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Community Interventions (community + intervention)
Selected AbstractsA Community Intervention by Firefighters to Increase 911 Calls and Aspirin Use for Chest PainACADEMIC EMERGENCY MEDICINE, Issue 4 2006Hendrika Meischke PhD Abstract Objectives: To test the effectiveness of an intervention, delivered face-to-face by local firefighters, designed to increase utilization of 911 and self-administration of aspirin for seniors experiencing chest pain. Methods: King County, Washington was divided into 126 geographically distinct areas that were randomized to intervention and control areas. A mailing list identified households of seniors within these areas. More than 20,000 homes in the intervention areas were contacted by local firefighters. Data on all 911 calls for chest pain and self-administration of aspirin were collected from the medical incident report form (MIRF). The unit of analysis was the area. Firefighters delivered a heart attack survival kit (that included an aspirin) and counseled participants on the importance of aspirin and 911 use for chest pain. Main outcome measures were 911 calls for chest pain and aspirin ingestion for a chest pain event, obtained from the MIRFs that are collected by emergency medical services personnel for 2 years after the intervention. Results: There were significantly more calls (16%) among seniors on the mailing list in the intervention than control areas in the first year after the intervention. Among the seniors who were not on the mailing list, there was little difference in the intervention and control areas. The results were somewhat sensitive to the analytical model used and to an outlier in the treatment group. Conclusions: A community-based firefighter intervention can be effective in increasing appropriate response to symptoms of a heart attack among elders. [source] Community intervention and public policy in the prevention of antisocial behaviorTHE JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AND ALLIED DISCIPLINES, Issue 1-2 2009Kenneth A. Dodge As academic clinical science moves to community intervention to achieve impact on population prevalence of antisocial behavior disorders, exciting potential is tempered by realistic caution. Three kinds of efforts are noted. First, individual evidence-based therapies are being implemented at scale. Difficulties in high-fidelity implementation are noted, and the unlikelihood of population impact is highlighted. Second, communities are receiving new resources to support individuals, although connecting community resources to highest-risk individuals is difficult. Third, community factors are being targeted for change through policy reform, with mixed results. As the field moves in this direction, the importance of adhering to principles of scientific rigor and empirical evidence is emphasized, to keep scientist-practitioners from overstepping their bounds. [source] Effects of a community intervention to reduce the serving of alcohol to intoxicated patronsADDICTION, Issue 6 2010Katariina Warpenius ABSTRACT Aims To assess the effects of an alcohol prevention programme to reduce the serving of alcoholic beverages to intoxicated clients on licensed premises. Research design A controlled pre- (2004) and post-intervention study (2006) design. Intervention A community-based programme combining law enforcement, responsible beverage service training, information campaigns and policy initiatives in one Finnish town (Jyväskylä). Participants and measurements A male actor pretended to be clearly under the influence of alcohol and tried to buy a pint of beer at licensed premises. For the baseline measurement, every bar and nightclub was visited in the intervention and the control areas (94 licensed premises in total). Post-intervention data were gathered with the same principles (100 licensed premises in total). A researcher observed every visit and documented the results. Results In the post-intervention study there was a statistically significant increase in refusals to serve denials alcohol to the actor in the intervention area (from 23% to 42% of the licensed premises) compared to refusals in the control area (from 36% to 27% of the licensed premises). Conclusion Previous research has documented that multi-component community-based interventions can have a significant impact on over-serving of alcohol when training and house policies are combined with effective law enforcement. The present findings also demonstrate that comprehensive Responsible Beverage Service (RBS) interventions applied at a local community level can be effective in decreasing service to intoxicated clients in a Nordic context. [source] An evaluation of a six-week intervention designed to facilitate coping with psychological stressJOURNAL OF CLINICAL PSYCHOLOGY, Issue 12 2001Leah Blumberg Lapidus Community dwelling Korean adults (N = 40) coping with the stress of severe mental illness were randomly assigned to a six-week differentiation furthering intervention (experimental) or a directed problem-solving treatment program (control) and administered pre- and posttreatment measures including the Morey Personality Assessment Screener (PAS) and Group Embedded Figures Test (GEFT). As predicted, the