discussed in relation to desistance literature and the Good Lives Model. Practical implications This research identifies through the participants’ narratives that engaging with the programme appeared to facilitate the desistance process. The importance of community programmes that provide participants skills and social integration must be acknowledged. Originality/value There is limited research on the experiences of forensic services users’ experiences of community programmes, especially those that are not aimed specifically at ex-offenders. The results of this research can be used to enhance services and identify further research areas.
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Murphy, Patricia. "Rising to the challenge: a COVID-19 vaccination service for the housebound population." British Journal of Community Nursing 26, no. 7 (July 2, 2021): 328–33. http://dx.doi.org/10.12968/bjcn.2021.26.7.328.
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The COVID-19 pandemic has necessitated innovations in practice in almost all areas of healthcare, not least community nursing services. This article details how one organisation planned and executed a home vaccination programme for housebound members of the population in its remit. It discusses the challenges faced by the team, as well as the key learnings achieved from this programme, which will guide future home immunisation programmes. Implementation of this programme required excellent coordination between clinicians and administrative staff. Importantly, support from the procurement and IT teams and the medicines management committee went a long way in the ironing out of early hiccups and in ensuring smooth running of the programme.
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Puett, Chloe, and Saul Guerrero. "Barriers to access for severe acute malnutrition treatment services in Pakistan and Ethiopia: a comparative qualitative analysis." Public Health Nutrition 18, no. 10 (November 13, 2014): 1873–82. http://dx.doi.org/10.1017/s1368980014002444.
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AbstractObjectiveTo understand and compare the primary barriers households face when accessing treatment for cases of childhood severe acute malnutrition (SAM) in different cultural settings with different types of implementing agencies.DesignThe study presents a comparative qualitative analysis of two SAM treatment services, selected to include: (i) one programme implemented by a non-governmental organization and one by a Ministry of Health; and (ii) programmes considered to be successful, defined as either coverage level achieved or extent of integration within government infrastructure. Results from individual interviews and group discussions were recorded and analysed for themes in barriers to access.SettingSindh Province, Pakistan; Tigray Region, Ethiopia.SubjectsBeneficiary communities and staff of SAM treatment services in two countries.ResultsCommon barriers were related to distance, high opportunity costs, knowledge of services, knowledge of malnutrition and child’s refusal of ready-to-use foods. While community sensitization mechanisms were generally strong in these well-performing programmes, in remote areas with less programme exposure, beneficiaries experienced barriers to remaining in the programme until their children recovered.ConclusionsHouseholds experienced a number of barriers when accessing SAM treatment services. Integration of SAM treatment with other community-based interventions, as the UN recommends, can improve access to life-saving services. Efforts to integrate SAM treatment into national health systems should not neglect the community component of health systems and dedicated funding for the community component is needed to ensure access. Further research and policy efforts should investigate feasible mechanisms to effectively reduce barriers to access and ensure equitable service delivery.
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Rezola, Juan Gondra, Javier Santolaya, Javier Orduna, and Francisco Dehesa. "School health services and community nutrition: a historical perspective." Public Health Nutrition 4, no. 6a (April 1, 2001): 1337–38. http://dx.doi.org/10.1079/phn2001213.
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Abstract:The Bilbao School Health Service was created at the beginning of the century with the aim of preventing transmittable diseases among children as well as improving nutrition. At that time such services were established in many other countries. Since then, according to evolving societal changes and emerging needs, the Service has reoriented its scope and structure towards the Health Promotion scheme.Current tasks include health screening examinations and hygiene surveillance as well as preventive and health education programmes.
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Potter, Anna, Danielle Sansonetti, Kate D'Cruz, and Natasha Lannin. "What is Known About Transitional Living Services for Adults With an Acquired Brain Injury? A Scoping Review." Brain Impairment 18, no. 2 (May 15, 2017): 240–57. http://dx.doi.org/10.1017/brimp.2017.8.
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Transitional living service (TLS) programmes for adults with an acquired brain injury are considered an important part of rehabilitation. However, considerable variability exists in the design and structure of these services, with limited research to guide the development of a programme based on best evidence. A scoping literature review was completed to answer the question ‘What is known about TLS programmes for adults with an acquired brain injury?’ Four electronic databases were systematically searched, followed by a grey literature search (from 1996 to 2015). 3183 articles were screened and 13 articles were included in the final review. Themes that emerged from the literature include the types of residents using TLS programmes, the subjective experience of residents and staff, intervention approaches, programme staffing, and programme outcomes. The research reviewed supports the use of TLS programmes to maximise functional independence and community integration of individuals with an acquired brain injury. Clinical practise recommendations were developed to help support implementation of TLS programmes based on best evidence, these included: to use multiple outcome measures, implement collaborative goal setting, support generalisation of skills learnt in the TLS to the home environment and for eligibility criteria for these programmes to include individuals across all phases of recovery.
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Meiklejohn, Sarah J., Liza Barbour, and Claire E. Palermo. "An impact evaluation of the FoodMate programme: Perspectives of homeless young people and staff." Health Education Journal 76, no. 7 (July 14, 2017): 829–41. http://dx.doi.org/10.1177/0017896917715780.
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Objectives: Food insecurity remains an issue for vulnerable populations in developed countries. The potential dietary and food security impacts of nutrition education programmes in Australia remain largely undocumented. This study investigated the impacts of an eight-session nutrition education programme delivered within community case management services for young people experiencing homelessness. Design and setting: A qualitative case study was undertaken in a community-based youth housing agency in Western Melbourne, Australia. Methods: Seven semi-structured interviews and two focus groups were conducted with a purposive sample of 10 past programme graduates and five youth service staff. Data were thematically analysed using a phenomenological lens. Results: The impacts of the programme were described by four themes: (1) the nutrition education programme created a platform for social engagement, (2) reduced reliance on emergency food relief for participants, (3) participants developed food-related knowledge and skills and (4) the programme was seen as a step towards food security for young people. These impacts were dependent on a myriad of personal and programme-related characteristics. Personal characteristics included participants’ intrinsic motivating factors to change their behaviours or a pre-existing interest in nutrition. Programme characteristics included the programme’s flexible structure and facilitation by caseworkers that were known to the young people. Conclusion: Study findings highlight the potential impacts of a nutrition education programme on dietary behaviours and food security status when embedded within community-based services.
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Hickey, Grainne, Sinead McGilloway, Yvonne Leckey, and Ann Stokes. "A Universal Early Parenting Education Intervention in Community-Based Primary Care Settings: Development and Installation Challenges." Education Sciences 8, no. 4 (October 20, 2018): 178. http://dx.doi.org/10.3390/educsci8040178.
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Prevention and early intervention programmes, which aim to educate and support parents and young children in the earliest stages of the family lifecycle, have become an increasingly popular policy strategy for tackling intergenerational disadvantage and developmental inequality. Evidence-based, joined-up services are recommended as best practice for achieving optimal outcomes for parents and their children; however, there are persistent challenges to the development, adoption and installation of these kinds of initiatives in community-based primary health care settings. In this paper, we present a description of the design and installation of a multi-stakeholder early parenting education and intervention service model called the Parent and Infant (PIN) programme. This new programme is delivered collaboratively on a universal, area-wide basis through routine primary care services and combines standardised parent-training with other group-based supports designed to educate parents, strengthen parenting skills and wellbeing and enhance developmental outcomes in children aged 0–2 years. The programme design was informed by local needs analysis and piloting to establish an in-depth understanding of the local context. The findings demonstrate that a hospitable environment is central to establishing interagency parenting education and supports. Partnership, relationship-building and strategic leadership are vital to building commitment and buy-in for this kind of innovation and programme implementation. A graduated approach to implementation which provides training/education and coaching as well as organisational and administrative supports for practice change, are also important in creating an environment conducive to collaboration. Further research into the impact, implementation and cost-effectiveness of the PIN programme will help to build an understanding of what works for parents and infants, as well as identifying lessons for the development and implementation of other similar complex prevention and intervention programmes elsewhere. This kind of research coupled with the establishment of effective partnerships involving service providers, parents, researchers and policy makers, is necessary to meeting the challenge of improving family education and enhancing the capacity of family services to help promote positive outcomes for children.
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Youssef, Carollyne. "Adaptive theory: an underutilised approach to sexual offender research." Qualitative Research Journal 19, no. 2 (May 7, 2019): 171–84. http://dx.doi.org/10.1108/qrj-12-2018-0021.
