A pragmatic randomized controlled trial of the Flinders Program of chronic condition management in community health care services

2015 ◽  
Vol 98 (11) ◽  
pp. 1367-1375 ◽  
Author(s):  
Malcolm Battersby ◽  
Melanie Harris ◽  
David Smith ◽  
Richard Reed ◽  
Richard Woodman
Keyword(s):  
Health Care ◽  
Randomized Controlled Trial ◽  
Community Health ◽  
Chronic Condition ◽  
Health Care Services ◽  
Controlled Trial ◽  
Community Health Care ◽  
Pragmatic Randomized Controlled Trial ◽  
Randomized Controlled ◽  
Care Services

Promoting Health in Rural India: Enhancing Job Performance of Lay Health Care Activists

2019 ◽  
Vol 9 (2) ◽  
pp. 226-242 ◽  
Author(s):  
Jatin Pandey ◽  
Manjari Singh ◽  
Biju Varkkey ◽  
Dileep Mavalankar
Keyword(s):  
Health Care ◽  
Job Performance ◽  
Community Health ◽  
Health Care Workers ◽  
Rural Areas ◽  
Health Care Services ◽  
Rural India ◽  
Community Health Care ◽  
Care Services ◽  
Care Workers

The health of people in a nation is a potential indicator of its development. Over and above that, the job performance of people involved in the delivery and facilitation of health care services within a nation reflects the actual health conditions in it. In developing countries, where a large chunk of the population lives in rural areas, the job performance of grass-roots health care workers gains significant importance in order to ensure effective and efficient delivery of health care services to the masses and marginalized communities. The present study takes the case of Accredited Social Health Activists (ASHAs) in difficult rural areas of India to identify factors that affect their job performance and suggests interventions through which it could be enhanced. Fifty-five ASHAs were interviewed and five focused group discussions (FGDs) were conducted. Additionally, triangulation was done by interviewing other stakeholders, while studying relevant documents. Through content analysis of these interviews and documents, this study identifies the demands, resources and stressors that affect the job performance of these important intermediaries in the health care supply chain (in the Indian context). The study also suggests policy-level decisions that could help in enhancing job performance of ASHAs by managing demands, increasing resources and reducing stressors. Key Messages We have developed a model that delineates the demands, resources and stressors that affect job performance of women workers in rural India. We have studied Accredited Social Health Activists (ASHAs) who are part of community health care sector. However, our findings are applicable to a wider set of similar job roles. We have studied the nuances of factors affecting job performance for a category of community health care workers who are not full-time employees, have received minimal training and work in close proximity of their residence in a closely knit society. We have looked at job performance of ASHAs who are women community health workers, with low educational qualifications, based in rural setting of a developing country. We have recommended policy implications that would aid in enhancing the performance of ASHAs and thus improve the health care situation in rural India.

scholarly journals How to Screen Suitable Service Improve Community Health Care Services by University Students in Taiwan

2020 ◽  
Vol 17 (15) ◽  
pp. 5402 ◽  
Author(s):  
Guey-Shin Shyu ◽  
Shinn-Jou Lin ◽  
Wei-Ta Fang ◽  
Bai-You Cheng
Keyword(s):  
Health Care ◽  
Health Services ◽  
University Students ◽  
Community Health ◽  
Health Care Services ◽  
Explanatory Power ◽  
Community Health Services ◽  
Community Health Care ◽  
Care Services ◽  
Study Results

Engaging in social contributions to enhance social participation and attending community experiential service learning or internship courses have become an essential learning experience for university students. On the basis of postmodern education theories, this study adopted images and oral accounts involving personal experiences to construct a postmodern education research scheme by using the method of collaborative ethnography. This study selected and performed the following services: filming a community documentary, administering community health dance classes, and archiving community cultural artifacts in databases. Interviews were also administered to facilitate implementation of the actual services. Community health services commonly seen in Taiwan and abroad were compiled, and the resources required for each service were examined. Subsequently, factor analysis was performed to explore the characteristic of these services in order to recommend feasible services for university students to undertake. The results indicated that the eight resources required for the 59 common community health services were (1) a designated space or venue, (2) materials, (3) monetary resources, (4) human resources, (5) expertise, (6) professional equipment, (7) patience, and (8) empathy. The results revealed three principal components, namely labor services, high-resource services, and professional services, for a total explanatory power of 67.99%; the individual explanatory power of these components accounted for 25.04%, 21.81%, and 21.15%, respectively. Next, community health care services suitable for university students to perform were selected and implemented, and these services were well received. The study results indicated that community and environmental justice can be realized by identifying with the value of community health services and promoting postmodern education theories and social norms. The research results are suitable for implementation after the COVID-19 pandemic.

