scholarly journals 'Community navigators': making a difference by promoting health in culturally and linguistically diverse (CALD) communities in Logan, Queensland

2011 ◽  
Vol 17 (4) ◽  
pp. 347 ◽  
Author(s):  
Saras Henderson ◽  
Elizabeth Kendall
Keyword(s):  
Health Services ◽  
Health Outcomes ◽  
Lived Experience ◽  
National Health ◽  
Health Reform ◽  
Access To Health Care ◽  
Service Providers ◽  
Phenomenological Approach ◽  
Service Access ◽  
Community Members

A key component of the 2011 Australian National Health Reform, via the Access and Equity Policy, is to improve access to quality health services for all Australians including CALD communities. Awareness has been raised that certain CALD communities in Australia experience limited access to health care and services, resulting in poor health outcomes. To address this issue, the Community Navigator Model was developed and implemented in four CALD communities in Logan, Queensland, through a partnership between government and non-government organisations. The model draws on local natural leaders selected by community members who then act as a conduit between the community and health service providers. Nine ‘navigators’ were selected from communities with low service access including the Sudanese, Burmese, Afghan and Pacific Islander communities. The navigators were trained and employed at one of two local non-government organisations. The navigators’ role included assessing client needs, facilitating health promotion, supporting community members to access health services, supporting general practitioners (GPs) to use interpreters and making referrals to health services. This paper explores the ‘lived experience’ of the navigators using a phenomenological approach. The findings revealed three common themes, namely: (1) commitment to an altruistic attitude of servility allowing limitless community access to their services; (2) becoming knowledge brokers, with a focus on the social determinants of health; and (3) ‘walking the walk’ to build capacity and achieving health outcomes for the community. These themes revealed the extent to which the role of CALD community navigators has the potential to make a difference to health equity in these communities, thus contributing to the Australian National Health Reform.

Impact of community participation in primary health care: what is the evidence?

2015 ◽  
Vol 21 (1) ◽  
pp. 2 ◽  
Author(s):  
Jessamy Bath ◽  
John Wakerman
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Outcomes ◽  
Community Participation ◽  
Service Providers ◽  
Developmental Process ◽  
Service Access ◽  
Primary Health ◽  
Intermediate Outcomes ◽  
The Impact

Community participation is a foundational principle of primary health care, with widely reputed benefits including improved health outcomes, equity, service access, relevance, acceptability, quality and responsiveness. Despite considerable rhetoric surrounding community participation, evidence of the tangible impact of community participation is unclear. A comprehensive literature review was conducted to locate and evaluate evidence of the impact of community participation in primary health care on health outcomes. The findings reveal a small but substantial body of evidence that community participation is associated with improved health outcomes. There is a limited body of evidence that community participation is associated with intermediate outcomes such as service access, utilisation, quality and responsiveness that ultimately contribute to health outcomes. Policy makers should strengthen policy and funding support for participatory mechanisms in primary health care, an important component of which is ongoing support for Aboriginal Community Controlled Health Services as exemplars of community participation in Australia. Primary health-care organisations and service providers are encouraged to consider participatory mechanisms where participation is an engaged and developmental process and people are actively involved in determining priorities and implementing solutions.

scholarly journals Study protocol for a longitudinal study evaluating the impact of rape on women’s health and their use of health services in South Africa

BMJ Open ◽  
2017 ◽  
Vol 7 (9) ◽  
pp. e017296 ◽  
Author(s):  
Naeemah Abrahams ◽  
Soraya Seedat ◽  
Carl Lombard ◽  
Andre P Kengne ◽  
Bronwyn Myers ◽  
...  
Keyword(s):  
Mental Health ◽  
South Africa ◽  
Longitudinal Study ◽  
Health Services ◽  
Health Outcomes ◽  
Service Providers ◽  
Adult Women ◽  
Gender Based Violence ◽  
Gender Based ◽  
The Impact

IntroductionSouth Africa is a country known for its high levels of HIV infection and sexual violence. Although the interface between gender-based violence, HIV and mental health has been described, there are substantial gaps in knowledge of the medium-term and long-term health impact. The 2010 Global Burden of Disease study excluded many health outcomes associated with rape and other forms of gender-based violence because systematic reviews revealed huge gaps in data and poor evidence of health effects. This study aims to describe the incidence and attributable burden of physical and mental health problems (including HIV acquisition) in adult women over a 2-year postrape period, through comparison with a cohort of women who have not been raped. The study will substantially advance our understanding of the impact of rape and will generate robust data to assist in the development of postrape health services and the delivery of evidence-based care.Methods and analysisThis longitudinal study seeks to recruit 1008 rape-exposed and 1008 rape non-exposed women. Women were recruited from health services, and assessments were carried out at baseline, 3, 6, 9, 12, 18 and 24 months. Outcome measures include exposure to risk factors; mental health status; cardio-metabolic risks; and biomarkers for HIV, sexually transmitted infections, pregnancy and stress. The primary analysis will be to compare HIV incidence in the two groups using log-rank tests. Appropriate models to predict health outcomes over time will also be applied.Ethics and disseminationThe South African Medical Research Council’s Ethics Committee approved the study. As rape is a key element of the study, the safety and protection of participants guides the research process. We will adopt a research uptake strategy to ensure dissemination to policy makers, service providers and advocacy groups. Peer-reviewed journal articles will be published.

scholarly journals Engaging men in the health system: observations from service providers

