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Health Programs (health + program)
Kinds of Health Programs Selected AbstractsA CRITIQUE OF THE INNOVATION ARGUMENT AGAINST A NATIONAL HEALTH PROGRAMBIOETHICS, Issue 6 2007ALEX RAJCZI ABSTRACT President Bush and his Council of Economic Advisors have claimed that the US shouldn't adopt a national health program because doing so would slow innovation in health care. Some have attacked this argument by challenging its moral claim that innovativeness is a good ground for choosing between health care systems. This reply is misguided. If we want to refute the argument from innovation, we have to undercut the premise that seems least controversial , the premise that our current system produces more innovation than a national health program would. I argue that this premise is false. The argument requires clarifying the concept ,national health program' and examining various theories of human well-being. [source] Organization and delivery of primary health care services in Petrópolis, BrazilINTERNATIONAL JOURNAL OF HEALTH PLANNING AND MANAGEMENT, Issue 4 2004James Macinko Abstract The objective of the study was to adapt and apply an instrument to measure the organizational features of the primary care system in the municipality of Petrópolis. The study compared the performance of the new Family Health Program (Programa Saúde da Família or PSF) with traditional primary care facilities using data from facility surveys and key informant interviews. The main results include: (a) the methodology was capable of distinguishing between the two types of primary care services in the municipality; (b) the PSF clinics scored higher on most dimensions of primary care, although in some areas the traditional health units had equivalent scores; and (c) data obtained from interviewing key informants was generally compatible with that obtained by conducting facility surveys. The results suggests that in spite of making important advances in primary care, the municipality of Petrópolis continues to face several challenges including the need to improve access, enforce the gatekeeper role of primary care, and improve the coordination and community orientation of both types of primary care services. The methodology could be used to set objectives and monitor progress towards improving the organization and delivery of primary care in Petrópolis and elsewhere. Copyright © 2004 John Wiley & Sons, Ltd. [source] An educational process to strengthen primary care nursing practices in São Paulo, BrazilINTERNATIONAL NURSING REVIEW, Issue 4 2007A.M. Chiesa rn Objective:, To describe the experience of a registered nurse (RN) training process related to the Family Health Program (FHP) developed in the city of São Paulo, Brazil. Background:, The FHP is a national, government strategy to restructure primary care services. It focuses on the family in order to understand its physical and social structure in regards to the health,illness process. In the FHP, the RN is a member of a team with the same number as medical doctors , an unprecedented situation. The FHP requires a discussion of the RNs' practice, by qualifying and empowering them with tools and knowledge. Methods:, The training process was based on Freire's approach founded on critical pedagogy in order to address the fundamental problem of inequalities in health. The first phase included workshops and the second one included a course. The workshops identified the following problems related to the RN's work: lack of tools to identify the population's needs; overload of work due to the accumulation of management and assistance activities; difficulties regarding teamwork; lack of tools to evaluate the impact of nursing interventions; lack of tools to improve the participation of the community. The course was organized to tackle these problems under five thematic headings. Results:, The RN's training process allowed the group to reflect deeply on its work. This experience led to the need for the construction of tools to intervene in the reality, mainly against social exclusion, rescuing and adapting of the knowledge accumulated in the healthcare practice, identifying settings which demand institutional solutions and engaging the RN in research groups in order to develop projects according to the complexity of the primary care services. Conclusion:, The application of the concept of equity in the health sector represented a reaction against the processes of social exclusion, starting from performance at a local level to become a reality in the accomplishments achieved by the Brazilian National Health System. This training process allowed us to evaluate that partnership, which has produced many concrete results in addressing both parts of the Inequalities in Health dilemma and which is a productive way of building up a new model of health. [source] Cultural Perspectives of International Breast Health and Breast Cancer EducationJOURNAL OF NURSING SCHOLARSHIP, Issue 2 2007Karen Dow Meneses Purpose: To (a) describe teaching,learning strategies to foster cultural exchange among participants in the Train-The-Trainer (TTT) International Breast Health Program; (b) describe participants' perceptions of cultural influences on breast health and breast cancer; and (c) explore lessons learned about cultural influences on breast health TTT educational programs. Organizing Construct: The TTT curriculum was grounded in the belief that nurses can effectively deliver breast health and breast cancer education, that educational programs must be culturally relevant and sensitive to the needs of the target population, and that