-
1
المصدر: Ciência & Saúde Coletiva, Vol 23, Iss 1, Pp 93-102
Ciência & Saúde Coletiva, Volume: 23, Issue: 1, Pages: 102-93, Published: JAN 2018
Ciência & Saúde Coletiva v.23 n.1 2018
Ciência & Saúde Coletiva
Associação Brasileira de Saúde Coletiva (ABRASCO)
instacron:ABRASCOمصطلحات موضوعية: medicine.medical_specialty, Economic growth, Domestic Violence, Ethnography, Public policy, Public Policy, Gender-Based Violence, Suicide prevention, Public policies, Occupational safety and health, 03 medical and health sciences, 0302 clinical medicine, Etnografia, Political science, Health care, medicine, Políticas públicas, Humans, 030212 general & internal medicine, Health policy, Crime Victims, Uncategorized, Community Health Workers, Family Health, 030505 public health, Primary Health Care, Community health workers, business.industry, Public health, Health Policy, lcsh:Public aspects of medicine, Public Health, Environmental and Occupational Health, lcsh:RA1-1270, Professional-Patient Relations, Atenção Primária à Saúde, Violence against women, Agentes comunitários de saúde, Health promotion, Violência contra a mulher, Domestic violence, Female, 0305 other medical science, business, Brazil
الوصف: Domestic violence creates multiple harms for women's health and is a ‘wicked problem’ for health professionals and public health systems. Brazil recently approved public policies to manage and care for women victims of domestic violence. Facing these policies, this study aimed to explore how domestic violence against women is usually managed in Brazilian primary health care, by investigating a basic health unit and its family health strategy. We adopted qualitative ethnographic research methods with thematic analysis of emergent categories, interrogating data with gender theory and emergent Brazilian collective health theory. Field research was conducted in a local basic health unit and the territory for which it is responsible, in Southern Brazil. The study revealed: 1) a yawning gap between public health policies for domestic violence against women at the federal level and its practical application at local/decentralized levels, which can leave both professionals and women unsafe; 2) the key role of local community health workers, paraprofessional health promotion agents, who aim to promote dialogue between women experiencing violence, health care professionals and the health care system. Resumo A violência doméstica (VD) cria múltiplos agravos à saúde das mulheres e é um desafio para profissionais e para os sistemas de saúde. O Brasil aprovou recentemente políticas públicas (PP) para manejo e cuidado de mulheres em situação de VD. Considerando essas PP, este estudo objetivou explorar como a VD contra mulheres é usualmente manejada na atenção primária à saúde brasileira, por meio da investigação de uma unidade básica de saúde e de sua estratégia de saúde da família. Foi adotada metodologia de pesquisa qualitativa de cunho etnográfico, com análise temática de categorias emergentes, interrogando os dados com teoria de gênero e com a produção teórica do campo da saúde coletiva brasileira. A pesquisa de campo foi conduzida em uma unidade básica de saúde e em seu território adscrito, localizado na região sul do Brasil. O estudo revelou: 1) um hiato entre PP direcionadas à VD contra mulheres implantadas a nível federal e sua aplicação prática a nível local/descentralizado, que pode deixar tanto profissionais quanto mulheres em risco; 2) o papel chave de agentes comunitários de saúde, profissionais de promoção da saúde, que objetivam promover o diálogo entre as mulheres experienciando violência, profissionais de saúde e o sistema de saúde.
وصف الملف: text/html
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::6e080cb61bcfb514a12202ada7c85073
-
2
المؤلفون: Francesca Gany, Florence Lui, Randall Li, Jennifer Leng
المصدر: J Cancer Educ
مصطلحات موضوعية: medicine.medical_specialty, China, Lung Neoplasms, media_common.quotation_subject, Immigration, Article, 03 medical and health sciences, 0302 clinical medicine, Intervention (counseling), Cancer screening, Medicine, Humans, 030212 general & internal medicine, Early Detection of Cancer, media_common, Community Health Workers, Cancer prevention, integumentary system, business.industry, Public Health, Environmental and Occupational Health, Oncology, 030220 oncology & carcinogenesis, Family medicine, Community health, Needs assessment, Health education, business, Delivery of Health Care, Lung cancer screening
الوصف: BACKGROUND: Chinese immigrant for-hire vehicle (FHV) drivers who smoke or smoked are at high risk for lung cancer due to the combined impact of tobacco use and air pollution exposure yet underutilize lung cancer screening (LCS). Community Health Worker (CHW) programs have been effective at improving cancer screening rates. This study describes a community needs assessment to inform the adaptation of an existing CHW intervention to facilitate LCS among Chinese FHV drivers. METHODS: Interviews were conducted until saturation with 13 Chinese-serving health professionals to determine the community’s needs, priorities, and preferences. Transcripts were qualitatively analyzed using Atlas.ti. RESULTS: Seven frequently occurring themes were identified: Knowledge of Guidelines/Access to LCS, Acceptability of CHW Program, CHW Role in Screening Process, Qualities of an Ideal CHW, Barriers to LCS, Challenges to Implementing a CHW Program, and Adaptations to CHW Program. DISCUSSION: The adapted CHW intervention should include culturally tailored health education to increase LCS knowledge for patients and providers.