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Purpose While most studies utilise quantitative methodologies to examine issues relevant to sexual offending behaviour, such as treatment programmes and risk assessments; substantially fewer studies have utilised qualitative methods, and specifically Layder’s Adaptive Theory (AT) as a methodology; and there is a paucity of research examining community maintenance programmes altogether. The purpose of this paper is to report on the use of AT to the understanding of the significance of community maintenance programmes for high-risk sexual offenders. Design/methodology/approach Using AT as a unique framework, this study examined an Australian sample of services providers and high-risk sexual offenders participating in a community maintenance programme. In particular, the current research aimed to develop an understanding of community maintenance programmes for released sexual offenders, in a bid to develop a theoretical framework for these programmes. The research had three subject groups, service providers, programme participants who had not reoffended and programme participants who had sexually reoffended. Findings It appears that this methodology is a useful approach to studies within forensic rehabilitation and offender research. Common, reoccurring themes have been gathered through this approach, which would not have been possible with a quantitative methodology. Research limitations/implications While this research methodology was applied to a small sample size, its use suggested that AT was an informative and useful research approach to utilise in offender research more broadly, yielding rich in-depth information. Practical implications Utilising AT provided an in-depth understanding and exploration of experiences for offender populations as well as staff delivering programmes, which enhances the efficacy of programmes delivered by incorporating “user feedback” and allows programme developers to utilise such feedback to improve programmes. An AT approach to offender rehabilitation has been useful in providing exploratory information in the absence of any conceptual or theoretical frameworks and with a very little extant information. Given maintenance programmes are quite understudied, this approach allowed for common themes to emerge in order to guide future research as well as the development of a paradigm. It is worth considering the utility of this methodology for a variety of forensic research, particularly areas which remain understudied. Social implications Sexual offending behaviour is a significant societal concern. A better understanding of what makes programmes more effective for those who use them and run them, will assist in reducing recidivism, which will benefit the community at large. Originality/value Layder’s AT has not been used with an offender population in the past, and specifically within the sexual offending realm, thus this paper offers a unique and effective approach to offender research.
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Rowe, Michael, Adele Irving, and Sarah Soppitt. "The legitimacy of offender management programmes in a post-TR landscape." Safer Communities 17, no. 2 (April 9, 2018): 69–80. http://dx.doi.org/10.1108/sc-07-2017-0028.
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Purpose The purpose of this paper is to explore the under-considered perspectives of service users engaged in various community sentences based on a “strengths-based” approach to desistance. Further to recent changes in the sector, the paper considers service user views for programmes delivered by combinations of agencies from private, public and third sectors. Design/methodology/approach The paper is based on analysis of 64 semi-structured interviews with users of four programmes, accompanied with informal fieldwork observations by the researchers as they carried out the research at the premises of service providers. Findings The research finds that service user perceptions of the legitimacy of programmes are closely related to their understanding of three key dimensions: first, the “authenticity” of those delivering the service; second, the instrumental (in broad terms) gains they expect from engagement; and third, their understanding of the identity and ethos of the programme. Originality/value The paper adds important understanding based on service user perceptions in a period when service provision is being diversified. Further directions for other research are identified and it is recognised that a limitation of the current study is that it incorporates a sample drawn from one area.
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Penn, Rebecca Ann, Carol Strike, and Sabin Mukkath. "Building recovery capital through peer harm reduction work." Drugs and Alcohol Today 16, no. 1 (March 7, 2016): 84–94. http://dx.doi.org/10.1108/dat-08-2015-0039.
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Purpose – Peer harm reduction programmes engage service users in service delivery and may help peers to develop employment skills, better health, greater stability, and new goals. Thus far, peer work has not been discussed as an intervention to promote recovery. The purpose of this paper is to provide findings related to two research questions: first,do low-threshold employment programmes have the potential to contribute to positive recovery capital, and if so, how? Second, how are such programmes designed and what challenges do they face in supporting the recovery process? Design/methodology/approach – Using a community-based research approach, data were collected at a Toronto, Canada community health centre using in-depth interviews with peer workers (n=5), staff (n=5), and programme clients (n=4) and two focus groups with peer workers (n=12). A thematic analysis was undertaken to describe the programme model and to explore the mechanisms by which participation contributes to the development of recovery capital. Findings – The design of the Regent Park Community Health Centre peer work model demonstrates how opportunities for participation in community activities may spark cumulative growth in positive recovery capital within the community of PUDs. However, the recovery contagion of peer work may lose momentum with insufficient opportunities for new and experienced peer workers. Originality/value – Using the concept of recovery capital, the authors demonstrate how low-threshold employment interventions have the potential to contribute to the development of positive recovery capital.
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Lehmann, Uta, Nana A. Y. Twum-Danso, and Jennifer Nyoni. "Towards universal health coverage: what are the system requirements for effective large-scale community health worker programmes?" BMJ Global Health 4, Suppl 9 (October 2019): e001046. http://dx.doi.org/10.1136/bmjgh-2018-001046.
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Against the background of efforts to strengthen health systems for universal health coverage and health equity, many African countries have been relying on lay members of the community, often referred to as community health workers (CHWs), to deliver primary healthcare services. Growing demand and great variability in definitions, roles, governance and funding of CHWs have prompted the need to revisit CHW programmes and provide guidance on the implementation of successful programmes at scale. Drawing on the synthesised evidence from two extensive literature reviews, this article determines foundational elements of functioning CHW programmes, focusing in particular on the systems requirements of large-scale programmes. It makes recommendations for the effective development of large-scale CHW programmes. The key foundational elements of successful CHW programmes identified are (1) embeddedness, connectivity and integration into the larger system of healthcare service delivery; (2) cadre differentiation and role clarity in order to maintain clear scopes of work and accountability; (3) sound programme design based on local contextual factors and effective people management; and (4) ongoing monitoring, learning and adapting based on accurate and timely local data in order to ensure optimal fit to local context since one size does not fit all. We conclude that CHWs are an investment in health systems strengthening and community resilience with enormous potential for contributing to universal health coverage and the sustainable development goals if well designed and managed. While the evidence base is uneven and mixed, it provides extensive insight and knowledge to strengthen, scale up and sustain CHW programmes throughout Africa.
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BARBERIS, M., and P. D. HARVEY. "COSTS OF FAMILY PLANNING PROGRAMMES IN FOURTEEN DEVELOPING COUNTRIES BY METHOD OF SERVICE DELIVERY." Journal of Biosocial Science 29, no. 2 (April 1997): 219–33. http://dx.doi.org/10.1017/s0021932097002198.
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The cost effectiveness of several modes of family planning service delivery based on the cost per couple-year of protection (CYP), including commodity costs, is assessed for 1991–92 using programme and project data from fourteen developing countries (five in Africa, four in Asia, three in Latin America and two in the Middle East). More than 100 million CYP were provided through these family planning services during the 12 months studied. Sterilisation services provided both the highest volume (over 60% of total) and the lowest cost per CYP ($1.85). Social marketing programmes (CSM), delivering almost 9 million CYPs, had the next lowest cost per CYP on average ($2.14). Clinic-based services excluding sterilisation had an average cost of $6.10. The highest costs were for community-based distribution projects (0·7 million CYPs), which averaged $9.93, and clinic-based services with a community-based distribution component (almost 6 million CYPs), at a cost of $14.00 per CYP. Based on a weighted average, costs were lowest in the Middle East ($3.37 per CYP for all modes of delivery combined) and highest in Africa ($11.20).
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Kok, Michele, Lisa Bryant, Clare Cook, Sara Blackmore, and Mat Jones. "Integrating Local Knowledge into a National Programme: Evidence from a Community-Based Diabetes Prevention Education Programme." Healthcare 7, no. 1 (March 7, 2019): 38. http://dx.doi.org/10.3390/healthcare7010038.
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Type 2 diabetes prevention is a major priority for healthcare services and public health. This study aimed to evaluate how a local authority in England piloted a diabetes prevention programme. The South Gloucestershire Diabetes Prevention (Pilot) Programme (SGDPP) comprised a group health education course over six weeks with subsequent support provision up to six months post-enrolment. Of the 300 patients invited onto the programme, 32% enrolled and 29% completed the full six-month programme. There was an attendance rate of 84% throughout group sessions and at a six-month follow-up. There were significant improvements across most measures at six months, including a 4 kg mean weight loss and a 3.45 mmol/mol mean HbA1c reduction. Clear goals, high quality organization and personal qualities of educators were identified as central for the programme’s success. The unit costs were similar to pilots of other healthy lifestyle programmes. The evaluation found evidence of reduced type 2 diabetes risk markers, positive impacts for dietary and physical activity, and potential cost-effectiveness for this format of group-based diabetes prevention intervention. Feedback from multiple stakeholders provided insight on how to successfully embed and scale-up delivery of diabetes prevention work. This evidence enables the integration of learning in local service delivery and provides a basis to support development of the national diabetes prevention programme.