an urgent need exists worldwide to reduce the burden of breast cancer. Methods: A total of 32 nurses from 20 countries participated in three TTT programs held before the biennial meetings of the International Society of Nurses in Cancer Care (ISNCC) since 2000, with follow-up by E-mail survey. Narrative descriptions of their perspectives and experiences are reported. Results: Teaching,learning strategies incorporated cultural values into a TTT program to engage participants in sharing their individual and collective experiences about women with breast cancer. Conclusions: Developing countries are increasingly multicultural. Developed countries have large immigrant populations that generally maintain the cultural values and practices about breast cancer from the country of origin. These "lessons learned" are important in planning other educational programs. [source] An Ecological Model of the Coordinated School Health Program: A CommentaryJOURNAL OF SCHOOL HEALTH, Issue 1 2010FASHA, Joyce V. Fetro PhD No abstract is available for this article. [source] Implementation of a Coordinated School Health Program in a Rural, Low-Income CommunityJOURNAL OF SCHOOL HEALTH, Issue 9 2007BSHRM, Lisa Cornwell RN ABSTRACT Background:, Coordinated school health programs (CSHPs) bring together educational and community resources in the school environment. This method is particularly important in rural areas like Kansas, where resources and trained health professionals are in short supply. Rural Stafford County, Kansas, struggles with health professional shortages and a low-income, high-need population. Methods:, In 2001, Stafford County's Unified School District 349 began a multiyear CSHP development process, which required adaptations for implementation in a rural area. First, a CSHP team was formed of community and administrative stakeholders as well as school system representatives. Next, the CSHP team assessed school district demographics so the program framework could be targeted to health needs. During a yearlong planning phase, the CSHP team determined 4 priority areas for program development, as limited staff and funds precluded developing programs in all 8 traditional CSHP areas. Program activities were tailored to the population demographics and available resources. Results:, Program outcomes were supported by School Health Index (SHI) data. Of the 8 CSHP focus areas, the SHI found high scores in 3 of the Stafford CSHP's priority areas: Health Services; Psychological, Counseling, and Social Services; and Physical Education. The fourth Stafford CSHP priority area, Nutrition Services, scored similarly to the less prioritized areas. Conclusions:, The process by which the Stafford school district modified and implemented CSHP methods can serve as a model for CSHPs in other rural, high-need areas. [source] Promoting Physical Activity in GirlsJOURNAL OF SCHOOL HEALTH, Issue 2 2005A Case Study of One School's Success ABSTRACT: This case study profiles one of 24 high schools that participated in a school-based, NIH-funded study to increase physical activity among high school girls. The case study school was one of 12 randomly assigned to the intervention group. The study intervention was based on the premise that a successful intervention is developed and tailored by teachers and staff to fit the context of their school. Intervention guidelines (Essential Elements) and the Coordinated School Health Program (CSHP) model were used to direct intervention activities for physical education, health education, school environment, school health services, faculty/staff health promotion, and family/community involvement. All girls at the case study school received the intervention. A team of school employees provided leadership to develop and implement the intervention in collaboration with a university project staff. Data collected over a two-year period were used to describe changes that occurred in each CSHP area. Key changes were made in the school environment, curricula, policies, and practices. Qualitative measures showed girls more involved in physical activity. Quantitative measures taken in eighth grade, and repeated with the same set of girls in ninth grade, showed increases in both moderate-to-vigorous physical activity (p = < .01) and vigorous physical activity (p = .04). Other schools can use this case to modify components of the CSHP model to increase physical activity among high school girls. [source] Implementing a School-Based Dental Health Program: The Montefiore ModelJOURNAL OF SCHOOL HEALTH, Issue 6 2002Olapeju Simoyan BDS No abstract is available for this article. [source] Advocacy to Action: Addressing Coordinated School Health Program Issues with School BoardsJOURNAL OF SCHOOL HEALTH, Issue 1 2005(former trustee, David C. Wiley PhD, FASHA, Hays CISD, Tex.) Professor ABSTRACT: As the need for Coordinated School Health Programs (CSHP) increases, so does recognition of the importance for advocating with local school boards for their support. Identifying the diversified make up of school board members and implementing effective strategies to advocate for coordinated school health can help facilitate the successful inclusion of such a program. With increasing emphasis placed on standardized testing and the "basic" curriculum, school board members need to become aware of specific benefits a CSHP can provide their district. With the relationship between health status and academic achievement confirmed in scientific research, school boards may begin paying more attention to providing high-quality health services and health instruction for students. This article presents items