experimental group showed greater improvement on 6 out of 10 mental health subscales (PAS) and on the GEFT than the controls. For the entire sample, differentiation gainers showed more improvement on three PAS subscales compared with the no change or loss in differentiation groups. A three-month follow-up showed greater attendance at mental health appointments for the experimental group over controls and for total sample differentiation gainers over nongainers. Implications are discussed of this empirically tested model of a community intervention to facilitate coping with stress and enhancing competence. © 2001 John Wiley & Sons, Inc. J Clin Psychol 57: 1381,1401, 2001 [source] Implementing a community intervention to reduce young people's risks for getting HIV: Unraveling the complexitiesJOURNAL OF COMMUNITY PSYCHOLOGY, Issue 2 2004Maretha J. Visser The ineffectiveness of community-based interventions can often be traced to problems that occur during implementation. In this study, we outline the implementation of a human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) prevention program in an educational setting in South Africa. An action research approach was used in the implementation of the intervention and a process and outcome evaluation, integrating qualitative and quantitative research methods, was made. The research illustrated the various levels of interaction in the community and the complexity of the processes involved in the implementation of interventions to facilitate community change. Social ecological theory, systems theory, and the social constructional approach are used to clarify the complexities of the implementation of community interventions. © 2004 Wiley Periodicals, Inc. J Comm Psychol 32: 145,165, 2004. [source] Delivering the goods: The importance of screening accuracy for effective community intervention and preventionJOURNAL OF COMMUNITY PSYCHOLOGY, Issue 2 2002Edmond D. Shenassa The utility and feasibility of community intervention and prevention programs depend greatly on the accuracy by which programs' participants are screened from among community dwellers. This is because indiscriminate application of the program to the entire community benefits only a few, while it can even harm the many others. It is therefore necessary to define and screen a target population so the program can be delivered exclusively to them. Consequently, screening accuracy has implications for the plan, design, and evaluation of community-based programs. In this manuscript indices of screening accuracy are discussed in the context of screening for substance use, and depression. Receiver Operating Characteristic curves, measurement error, as well as design and evaluation of community programs are also discussed in the context of screening accuracy. © 2002 John Wiley & Sons, Inc. [source] Community intervention and public policy in the prevention of antisocial behaviorTHE JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AND ALLIED DISCIPLINES, Issue 1-2 2009Kenneth A. Dodge As academic clinical science moves to community intervention to achieve impact on population prevalence of antisocial behavior disorders, exciting potential is tempered by realistic caution. Three kinds of efforts are noted. First, individual evidence-based therapies are being implemented at scale. Difficulties in high-fidelity implementation are noted, and the unlikelihood of population impact is highlighted. Second, communities are receiving new resources to support individuals, although connecting community resources to highest-risk individuals is difficult. Third, community factors are being targeted for change through policy reform, with mixed results. As the field moves in this direction, the importance of adhering to principles of scientific rigor and empirical evidence is emphasized, to keep scientist-practitioners from overstepping their bounds. [source] A systematic review of the effectiveness of brief interventions with substance using adolescents by type of drugDRUG AND ALCOHOL REVIEW, Issue 3 2003Dr ROBERT J. TAIT Abstract The aim of this paper is to evaluate the effectiveness of brief interventions (BI) with adolescents (mean age < 20) in reducing alcohol, tobacco or other drug (ATOD) use by means of a systematic review of BI for adolescent substance use in the English language literature up to 2002. We identified 11 studies involving 3734 adolescents. Follow-up ranged from 6 weeks to 24 months. Motivational interviewing was the predominant approach, underpinning eight studies: the remaining three provided personalized health information. Seven papers reported outcomes for alcohol interventions and four involved other substances (including one with separate alcohol outcomes). The overall effect size was d= 0.126 with borderline homogeneity (Q = 14.9, df = 9, p = 0.09). The effect size from the eight alcohol interventions (n = 1075) was classified as significant but "small" (d = 0.275). The remaining non-alcohol studies were considered separately as interventions involving tobacco or multiple substance use. The two interventions with tobacco involved a substantial sample (n = 2626) but had a very small effect (d = 0.037), while the two interventions addressing multiple substances involved few participants (n = 110) but