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Yang, Stella Xinchen, Katherine Chiu Man Leung, Chloe Meng Jiang, and Edward Chin Man Lo. "Dental Care Services for Older Adults in Hong Kong—A Shared Funding, Administration, and Provision Mode." Healthcare 9, no. 4 (April 1, 2021): 390. http://dx.doi.org/10.3390/healthcare9040390.
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Hong Kong has a large and growing population of older adults but their oral health conditions and utilization of dental services are far from optimal. To reduce the financial barriers and to improve the accessibility of dental care services to the older adults, a number of programmes adopting an innovative shared funding, administration, and provision mode have recently been implemented. In this review, an online search on the Hong Kong government websites and the electronic medical literature databases was conducted using keywords such as “dental care,” “dental service,” and “Hong Kong.” Dental care services for older adults in Hong Kong were identified. These programmes include government-funded outreach dental care service provided by non-governmental organizations (NGOs), provision of dentures and related treatments by private and NGO dentists supported by the Community Care Fund, and government healthcare vouchers for private healthcare, including dental, services. This paper presents the details of the operation of these programmes and the initial findings. There is indirect evidence that these public-funded dental care service programmes have gained acceptance and support from the government, the service recipients, and the providers. The experience gained is of great value for the development of appropriate dental care services for the older adults in Hong Kong and worldwide.
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John, Aparna, Nicholas Nisbett, Inka Barnett, Rasmi Avula, and Purnima Menon. "Factors influencing the performance of community health workers: A qualitative study of Anganwadi Workers from Bihar, India." PLOS ONE 15, no. 11 (November 25, 2020): e0242460. http://dx.doi.org/10.1371/journal.pone.0242460.
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Globally, there remain significant knowledge and evidence gaps around how to support Community Health Worker (CHW) programmes to achieve high coverage and quality of interventions. India’s Integrated Child Development Services scheme employs the largest CHW cadre in the world—Anganwadi Workers (AWWs). However, factors influencing the performance of these workers remain under researched. Lessons from it have potential to impact on other large scale global CHW programmes. A qualitative study of AWWs in the Indian state of Bihar was conducted to identify key drivers of performance in 2015. In-depth interviews were conducted with 30 AWWs; data was analysed using both inductive and deductive thematic analysis. The study adapted and contextualised existing frameworks on CHW performance, finding that factors affecting performance occur at the individual, community, programme and organisational levels, including factors not previously identified in the literature. Individual factors include initial financial motives and family support; programme factors include beneficiaries’ and AWWs’ service preferences and work environment; community factors include caste dynamics and community and seasonal migration; and organisational factors include corruption. The initial motives of the worker (the need to retain a job for family financial needs) and community expectations (for product-oriented services) ensure continued efforts even when her motivation is low. The main constraints to performance remain factors outside of her control, including limited availability of programme resources and challenging relationships shaped by caste dynamics, seasonal migration, and corruption. Programme efforts to improve performance (such as incentives, working conditions and supportive management) need to consider these complex, inter-related multiple determinants of performance. Our findings, including new factors, contribute to the global literature on factors affecting the performance of CHWs and have wide application.
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Huber, Sallie Craig, and Philip D. Harvey. "Family planning programmes in ten developing countries: cost effectiveness by mode of service delivery." Journal of Biosocial Science 21, no. 3 (July 1989): 267–77. http://dx.doi.org/10.1017/s0021932000017971.
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SummaryThe cost effectiveness of various modes of family planning service delivery based on the cost per couple-year of protection (CYP) is assessed using 1984 data for 63 projects in ten countries (three each in Africa and Asia, and four in Latin America). More than 4·8 million CYPs were provided through these projects during the year studied. Programmes with the highest volume of services delivered corresponded to lowest average costs: social marketing (2·8 million CYPs) and sterilization projects (960,000 CYPs) cost about $2 per CYP, on average; highest costs were for full service clinics and community-based distribution projects ($13–14 per CYP). Costs of clinics combined with community-based distribution services fell approximately midway between these two extremes.
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Singh, Devinder Kaur Ajit, Maziah Mamat, Roslee Rajikan, Nor Azlin Mohd Nordin, Cila Umat, Nor Najwatul Akmal Ab Rahman, and Nor Ayuslinawati bt Che Sidik. "Community Service Learning among Health Sciences and Medical Undergraduates at a Malaysian setting: Providers′ and Recipients′ Portraits." Mediterranean Journal of Social Sciences 8, no. 4 (July 27, 2017): 143–52. http://dx.doi.org/10.1515/mjss-2017-0013.
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AbstractCommunity Service learning (CSL) or Community engagement integrated teaching and learning (CEITL) offers reciprocal learning to both the providers and recipients. While it is important to consider the opinions of both parties for successful CSL, limited information exists in this topic area locally. The objective of this study was to explore undergraduates′ and communities′ perceptions regarding their experience and services provided during CSL. Recollections of 12 health sciences and medical undergraduates, and 18 members of the community whom participated in CSL programmes were sought using focus group discussions. This included their understanding of the programme, its benefits, challenges and their solutions and preferred activities. Undergraduates perceived CSL as an activity considered important to provide interactions between students and community. The perceived benefits of CSL were enhancement of interpersonal communication skills, negotiation of mutual understanding and experiencing real life situations. Undergraduates suggested that CSL should be well planned and scheduled. The CSL was seen by the communities as a platform for the recipients′ children to learn from the undergraduates as role models, future collaboration opportunities and health knowledge sharing. Weaknesses highlighted were; unstructured schedules, lack of variation in activities and CSL programme duration been too short to be effective. Suggestions provided for improved CSL were; extended time for health screening and better planned schedules. The findings suggest that undergraduates are aware of the significance of CSL in complementing their learning whereas the community have a positive outlook regarding CSL rendered by undergraduates. Further improvements are warranted in the implementation of more effective CSL programmes.
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Daly, Antoinette, Donna Tedstone Doherty, and Dermot Walsh. "Reducing the revolving door phenomenon." Irish Journal of Psychological Medicine 27, no. 1 (March 2010): 27–34. http://dx.doi.org/10.1017/s0790966700000896.
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AbstractObjectives: De-institutionalisation and the expansion of community services have resulted in a reduction in the number of inpatient admissions in Ireland having fallen by 31% between 1986 and 2006. However, despite this, readmissions continue to account for over 70% of all admissions. The policy document A Vision for Change identified many shortcomings in the current model of provision of mental health services, making recommendations for the future development of community-based services with emphasis on outreach components such as homecare, crisis intervention and assertive outreach approaches. These recommendations are reviewed in relation to readmissions and the impact they may have on reducing the revolving door phenomenon.Method: Three main intervention programmes essential to the delivery of an effective community-based service outlined and recommended by A Vision for Change, along with other pertinent factors, are discussed in relation to how they might reduce readmissions in Ireland. A series of Pearson correlations between Irish inpatient admissions rates and rates of outpatient attendances and provision of community mental health services are carried out and examined to explain possible relationships between increasing/decreasing admission rates and provision/attendances at community services. International literature is reviewed to determine the effectiveness of these intervention programmes in reducing admissions and readmissions and their relevance to the Irish situation is discussed.Conclusions: Whilst A Vision for Change goes a long way towards advocating a more person-centred, recovery oriented and integrated model of service delivery, it is apparent from the consistently high proportion of readmissions in Ireland that there are still many shortcomings in service provision. The availability of specialised community-based programmes of care is as yet relatively uncommon in Ireland and uneven in geographical distribution. A considerable improvement in their provision, quantitatively and qualitatively, is required to impact on the revolving door phenomenon. In addition a re-configuration of existing catchment populations is required if they are to be successfully introduced and expanded.
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Yoddumnern-Attig, Bencha, George A. Attig, and Uraiwan Kanungsukkasem. "Incorporating Explanatory Models in Planning Nutrition Education Programmes in Thailand." Nutrition and Health 8, no. 1 (January 1992): 17–31. http://dx.doi.org/10.1177/026010609200800102.