scholarly journals Non-use of community health-care services – an exploratory cross-sectional study among family care-givers for older, home-dwelling persons with dementia

2020 ◽  
pp. 1-25
Author(s):  
Jill-Marit Moholt ◽  
Oddgeir Friborg ◽  
Nils Henriksen ◽  
Torunn Hamran ◽  
Bodil H. Blix
Keyword(s):  
Health Care ◽  
Community Health ◽  
Health Care Services ◽  
Family Care ◽  
Community Health Care ◽  
Cross Sectional ◽  
Care Services ◽  
Care Givers ◽  
Care Giving ◽  
Use Of Services

Abstract Community health-care services for older, home-dwelling persons with dementia tend to be underutilised. Family care-givers provide substantial care, and they often arrange for and co-ordinate health-care services on behalf of persons with dementia. The aim of this study was to examine family care-givers’ knowledge of unused services and their self-reported reasons for non-use of such services. We gathered cross-sectional survey data from 430 family care-givers of older persons with dementia in Northern Norway. Multinomial logistic regression analysis was used to identify predictors of family care-givers’ knowledge of unused services. An open-ended question regarding reasons for non-use of services was analysed by thematic text analysis. Characteristics of family care-givers (e.g. education level) and factors related to the care-giving circumstances (e.g. negative impact of care-giving) predicted family care-givers’ knowledge of unused services. Reasons for non-use of services were multifaceted and complex, and were related to attributes of the person with dementia and/or the family care-giver (e.g. reluctance to use services) and/or the health-care services (e.g. low quality). Although services were unused, several family care-givers indicated substantial needs for the services. Strategies aimed at addressing the non-use of services should emphasise individuals’ and families’ needs and the adaptation of information about available services and their benefits for both care recipients and family care-givers. A relationship-centred care approach is thus recommended in dementia care.

scholarly journals Using visualisation methods to analyse referral networks within community health care among patients aged 65 years and over

2019 ◽  
Vol 26 (1) ◽  
pp. 354-375
Author(s):  
Ryan Palmer ◽  
Martin Utley ◽  
Naomi J Fulop ◽  
Stephen O’Connor
Keyword(s):  
Health Care ◽  
Community Health ◽  
Health Care Services ◽  
Single Point ◽  
Community Health Care ◽  
Coordinated Care ◽  
Care Services ◽  
Referral Networks ◽  
Community Provider ◽  
Multiple Services

Community health care services are considered integral to overcoming future problems in health care. However, this sector faces its own challenges, such as how to organise services to provide coordinated care given: their physical distribution, patients using multiple services, increased patient use and differing patient needs. The aim of this work was to explore, analyse and understand patterns in community referrals for patients aged 65 years and over, and their use of multiple services through data visualisation. Working with a large community provider, these methods helped researchers and service managers to investigate questions that were otherwise difficult to answer from raw data. Each map focuses on a different characteristic of community referrals: patients reusing services, concurrent uses of different services and patterns of subsequent referrals. We apply these methods to routine patient data and discuss their implications in designing of a single point of access – a service for streamlining referrals.

scholarly journals Strategies for community participation in developing countries

Curationis ◽  
2002 ◽  
Vol 25 (3) ◽  
Author(s):  
B.R. Chitambo ◽  
J.E. Smith ◽  
V.J. Ehlers
Keyword(s):  
Health Care ◽  
Developing Countries ◽  
Community Health ◽  
Community Participation ◽  
Health Care Services ◽  
Self Awareness ◽  
Community Health Care ◽  
Care Services ◽  
Community Programmes ◽  
Self Examination

Community participation has been hailed as the panacea for most community programmes. Community participation at high levels empowers communities, increases selfreliance, self-awareness and confidence in self-examination of problems and seeking solutions for them. Behavioural changes are promoted and utilisation and support of services is facilitated, which are of great importance to all community health efforts, especially in areas where the incidence of HIV/AIDS is high or increasing. The purpose of this article is to explore community participation strategies adopted in different countries for providing community health care services. Recommendations are provided for enhancing community participation in developing countries.