had a medium , large effect (d = 0.78). Across a diverse range of settings (dental clinic, schools, universities, substance treatment centres) and, therefore, probably diverse clients, BI conferred benefits to adolescent substance users. BI had a small effect on alcohol consumption and related measures. The data for tobacco interventions suggested a very small reduction, particularly with general community interventions. The effect of BI with multiple substances appears substantial but the small sample cautions against expansive generalization. [source] Assessment of health, well-being and social connections: A survey of women living in Western SydneyINTERNATIONAL JOURNAL OF NURSING PRACTICE, Issue 1 2007Rhonda Griffiths RN CM B.Ed(Nursing) M.Sc(Hons) DrPH Strengthening the physical and social environment has been shown to support health and strengthen community action for health. In an attempt to improve the social factors that influence the health of individuals and the community, community interventions increasingly include strategies to build networks and social capital and develop resilience. This study was undertaken to identify the most appropriate strategies to strengthen friendships and the social support networks for women aged 18,39 years living in Villawood, an area of high disadvantage in South Western Sydney, Australia. Although the majority reported positively on their health, one-third reported feeling isolated, experienced low energy levels and felt unhappy and anxious over the past month. Women who described themselves as unemployed felt more isolated than women in home duties. Women who were employed or engaged in home duties had more contact with neighbours, and had more in common with their neighbours. Those who reported more contact with their neighbours perceived their mental healthlevel as being higher. These results indicate that community development initiatives should include consultation with the community and consider the needs of socially isolated groups and those with the poorest health status. [source] Postdischarge nursing interventions for stroke survivors and their familiesJOURNAL OF ADVANCED NURSING, Issue 2 2004Kelly L. McBride MSc RN Background. The physical, cognitive, and emotional sequelae of stroke underscore the need for nursing interventions across the continuum of care. Although there are several published studies evaluating community interventions for stroke survivors, the nursing role has not been clearly articulated. Aim. The aim of this paper is to report a study to describe, using a standardized classification system, the nursing interventions used with stroke survivors during the initial 6 weeks following discharge home. Methods. In the context of a randomized controlled trial, two nurse case managers provided care to 90 community-dwelling stroke survivors who were assigned to the intervention arm of the trial. The nursing documentation was analysed, using the Nursing Intervention Classification (NIC) system, to identify and quantify the interventions that were provided. Findings. Stroke survivors received, on average, six different interventions. There was a trend for those who were older, more impaired, and who lived alone to receive more interventions. The most commonly reported interventions included those directed towards ensuring continuity of care between acute and community care, family care, and modifying stroke risk factors. The study was limited to the nursing documentation, which may represent an underestimation of the care delivered. Conclusions. The NIC system was useful in capturing the interventions delivered by the nurse case managers. Nursing interventions are often not clearly articulated and less often use standardized terminology. Describing nursing activities in a standard manner will contribute to an increase in nursing knowledge and to evidence-based practice. [source] Effectiveness of a Falls-and-Fracture Nurse Coordinator to Reduce Falls: A Randomized, Controlled Trial of At-Risk Older AdultsJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 8 2008(See editorial comments by Dr. Mary Tinetti on pp 156, 1565) OBJECTIVES: To assess the effectiveness of a community-based falls-and-fracture nurse coordinator and multifactorial intervention in reducing falls in older people. DESIGN: Randomized, controlled trial. SETTING: Screening for previous falls in family practice followed by community-based intervention. PARTICIPANTS: Three hundred twelve community-living people aged 75 and older who had fallen in the previous year. INTERVENTION: Home-based nurse assessment of falls-and-fracture risk factors and home hazards, referral to appropriate community interventions, and strength and balance exercise program. Control group received usual care and social visits. MEASUREMENTS: Primary outcome was rate of falls over 12 months. Secondary outcomes were muscle strength and balance, falls efficacy, activities of daily living, self-reported physical activity level, and quality of life (Medical Outcomes Study 36-item Short Form Questionnaire). RESULTS: Of the 3,434 older adults screened for falls, 312 (9%) from 19 family practices were enrolled and randomized. The average age was 81±5, and 69% (215/312) were women. The incidence rate ratio for