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An intersectoral child development services project is being undertaken in Thailand to develp a model process for providing age appropriate care and education to rural children through an integrated programme of nutrition, health and educational services designed to meet community needs and perceptions. Using behavioral analysis and explanatory models, project results show that the effectiveness of nutrition education can be facilitated by (1) recognizing the family as the unit of service, (2) focusing on solutions rather than problems, (3) using a two-stage promotional message strategy to encourage better child caretaking, and (4) viewing potential new practices as behavioral processes, rather than single entities aimed at a specific outcome. Program planning should also include the successive construction and analysis of community-based explanatory models which justify people's nutrition and health behaviors. The ultimate aim is to identify differences between explanatory models held by community members and health/nutrition educators, negotiate this conflict, and thereafter develop more practical and realistic methods for modifying behavior.
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Ship, Meredith, and Lyn Robinson. ""Permeating all community activities"?; comparing events and programming in Westminster and Tower Hamlets public libraries." Library and Information Research 36, no. 113 (December 18, 2012): 114–26. http://dx.doi.org/10.29173/lirg506.
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A comparative study of events and programming in two London public library services, Westminster and Tower Hamlets, is reported. The two services offer the same proportion of 'engagement' programming. Tower Hamlets operates a novel service model, though one with long antecedents, integrating library, learning and cultural services. Its extensive programmes of educational and special events have led to a great increase in visitors, though not to a corresponding increase in use of core library services.
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Elfituri, A. A., M. S. Elmahaishi, and T. H. MacDonald. "Role of health education programmes within the Libyan community." Eastern Mediterranean Health Journal 5, no. 2 (May 29, 1999): 268–76. http://dx.doi.org/10.26719/1999.5.2.268.
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The effectiveness of existing Libyan health education programmes was evaluated in order to assess how the service may be improved. A representative sample of the general public completed a questionnaire on health knowledge, healthy behaviours and the impact of various health education media. The 872 participants ranked health education media by effectiveness, with television ranked highest and booklets and leaflets lowest. We recommend reorganization of the use of different health education media in future planning
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Angwenyi, Vibian, Carolien Aantjes, Ketwin Kondowe, Joseph Zulu Mutchiyeni, Murphy Kajumi, Bart Criel, Jeffrey V. Lazarus, Tim Quinlan, and Joske Bunders-Aelen. "Moving to a strong(er) community health system: analysing the role of community health volunteers in the new national community health strategy in Malawi." BMJ Global Health 3, Suppl 3 (November 2018): e000996. http://dx.doi.org/10.1136/bmjgh-2018-000996.
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Since the Alma Ata Declaration in 1978, community health volunteers (CHVs) have been at the forefront, providing health services, especially to underserved communities, in low-income countries. However, consolidation of CHVs position within formal health systems has proved to be complex and continues to challenge countries, as they devise strategies to strengthen primary healthcare. Malawi’s community health strategy, launched in 2017, is a novel attempt to harmonise the multiple health service structures at the community level and strengthen service delivery through a team-based approach. The core community health team (CHT) consists of health surveillance assistants (HSAs), clinicians, environmental health officers and CHVs. This paper reviews Malawi’s strategy, with particular focus on the interface between HSAs, volunteers in community-based programmes and the community health team. Our analysis identified key challenges that may impede the strategy’s implementation: (1) inadequate training, imbalance of skill sets within CHTs and unclear job descriptions for CHVs; (2) proposed community-level interventions require expansion of pre-existing roles for most CHT members; and (3) district authorities may face challenges meeting financial obligations and filling community-level positions. For effective implementation, attention and further deliberation is needed on the appropriate forms of CHV support, CHT composition with possibilities of co-opting trained CHVs from existing volunteer programmes into CHTs, review of CHT competencies and workload, strengthening coordination and communication across all community actors, and financing mechanisms. Policy support through the development of an addendum to the strategy, outlining opportunities for task-shifting between CHT members, CHVs’ expected duties and interactions with paid CHT personnel is recommended.
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Petross, Chisomo, Shannon McMahon, Julia Lohmann, Rachel P. Chase, Adamson S. Muula, and Manuela De Allegri. "Intended and unintended effects: community perspectives on a performance-based financing programme in Malawi." BMJ Global Health 5, no. 4 (April 2020): e001894. http://dx.doi.org/10.1136/bmjgh-2019-001894.
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BackgroundSeveral performance-based financing (PBF) evaluations have been undertaken in low-income countries, yet few have examined community perspectives of care amid PBF programme implementation. We assessed community members’ perspectives of Support for Service Delivery Integration - Performance-Based Incentives (‘SSDI-PBI’), a PBF intervention in Malawi, and explored some of the unintended effects that emerged amid implementation.MethodsWe conducted 30 focus group discussions: 17 with community leaders and 13 with mothers within catchment areas of SSDI-PBI implementing facilities. We analysed data using the framework approach.ResultsCommunity leaders and women had mixed impressions regarding the effect of SSDI-PBI on service delivery in facilities. They highlighted several improvements (including improved dialogue between staff and community, and cleaner, better-equipped facilities with enhanced privacy), but also persisting challenges (including inadequate and overworked staff, overcrowded facilities and long distances to facilities) related to services in SSDI-PBI-implementing facilities. Further, respondents described how four targeted service indicators related to maternal risk factor management, antenatal care (ANC) in the first trimester, skilled birth attendance and couple’s HIV testing sparked unintended negative effects as experienced by women and communities. The unintended effects included women returning home for delivery, women feeling uncertain about their pregnancy status, women feeling betrayed or frustrated by the quality of care provided and partnerless women being denied ANC.ConclusionPBF programmes such as SSDI-PBI may improve some aspects of service delivery. However, to achieve system improvement, not only should necessary tools (such as medicines, equipment and human resources) be in place, but also programme priorities must be congruent with cultural expectations. Finally, facilities must be better supported to expect and then address increases in client load and heightened expectations in relation to services.
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Desplaces, David E., Fred Wergeles, and Patrick McGuigan. "Economic Gardening through Entrepreneurship Education." Industry and Higher Education 23, no. 6 (December 2009): 473–84. http://dx.doi.org/10.5367/000000009790156436.
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This article outlines the implementation of a service-learning approach in an entrepreneurship programme using an ‘economic gardening’ strategy. Economic Gardening through Service-Learning (EGS-L) is an approach to economic development that helps local businesses and students grow through a facilitated learning process. Learning is made possible by appealing to the action orientation of entrepreneurs and supplying students with a real laboratory in which to implement, test and experience theory. Economic gardening effectively strengthens businesses in the community and promotes community awareness by bringing businesses, students, academics and community leaders together in a receptive and proactive environment. The authors draw on first-hand experience from programmes at various institutions and include in their discussion some preliminary results with regard to civic attitudes.
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Raju, Bangaru, and David Meagher. "Patient-controlled benzodiazepine dose reduction in a community mental health service." Irish Journal of Psychological Medicine 22, no. 2 (June 2005): 42–45. http://dx.doi.org/10.1017/s0790966700008909.
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AbstactObjectives: We report a patient-controlled benzodiazepine discontinuation programme in a generic multidisciplinary community mental health service.Method: A prescribing audit identified suboptimal benzodiazepine use which stimulated a discontinuation programme [prescribing policy, psychoeducation, anxiety management] to encourage benzodiazepine cessation. Benzodiazepine status was re-assessed at 12 and 24 month follow-ups.Results: 158 patients were receiving benzodiazepines at study onset. At 12 month follow-up, 68 of these were still receiving benodiazepines. This was due to discontinuation (n = 32), dose reduction (n = 26) and service dropout (n = 71). Benzodiazepine status at follow-up was predicted by attendance at anxiety management sessions (p = 0.01) and shorter duration of benzodiazepine use (p = 0.005). Patients attending anxiety management sessions were 2.5 times more likely to reduce use. Discontinuation followed four patterns: (a) rapid and complete discontinuation (n = 19); (b) total discontinuation in a gradual manner (n = 13); (c) partial dose reduction without total discontinuation (n = 18) and (d) almost total discontinuation with continued low-dose use (n = 8). The patients that achieved total discontinuation were younger (p = 0.01) and in receipt of benzodiazepine agents for a shorter duration (p = 0.009). At 24 month follow-up only three patients had relapsed into benzodiazepine use and a further 13 had achieved total discontinuation.Conclusions: Many chronic benzodiazepine users can achieve lasting discontinuation with patient-controlled dose tapering. Patient refusal and service dropout are common during discontinuation programmes. Anxiety management is a valuable adjunct to discontinuation.
