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Conceptualizing and applying a minimum basic needs approach in southern Philippines

HEALTH POLICY AND PLANNING 2000年第2期15卷 194-206页

作者： Heinonen, T Mercader, M Quianzon, JL Peñera-Torralba, M Baluis, L Univ Manitoba Fac Social Work Winnipeg MB R3T 2N2 Canada Davao Med Sch Fdn IPHC Davao Philippines

This study, a collaboration between Canadian and Filipino researchers, focuses on how the national government's Minimum Basic Needs (MBN) Approach has been implemented at the local level in some selected sites in Region XI on the Philippine island of Mindanao. This case study of MBN implementation focuses on the experiences of three municipalities and three barangays (villages) within them. The research explores, through interviews and group discussions, what the mayors, technical working groups and volunteer health workers in these areas thought about MBN and how they participated in the initiative. The objectives of the study were: to explore models of MBN data utilization at the municipal and barangay levels;to understand how the MBN data guided decision-making about community priorities and resource allocation;to examine the role that community volunteers played in promoting the use of MBN data, and in community health and development activities which ensued;and to determine what factors challenged or encouraged the use of MBN data for social development at the barangay level. In all the sites, MBN had some impact, most often due to methods of concentrating information on unmet basic needs locally and making use of it in planning and project development processes. The findings show that although there is still some way to go before MBN is effectively integrated into local planning and project development, some responses to problems have been implemented and innovative projects were undertaken or being considered.

关键词：社区卫生计划/组织和管理用户参与合作行为数据收集卫生工作重点地方政府模型组织管理需求估价菲律宾私营部门方案评价志愿工作者人类

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Applying disease management strategies to Medicare

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MILBANK QUARTERLY 1999年第4期77卷 461-+页

作者： Tompkins, CP Bhalotra, S Trisolini, M Brandeis Univ Schneider Inst Hlth Policy Heller Grad Sch Waltham MA 02454 USA

Medicare coverage begins for many when they have already developed one or more chronic diseases, and it often pays for the latest and costliest phases. Population-based disease modeling, patient screening, and monitoring would be appropriate interventions for chronic renal disease. Patients who have not get advanced to end-stage renal disease would benefit from management of diabetes and hypertension, avoidance of nephrotoxic substances, and better preparation for dialysis. Administrative support could take the form of clinical guidelines, physician-led multidisciplinary teams, integrated delivery systems, provider and patient education, and new information technologies. Medicare reflects the long-term public perspective, and thus should further this new direction by supporting education, reimbursing for prevention efforts and allied health services, encouraging efficiency, and monitoring cost and quality outcomes.

关键词：社区卫生计划/组织和管理费用控制疾病管理预测肾功能衰竭慢性/经济学肾功能衰竭慢性/治疗长期医疗/组织和管理普查/组织和管理 Medicare/组织和管理需求估价/组织和管理诊疗准则(主题) 一级预防/组织和管理质量保证卫生保健/组织和管理美国人类

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Emergency medicine and police collaboration to prevent community violence

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ANNALS OF EMERGENCY MEDICINE 2001年第4期38卷 430-437页

作者： Shepherd, JP Cardiff Univ Violence Res Grp Cardiff CF14 4XY S Glam Wales

An important responsibility of emergency departments is the management of injuries sustained in assaults. Most assaults, including many causing serious injury, are not reported and: not recorded by the police. This is important because police investigation and the conviction of offenders has a substantial deterrent effect and because information about the circumstances, of intentional injury is key to prevention. Recent investigation of ED-police collaboration has shown that many of the injured, and ED staff want offenses to be reported but that there are attitudinal, logistic, and ethical-legal obstacles to achieving this. Organized joint efforts by emergency medicine personnel and police departments, on the basis of a sound, legal and ethical framework to protect the rights of both victims and offenders, should deter more violent offenders and would-be violent offenders. They also provide the police with unique aggregate, nonconfidential information that is of substantial, help in tackling violence. ED data can be used to measure and, refine violence prevention initiatives and are being developed as the basis of a new, independent measure of pol:ice performance. Strategies, practical ideas to overcome obstacles, and directions for future research are suggested.