-
3
المؤلفون: Matthew Hing, Mariano Matias Iberico, Ariwame Jimenez, Miry Choi, Daniel Palazuelos, Basimenye Nhlema, Emily B Wroe, Lassana Jabateh
المصدر: Global Health: Science and Practice
مصطلحات موضوعية: Community Health Workers, Structure (mathematical logic), Family Characteristics, Malawi, 030219 obstetrics & reproductive medicine, business.industry, Human immunodeficiency virus (HIV), Field Action Report, General Medicine, Plan (drawing), Public relations, Liberia, medicine.disease_cause, Variety (cybernetics), 03 medical and health sciences, 0302 clinical medicine, Community health, medicine, Humans, Community health workers, Public Health, 030212 general & internal medicine, Business, Psychosocial, Healthcare system
الوصف: Community health worker programs can contribute substantively to health systems working to implement universal health coverage, but there is no one-size-fits-all model. Program leaders should anticipate needing to adapt their plans as local realities demand, but lessons learned in other contexts can provide guidance on how to best proceed.
Key Findings Assigning community health workers to households, as opposed to individuals, is a feasible and functional method for structuring how community health can contribute to implementing universal health coverage. Key Implications Program managers should consider how to adapt international best practices for their unique contexts. The Partners In Health experience with implementing a new approach across 3 new program sites in 3 countries suggests that this is best done by both providing clarity on program architecture and also funding mechanisms for frontline program leadership to visit and learn from each other in situ. Policy makers should consider how community health programs can be structured as extensions of functioning health systems into households for all diseases and all age groups, as this provides a platform for working effectively toward universal health coverage.
Community health workers (CHWs) are integrated into health systems through a variety of designs. Partners In Health (PIH), a nongovernmental organization with more than 30 years of experience in over 10 countries, initially followed a vertical approach by assigning CHWs to individual patients with specific conditions, such as HIV, multidrug resistant-TB, diabetes, and other noncommunicable diseases, to provide one-on-one psychosocial and treatment support. Starting in 2015, PIH-Malawi redesigned their CHW assignments to focus on entire households, thereby offering the opportunity to address a wider variety of conditions in any age group, all with a focus on working toward effective universal health coverage. Inspired by this example, PIH-Liberia and then PIH-Mexico engaged in a robust cross-site dialogue on how to adapt these plans for their unique nongovernmental organization-led CHW programs. We describe the structure of this “household model,” how these structures were changed to adapt to different country contexts, and early impressions on the effects of these adaptations. Overall, the household model is proving to be a feasible and functional method for organizing CHW programs so that they can contribute toward achieving universal health coverage, but there is no “one-size-fits-all” approach. Other countries planning on adopting this model should plan to analyze and adapt as needed.URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::8081f1d659a42cca732cf962a4837453
https://doi.org/10.9745/ghsp-d-20-00405 -
4
المؤلفون: Dariya Mukamusoni, Gugu Mchunu, Clemence Nishimwe
المصدر: Journal of Clinical Nursing
مصطلحات موضوعية: medicine.medical_specialty, nurse/ midwifery primary health care, Referral, Psychological intervention, Context (language use), Review Article, Health Promotion, 03 medical and health sciences, 0302 clinical medicine, Nursing, systematic review, Pregnancy, Health care, medicine, Humans, Maternal Health Services, 030212 general & internal medicine, Review Articles, General Nursing, Africa South of the Sahara, Community Health Workers, 030504 nursing, business.industry, Public health, Infant, Newborn, General Medicine, Millennium Development Goals, maternal community health workers, Checklist, Systematic review, program planning and implementation, Africa, Female, 0305 other medical science, business, Psychology, maternal/ newborn healthcare, Delivery of Health Care
الوصف: Aim and objectives This review analysed the implementation and integration into healthcare systems of maternal and newborn healthcare interventions in Africa that include community health workers to reduce maternal and newborn deaths. Background Most neonatal deaths (99%) occur in low‐ and middle‐income countries, with approximately half happening at home. In resource‐constrained settings, community‐based maternal and newborn care is regarded as a sound programme for improving newborn survival. Health workers can play an important role in supporting families to adopt sound health practices, encourage delivery in healthcare facilities and ensure timeous referral. Maternal and newborn mortality is a major public health problem, particularly in sub‐Saharan Africa, where the Millennium Development Goals 4, 5 and 6 were not achieved at the end of 2015. Methods The review includes quantitative, qualitative and mixed‐method studies, with a data‐based convergent synthesis design being used, and the results grouped into categories and trends. The review took into account the participants, interventions, context and outcome frameworks (PICO), and followed the adapted PRISMA format for reporting systematic reviews of the qualitative and quantitative evidence guide checklist. Results The results from the 17 included studies focused on three themes: antenatal, delivery and postnatal care interventions as a continuum. The main components of the interventions were inadequate, highlighting the need for improved planning before each stage of implementation. A conceptual framework of planning and implementation was elaborated to improve maternal and newborn health. Conclusion The systematic review highlight the importance of thoroughly planning before any programme implementation, and ensuring that measures are in place to enable continuity of services. Relevant to the clinical practice Conceptual framework of planning and implementation of maternal and newborn healthcare interventions by maternal community health workers.