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Shrimpton, Roger, Lisanne M. du Plessis, Hélène Delisle, Sonia Blaney, Stephen J. Atwood, David Sanders, Barrie Margetts, and Roger Hughes. "Public health nutrition capacity: assuring the quality of workforce preparation for scaling up nutrition programmes." Public Health Nutrition 19, no. 11 (February 9, 2016): 2090–100. http://dx.doi.org/10.1017/s136898001500378x.
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AbstractObjectiveTo describe why and how capacity-building systems for scaling up nutrition programmes should be constructed in low- and middle-income countries (LMIC).DesignPosition paper with task force recommendations based on literature review and joint experience of global nutrition programmes, public health nutrition (PHN) workforce size, organization, and pre-service and in-service training.SettingThe review is global but the recommendations are made for LMIC scaling up multisectoral nutrition programmes.SubjectsThe multitude of PHN workers, be they in the health, agriculture, education, social welfare, or water and sanitation sector, as well as the community workers who ensure outreach and coverage of nutrition-specific and -sensitive interventions.ResultsOvernutrition and undernutrition problems affect at least half of the global population, especially those in LMIC. Programme guidance exists for undernutrition and overnutrition, and priority for scaling up multisectoral programmes for tackling undernutrition in LMIC is growing. Guidance on how to organize and scale up such programmes is scarce however, and estimates of existing PHN workforce numbers – although poor – suggest they are also inadequate. Pre-service nutrition training for a PHN workforce is mostly clinical and/or food science oriented and in-service nutrition training is largely restricted to infant and young child nutrition.ConclusionsUnless increased priority and funding is given to building capacity for scaling up nutrition programmes in LMIC, maternal and child undernutrition rates are likely to remain high and nutrition-related non-communicable diseases to escalate. A hybrid distance learning model for PHN workforce managers’ in-service training is urgently needed in LMIC.
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Lawton, Amy Elizabeth, Olivia Hamilton, and Cheryl Jackson. "Aboriginal Family Planning Circle evaluation: Empowering Aboriginal communities in evaluating and future-proofing Aboriginal-led community programmes." Evaluation Journal of Australasia 20, no. 1 (March 2020): 23–33. http://dx.doi.org/10.1177/1035719x20911332.
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The Aboriginal Family Planning Circle (AFPC) programme is an Aboriginal-led community programme, which works with Aboriginal families in Western Sydney to address their complex needs and reduce the risk of having their children put into out-of-home care (OOHC). This article explores two external evaluations undertaken by WESTIR Limited (WESTIR), a non-Aboriginal research service, on the AFPC programme. The purpose of the first evaluation was to provide an assessment of how effective the AFPC programme had been for participants and identify programme aspects that could be improved or developed. The second evaluation was undertaken to examine whether the AFPC programme had continued to meet its objectives and address some knowledge gaps, particularly the estimated savings and return on investment that the programme created for the OOHC system in New South Wales (NSW). The evaluations used qualitative and quantitative techniques, including interviews, focus groups and a return on investment analysis. This article outlines methods, results and recommendations from both evaluations, along with lessons learned to better inform evaluation practice. This case study shows that culturally responsive evaluations can provide an avenue for Aboriginal communities to advocate for the continued funding of their programmes. It also emphasises the need to adequately resource Aboriginal programme evaluations in the community services sector now and in the future.
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Joo, Nam-Seok, Yong-Woo Park, Kyung-Hee Park, Chan-Won Kim, and Bom-Taeck Kim. "Cost-effectiveness of a community-based obesity control programme." Journal of Telemedicine and Telecare 16, no. 2 (December 11, 2009): 63–67. http://dx.doi.org/10.1258/jtt.2009.090407.
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We evaluated two 12-week long community-based obesity control programmes in Korea. One was a visiting-type programme (V-type) ( n = 515) administered by a public health centre and the other was a remote-type programme (R-type) ( n = 410) utilizing an Internet website and mobile phones with a short message service. The total cost for the intention-to-treat subjects was US$116,993 in the V-type programme and $24,555 in the R-type programme. In the per-protocol subjects, 66% of V-type participants ( n = 117) achieved the target bodyweight reduction (5%) and 13% of R-type participants ( n = 15). In the per-protocol subjects, the cost per person was $227 (V-type) and $60 (R-type). The cost per person achieving the target weight reduction was $975 (V-type) and $1637 (R-type). The average amount that participants were willing to pay was $71 (V-type) and $21 (R-type). The cost-effectiveness of the visiting-type community-based, short-duration obesity control programme was higher than the remote-type programme.
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Manthorpe, Jill, and Stephanie Bramley. "Supporting ex-service personnel moving to social care work with older people: a systematic rapid review of the role of education." Working with Older People 23, no. 3 (August 29, 2019): 127–41. http://dx.doi.org/10.1108/wwop-02-2019-0004.
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Purpose The purpose of this paper is to review evidence about the role of education in supporting ex-service personnel to move to social care work with older people. Social care has long-standing, well-recognised problems of staff recruitment and retention in many jurisdictions. Within ageing societies, the need for more social care staff is predicted to rise. Therefore, policy makers and employers are exploring if there are untapped sources of potential employees. Some ex-service personnel may be interested in exploring a move to social care work with older people but may need to gain additional qualifications. Design/methodology/approach Databases and grey literature were searched systematically to provide an overview of the evidence on this topic. Six articles were included in the review. Findings A narrative analysis revealed two themes: preparing ex-service personnel for enrolment onto health and social care programmes, and supporting ex-service personnel during health and social care programmes. Research limitations/implications This review was confined to English language studies published between 2008 and 2018. Few mentioned specific user or client groups. Originality/value This review identified evidence gaps relating to whether the skills, education, training and experience gained in the armed services are transferable to civilian social care work with older people; the types of support which are offered to ex-service personnel who are interested in completing qualifications necessary for social care roles and the views of ex-service personnel about their experiences of completing educational courses to facilitate a transition into social care work with older people.
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Hogan, David B. "Impact of Geriatric Consultation Services for Elderly Patients Admitted to Acute Care Hospitals." Canadian Journal on Aging / La Revue canadienne du vieillissement 9, no. 1 (1990): 35–44. http://dx.doi.org/10.1017/s071498080001607x.
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RÉSUMÉCertains centres hospitaliers de soins à courte durée ont mis sur pied des programmes de consultation gériatrique destinés à l'intention des patients âgés. Des études évaluatives explorant l'utilité de ces programmes ont produit des résultats variés. Ces résultats inconsistants pourraient être causés par la différence au niveau de la conception des études de recherche, les différentes stratégies utilisées, les différentes façons d'analyser les résultats, et finalement certains facteurs propres à l'institution même. De toute évidence, la variable critique serait celle qui porte sur les méthodes utilisées pour recruter les patients. Des études plus poussées devraient être mises au point dans le but de (1) développer des stratégies cibles optimales, (2) déterminer la composition appropriée de service et fonction (3) étudier l'interaction entre ces programmes et les autres éléments d'un programme gériatrique d'envergure, (4) documenter l'effet à long terme (une année) sur les patients évalués et (5) évaluer l'impact institutionnel de ces programmes.
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Carpenter, Hannah, Sarah Audsley, Carol Coupland, John Gladman, Denise Kendrick, Natasher Lafond, Philippa Logan, et al. "PHysical activity Implementation Study In Community-dwelling AduLts (PHISICAL): study protocol." Injury Prevention 25, no. 5 (January 5, 2018): 453–58. http://dx.doi.org/10.1136/injuryprev-2017-042627.
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BackgroundFalls in older people are a leading causes of unintentional injury. Due to an ageing population, injuries are likely to increase unless more is done to reduce older people’s falls risk. In clinical trials, the Falls Management Exercise (FaME) programme has reduced the rate of falls and falls-related injuries in community-dwelling older adults. However, the commissioning of FaME is inconsistent across England, potentially due to a lack of evidence that FaME can be delivered effectively in a ‘real world’ setting. The PHysical activity Implementation Study In Community-dwelling AduLts (PHISICAL) study is designed to study the implementation of FaME in a range of different settings in England.MethodsThe PHISICAL study will use a mixed-methods, triangulation, multilevel design to explore the implementation of FaME. Framework analysis of semistructured interviews with up to 90 stakeholders (exercise programme users, service providers, referrers and commissioners) and observational data from locally led communities of practice will identify the factors that influence FaME’s implementation. Quantitative, anonymised, routine service data from up to 650 exercise programme users, including measures of falls and physical activity, will allow assessment of whether the benefits of FaME reported in clinical trials translate to the ‘real world’ setting.ConclusionThe findings from this study will be used to develop a toolkit of resources and guidance to inform the commissioning and delivery of future FaME programmes. This study has the potential to inform public health prevention strategies, and in doing so may reduce the number of falls in the older population while delivering cost savings to health and social care services.