to consider and steps to take before, during, and after addressing a local school board for their support in implementing a CSHP. [source] The School Health Portfolio System: A New Tool for Planning and Evaluating Coordinated School Health ProgramsJOURNAL OF SCHOOL HEALTH, Issue 9 2004Robert M. Weiler ABSTRACT: The School Health Portfolio System (SHPS), developed originally to evaluate the Florida Coordinated School Health Program Pilot Schools Project, offers a new and innovative system for planning and evaluating a coordinated school health program at the individual school level. The SHPS provides practitioners a detailed but easy-to-use system that enables schools to create new programs or modify existing programs across all eight components of the CSHP model, as well as administrative support critical to sustainability. The System comes packaged as a self-contained, notebook-style manual divided into 15 sections. It includes electronic templates of key documents to guide school teams in creating a customized portfolio, and a list of sample goals and artifacts that confirm achievement of a goal related to the school's coordinated school health program. An evaluation rubric provides a structured method to assess a program portfolio's contents, and the extent to which the contents document achievement of program goals. The rubric produces both a qualitative assessment, such as a narrative summary of program strengths and areas for improvement, and a quantitative assessment, such as a numerical score (0,100), letter grade (A-F), or 5-star system (* - *****). The physical structure, function, and scoring of the rubric depend on the method of assessment. The SHPS enables schools to set goals based on individual school needs, and incorporate CSHP goals into school improvement plans - a critical factor in sustainability and accountability. The System also offers teams the option of coordinating their efforts with CDC's School Health Index as a companion assessment measure. This article outlines the process a team would follow in developing a portfolio, and includes a sample assessment for the area of School Health Education. (J Sch Health. 2004;74(9):359,364) [source] Contributions of the American Cancer Society to Coordinated School Health Programs: A Changing View of SchoolsJOURNAL OF SCHOOL HEALTH, Issue 3 2004John R. Seffrin No abstract is available for this article. [source] Training Leaders for School Health Programs: The National School Health Coordinator Leadership InstituteJOURNAL OF SCHOOL HEALTH, Issue 3 2004Scott Winnail First page of article [source] Achieving Coordinated Mental Health Programs in SchoolsJOURNAL OF SCHOOL HEALTH, Issue 5 2000Linda Taylor No abstract is available for this article. [source] Quality of Diets Consumed by Older Rural AdultsTHE JOURNAL OF RURAL HEALTH, Issue 1 2002Mara Z. Vitolins Dr.P.H.R.D Older adults residing in rural communities are at risk for low dietary quality because of a variety of social, physical and environmental circumstances. Minority elders are at additional risk because of poorer health status and lower socioeconomic status. This study evaluated the food group intake of 130 older (>70 years) African American (34%), European American (36%), and Native American (30%) residents of two rural communities in central North Carolina. An interviewer-administered food frequency questionnaire was used to measure dietary intake. Food items were classified into food groups similar to the United States Department of Agriculture (USDA) Food Guide Pyramid and the National Cancer Institutés 5 A Day for Better Health program. None of the survey participants met minimum intake recommendations and most over-consumed fats, oils, sweets and snacks. African Americans and Native Americans consumed fewer servings of meats, fruits and vegetables, and fats, oils, sweets and snacks than European Americans. African American men consumed the fewest servings of fruits and vegetables of all gender/ethnic groups. Consumption of fats, oils and sweets was greatest among those 85 years and older and was more common among denture users. National strategies to educate the public about the importance of consuming a varied diet based on the recommendations presented in national nutrition education campaigns may not be reaching older adults in rural communities, particularly minority group members. [source] Keeping your globally mobile employees healthy, safe, and secureGLOBAL BUSINESS AND ORGANIZATIONAL EXCELLENCE, Issue 1 2009Myles Druckman Companies are sending higher numbers of older employees to difficult or dangerous locations, which increases the chances of a medical event where healthcare services are least available. Business travelers and international assignees and their employers need to adequately assess and prepare for such possibilities. The author describes five key processes that will help companies perform duty of care and minimize risks to the employee and company alike; the elements of a best-practice international preassignment health program to ensure assignees are fit for work in locations with high medical risk; and the five responsibilities of globally mobile employees for protecting their health and getting medical help if they need it. © 2009 Wiley Periodicals, Inc. [source] Research Submission: Chronic Headache and Comorbibities: A Two-Phase, Population-Based, Cross-Sectional StudyHEADACHE, Issue 8 2010Ariovaldo Da Silva Jr MD Background., Studies using resources of a public family health program to estimate the prevalence of chronic daily headaches (CDH) are lacking. Objectives., To estimate the 1-year prevalence of CDH, as