-
5
المؤلفون: Thomas J. Smith, Karen M. Freund, Ramy Sedhom, Lisa A. Cooper, Fabian M. Johnston, Jill T. Owczarzak, Richard Nudotor
المصدر: JCO Oncol Pract
مصطلحات موضوعية: Advance care planning, medicine.medical_specialty, Palliative care, MEDLINE, Pilot Projects, ORIGINAL CONTRIBUTIONS, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, Community health workers, 030212 general & internal medicine, Community Health Workers, African american, Oncology (nursing), business.industry, Health Policy, Palliative Care, Cancer, medicine.disease, Black or African American, Oncology, 030220 oncology & carcinogenesis, Family medicine, Hospice and Palliative Care Nursing, business
الوصف: PURPOSE:African American patients with cancer underutilize advance care planning (ACP) and palliative care (PC). This feasibility study investigated whether community health workers (CHWs) could improve ACP and PC utilization for African American patients with advanced cancer.METHODS:African American patients diagnosed with an advanced solid organ cancer (stage IV or stage III disease with a palliative performance score < 60%) were enrolled. Patients completed baseline surveys that assessed symptom burden and distress at baseline and 3 months post-CHW intervention. The CHW intervention consisted of a comprehensive assessment of multiple PC domains and social determinants of health. CHWs provided tailored support and education on the basis of iterative assessment of patient needs. Intervention feasibility was determined by patient and caregiver retention rate above 50% at 3 months.RESULTS:Over a 12-month period, 24 patients were screened, of which 21 were deemed eligible. Twelve patients participated in the study. Patient retention was high at 3 months (75%) and 6 months (66%). Following the CHW intervention, symptom assessment as measured by Edmonton Symptom Assessment System improved from 33.8 at baseline to 18.8 ( P = .03). Psychological distress improved from 5.5 to 4.7 ( P = .36), and depressive symptoms from 42.2 to 33.6 ( P = .09), although this was not significant. ACP documentation improved from 25% at baseline to 75% at study completion. Sixty-seven percentage of patients were referred to PC, with 100% of three decedents using hospice.CONCLUSION:Utilization of CHWs to address PC domains and social determinants of health is feasible. Although study enrollment was identified as a potential barrier, most recruited patients were retained on study.
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::24a27ce053bb3683894f33d4c15812c6
https://doi.org/10.1200/op.20.00574 -
6
المؤلفون: Rosie Piper, Laura Coco, Nicole Marrone
المصدر: Int J Audiol
مصطلحات موضوعية: Community Health Workers, Linguistics and Language, medicine.medical_specialty, Medical education, Audiology, Article, Language and Linguistics, Health centre, 03 medical and health sciences, Speech and Hearing, 0302 clinical medicine, Facilitator, Training study, medicine, Feasibility Studies, Humans, Community health workers, Health Facilities, Hearing Loss, 030223 otorhinolaryngology, Training program, Psychology, 030217 neurology & neurosurgery
الوصف: OBJECTIVE: We evaluated the feasibility of a multi-level teleaudiology patient-site facilitator training program for Community Health Workers (CHWs) at a partnering health center in southern Arizona. DESIGN: Three levels were offered: Introductory, with basic information on hearing loss and teleaudiology; Intermediate, on technology, team roles, and access issues; and Facilitator, on further knowledge and hands-on skills to serve as patient-site facilitators in synchronous hearing aid service delivery. Six domains of feasibility were addressed using a mixed-methods design. Quantitative data included survey responses and observation of hands-on skills. Qualitative data included field notes from group discussion and open-ended survey questions, and were analyzed using CHW core competencies. STUDY SAMPLE: Twelve CHWs participated in the introductory training, ten moved on to intermediate, and three continued to the facilitator. RESULTS: Quantitative outcomes indicated that the trainings were feasible according to each of the six domains. CHWs in the facilitator training passed the practical hands-on skill assessment. Qualitative analyses revealed CHWs comments addressed eight of the ten possible CHW core competencies, and focused on service coordination/navigation, and capacity building. CONCLUSIONS: Teleaudiology trainings for CHWs were feasible, increasing service capacity for a potential pathway to improve access to hearing health care in low-resource areas.