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Hugo, Rene. "Communication Pathology: The Way In Africa*." South African Journal of Communication Disorders 45, no. 1 (December 31, 1998): 3–9. http://dx.doi.org/10.4102/sajcd.v45i1.706.
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Universities in Southern Africa are currently deeply involved in transformation processes in order to ensure world class tertiary education. More specifically in the case of vocationally oriented tertiary programmes, it has become necessary to provide answers to questions like: are the academic outcomes of higher education relevant to and accountable in the context of the workplace? For the Department of Communication Pathology at the University of Pretoria the answer is unequivocal - a programme that aims to provide learning opportunities for professionals who must eventually render a service to a specific population (the individual with a speech, voice; language or hearing disorder), should ensure that the characteristics of this population serve as the basis for strategic planning. This population is an African population. Educational programmes, research projects and community service must therefore be africanised.
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De La Cruz, Monica M., Kimmy Phan, and Janine S. Bruce. "More to offer than books: stakeholder perceptions of a public library-based meal programme." Public Health Nutrition 23, no. 12 (April 21, 2020): 2179–88. http://dx.doi.org/10.1017/s1368980019004336.
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AbstractObjective:To examine the perspectives of librarians and staff about Lunch at the Library, a library-based summer meal programme for children. The study examines: (i) motivating factors behind implementing the meal programme; (ii) issues of feasibility; and (iii) perceived programme outcomes.Design:One-on-one semi-structured interviews with library stakeholders (librarians and staff) from a purposeful sample of California libraries.Setting:Twenty-two library jurisdictions across California that implemented the Lunch at the Library summer meal programme in 2015 in areas of high financial need.Participants:Twenty-five library stakeholders representing twenty-two of the thirty-three Californian library jurisdictions that implemented Lunch at the Library at their sites.Results:Library stakeholders recognised the need for a child meal programme during summer. Despite lack of sufficient resources and personnel, they were motivated to implement the programme not only to fill a community need but also to ensure children at their libraries were primed for learning over the summer. Library stakeholders also perceived the public library’s changing role in society as shifting from reference provision to social service provision either directly or by referral.Conclusions:The public library is an ideal place to provide social services because of its accessibility to all. Librarians and library staff are motivated to address the social needs of their communities. This study demonstrates the feasibility of implementing new social programmes at public libraries. Funding to support these programmes would increase the library’s capacity to address other community needs.
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Pescheny, Julia, Gurch Randhawa, and Yannis Pappas. "Patient uptake and adherence to social prescribing: a qualitative study." BJGP Open 2, no. 3 (August 7, 2018): bjgpopen18X101598. http://dx.doi.org/10.3399/bjgpopen18x101598.
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BackgroundSocial prescription is an initiative that aims to link patients in primary care with sources of support within the community and voluntary sector to improve their health, wellbeing, and care experience. Such programmes usually include navigators, who work with referred patients and issue onward referrals to sources of non-medical support. Most research on social prescribing (SP) has focused on outcome evaluations, resulting in a knowledge gap of factors affecting uptake and adherence. Understanding such factors enables the refinement of programmes, which has the potential to enhance uptake and adherence, reduce health inequalities, and optimise investment.AimTo explore the experiences and views of service users, involved GPs, and navigators on factors influencing uptake and adherence to SP.Design & settingQualitative interviews were conducted with stakeholders involved in an SP programme in the east of England (Luton).MethodData were collected from semi-structured face-to-face interviews with service users, navigators, and GPs. Thematic analysis was used to analyse the data.ResultsFactors affecting uptake and adherence to SP were related to patients’ trust in GPs, navigators' initial phone call, supportive navigators and service providers, free services, and perceived need and benefits. Reported barriers to uptake and adherence were fear of stigma of psychosocial problems, patient expectations, and the short-term nature of the programme.ConclusionThis study provides an insight into factors affecting patient uptake and adherence to SP programmes. More research in this field, including patients who refused to participate in SP, is needed.
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Satinsky, Emily, David Crepaz-Keay, and Antonis Kousoulis. "Making peer-focused self-management programmes work in public mental health." Journal of Mental Health Training, Education and Practice 13, no. 5 (September 10, 2018): 257–63. http://dx.doi.org/10.1108/jmhtep-08-2017-0052.
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Purpose The purpose of this paper is to review the Mental Health Foundation’s experiences designing, implementing and evaluating peer-focused self-management programmes. Through a discussion of barriers and good practice, it outlines ways to be successful in making such projects work to improve mental health and wellbeing among at-risk populations. Design/methodology/approach A total of 11 Mental Health Foundation programmes implemented over the past ten years were reviewed through reading manuals and publications and interviewing programme managers. Key data were extracted from each programme to analyse trends in aims, outcomes and recommendations. Findings Through a focus on peer-work, programmes taught individuals from a variety of societal sectors self-management skills to effectively deal with life stressors. Through sharing in non-judgmental spaces and taking ownership of programme design and content, individuals realised improvements in wellbeing and goal achievement. Practical implications Good practice, barriers and recommendations can be taken from this review and applied to future peer-focused self-management programmes. By better embedding quantitative and qualitative evaluations into programme development and implementation, programmes can add to the evidence base and effectively target needs. Originality/value This review lays out valuable experience on an innovative community service paradigm and supports the evidence on effectiveness of peer-focused self-management programmes with a variety of group populations.
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Hurst, Alison, Anna Price, Rebecca Walesby, Moira Doolan, Wendy Lanham, and Tamsin Ford. "Routine outcome monitoring of evidence-based parenting programmes: indications of effectiveness in a community context." Journal of Children's Services 9, no. 1 (March 12, 2014): 58–74. http://dx.doi.org/10.1108/jcs-09-2013-0030.
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Purpose – Despite an increasing policy focus, routine outcome monitoring (ROM) is not common practice in UK children's services. This paper aims to examine whether it is feasible and valid to use measures from ROM of evidence-based parenting programmes (EBPPs) to assess the impact of services and to drive service improvements through feedback mechanisms. Design/methodology/approach – This is a secondary analysis of ROM measures collected from a London clinic offering EBPPs over five years. Demographic information from referrals was compared for attendees and non-attendees. Changes in parent reported child behaviour were measured using the Strengths and Difficulties Questionnaire (SDQ), and a Visual Analogue Scale (VAS). Findings – No significant differences were found in socio-demographic characteristics of attendees and non-attendees. Statistically significant differences were found between pre- and post-scores on parent reported SDQ scores and VAS concerns, as well as the SDQ Added Value Score. The data collected did not allow for investigation of a dose-response relationship between the level of attendance and any improvement made. Originality/value – This study illustrates that ROM can provide useful information about the impact of EBPPs in a particular clinical context. Demographic data could support service managers to evaluate reach and uptake while evidence of improvements can be communicated back to parents and support future funding bids. Incomplete data limited the inferences that could be drawn, and collaborations between research centres and clinics may be a way to optimise the use of ROM to drive service improvement and innovation.
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Guest, Cheryl, Philip Wainwright, Margaret Herbert, and Iain Murray Smith. "Driving quality improvement with a massive open online course (MOOC)." BMJ Open Quality 10, no. 1 (March 2021): e000781. http://dx.doi.org/10.1136/bmjoq-2019-000781.
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BackgroundQuality improvement (QI) is a priority for national regulatory bodies in health and care in the UK. However, many health and care staff do not know where to go for support in gaining the required skills and knowledge in QI. This paper reviews Improvement Fundamentals, a massive open online course (MOOC), designed to address this gap, run by an improvement team in the national regulatory body.MethodsIn 2015, National Health Service (NHS) Improving Quality (subsequently the sustainable improvement team in NHS England) established Improvement Fundamentals: a programme of online, self-directed courses in QI for those involved in heath or social care. The programme ran in two cycles: twice in 2015, followed by a re-launch in 2018 (this programme also ran into 2019). A mixed-methods evaluation was carried out of the 2015 programme involving surveys, interviews and social listening. The 2018–2019 programme was evaluated using post-course surveys of participants and activity data from the platform.OutcomesSince the start of the 2015 programme, 604 improvement projects have been developed, run and submitted for formal assessment, with some demonstrating clear improvements in services. Themes from participant feedback on both programmes have included improved understanding of QI tools and methods; greater energy for QI; a greater sense of community and connectedness in participants’ work and increased confidence in using QI tools and techniques.DiscussionBoth programmes delivered benefits for participants, and the team’s investment in improvement skills on these programmes has helped to increase capability for future change endeavours. The collaborative nature of the programmes has been key to their successes.ConclusionImprovement Fundamentals demonstrates that MOOCs can be instrumental in driving forward improvements in health and care. The programmes may have utility as a model for future MOOCs, both in QI and other topics, to help drive further improvements in health and care.