关键词：社区卫生计划/组织和管理合作行为急诊室医院/标准大不列颠职业间关系法定报告警察/标准一级预防/组织和管理敏感性与特异性暴力/预防和控制女(雌)性人类男(雄)性

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The governance and management of effective community health partnerships: A typology for research, policy, and practice

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MILBANK QUARTERLY 2000年第2期78卷 241-+页

作者： Mitchell, SM Shortell, SM Univ Calif Berkeley Sch Publ Hlth Div Hlth Policy & Management Berkeley CA 94720 USA

Community health partnerships (CHPs) are voluntary collaborations of diverse community organizations that have joined forces in order co pursue a shared interest in improving community health. Although these cross-sectoral collaborations represent a way to address social determinants of health and disease in society, they suffer from governance and management problems associated with interorganizational relationships in general and health care challenges specifically. A typology of effective governance and management characteristics provides a systematic, theoretically based way of addressing dimensions of governance and management and serves as a guide in constructing, maintaining, and measuring successful partnerships. It offers a multidisciplinary perspective for classifying important organizational issues, identifying barriers to successful development and sustainability, and facilitating the attainment of goals.

关键词：社区卫生计划/组织和管理社区网络/组织和管理卫生政策机构间关系组织目标研究美国人类

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Decision-making in HIV prevention community planning: An integrative review

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JOURNAL OF COMMUNITY HEALTH 2000年第2期25卷 95-112页

作者： Johnson-Masotti, AP Pinkerton, SD Holtgrave, DR Valdiserri, RO Willingham, M Med Coll Wisconsin Dept Psychiat & Behav Med Ctr AIDS Intervent Res Milwaukee WI 53202 USA Ctr Dis Control & Prevent Natl Ctr HIV STD & TB Prevent Div HIV AIDS Prevent Intervent Res & Support Atlanta GA USA

Since 1994, the Centers for Disease Control and Prevention has required that the 65 health department grantees that receive funding for HN prevention interventions engage in a community planning process to involve affected communities in local prevention decision making;to increase the use of epidemiological data to target HIV prevention resources;and to ensure that the planning process takes into account scientific information on the effectiveness and efficiency of different HIV interventions. Local community planning groups are charged with identifying End prioritizing unmet HIV prevention needs in their communities, as well as prioritizing prevention interventions designed to address these needs. Their recommendations, in turn, form the basis for the local health department's request for HIV prevention funding from the Centers for Disease Control and Prevention. Given the community planning process's central role in the allocation of federal HIV prevention funds, it is critical that sound decisionmaking procedures inform this process. In this article, we review the basics of the community planning prioritization process and summarize the decision-making experiences of community planning groups across the US. We then describe several priority-setting tools and decision analytic models that have been developed to assist in HIV community planning prioritization and discuss their strengths and weaknesses. Finally, we offer suggestions for improving the decision-analytic basis for HN prevention community planning.

关键词：社区卫生计划/经济学社区卫生计划/组织和管理决策组织 HIV感染/流行病学 HIV感染/预防和控制卫生保健公平提供卫生工作重点预防卫生服务/经济学预防卫生服务/组织和管理美国/流行病学人类

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BACKGROUND, CONCEPTUALIZATION AND DESIGN OF A COMMUNITY-WIDE RESEARCH-PROGRAM ON ADOLESCENT ALCOHOL-USE - PROJECT NORTHLAND

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HEALTH EDUCATION RESEARCH 1993年第1期8卷 125-136页