falls for the intervention group compared with the control group was 0.96 (95% confidence interval=0.70,1.34). There were no significant differences in secondary outcomes between the two groups. CONCLUSION: This nurse-led intervention was not effective in reducing falls in older people who had fallen previously. Implementation and adherence to the fall-prevention measures was dependent on referral to other health professionals working in their usual clinical practice. This may have limited the effectiveness of the interventions. [source] Escaping homelessness: anticipated and perceived facilitators,JOURNAL OF COMMUNITY PSYCHOLOGY, Issue 7 2009Allisha Patterson One study with two distinct sections was conducted to identify factors facilitating escape from homelessness. In Section 1, 58 homeless individuals rated possible facilitators of escape (factors they believed would help them become more independent and self-sufficient). In Section 2, 80 participants who had already exited homelessness rated the same facilitators (factors that would have helped them become more independent and self-sufficient) and the importance of actual factors that facilitated escape. When rating factors in the hypothetical, both groups rated obtaining housing as being particularly important for facilitating movement toward independence. People formerly homeless who reported perceived facilitators of escape, however, also reported that their escape was facilitated by realization of their own abilities and potential to offer something to the world. The findings have implications for the design of community interventions helping individuals who are homeless. © 2009 Wiley Periodicals, Inc. [source] Social support in women with fibromyalgia: Is quality more important than quantity?JOURNAL OF COMMUNITY PSYCHOLOGY, Issue 4 2004Heather M. Franks The present study is an examination of the effects of quality and quantity of social support on the psychological and physical well-being of women with fibromyalgia syndrome (FMS). Participants were 568 women who were members of a health maintenance organization (HMO) with a confirmed diagnosis of FMS. Participants were administered a battery of questionnaires assessing their psychological and physical well-being. Measures of depression, self-efficacy, helplessness, mood disturbance, health status, impact of FMS, and social support were included. Regression analyses indicated that larger social support networks were associated with greater levels of self-efficacy for pain and symptom management, while the perceived quality of social support was associated with lower levels of depression, helplessness, mood disturbance, impact of FMS, higher levels of self-efficacy for function and symptom management, as well as overall psychological well-being. These findings indicate that the quality of social support is more important than quantity in determining outcomes in women with FMS. Thus, the quality of social support has important financial and psychosocial implications for the individual and for the community as a whole. Future research should examine longitudinal changes in quality of social support and the corresponding changes in health status and psychological well-being, as well as the effects of integrating manipulations designed to affect the quality of social support into community interventions designed to enhance the well-being of women with FMS. © 2004 Wiley Periodicals, Inc. J Comm Psychol 32: 425,438, 2004. [source] Influences on Detention Decisions in the Juvenile Justice SystemJUVENILE AND FAMILY COURT JOURNAL, Issue 1 2002BRIAN F. O'NEILL MSW, PH.D. ABSTRACT This paper examines the pretrial detention of juveniles in County X located in a northeastern state. The sample (N=642) included Black, White, and Hispanic males and females adjudicated delinquent in the summer of 2000. The following independent variables were analyzed with respect to the dependent variable of pretrial detention: age, sex, address, race, current offense (misdemeanors, violent misdemeanors, felonies, violent felonies, and probation violations), prior offense (misdemeanors, violent misdemeanors, felonies, and violent felonies), and previous dispositions (community or placement). Several variables were found to be significant in increasing the odds of pretrial detention: probation violations, prior misdemeanors, prior residential placements, prior community interventions, age, sex, urban address, felonies, prior violent misdemeanors, and prior violent felonies. It was expected that minority youths would be more likely to be detained, but race was only significant in the absence of the variable of address. Urban youths were more likely to be detained resulting in an over-representation of minorities in detention, since most of the minority population resides in the urban area. Also included is supplemental material based on interviews with defense lawyers, judges, masters, and juvenile probation officers. [source] Factors affecting member perceptions of coalition impactNONPROFIT MANAGEMENT & LEADERSHIP, Issue 3 2009Rebecca Wells The purpose of this study was to identify attributes of communitybased coalitions associated with member perceptions of greater impact. Based on Hackman's model of work group effectiveness, we