-
7
المؤلفون: Tokunbo S Obajolowo, Olugbenga A. Mokuolu, Victoria A. Olatunji, Tanimola M. Akande, Dupe S Ademola-Popoola
المصدر: Taiwan Journal of Ophthalmology, Vol 11, Iss 1, Pp 77-85 (2021)
Taiwan Journal of Ophthalmologyمصطلحات موضوعية: 0301 basic medicine, medicine.medical_specialty, Referral, genetic structures, preschool vision screening, Glaucoma, 03 medical and health sciences, 0302 clinical medicine, Red reflex, community health workers, lcsh:Ophthalmology, medicine, Community health workers, medicine.diagnostic_test, business.industry, interview, medicine.disease, eye diseases, Ophthalmology, 030104 developmental biology, Immunization, Eye examination, lcsh:RE1-994, Family medicine, Community health, 030221 ophthalmology & optometry, Eye disorder, Original Article, bruckner test, business, instrument vision screener
الوصف: PURPOSE: Routine eye examination in early life is not the practice in most resource-limited countries. Delay in the presentation for eye problems is typical. Community health officers are often consulted by caregivers for all health problems during routine immunization and well-baby clinics in primary healthcare for children aged 0–2 years. This study evaluated the value and limitation of interview, Bruckner red reflex test, and instrument vision screener by noneye care middle-level staff of rural and urban well-baby immunization clinics, in early detection and referral for childhood eye disorders. MATERIALS AND METHODS: This was a cross-sectional study. Middle-level community health workers (CHWs) working at well-baby/ immunization clinics were trained to perform vision screening using interview of caregivers, red reflex eye examination with ophthalmoscope, and instrument vision screener (Welch Allyn SPOT™ Vision Screener) without mydriatic drugs during routine immunization of children aged 0–2 years. IRB approval was obtained. RESULTS: Over a 6-month period in 2017, the CHWs screened 5609 children. Overall, 628 (11.2%) patients were referred to the tertiary child eye care unit. Referred cases included cataract, glaucoma, congenital nasolacrimal duct obstruction, ophthalmia neonatorum, retinoblastoma, and significant refractive errors. Referral from the interview of mothers was enhanced if specific questions to elicit visual function were asked. Bruckner red reflex test was more effective than instrument vision screener in the detection of cataract and life-threatening diseases such as retinoblastoma. Instrument vision screener was preferred by parents and better at detecting amblyopic risk factors. CONCLUSION: Preschool vision screening during routine immunization by primary healthcare workers in resource-limited settings was effective. Whenever instrument vision screener does not give any recommendation during screening, consider vision- or life-threatening pathology and refer.