作者： PERRY, CL WILLIAMS, CL FORSTER, JL WOLFSON, M WAGENAAR, AC FINNEGAN, JR MCGOVERN, PG VEBLENMORTENSON, S KOMRO, KA ANSTINE, PS UNIV MINNESOTA SCH PUBL HLTHDIV EPIDEMIOL1300 2ND ST SSUITE 300MINNEAPOLISMN 55454 USA

Project Northland is a community-wide research program funded by the National Institute on Alcoholism and Alcohol Abuse, for a 5-year period (1990-95). The aim of the study is to prevent or delay onset of alcohol use among young adolescents, as well as to reduce use among those who are already drinkers. Twenty communities were recruited in northeastern Minnesota, an area referred to as the Northland, Arrowhead or Iron Range region, and then were randomly assigned to either Education or Delayed Program conditions. The 10 Education school districts have agreed to participate in 3 years of intervention programs in schools, with parents and in the community-at-large. One group of young adolescents, the Class of 1998 (sixth grade students in the 1991 - 92 school year), form the study cohort. Surveys (1991-94) of the Class of 1998, their parents, community leaders and alcohol merchants are the primary components of the program's evaluation. Many conceptual and methodological questions emerged during the development of the research protocols for Project Northland over the past 2 years. These questions are the impetus for this article. Specifically, the focus on young adolescents and alcohol use was selected, as contrasted with older adolescents or with multiple problem behaviors. The project was designed using a community-wide model that addresses both supply and demand issues, rather than limited to a school-based model. Intervention strategies and evaluation methods were chosen that could address community-level as well as individual-level behavior change, which required the development and application of new technologies. The rationale for these decisions may be useful to others considering community-wide health promotion efforts.

关键词：青少年青春期行为饮酒/预防和控制饮酒/心理学社区卫生计划/组织和管理数据收集健康行为健康计划健康促进/组织和管理人类明尼苏达方案评价学生/心理学

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Training by satellite: Planning and evaluating a video conference for injury prevention practitioners

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JOURNAL OF COMMUNITY HEALTH 1999年第6期24卷 451-466页

作者： Bontempi, JMB Runyan, CW Heath, J Univ N Carolina Sch Publ Hlth Dept Hlth Behav & Hlth Educ Injury Prevent Res Ctr Chapel Hill NC 27599 USA Univ Calif Davis Child Protect Ctr Dept Pediat Calif Med Training Ctr Davis CA 95616 USA

A non-experimental design was employed to conduct both a process and impact evaluation of a video conference for injury control specialists and other community members. The video conference was designed to teach participants how to conceptualize, develop, and implement community-based injury and violence prevention programs. The six-hour event was broadcast to 120 sites all across the United States and had a total of 1270 participants. The video conference format included a panel of injury control specialists and a moderator, video and audio clips that were shown throughout the program, on and off screen activities for participants, and an opportunity for participants to ask questions of the panel. Three groups were included in the evaluation sample: participants;site facilitators;and stakeholders;which included the planning committee members, conference speakers, moderator,and audiovisual personnel. Evaluation data were collected by telephone and in-person interviews, focus groups, and surveys completed at all the viewing sites. Results showed that there was high satisfaction among the participants and that the program should be continued as a series of video conferences with a changing content. There was lower satisfaction with the online activities, applicability of material to their work, and the opportunity to network with others and to participate in discussion. Recommendations made for improving future programs include shortening the video conference program, focusing on specific issues within injury and violence prevention, training the program presenters on the workings of the satellite video conference technology, use of video streaming, and using web-based forms for registration and evaluation.