scholarly journals Helsepersonells erfaringer og tanker om bruk av frivillige i palliativ omsorg

2017 ◽  
Vol 13 (1) ◽  
Author(s):  
Ragnhild Skaar ◽  
Marthe M. F. Fensli ◽  
Sylvi M. Flateland ◽  
Ulrika Söderhamn
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
Community Health ◽  
Health Care Services ◽  
Qualitative Content Analysis ◽  
Health Care Personnel ◽  
Close Monitoring ◽  
Community Health Care ◽  
Individual Interviews ◽  
Care Services

Health care personnel’s experiences and thoughts on the use of volunteers in palliative care in a social perspectiveThe government of Norway is planning for the municipalities’ health care resources, including volunteering. The purpose of this study was to shed light on the experiences and thoughts of a group of health care personnel on the use of volunteers in palliative care in the community health care services, and to discuss the findings in a social perspective. Individual interviews were conducted with seven nurses and three nursing assistants. Using a qualitative content analysis three categories emerged: "The importance of organization, clarification and responsibility," "Qualifications" and "Different types of tasks," with the overarching theme: “Close monitoring and good clarification of roles can contribute to suitable volunteers functioning as an appropriate supplement for patients in palliative care in the community health care services”. The informants stated that trained health care personnel must perform the nursing tasks in palliative care while volunteers can be a positive supplement for the patient.

scholarly journals Access to primary and community health-care services for people 16 years and over with intellectual disabilities: a mapping and targeted systematic review

2020 ◽  
Vol 8 (5) ◽  
pp. 1-142 ◽  
Author(s):  
Anna Cantrell ◽  
Elizabeth Croot ◽  
Maxine Johnson ◽  
Ruth Wong ◽  
Duncan Chambers ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Health Services ◽  
Intellectual Disabilities ◽  
Community Health ◽  
Health Care Services ◽  
Community Health Care ◽  
Care Services ◽  
Mapping Review ◽  
Adults With Intellectual Disabilities

Background In 2015, approximately 2.16% of adults were recorded as having intellectual disabilities. UK government policy is that adults with intellectual disabilities should access mainstream health services. However, people with intellectual disabilities experience challenges when accessing primary and community health services that can lead to inequalities and shorter life expectancy. Objectives To map and review the evidence on access to primary and community health-care services for adults with intellectual disabilities and their carers. To identify influencing factors for gaining access to primary and community health-care services. To determine which actions, interventions or models of service provision improve entry access to these services for people with intellectual disabilities and their carers. Finally, to identify the gaps in evidence and provide implications for health care and recommendations for research. Data sources MEDLINE, The Cochrane Library, Web of Science, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Applied Social Sciences Index and Abstracts (ASSIA) and Education Resources Information Center (ERIC) were searched from 2002 to 2018. Review methods The mapping review methodology included an extensive literature search, article selection and data extraction of relevant abstracts. Findings from the mapping review informed the scope of the targeted systematic review. Methodology for the targeted systematic review included an extensive literature search informed by the mapping review, article selection, data extraction, quality appraisal and narrative synthesis. Results The mapping review included 413 studies with data extraction completed on abstracts. The targeted systematic review synthesised the evidence from 80 studies reported in 82 publications. During the review process, the team identified three key points at which people with intellectual disabilities potentially interacted with primary and community health-care services: identifying needs, accessing services and interaction during a consultation. In addition, there were a number of papers about interventions or innovations to improve access. Evidence from the studies was synthesised within the four clusters. Influencing factors were identified: staff knowledge/skills, joint working with learning disability services, service delivery model, uptake, appointment making, carer/support role, relationship with staff, time, accessible information and communication. The influencing factors were cross-cutting through the literature, with certain factors having more importance in certain clusters. Limitations The main limitation was the weak evidence base. The studies generally had small samples, had study designs that were open to potential biases and measured only short-term outcomes. Conclusions Health checks were found to help identify health needs and improve the care of long-term conditions. Important factors for accessing health services for adults with intellectual disabilities were consistency of care and support, staff training, communication skills and time to communicate, and provision of accessible information. Health professionals need to ensure that there is joint working between different services, clear communication and accurate record-keeping. Future research questions centre on the need to develop and value creative study designs capable of addressing the complex issues identified in the findings of the review for this complex population. Funding This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 8, No. 5. See the NIHR Journals Library website for further project information.

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