Catalogue Search | MBRL
Are you sure you want to remove the book from the shelf?
{{itemTitle}}
460,357
result(s) for
"Community Health"
Sort by:
Dimensions of community-based projects in health care
This salient reference grounds readers in the theoretical basis and day-to-day practice of community-based health care programs, and their potential as a transformative force in public health. Centering around concepts of self-determination, empowerment, and inclusiveness, the book details the roles of physicians, research, and residents in the transition to self-directed initiatives and greater community control. Community-focused interventions and methods, starting with genuine dialogue between practitioners and residents, are discussed as keys to understanding local voice and worldview, and recognizing residents as active participants and not simply targets of service delivery. And coverage pays careful attention to training issues, including how clinicians can become involved in community-based care without neglecting individual patient needs.
Book
Training nurses in task-shifting strategies for the management and control of hypertension in Ghana: a mixed-methods study
Background
Nurses in Ghana play a vital role in the delivery of primary health care at both the household and community level. However, there is lack of information on task shifting the management and control of hypertension to community health nurses in low- and middle-income countries including Ghana. The purpose of this study was to assess nurses’ knowledge and practice of hypertension management and control pre- and post-training utilizing task-shifting strategies for hypertension control in Ghana (TASSH).
Methods
A pre- and post- test survey was administered to 64 community health nurses (CHNs) and enrolled nurses (ENs) employed in community health centers and district hospitals before and after the TASSH training, followed by semi-structured qualitative interviews that assessed nurses’ satisfaction with the training, resultant changes in practice and barriers and facilitators to optimal hypertension management.
Results
A total of 64 CHNs and ENs participated in the TASSH training. The findings of the pre- and post-training assessments showed a marked improvement in nurses’ knowledge and practice related to hypertension detection and treatment. At pre-assessment 26.9% of the nurses scored 80% or more on the hypertension knowledge test, whereas this improved significantly to 95.7% post-training. Improvement of interpersonal skills and patient education were also mentioned by the nurses as positive outcomes of participation in the intervention.
Conclusions
Findings suggest that if all nurses receive even brief training in the management and control of hypertension, major public health benefits are likely to be achieved in low-income countries like Ghana. However, more research is needed to ascertain implementation fidelity and sustainability of interventions such as TASSH that highlight the potential role of nurses in mitigating barriers to optimal hypertension control in Ghana.
Trial registration
Trial registration for parent TASSH study:
NCT01802372
. Registered February 27, 2013.
Journal Article
Community-based healthcare : the search for mindful dialogues
This is a book for practitioners working in community-based healthcare as well as educators of future practitioners and researchers exploring this practice field and for people with chronic disabilities and their families and carers. The book invites readers to re-think and re-shape the way that community-based healthcare is practised by practitioners and experienced/engaged with by clients/patients and their families and other carers. Based on a PhD study of therapeutic relationships in community healthcare settings in NSW, Australia, and on real-life experiences of practitioners, clients and clients' families and care givers, this book paints a rich picture of the lived experiences of these participants in community-based healthcare. It examines the issues and challenges they face and the ways they deal with these. Key themes identified across the book are: the value and nature of relationships in this unique healthcare setting, the importance of time and using it well, the way good teamwork facilitates good community-based, patient-centred healthcare, balancing autonomy and equality with healthcare quality, practice wisdom embodied in healthcare, and ways of improving healthcare in clients' own homes -- Provided by the publisher.
Book
Economic evaluation of a task-shifting intervention for common mental disorders in India
To carry out an economic evaluation of a task-shifting intervention for the treatment of depressive and anxiety disorders in primary-care settings in Goa, India.
Cost-utility and cost-effectiveness analyses based on generalized linear models were performed within a trial set in 24 public and private primary-care facilities. Subjects were randomly assigned to an intervention or a control arm. Eligible subjects in the intervention arm were given psycho-education, case management, interpersonal psychotherapy and/or antidepressants by lay health workers. Subjects in the control arm were treated by physicians. The use of health-care resources, the disability of each subject and degree of psychiatric morbidity, as measured by the Revised Clinical Interview Schedule, were determined at 2, 6 and 12 months.
Complete data, from all three follow-ups, were collected from 1243 (75.4%) and 938 (81.7%) of the subjects enrolled in the study facilities from the public and private sectors, respectively. Within the public facilities, subjects in the intervention arm showed greater improvement in all the health outcomes investigated than those in the control arm. Time costs were also significantly lower in the intervention arm than in the control arm, whereas health system costs in the two arms were similar. Within the private facilities, however, the effectiveness and costs recorded in the two arms were similar.
Within public primary-care facilities in Goa, the use of lay health workers in the care of subjects with common mental disorders was not only cost-effective but also cost-saving.