关键词：卫生保健辅助人员/教育卫生保健辅助人员/心理学社区卫生计划/方法社区卫生计划/组织和管理会议用户满意数据收集教育远程评价研究卫星通信/组织和管理美国暴力/预防和控制创伤和损伤/预防和控制人类

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Planning the Development of Cystic Fibrosis Gene Carrier Screening

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Journal of Health Services Research & Policy 1996年第2期1卷 81-92页

作者： Beech, Roger Bekker, Hilary Department of Public Health Medicine UMDS St Thomas's Campus London United Kingdom Psychology and Genetics Research Group UMDS Guy's Campus London United Kingdom

It is now possible to test individuals to assess their cystic fibrosis gene carrier status and a range of strategies for screening the population have been piloted. The objective of this research was to develop a planning framework which health care planners and purchasers can use to assess the overall quantifiable outcomes and direct costs resulting from a year of alternative screening strategies and the ways costs and outcomes evolve over time. Beyond broader ethical and clinical considerations the information provided by such a framework is needed to support decisions surrounding the development of screening programmes. Operational Research modelling techniques were used to develop the planning framework. To help illustrate the framework it was then used to assess the quantifiable outcomes and direct costs of three of the main alternative screening strategies: From antenatal clinics, ‘2-step’ screening where females are tested first followed by a screening invitation to the partners of female carriers, and ‘couple’ screening where both partners must agree to be tested at the outset;and from primary practice clinics ‘active’ contact of attenders. Quantifiable outcomes are defined as the number of individuals informed of their carrier status and the number of carriers, carrier couples, and affected fetuses detected. Direct costs are those associated with the recruitment and testing of individuals and the subsequent counselling of any gene carriers or carrier couples identified. Results are based on services for a resident population of 250 000 at two time points, year one and a year at ‘steady state’. The resultant framework estimates the number of individuals tested using data on the size of the target population, the proportion of that population alerted to the screening service, and the proportion who agree to be tested when approached. Given service users, prevalence data are used to assess service outcomes. Given the number of individuals approached and the su

关键词：社区卫生计划/组织和管理囊性纤维化/遗传学遗传筛查/经济学遗传筛查/组织和管理大不列颠卫生保健费用杂合子检测模型组织管理结果评价(卫生保健) 规划技术敏感性与特异性女(雌)性人类男(雄)性

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Coalition-building: The promise of government

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AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2001年第2期29卷 285-291页

作者： Kurland, J Zeder, J Harvard Univ Sch Publ Hlth Dept Hlth Policy & Management Boston MA 02115 USA Islan Freelancing Lexington MA USA

Examines the impact of the United States government on the development of community organizations. Transition from government-dominated to community empowerment model; Elements of coalition building; Control over cont... 详细信息

关键词：哮喘/预防和控制社区卫生计划/组织和管理社区和机构的关系用户参与政府机构卫生保健联合体/组织和管理健康促进权力(心理学) 方案评价心理学社会美国人类

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Rural mental health leaders' perceptions of stigma and community issues

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JOURNAL OF RURAL HEALTH 1997年第1期13卷 59-70页

作者： Johnsen, MC Morrissey, JP Calloway, MO Fried, BJ Blank, M Starrett, BE ROW SCI INC 1700 RES BLVDSUITE 400ROCKVILLEMD 20850 USA

This paper provides a description of the attitudes of rural leaders toward mental health issues using data collected in two rural counties (one in Virginia and one in North Carolina). Study participants (N=63) are individuals identified as leaders making a significant positive contribution to mental health issues in each county. While the counties were matched on a number of demographic characteristics, the counties had one difference believed important: one had a county mental health center located within the county boundary while the other had no in-county mental health center. The study found that rural leaders believed that other community members held attitudes toward mentally ill persons that were more discriminatory than their own. In addition, rural lenders expressed that mental health teas a move important concern to them than if was to the community as a whole. Finally, the importance placed on issues of importance to the community and the resulting issue of priority of relevance varied in response to the occupation of respondents. The study presents an approach to understanding how occupational structures affect community issue priorities among rural leaders.

关键词：健康态度社区卫生计划/组织和管理社区精神卫生中心/组织和管理数据收集卫生工作重点领导精神障碍/心理学精神卫生服务/组织和管理北卡罗来纳偏见乡村卫生服务/组织和管理弗吉尼亚人类

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