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Lessons from the Field. Continuous Quality Improvement: A multiyear HMRF case study of best practices in outreach program excellence
Objective We describe the process and outcomes of developing continuous quality improvement (CQI) procedures for a multiyear, multimillion‐dollar healthy marriage and responsible fatherhood (HMRF) relationship enhancement education program. We present lessons learned, including adaptations used to move all programming online due to the COVID‐19 pandemic. Background Continuous quality improvement (CQI) is a set of best practices that are often neglected in outreach programming due to challenges associated with funding, available expertise, and fear of underwhelming results. However, this practice provides valuable insight and benefits to programs and participants and can be implemented without interrupting program delivery. Method We developed a “living” CQI plan over the course of 5 years using three sources of data to track, evaluate, and inform CQI high‐performance decision‐making: program data, fidelity data, and outcome data. Results A sample of the preliminary descriptive quantitative results is presented including program registrations and show rates, facilitator effectiveness scores, intervention outcomes, and participant responses to online delivery to illustrate how the three types of data collected are used in the SMART Couples Project to support CQI efforts. Conclusions and Implications Our study demonstrates the benefits of using CQI as a powerful tool for program improvement, with staff and participants alike. It is the nature of the CQI process to be amenable to changes, including unforeseen disruptions in program delivery. Implementing an intentional formative and summative CQI strategy provides benefits to social outreach and family life education programs across delivery formats and contexts.
Journal Article
Toward a Socioeconomic Equity in Combating Adolescent Substance Abuse: An Outreach and Drop-In Centre to Bridge the Gap
This paper describes a case study of an Outreach and Drop-in Centre (ODIC) established under the National Action Plan for Drug Demand Reduction, Ministry of Social Justice and Empowerment, Government of India. In the quantitative part, data were gathered from the ODIC office documents and analysed using MS Excel. Linear regression analysis demonstrated a relationship between the number of in-centre clients and the number of Community Outreach Programmes (COPs). Similarly, this study examined the relationship between the number of networks established and the number of participants in COPs. Hence, two regression lines were derived accordingly. In addition, qualitative data collected through key informant interviews corroborated the quantitative results. This case study highlights the importance of networks and COPs in increasing the reach of ODIC and ensuring the quality of services. Finally, in partnership with other government agencies, this ODIC sets a model for engaging marginalised adolescents in reducing substance abuse.
Journal Article
Differences in Utilization of Medical and Dental Services among Homeless People in South Korea
(1) Background: Homelessness contributes to both needs for care and barriers to access. This study aimed to explore the utilization of medical or dental services using Andersen’s model for a vulnerable population of homeless in South Korea. (2) Methods: The data were applied from the first national survey for homeless people in South Korea, 2016. Totally 2032 persons participated in the interview survey. This study team requested the raw data through the public portal and analyzed them. (3) Results: The participants who were homeless for more than ten years, staying in small rooming house or shelter, non-employed, earning less than 500,000 won per month, and having a medical condition showed a significantly higher chance of using Medicaid. The use of outreach programs had a significant relationship with gender, duration of homelessness, and monthly income. Among dental patients, the homeless who did not consume alcohol, stayed in a shelter, and were employed had higher chances of using dental service. (4) Conclusions: Medicaid service was strongly related to enabling factors but outreach programs with predisposing factors. Dental service showed strong relationships with the enabling domain, but the pattern was opposite: the jobless had less chance to avail it. The policymakers need to consider these domains of service utilization to provide equitable access to healthcare services.
Journal Article
Outreach and screening following the 2005 London bombings: usage and outcomes
Little is known about how to remedy the unmet mental health needs associated with major terrorist attacks, or what outcomes are achievable with evidence-based treatment. This article reports the usage, diagnoses and outcomes associated with the 2-year Trauma Response Programme (TRP) for those affected by the 2005 London bombings.MethodFollowing a systematic and coordinated programme of outreach, the contact details of 910 people were obtained by the TRP. Of these, 596 completed a screening instrument that included the Trauma Screening Questionnaire (TSQ) and items assessing other negative responses. Those scoring ≥6 on the TSQ, or endorsing other negative responses, received a detailed clinical assessment. Individuals judged to need treatment (n=217) received trauma-focused cognitive-behaviour therapy (TF-CBT) or eye movement desensitization and reprocessing (EMDR). Symptom levels were assessed pre- and post-treatment with validated self-report measures of post-traumatic stress disorder (PTSD) and depression, and 66 were followed up at 1 year.
Case finding relied primarily on outreach rather than standard referral pathways such as primary care. The effect sizes achieved for treatment of DSM-IV PTSD exceeded those usually found in randomized controlled trials (RCTs) and gains were well maintained an average of 1 year later.
Outreach with screening, linked to the provision of evidence-based treatment, seems to be a viable method of identifying and meeting mental health needs following a terrorist attack. Given the failure of normal care pathways, it is a potentially important approach that merits further evaluation.
Journal Article
Your Technology Outreach Adventure
This guide will empower libraries to design and prototype technology-based outreach ideas safely, quickly, and with confidence, leading to better service for all members of the community.
eBook
A Trauma-Informed Approach to Library Services
Using the trauma-informed approach outlined in this book, libraries can ensure they are empathetic community hubs where everyone feels welcomed, respected, and safe.
eBook
Mistrust of Outreach Workers and Lack of Confidence in Available Services Among Individuals who are Chronically Street Homeless
This qualitative study explored how individuals who are homeless perceive outreach practices and available services. Interviews were conducted with 24 people who had been homeless for ≥1 year and who consistently resided on the streets of west midtown, Manhattan, New York. Reasons why these individuals refuse services include a pervasive mistrust of outreach workers and the agencies that employ them, as well as a prominent lack of confidence in available services. The findings suggest a need for an approach to outreach that incorporates giving individualized attention from outreach workers, using an empathetic listening approach, minimizing stereotyping, providing greater choices, and employing formerly homeless people as outreach workers.
Journal Article
Information outreach interventions to promote the information access, use and exchange in the rural areas of Pakistan
Purpose
This study is a part of the doctoral dissertation that proposes concrete measures to improve health-care information outreach program for rural health-care professionals in primary and secondary health care in Punjab, Pakistan. This study aims to report on the barriers to accessing and using online health-care information from rural settings of the Punjab province of Pakistan.
Design/methodology/approach
A cross-sectional survey was conducted in primary and secondary health-care settings in the Punjab province of Pakistan. The study’s population consisted of the rural primary care physicians (PCPs), who were geographically dispersed across 2,873 different remote health-care settings across Punjab. These practice settings included 2,455 basic health units, 293 rural health centers, 89 tehsil headquarter hospitals and 36 district headquarter hospitals.
Findings
Limited internet access, non-availability of required equipment and lack of training facilities were identified as the main barriers. PCPs’ gender, previous enrollment in post-graduation programs and type of health-care facility were significant factors in the perceived barriers related to both “non-availability of required equipment” and “inadequate training facilities on the use of information resources”.
Practical implications
The findings of the study hold some important practical implications for different stakeholders. This study identifies and addresses the barriers to accessing and using health-care information for PCPs in rural settings. The success of the health-care information outreach program in Punjab, Pakistan, should rely on the eradication of these barriers.
Originality/value
To the best of the authors’ knowledge, this is the first large-scale study in Pakistan that assesses the barriers and proposes ways to overcome these barriers to effectively access and use health-care information.
Journal Article