Journal Article
Community as partner : theory and practice in nursing
\"Community As Partner: Theory and Practice in Nursing, 8th Edition offers a foundational overview of the concepts of epidemiology, environment, culture, ethics, empowerment, health policy, informatics, bioterrorism, and emerging infectious diseases as they relate to community health. Authors and theorists Dr. Anderson and Dr. McFarlane of the Community As Partner Model arm students with the \"how to\" knowledge they need to apply the nursing process to an entire community, and take readers through the entire nursing process with a real-life community as an example! Anderson offers a handbook with practical skills that ACHNE has outlined as essential for generalist nurses, including how to do a community assessment, how to analyze data, how to form a community nursing diagnosis, as well as how to plan, implement, and evaluate a community health program. Community As Partner analyzes the relationship between globalization and health, and inspires students to contribute to the reduction of global health challenges and promoting health for all, including marginalized populations and health promotion in school communities, rural communities, and faith communities. In this edition, instructors will receive PowerPoints enhanced with lecture notes and iclicker questions. These PowerPoints will be developed to serve a dual purpose. You can choose to share the decks with your students to use as self-paced Study Notes and knowledge check multiple choice questions. Our NCLEX style test bank has been revised and enhanced with more questions at the application level and higher\"-- Provided by publisher.
Community Health Centers
The aftermath of Hurricane Katrina has placed a national spotlight on the shameful state of healthcare for America's poor. In the face of this highly publicized disaster, public health experts are more concerned than ever about persistent disparities that result from income and race.This book tells the story of one groundbreaking approach to medicine that attacks the problem by focusing on the wellness of whole neighborhoods. Since their creation during the 1960s, community health centers have served the needs of the poor in the tenements of New York, the colonias of Texas, the working class neighborhoods of Boston, and the dirt farms of the South. As products of the civil rights movement, the early centers provided not only primary and preventive care, but also social and environmental services, economic development, and empowerment.Bonnie Lefkowitz-herself a veteran of community health administration-explores the program's unlikely transformation from a small and beleaguered demonstration effort to a network of close to a thousand modern health care organizations serving nearly 15 million people. In a series of personal accounts and interviews with national leaders and dozens of health care workers, patients, and activists in five communities across the United States, she shows how health centers have endured despite cynicism and inertia, the vagaries of politics, and ongoing discrimination.
eBook
Systems-level barriers to treatment in a cervical cancer prevention program in Kenya: Several observational studies
To identify health systems-level barriers to treatment for women who screened positive for high-risk human papillomavirus (hrHPV) in a cervical cancer prevention program in Kenya.
In a trial of implementation strategies for hrHPV-based cervical cancer screening in western Kenya in 2018-2019, women underwent hrHPV testing offered through community health campaigns, and women who tested positive were referred to government health facilities for cryotherapy. The current analysis draws on treatment data from this trial, as well as two observational studies that were conducted: 1) periodic assessments of the treatment sites to ascertain availability of resources for treatment and 2) surveys with treatment providers to elicit their views on barriers to care. Bivariate analyses were performed for the site assessment data, and the provider survey data were analyzed descriptively.
Seventeen site assessments were performed across three treatment sites. All three sites reported instances of supply stockouts, two sites reported treatment delays due to lack of supplies, and two sites reported treatment delays due to provider factors. Of the 16 providers surveyed, ten (67%) perceived lack of knowledge of HPV and cervical cancer as the main barrier in women's decision to get treated, and seven (47%) perceived financial barriers for transportation and childcare as the main barrier to accessing treatment. Eight (50%) endorsed that providing treatment free of cost was the greatest facilitator of treatment.
Patient education and financial support to reach treatment are potential areas for intervention to increase rates of hrHPV+ women presenting for treatment. It is also essential to eliminate barriers that prevent treatment of women who present, including ensuring adequate supplies and staff for treatment.
Journal Article
The impact of community health worker-led home delivery of antiretroviral therapy on virological suppression: a non-inferiority cluster-randomized health systems trial in Dar es Salaam, Tanzania
Background
Home delivery of antiretroviral therapy (ART) by community health workers (CHWs) may improve ART retention by reducing the time burden and out-of-pocket expenditures to regularly attend an ART clinic. In addition, ART home delivery may shorten waiting times and improve quality of care for those in facility-based care by decongesting ART clinics. This trial aims to determine whether ART home delivery for patients who are clinically stable on ART combined with facility-based care for those who are not stable on ART is non-inferior to the standard of care (facility-based care for all ART patients) in achieving and maintaining virological suppression.
Methods
This is a non-inferiority cluster-randomized trial set in Dar es Salaam, Tanzania. A cluster is one of 48 healthcare facilities with its surrounding catchment area. 24 clusters were randomized to ART home delivery and 24 to the standard of care. The intervention consists of home visits by CHWs to provide counseling and deliver ART to patients who are stable on ART, while the control is the standard of care (facility-based ART and CHW home visits without ART home delivery). In addition, half of the healthcare facilities in each study arm were randomized to standard counseling during home visits (covering family planning, prevention of HIV transmission, and ART adherence), and half to standard plus nutrition counseling (covering food production and dietary advice). The non-inferiority design applies to the endpoints of the ART home delivery trial; the primary endpoint is the proportion of ART patients at a healthcare facility who are virally suppressed at the end of the study period. The margin of non-inferiority for this primary endpoint was set at nine percentage points.
Discussion
As the number of ART patients in sub-Saharan Africa is expected to rise, this trial provides causal evidence on the effectiveness of a home-based care model that could decongest ART clinics and reduce patients’ healthcare expenditures. More broadly, this trial will inform the increasing policy interest in task-shifting of chronic disease care from facility- to community-based healthcare workers.
Trial registration
ClinicalTrials.gov:
NCT02711293
. Registration date: 16 March 2016.
Journal Article