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::c151b73d7d027d3b9047751357a6306c
http://www.e-tjo.org/article.asp?issn=2211-5056;year=2021;volume=11;issue=1;spage=77;epage=85;aulast=Ademola-Popoola -
8
المؤلفون: Segora Babui, Anne Marie Lee, Angela Kelly, Anna P. Ralph, Valerina Mungatopi, Vicki Kerrigan, Vicki Wade, Rosemary Wyber, Nina Black, David Peiris, End Rhd Communities Investigator, Christine Fitzgerald
المصدر: Australian and New Zealand Journal of Public Health, Vol 45, Iss 5, Pp 449-454 (2021)
مصطلحات موضوعية: medicine.medical_specialty, Native Hawaiian or Other Pacific Islander, 030309 nutrition & dietetics, environmental health, Audit, Formative assessment, 03 medical and health sciences, community health workers, 0302 clinical medicine, medicine, Health Services, Indigenous, Humans, Prospective Studies, 030212 general & internal medicine, Retrospective Studies, Community based, 0303 health sciences, business.industry, Incidence, Incidence (epidemiology), Public health, Group A streptococcus, Public Health, Environmental and Occupational Health, Acute rheumatic fever, rheumatic fever, medicine.disease, Outreach, Family medicine, Rheumatic fever, Public aspects of medicine, RA1-1270, business, Aboriginal and Torres Strait Islander health
الوصف: Objectives: To explore the acceptability of a novel, outreached‐based approach to improve primary and primordial prevention of Strep A skin sores, sore throats and acute rheumatic fever in remote Aboriginal communities. Methods: A comprehensive prevention program delivered by trained Aboriginal Community Workers was evaluated using approximately fortnightly household surveys about health and housing and clinical records. Results: Twenty‐seven primary participants from three remote Aboriginal communities in the Northern Territory consented, providing 37.8 years of retrospective baseline data and 18.5 years of prospective data during the study period. Household members were considered to be secondary participants. Five Aboriginal Community Workers were trained and employed, delivering a range of supports to households affected by acute rheumatic fever including environmental health support and education. Clinical record audit and household self‐report of Strep A infections were compared. No association between clinical‐ and self‐report was identified. Conclusions: Ongoing participation suggests this outreach‐based prevention program was acceptable and associated with improved reporting of household maintenance issues and awareness of prevention opportunities for Strep A infections. Implications for public health: Biomedical, clinic‐based approaches to the management of Strep A infections in remote communities can be usefully augmented by outreach‐based supports delivered by Aboriginal Community Workers responding to community needs.
-
9
المؤلفون: Kimberly Brown, David Zimmerman, Samantha Shaak, Christine Reichart
المصدر: Journal of Asthma. 59:572-579
مصطلحات موضوعية: Pulmonary and Respiratory Medicine, 03 medical and health sciences, 0302 clinical medicine, immune system diseases, 030225 pediatrics, Environmental health, Intervention (counseling), medicine, Humans, Immunology and Allergy, Community health workers, Child, health care economics and organizations, Asthma trigger, Asthma, Community Health Workers, business.industry, medicine.disease, respiratory tract diseases, Caregivers, 030228 respiratory system, Pediatrics, Perinatology and Child Health, Housing, Emergency Service, Hospital, business
الوصف: Objectives: Children living in urban areas experience disproportionate rates of asthma. Substandard housing conditions in some urban areas contribute to greater exposure to household asthma trigger...
-
10
المؤلفون: Kevin McKague, Heather Krause, Reajul Chowdhury
المصدر: Health Policy and Planning
مصطلحات موضوعية: medicine.medical_specialty, Percentile, media_common.quotation_subject, Jealousy, status competition, 03 medical and health sciences, 0302 clinical medicine, Reward, Negatively associated, 0502 economics and business, medicine, Community health workers, Humans, AcademicSubjects/MED00860, Uganda, 030212 general & internal medicine, social recognition, Qualitative Research, media_common, Social comparison theory, Community Health Workers, Motivation, Health Policy, Public health, 05 social sciences, Social recognition, Motivational incentives, Original Article, Psychology, 050203 business & management, Demography
الوصف: This paper investigates the effect of a non-financial incentive—a competitive annual award—on community health workers’ (CHWs) performance, an issue in the public health literature that has not been explored to its potential. Combining data on a competitive social ‘Best CHW’ award with the monthly performance of 4050 CHWs across Uganda, we examined if introducing social recognition awards improved the performance of CHWs. In contrast to predominant explanations about the effect of awards on motivation, our first multilevel mixed-effect models found that an award within a branch (consisting of ∼30 CHWs) was negatively associated with the performance of the local peers of the winning CHW. Models focused on non-winning branch offices revealed two additional findings. First, a branch showed underperformance if a CHW from any of the three neighbouring branches won an award in the previous year, with average monthly performance scores dropping by 27 percentage points. Second, this negative association was seen only in the top 50th percentile of CHWs. The bottom 50th percentile of CHWs exhibited increased performance by 13 percentage points. These counter-intuitive results suggest that the negative response from high performers might be explained by their frustration of not winning the award or by emotions such as envy and jealousy generated by negative social comparisons. Our results suggest that more fine-grained examination of data pertaining to motivators for CHWs in low-income countries is needed. Motivational incentives like awards may need to be customized for higher- and lower-performing CHWs.
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::e5143fb8c6e2d2e1b3afc96e7013f096
http://europepmc.org/articles/PMC8058949
إعادة تعيين المنقحات
عرض المنقحات (%%عد%%)
PDF full text from Publisher 
Full Text via ClinicalKey