well as the presence of associated psychiatric and temporomandibular disorders (TMD) comorbidities, on the entire population of a city representative of the rural area of Brazil. Methods., This was a cross-sectional, population-based, 2-phase study. In the first phase, health agents interviewed all individuals older than 10 years, in a rural area of Brazil. In the second stage, all individuals who reported headaches on 4 or more days per week were then evaluated by a multidisciplinary team. CDH were classified according to the second edition of the International Classification of Headache Disorders (ICHD-2). Medication overuse headache was diagnosed, as per the ICHD-2, after detoxification trials. Psychiatric comorbidities and TMD were diagnosed based on the DSM-IV and on the Research Diagnostic Criteria for Temporomandibular Disorders criteria, respectively. Results., A total of 1631 subjects participated in the direct interviews. Of them, 57 (3.6%) had CDH. Chronic migraine was the most common of the CDH (21, 36.8%). Chronic tension-type headache (10, 17.5%), medication overuse headache (13, 22.8%) and probable medication overuse headache (10, 17.5%) were also common. Psychiatric disorders were observed in 38 (67.3%) of the CDH subjects. TMD were seen in 33 (58.1)% of them. Conclusions., The prevalence of CDH in the rural area of Brazil is similar to what has been reported in previous studies. A significant proportion of them have psychiatric comorbidities and/or TMD. In this sample, comorbidities were as frequent as reported in convenience samples from tertiary headache centers. (Headache 2010;50:1306-1312) [source] Family Network Support and Mental Health RecoveryJOURNAL OF MARITAL AND FAMILY THERAPY, Issue 1 2010Francesca Pernice-Duca Family members often provide critical support to persons living with a serious mental illness. The focus of this study was to determine which dimensions of the family support network were most important to the recovery process from the perspective of the recovering person. Consumers of a community mental health program completed in-depth structured interviews that included separate measures of social network support and recovery. Consumers named an average of 2.6 family members on the social network, interacted with family on a weekly basis, and were quite satisfied with their contact. This study revealed that support and reciprocity with family members are important dimensions of a personal support network that relates to the recovery process. [source] A Retrospective Examination of the Relationship Between Implementation Quality of the Coordinated School Health Program Model and School-Level Academic Indicators Over Time,JOURNAL OF SCHOOL HEALTH, Issue 3 2009Scott Rosas PhD ABSTRACT BACKGROUND:, Although models such as the coordinated school health program (CSHP) are widely available to address student health needs, school professionals have been unconvinced that scarce resources should be allocated to improving student health. Concern that attention may be diverted from meeting academic accountability goals is often seen as a reason not to attend to student health. Despite continuing calls for the study of multicomponent health programs in relation to educational achievement, the understanding of the extent to which adherence to the characteristics of CSHP contributes to or compromises academic outcomes over time remains incomplete. METHODS:, A retrospective study was conducted of CSHP implementation across 158 public schools in Delaware, serving grades K-12. Using a doubly multivariate design, this study examined 3 levels of CSHP implementation across 5 school-level academic indicators for 3 years. Indicators included school performance, school progress, and aggregated student performance in 3 content areas,reading, mathematics, and writing. Data for the years prior to, during, and following implementation of CSHP were analyzed. RESULTS:, Multivariate main effects of year by implementation level were detected. CSHP schools with high levels of implementation had better school-level performance and progress ratings. CSHP implementation did not have an effect on reading, math, and writing indicators, though all groups showed significant improvements over time in these areas. CONCLUSIONS:, Results of this study suggest that quality implementation of CSHP does not adversely impact school-level academic indicators over time. Moreover, findings suggest a better fit with school-wide accountability indicators than with specific content-based achievement indicators. [source] The School Health Portfolio System: A New Tool for Planning and Evaluating Coordinated School Health ProgramsJOURNAL OF SCHOOL HEALTH, Issue 9 2004Robert M. Weiler ABSTRACT: The School Health Portfolio System (SHPS), developed originally to evaluate the Florida Coordinated School Health Program Pilot Schools Project, offers a new and innovative system for planning and evaluating a coordinated school health program at the individual school level. The SHPS provides practitioners a detailed but easy-to-use system that enables schools to create new programs or modify existing programs across all eight components of the CSHP model, as well as administrative support critical to sustainability. The System comes packaged as a self-contained, notebook-style manual divided into 15 sections. It includes electronic templates of key documents to guide school teams in creating a customized portfolio, and a list of sample goals and artifacts that confirm achievement of a goal related to the school's coordinated school health program. An evaluation rubric provides a structured