hypothesized that member effort, knowledge and skill, and performance strategies would affect their perceptions of coalition impact. Findings from a lagged regression on a sample of forty-five youth-oriented coalitions indicated that two aspects of member effort were associated with subsequent perceived impact, as were performance strategies for both coalition governance and community interventions. There were no associations, however, between member knowledge and skill and perceived impact. These results suggest that leaders may improve perceived coalition impact by encouraging member participation in discussions and interventions and by developing effective strategies for both governance and implementation. [source] Assessment of violence potential among school children: Beyond profilingPSYCHOLOGY IN THE SCHOOLS, Issue 3 2001Matthew K. Burns The increasing level of public attention to violence in American schools makes the issue a top priority among educators. School psychologists could play an important role in identifying at-risk youth, and planning appropriate individual, school, and community interventions related to school violence. However, there is limited literature examining different assessment approaches that could be used to evaluate student risk for violence. This article reviews (a) characteristics of students "at risk" for violence, (b) informal checklists and matching student characteristics to profiles of typical violent students and (c) threat assessment based on Borum et al.'s (1999) model. Ethical and legal considerations are covered as well. © 2001 John Wiley & Sons. Inc. [source] Construction of an Aboriginal Theory of Mind and Mental Health1ANTHROPOLOGY OF CONSCIOUSNESS, Issue 2 2009Lewis Mehl-Madrona ABSTRACT Most research on aboriginal mind and mental health has sought to apply or confirm preexisting European-derived theories among aboriginal people. Culture has been underappreciate. An understanding of uniquely aboriginal models for mind and mental health might lead to more effective and robust interventions. To address this issue, a core group of elders from five separate regions of North America was developed to help determine how aboriginal people conceived of mind, self, and identity before European contact. The process utilized for this study is iterative and involves discussions of teachings, traditional stories, and elder's comments on conclusions drawn. The elders endorsed a relational theory of mind in which mind exists between people as a product of the stories told and created within and by that relationship. Mind is distinguished from consciousness which is without language and exists within the individual as awareness. Language immediately results in an "out there" orientation in which two or more individuals generate stories about their experiences. The community is the basic unit of study for mind and mental health, and mental "illness" is not distinguished from physical "illness," but rather all are seen as a continuum of suffering and pain. What emerged from this research is that North American theories of mind are more closely related to Daoist and Shinto theories than to the logical positivism which drives most of North America's conventional psychology and psychiatry. Within European traditions, however, the philosophy of Mikhail Bakhtin with his emphasis on a dialogical self coupled with system theory comes closest to resembling North American aboriginal theories. This model explains why ceremony and ritual, community interventions, talking circles (including AA and the Wellbriety Movement), and family therapy are more compatible with aboriginal thought than conventional North American biomedicine and psychology. [source] Do community-based support services benefit bereaved children?CHILD: CARE, HEALTH AND DEVELOPMENT, Issue 6 2001A review of empirical evidence Abstract Aims To consider the evidence of effect from English language, empirically based quantitative evaluations of community-based interventions for bereaved children; community-based interventions being understood as those taking place outside a clinical setting. Methods MedLine, PsychInfo, Applied Social Sciences Index and Sociological Abstracts were searched for documents containing the words ,child', ,bereavement' and ,program', ,group', ,intervention', ,support' or ,evaluation'. The criterion for inclusion was that studies use a control group or pre- and post-test measurements using a standardized instrument. Results Nine relevant studies were identified. However, empirical evidence of positive outcomes for children was limited and compromised by methodological weaknesses in the design of the studies. Small sample sizes, irregular attendance, high levels of attrition, short time scales between pre- and post-testing and difficulty in developing appropriate instrumentation, including assessment of adherence to the agreed intervention programme, all created problems. Conclusions The case for universal inclusion of this group of children in such support programmes remains unproven, and further exploration of the outcomes of a range of different community interventions is required, with a specific focus on long-term and/or unwanted effects and evaluation of the basis for referral. [source] | ||||||||||||||||