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Ahmed, Anam, Maria E. T. C. van den Muijsenbergh, Janne C. Mewes, Walter P. Wodchis, and Hubertus J. M. Vrijhoef. "Untangling the inter-relatedness within integrated care programmes for community-dwelling frail older people: a rapid realist review." BMJ Open 11, no. 4 (April 2021): e043280. http://dx.doi.org/10.1136/bmjopen-2020-043280.
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ObjectiveTo identify the relationships between the context in which integrated care programmes (ICPs) for community-dwelling frail older people are applied, the mechanisms by which the programmes do (not) work and the outcomes resulting from this interaction by establishing a programme theory.DesignRapid realist review.Inclusion criteriaReviews and meta-analyses (January 2013–January 2019) and non-peer-reviewed literature (January 2013–December 2019) reporting on integrated care for community-dwelling frail older people (≥60 years).AnalysisSelection and appraisal of documents was based on relevance and rigour according to the Realist And Meta-narrative Evidence Syntheses: Evolving Standards criteria. Data on context, mechanisms, programme activities and outcomes were extracted. Factors were categorised into the five strategies of the WHO framework of integrated people-centred health services (IPCHS).Results27 papers were included. The following programme theory was developed: it is essential to establish multidisciplinary teams of competent healthcare providers (HCPs) providing person-centred care, closely working together and communicating effectively with other stakeholders. Older people and informal caregivers should be involved in the care process. Financial support, efficient use of information technology and organisational alignment are also essential. ICPs demonstrate positive effects on the functionality of older people, satisfaction of older people, informal caregivers and HCPs, and a delayed placement in a nursing home. Heterogeneous effects were found for hospital-related outcomes, quality of life, healthcare costs and use of healthcare services. The two most prevalent WHO-IPCHS strategies as part of ICPs are ‘creating an enabling environment’, followed by ‘strengthening governance and accountability’.ConclusionCurrently, most ICPs do not address all WHO-IPCHS strategies. In order to optimise ICPs for frail older people the interaction between context items, mechanisms, programme activities and the outcomes should be taken into account from different perspectives (system, organisation, service delivery, HCP and patient).
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Bale, Rob, Matthew Fiander, and Tom Burns. "Computers and process description for community mental health care." Epidemiologia e psichiatria sociale. Monograph Supplement 6, S1 (April 1997): 81–90. http://dx.doi.org/10.1017/s182743310000085x.
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The focus of mental health care has seen a significant shift from institutional care to community based care and has been well described (Thornicroft & Bebbington, 1989). This shift has necessitated the development of new and flexible models for ensuring that patients' needs are met. Mental health professionals have to operate across a wide range of community contexts dealing with a complex range of needs. Intensive Case Management (ICM) also known as Assertive Community Treatment is a model of service provision to the long term mentally ill in the community. The Programme of Assertive Community Treatment (ACT) developed by Stein & Test (1980) in the United States has a number of Key elements (figure 1).ACT-based ICM is unusual in that it has been extensively researched (principally in the United States of America), and programmes are relatively well described. Such descriptions, especially of programmes outside America, often focus on underlying principals and philosophies and do little to measure practice. Teague et al. (1995), however, devised clear criteria for measuring practice components and McGrew et al. (1994) asked ACT “experts” to rate the “key” elements of PACT and related a number of these to levels of hospital use. In the United Kingdom, Thornicroft (1991) listed twelve axes for describing the central practice characteristics of case management (a broad concept including ICM). These UK ‘practice characteristics’ also focus more on macro-level programme description rather than on the practices of programme staff. There is a pressing need for research into exactly what teams do.
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Urciuoli, Bonnie. "The promise and practice of service learning and engaged scholarship." Learning and Teaching 6, no. 2 (June 1, 2013): 1–10. http://dx.doi.org/10.3167/latiss.2013.060201.
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Service learning and other engaged scholarship programmes ideally operate in an academic framework to enhance student understanding of citizenship and community engagement. In reality, given the constraints on institutional budgets, such programmes are likely to be underfunded and academically understaffed. Structured as choices on an institutional menu, programmes are routinely touted as transformative though what they transform may be indeterminate. The ways in which such programmes are presented encourage students to interpret transformation as personal experience, valued to the extent that students can do good in the world by acting as agents of progress, solving problems for people imagined to need their expertise, ideally in exotic settings as unlike students' routine lives as possible, while students develop skills and connections useful in their post-college careers. This construction of engaged scholarship readily lends itself to institutional promotional language but can undermine students' effective action in actual projects.
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Munk-Jørgensen, Povl. "Cumulated need for psychiatric service as shown in a community psychiatric project." Psychological Medicine 15, no. 3 (August 1985): 629–35. http://dx.doi.org/10.1017/s0033291700031482.
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SynopsisDistrict psychiatric services often supplement intramural mental health programmes. They usually result in an increase in the number of referrals to the mental health facilities, which reflects a cumulative need for psychiatric examination and treatment in the population. A significant decrease in the annual first referral rates per 1000 inhabitants aged 15 years and above is apparent in an analysis of the trends in the Danish Samsø community psychiatric service from its inception in 1957 until 1982. The average annual rates were 19·4 in the first 5-year period, 10·0 in the second 5-year period, and 8·4 in the ‘steady state period’ from 1967 to 1982. The conclusion is, therefore, that the work load connected with the cumulative need for psychiatric examination and treatment should be terminated in approximately 10 years. A comparison of the two 5-year periods, 1957–61 and 1978–82, demonstrated a decrease in first referral rates in almost all diagnostic groups: this is significant among manic-depressive psychoses, neurotic states and unspecified mental disorders. The rates of no mental disorders and senile and arteriosclerotic psychoses were almost unchanged. In the 10-year age groups there was a decrease in first referral rates for all groups, except for the groups aged 75 years and above whose rates were unchanged. The concept of cumulative need for psychiatric examination and treatment is discussed in relation to the reports of various district psychiatric service programmes in different European countries.
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Kolbe, Lloyd J., Gerald N. Tirozzi, Eva Marx, Mary Bobbitt-Cooke, Sara Riedel, Jack Jones, and Michael Schmoyer. "Health programmes for school employees: improving quality of life, health and productivity." Promotion & Education 12, no. 3-4 (September 2005): 157–61. http://dx.doi.org/10.1177/10253823050120030115.
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School health programmes in the 21 century could include eight components: 1) health services; 2) health education; 3) healthy physical and psychosocial environments; 4) psychological, counselling, and social services; 5) physical education and other physical activities; 6) healthy food services; and 7) integrated efforts of schools, families, and communities to improve the health of school students and employees. The eighth component of modern school health programmes, health programmes for school employees, is the focus of this article. Health programmes for school employees could be designed to increase the recruitment, retention, and productivity of school employees by partially focusing each of the preceding seven components of the school health programme on improving the health and quality of life of school employees as well as students. Thus, efforts to improve the quality of life, health, and productivity of school employees may be distinct from, but integrated with, efforts to improve the quality of life, health, and education of students. School employee health programmes can improve employee: 1) recruitment; 2) morale; 3) retention; and 4) productivity. They can reduce employee: 5) risk behaviours (e.g., physical inactivity); 6) risk factors (e.g., stress, obesity, high blood pressure); (7) illnesses; 8) work-related injuries; 9) absentee days; 10) worker compensation and disability claims; and 11) health care and health insurance costs. Further, if we hope to improve our schools' performance and raise student achievement levels, developing effective school employee health programmes can increase the likelihood that employees will: 12) serve as healthy role models for students; 13) implement effective school health programmes for students; and 14) present a positive image of the school to the community. If we are to improve the quality of life, health, and productivity of school employees in the 21st Century: school administrators, employees, and policymakers must be informed about the need and the means to do so; school employee health programmes must become part of the culture of education and the expectation of educators; and colleges that prepare school administrators and other school employees must provide the pre-service and in-service training, research, development, and leadership to make it happen. This article outlines ten actions that can be taken by school districts to build or improve school employee health programmes, and a list of websites that provides more detailed information about such programmes.