method to assess a program portfolio's contents, and the extent to which the contents document achievement of program goals. The rubric produces both a qualitative assessment, such as a narrative summary of program strengths and areas for improvement, and a quantitative assessment, such as a numerical score (0,100), letter grade (A-F), or 5-star system (* - *****). The physical structure, function, and scoring of the rubric depend on the method of assessment. The SHPS enables schools to set goals based on individual school needs, and incorporate CSHP goals into school improvement plans - a critical factor in sustainability and accountability. The System also offers teams the option of coordinating their efforts with CDC's School Health Index as a companion assessment measure. This article outlines the process a team would follow in developing a portfolio, and includes a sample assessment for the area of School Health Education. (J Sch Health. 2004;74(9):359,364) [source] An Evaluation of Client Satisfaction With Training Programs and Technical Assistance Provided by Florida's Coordinated School Health Program OfficeJOURNAL OF SCHOOL HEALTH, Issue 9 2000Robert M. Weiler ABSTRACT: Client or customer satisfaction surveys assess the perceived quality of programs, products, services, and employee performance. Such assessments prove beneficial for evaluation and planning purposes. This survey examined the satisfaction of clients using the programs, services, and technical assistance provided through the Coordinated School Health Program Office (CSHPO) in the Florida Department of Education. Using the 42-item Client Satisfaction Survey, data were collected in summer 1999 from 300 of 574 clients (52.3%) who attended training sessions or sought technical assistance from CSHPO during 1996,1999. More than two-thirds (67.2%) of clients rated the training programs as "very good" or "excellent" at increasing their understanding about the concept of a coordinated school health program. Overall, 69.7% of clients rated the training programs they attended as "very good" or "excellent." Resource materials and staff effectiveness rated positively as well. Findings confirmed client satisfaction with CSHPO's training programs, technical assistance, and staff. Information obtained through the client satisfaction survey can be used by CSHPO to assist in future program planning and resource allocations. [source] Promoting mental health following the London bombings: A screen and treat approachJOURNAL OF TRAUMATIC STRESS, Issue 1 2008Chris R. Brewin Following the 2005 London bombings, a novel public health program was instituted to address the mental health needs of survivors. In this article, the authors describe the rationale for the program, characteristics of individuals assessed within the program, and preliminary outcome data. In addition to validated screening instruments and routine service usage data, standardized questionnaire outcome measures were collected. Seventy-one percent of individuals screened positive for a mental disorder. Of those receiving a more detailed clinical assessment, PTSD was the predominant diagnosis. Preliminary outcome data on 82 patients revealed large effect sizes for treatment comparable to those previously obtained in randomized controlled trials. The program succeeded in its aim of generating many more referrals of affected individuals than came through normal referral channels. [source] International Family, Adult, and Child Enhancement Services (FACES): A Community-Based Comprehensive Services Model for Refugee Children in ResettlementAMERICAN JOURNAL OF ORTHOPSYCHIATRY, Issue 1 2008Dina Birman PhD The development of evidence-based mental health interventions for refugees is complicated by the cultural and linguistic diversity of the participants, and the need to balance treatment of past traumatic experiences with ongoing support during the process of acculturation. In an effort to gather "practice-based evidence" from existing mental health services for refugees, a collaborative study of International Family, Adult, and Child Enhancement Services (FACES), a comprehensive, community-based mental health program working with refugee children, was conducted to describe the program participants and service delivery model and to assess whether participants improved over time as a function of services. Results showed that participants improved, but that the improvement was not related to dosage of services. Implications of these findings for refugee mental health services are discussed and suggestions are made for future evaluation research of mental health services with refugees. [source] China,Australia,Hong Kong tripartite community mental health training programASIA-PACIFIC PSYCHIATRY, Issue 2 2009Chee Hong Ng MBBS MD FRANZCP Abstract The present paper describes the unique mental health training cooperation between two countries involving three training sites to facilitate the improvement of mental health care and service delivery in China. The priority is to build workforce capacity to deliver appropriate mental health care and rehabilitation in the community. In response to this challenge, a training program was collaboratively planned between partners in both countries to provide a comprehensive training program for multiskilled case workers for mainland China. The development and key activities of the training and exchange program correspond to a diverse range of training programs across multiple levels of staff and sectors. The tripartite training program represents a unique, large scale training program that has contributed significantly to developing one of the largest global national mental health program of reform and building a national community mental health service system for China. Over their many years of cooperation, the Australian and Chinese partners have developed a model for successful collaboration, one based on mutual respect, exchange of expertise and a deep appreciation of cultural difference and its influences on broad aspects of health system development. [source] A CRITIQUE OF THE INNOVATION ARGUMENT AGAINST A NATIONAL HEALTH PROGRAMBIOETHICS, Issue 6 2007ALEX RAJCZI ABSTRACT President Bush and his Council of Economic Advisors have claimed that the US shouldn't adopt a national health program because doing so would slow innovation in health care. Some have attacked this argument by challenging its moral claim that innovativeness is a good ground for choosing between health care systems. This reply is misguided. If we want to refute the argument from innovation, we have to undercut the premise that seems least controversial , the premise that our current system produces more innovation than a national health program would. I argue that this premise is false. The argument requires clarifying the concept ,national health program' and examining various theories of human well-being. [source] Data Governance and Stewardship: Designing Data Stewardship Entities and Advancing Data AccessHEALTH SERVICES RESEARCH, Issue 5p2 2010Sara Rosenbaum U.S. health policy is engaged in a struggle over access to health information, in particular, the conditions under which information should be accessible for research when appropriate privacy protections and security safeguards are in place. The expanded use of health information,an inevitable step in an information age,is widely considered be essential to health system reform. Models exist for the creation of data-sharing arrangements that promote proper use of information in a safe and secure environment and with attention to ethical standards. Data stewardship is a concept with deep roots in the science and practice of data collection, sharing, and analysis. Reflecting the values of fair information practice, data stewardship denotes an approach to the management of data, particularly data that can identify individuals. The concept of a data steward is intended to convey a fiduciary (or trust) level of responsibility toward the data. Data governance is the process by which responsibilities of stewardship are conceptualized and carried out. As the concept of health information data stewardship advances in a technology-enabled environment, the question is whether legal barriers to data access and use will begin to give way. One possible answer may lie in defining the public interest in certain data uses, tying provider participation in federal health programs to the release of all-payer data to recognized data stewardship entities for aggregation and management, and enabling such entities to foster and enable the creation of knowledge through research. [source] Development of a community health promotion center based on the World Health Organization's Ottawa Charter health promotion strategiesJAPAN JOURNAL OF NURSING SCIENCE, Issue 2 2009Chung Yul LEE Abstract Aim:, To describe the development process of nursing school-led community health promotion centers (CHPC) to improve the health of the surrounding communities. Methods:, This study design was a research and development study. (i) Assessment of health needs by interviewing 359 people in the community to select health programs for the community health promotion center. (ii) Five health promotion strategies from the Ottawa Charter were applied to develop the community health promotion center for a city community. Results:, (i) The people in the community had higher socioeconomic status levels and better health behaviors compared to the general Korean population, and they also listed chronic health problem management as their first priority health service. (ii) Development of the community health promotion center was done based on the five World Health Organization's Ottawa Charter Health Promotion Strategies: build healthy public policy, create supportive environments, strengthen community actions, develop personal skills, and reorient health services. Conclusions:, The present study showed that the WHO's five Ottawa Charter Health Promotion Strategies were useful for developing health promotion centers in the community. [source] Considering a multisite study?JOURNAL OF COMMUNITY PSYCHOLOGY, Issue 2 2002How to take the leap, have a soft landing Although most policymakers agree that a fundamental goal of the mental health system is to provide integrated community-based services, there is little empirical evidence with which to plan such a system. Studies in the community mental health literature have not used a standard set of evaluation methods. One way of addressing this gap is through a multisite program evaluation in which multiple sites and programs evaluate the same outcomes using the same instruments and time frame. The proposition of introducing the same study design in different settings and programs is deceptively straightforward. The difficulty is not in the conceptualization but in the implementation. This article examines the factors that act as implementation barriers, how are they magnified in a multisite study design, and how they can be successfully addressed. In discussing the issue of study design, this article considers processes used to address six major types of barriers to conducting collaborative studies identified by Lancaster or Lancaster's six Cs,contribution, communication, compatibility, consensus, credit, and