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Simane-Netshisaulu, Khathutshelo G., and Maria S. Maputle. "Clinical Practice of Midwifery Graduates During Community Service Placement, Limpopo Province South Africa." Global Journal of Health Science 11, no. 10 (August 16, 2019): 97. http://dx.doi.org/10.5539/gjhs.v11n10p97.
Full textAbstract:
Midwifery graduates are placed in health facilities for community service during their first year of practice. The purpose of the study was to explore how midwifery graduates experienced their clinical practice during community service placement in Limpopo province. A qualitative study which is explorative and descriptive in nature was conducted in five selected hospitals. Population comprised of all midwifery graduates who have undergone a comprehensive nursing programme regulated by R425 of 19 February 1985, as amended; working in selected hospitals. Non-probability, purposive sampling method was used to select five graduates working in maternity unit of each selected hospital. Sample comprised of twenty-five participants. In-depth face to face interviews were used to collect data. Findings revealed that graduates experienced differences between theory and practice at different levels. Loss of students’ status, high level of responsibility and inadequate clinical learning opportunities made their transition difficult. In conclusion, graduates felt exposed to two different worlds of midwifery practice resulting in frustration and reality shock. Study recommends that midwifery training programme include opportunities to discuss realities of transition period, to enable graduates to deal with midwifery issues in a real and practical situation. Mentors should help graduates to bridge the gap between theory and practice. Structured support programmes should be offered to alley feelings of fear and insecurity resulting from increased levels of responsibility and accountability graduates are faced with.
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Tucker, Guy, Joanne Atkinson, Janet Kelly, Lynette Parkin, Alison McKenzie, Sue Scott, Suzanne Joyce, and Doreen Davidson. "Evaluation of a structured preceptorship programme." British Journal of Community Nursing 24, no. 11 (November 2, 2019): 554–57. http://dx.doi.org/10.12968/bjcn.2019.24.11.554.
Full textAbstract:
Preceptorship is a period in which newly qualified staff nurses receive support from an experienced nurse to smooth their transition into the service. District nurses (DNs) from the authors’ trust informally expressed the need for a better transition between the completion of district nursing education and entry into the workforce. Hence, a structured preceptorship programme was developed and delivered. This article describes this service initiative and its evaluation by preceptors (n=14) and preceptees (newly qualified DNs; n=13). Both groups valued having a structured preceptorship programme. Preceptees agreed that having a named preceptor was very important, and preceptors felt that the role which they played was rewarding. Both groups felt that the role of the DN was a specialist role and that the preceptorship programme helped to support newly qualified staff make the transition into qualified DNs, clinical team leaders and, ultimately, caseload holders. A large-scale study of DN practice is required to develop a national consensus on the structure and content of preceptorship programmes for district nursing.
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Nimmagadda, Sneha, Lakshmi Gopalakrishnan, Rasmi Avula, Diva Dhar, Nadia Diamond-Smith, Lia Fernald, Anoop Jain, et al. "Effects of an mHealth intervention for community health workers on maternal and child nutrition and health service delivery in India: protocol for a quasi-experimental mixed-methods evaluation." BMJ Open 9, no. 3 (March 2019): e025774. http://dx.doi.org/10.1136/bmjopen-2018-025774.
Full textAbstract:
IntroductionMillions of children in India still suffer from poor health and under-nutrition, despite substantial improvement over decades of public health programmes. The Anganwadi centres under the Integrated Child Development Scheme (ICDS) provide a range of health and nutrition services to pregnant women, children <6 years and their mothers. However, major gaps exist in ICDS service delivery. The government is currently strengthening ICDS through an mHealth intervention called Common Application Software (ICDS-CAS) installed on smart phones, with accompanying multilevel data dashboards. This system is intended to be a job aid for frontline workers, supervisors and managers, aims to ensure better service delivery and supervision, and enable real-time monitoring and data-based decision-making. However, there is little to no evidence on the effectiveness of such large-scale mHealth interventions integrated with public health programmes in resource-constrained settings on the service delivery and subsequent health and nutrition outcomes.Methods and analysisThis study uses a village-matched controlled design with repeated cross-sectional surveys to evaluate whether ICDS-CAS can enable more timely and appropriate services to pregnant women, children <12 months and their mothers, compared with the standard ICDS programme. The study will recruit approximately 1500 Anganwadi workers and 6000+ mother-child dyads from 400+ matched-pair villages in Bihar and Madhya Pradesh. The primary outcomes are the proportion of beneficiaries receiving (a) adequate number of home visits and (b) appropriate level of counselling by the Anganwadi workers. Secondary outcomes are related to improvements in other ICDS services, and knowledge and practices of the Anganwadi workers and beneficiaries.Ethics and disseminationEthical oversight is provided by the Committee for the Protection of Human Subjects at the University of California at Berkeley, and the Suraksha Independent Ethics Committee in India. The results will be published in peer-reviewed journals and analysis data will be made public.Trial registration numberISRCTN83902145
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Macfarlane, Kym, Amy Hayes, Ali Lakhani, and Glenn Hodgson. "Building Fathering Competencies Through a Universal, Soft-Entry, Early Intervention and Prevention Service." Children Australia 42, no. 4 (October 9, 2017): 248–55. http://dx.doi.org/10.1017/cha.2017.35.
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There is sparse research on playgroups for fathers, therefore, the benefits of such programmes are difficult to discern. However, there is much research on the positive developmental outcomes children experience with involved fathers (Appl, Brown, & Stone, 2008; Evans, Harrison, Rempel, & Slater, 2006; Green, 2003; Rosenberg & Wilcox, 2006). This research focused on a Dad's playgroup run as part of the Communities for Children Logan Project in south-east Queensland, Australia. The research found that the fathers gained positive results as being a part of the playgroup, including improved family functioning, a feeling of belonging to a community in which advice was freely available, improved relationships with their child/children and feelings that this programme met the unique needs of fathers when others in the community have not. These needs were met through the play environment, scheduling, staffing and support networks.
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Buys, David R., Malcolm L. Marler, Caroline O. Robinson, Christopher M. Hamlin, and Julie L. Locher. "Recruitment of volunteers for a home-delivered meals programme serving homebound older adults: a theoretically derived programme among faith communities." Public Health Nutrition 14, no. 8 (October 19, 2010): 1473–78. http://dx.doi.org/10.1017/s1368980010002880.
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AbstractObjectiveHome-delivered nutrition programmes that are federally subsidized by the US Administration on Aging seek to ensure that socially isolated older adults who are unable to purchase and prepare their own food have nutritious meals delivered to them regularly by both employed and volunteer staff. Unfortunately, there are long waiting lists in some neighbourhoods that are often due to a shortage of volunteers. The present paper describes a theoretically driven community-based project designed to increase volunteer participation in serving Meals on Wheels (MOW) clients.DesignA Support Team model was applied in the project wherein existing social capital among religious faith communities, and social networks within those organizations, was joined with a local MOW programme to create a sustainable meal delivery route to vulnerable homebound older adults.SettingThe programme participants were in one underserved neighbourhood in Birmingham, Alabama, an urban city in the south-eastern USA.SubjectsThe subjects under consideration are both MOW clients and volunteers. MOW clients are those individuals aged 60 years and above who qualify for the service; the volunteers are from community churches.ResultsOne volunteer route, comprising six congregations that delivered meals to sixteen homebound older adults, was created. The route served more than 2000 meals in 2006 (the year the programme began) and continues to serve clients today.ConclusionsThe programme’s successful implementation provides evidence that reliance on theory is critical in planning and developing effective community-based programme interventions.
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Cowley, Sarah. "Home visitors and child health in England: advances and challenges." Revista da Escola de Enfermagem da USP 45, spe2 (December 2011): 1810–16. http://dx.doi.org/10.1590/s0080-62342011000800030.
Full textAbstract:
There is increasing interest in the early years as a focus for reducing health inequalities as well as one that is important for the children themselves. This paper describes the introduction in England of Sure Start Local Programmes, which included home visiting within a community development approach, and an intensive home visiting programme, the Nurse-Family partnership, for disadvantaged teenage mothers. It reflects on changes and challenges in service provision to mothers and their pre-school children in England, explaining that a long tradition of home visiting was, paradoxically, reduced as attention focused on the newer initiatives. This is now being addressed, with attention to a range of evidence based programmes and a specific focus on heath visitor provision.