commitment. A case study approach is used to examine implementation of a multisite community mental health evaluation of services and supports (case management, self-help initiatives, crisis interventions) represented by six independent evaluations of 15 community health programs. A principal finding was that one of the main vehicles to a successful multisite project is participation. It is only through participation that Lancaster's six Cs can be addressed. Key factors in large, geographically dispersed, and diverse groups include the use of advisory committees, explicit criteria and opportunities for participation, reliance on all modes of communication, and valuing informal interactions. The article concludes that whereas modern technology has assisted in making complicated research designs feasible, the operationalization of timeless virtues such as mutual respect and trust, flexibility, and commitment make them successful. © 2002 John Wiley & Sons, Inc. [source] Behavioural pediatrics and mental health programs: A case for integration?JOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 3 2007Dr Peter Birleson No abstract is available for this article. [source] Identifying Children with Dental Care Needs: Evaluation of a Targeted School-based Dental Screening ProgramJOURNAL OF PUBLIC HEALTH DENTISTRY, Issue 2 2004David Locker BDS Abstract Objectives: It has been suggested that changes in the distribution of dental caries mean that targeting high-risk groups can maximize the cost effectiveness of dental health programs. This study aimed to assess the effectiveness of a targeted school-based dental screening program in terms of the proportion of children with dental care needs it identified. Methods: The target population was all children in junior and senior kindergarten and grades 2, 4, 6, and 8 who attended schools in four Ontario communities. The study was conducted in a random sample of 38 schools stratified according to caries risk. Universal screening was implemented in these schools. The parents of all children identified as having dental care needs were sent a short questionnaire to document the sociodemographic and family characteristics of these children. Children with needs were divided into two groups: those who would and who would not have been identified had the targeted program been implemented. The characteristics of the two groups were compared. Results: Overall, 21.0 percent of the target population were identified as needing dental care, with 7.4 percent needing urgent care. The targeted program would have identified 43.5 percent of those with dental care needs and 58.0 percent of those with urgent needs. There were substantial differences across the four communities in the proportions identified by the targeted program. Identification rates were lowest when the difference in prevalence of need between the high- and low-risk groups was small and where the low-risk group was large in relation to the high-risk group. The targeted program was more effective at identifying children from disadvantaged backgrounds. Of those with needs who lived in households receiving government income support, 59.0 percent of those with needs and 80.1 percent of those with urgent needs would be identified. Conclusions: The targeted program was most effective at identifying children with dental care needs from disadvantaged backgrounds. However, any improvements in cost effectiveness achieved by targeting must be balanced against inequities in access to public health care resources. [source] A Retrospective Examination of the Relationship Between Implementation Quality of the Coordinated School Health Program Model and School-Level Academic Indicators Over Time,JOURNAL OF SCHOOL HEALTH, Issue 3 2009Scott Rosas PhD ABSTRACT BACKGROUND:, Although models such as the coordinated school health program (CSHP) are widely available to address student health needs, school professionals have been unconvinced that scarce resources should be allocated to improving student health. Concern that attention may be diverted from meeting academic accountability goals is often seen as a reason not to attend to student health. Despite continuing calls for the study of multicomponent health programs in relation to educational achievement, the understanding of the extent to which adherence to the characteristics of CSHP contributes to or compromises academic outcomes over time remains incomplete. METHODS:, A retrospective study was conducted of CSHP implementation across 158 public schools in Delaware, serving grades K-12. Using a doubly multivariate design, this study examined 3 levels of CSHP implementation across 5 school-level academic indicators for 3 years. Indicators included school performance, school progress, and aggregated student performance in 3 content areas,reading, mathematics, and writing. Data for the years prior to, during, and following implementation of CSHP were analyzed. RESULTS:, Multivariate main effects of year by implementation level were detected. CSHP schools with high levels of implementation had better school-level performance and progress ratings. CSHP implementation did not have an effect on reading, math, and writing indicators, though all groups showed significant improvements over time in these areas. CONCLUSIONS:, Results of this study suggest that quality implementation of CSHP does not adversely impact school-level academic indicators over time. Moreover, findings suggest a better fit with school-wide accountability indicators than with specific content-based achievement indicators. [source] | |||||||||||||||||||