2007 ◽  
Vol 31 (2) ◽  
pp. 211 ◽  
Author(s):  
Abdul Monaem ◽  
Micheal Woods ◽  
John Macdonald ◽  
Rodney Hughes ◽  
Michael Orchard
Keyword(s):  
Public Health ◽  
Health Services ◽  
Health Outcomes ◽  
Health System ◽  
Service Provider ◽  
Service Providers ◽  
Public Health Issue ◽  
Health Indices ◽  
Engaging Men ◽  
Significant Public Health

Men?s health is a significant public health issue in Australia. Increasingly, health indices show poor health outcomes for them. Literature suggests limitations in the health services dealing with their needs. If we are to improve boys? and men?s health, we should look at the efficacy of these services and address their limitations. This study provides data from a survey about the types of services available for boys and men. The service provider respondents expressed major concerns and identified ways of improving services.

scholarly journals Barriers and Facilitators to Accessing Health Services: A Qualitative Study Amongst People with Disabilities in Cameroon and India

2019 ◽  
Vol 16 (7) ◽  
pp. 1126 ◽  
Author(s):  
Maria Zuurmond ◽  
Islay Mactaggart ◽  
Nanda Kannuri ◽  
Gudlavalleti Murthy ◽  
Joseph Oye ◽  
...  
Keyword(s):  
Health Services ◽  
Access To Health Care ◽  
Social Inclusion ◽  
Service Providers ◽  
People With Disabilities ◽  
Personal Factors ◽  
Access To Health Services ◽  
Structured Interviews ◽  
Cross Sectional ◽  
Access To Health

Background: Article 25 of the UNCRPD stipulates the right of people with disabilities to the highest attainable standard of health, and the timely uptake of appropriate health and rehabilitation services. This study seeks to explore the factors which influence access to health care among adults with disabilities in Cameroon and India. Methods: A total of 61 semi-structured interviews were conducted with a purposive sample of adults with vision, hearing or musculoskeletal impairments, using data from an earlier cross-sectional disability survey. In addition, 30 key informants were interviewed to provide contextual information about the local services and context. Results: Key themes included individual-level factors, understanding and beliefs about an impairment, and the nature of the impairment and interaction with environmental factors. At the community and household level, key themes were family dynamics and attitudes, economic factors, social inclusion and community participation. Intersectionality with gender and age were cross-cutting themes. Trust and acceptability of health service providers in India and poor understanding of referral processes in both countries were key service-level themes. Conclusions: The interaction of environmental and personal factors with the impairment and their levels of participation and inclusion in community structures, all contributed to the take up of services. This study illustrated the need for a multi-faceted response to improve access to health services for people with disabilities.

Evaluation of a new recovery college: delivering health outcomes and cost efficiencies via an educational approach

2019 ◽  
Vol 23 (1) ◽  
pp. 36-46 ◽  
Author(s):  
Katie Kay ◽  
George Edgley
Keyword(s):  
Public Health ◽  
Mental Health ◽  
Health Services ◽  
Health Outcomes ◽  
Secondary Care ◽  
Service Providers ◽  
Integrative Approach ◽  
Educational Approach ◽  
Content Type ◽  
Cost Efficiencies

Purpose The purpose of this paper is to evaluate cost efficiencies and health outcomes after one academic year of course delivery, in a recovery college. Design/methodology/approach The paper used service evaluation and review of data. Findings There is significant impact on health outcomes when standardised measures of Patient Activation Measure and Warwick–Edinburgh Mental Wellbeing Scale were completed pre- and post-intervention, with indications of possible financial efficiencies identified within secondary care mental health pathways. Research limitations/implications The current evaluation sample is only representative of community mental health populations rather than broader communities. However, indications are that the model is effective from a wider public health perspective (early intervention/prevention) in producing significant health outcomes in terms of improved wellbeing and increased levels of activation/self-management. More in-depth research collaboration with an academic institution is now required. Practical implications There is an implication that the recovery college needs to be fully embedded within the mental health pathway as part of the core offer. This would require significant service redesign and culture change within the organisation. Social implications There is a need to continue to work with other statutory service providers, key stakeholders, voluntary and community sectors to embed the college with wider public health services and ensure a holistic approach across local communities and the whole health pathway. Originality/value Although the model is based on the widely recognised national recovery college model, it has moved away from the usual boundaries of access only being for those attached to secondary care mental health services to a more holistic and integrative approach of offering access to the whole population. Social value is indicated in the ownership and co-production of the model by the collaboration of student expertise, experts by experience and experts by expertise. The co-produced integrated volunteering and work pathway offers positive and cost-efficient health outcomes from a co-designed and co-delivered educational approach.

scholarly journals Developing and testing a principle-based fidelity index for peer support in mental health services

2021 ◽  
Author(s):  
S. Gillard ◽  
N. Banach ◽  
E. Barlow ◽  
J. Byrne ◽  
R. Foster ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Lived Experience ◽  
Peer Support ◽  
Service User ◽  
Service Providers ◽  
Evidence Base ◽  
Clinical Patient ◽  
One To One

Abstract Purpose Evidence suggests that the distinctive relational qualities of peer support—compared to clinical-patient relationships—can be eroded in regulated healthcare environments. Measurement of fidelity in trials of peer support is lacking. This paper reports the development and testing of a fidelity index for one-to-one peer support in mental health services, designed to assess fidelity to principles that characterise the distinctiveness of peer support. Methods A draft index was developed using expert panels of service user researchers and people doing peer support, informed by an evidence-based, peer support principles framework. Two rounds of testing took place in 24 mental health services providing peer support in a range of settings. Fidelity was assessed through interviews with peer workers, their supervisors and people receiving peer support. Responses were tested for spread and internal consistency, independently double rated for inter-rater reliability, with feedback from interviewees and service user researchers used to refine the index. Results A fidelity index for one-to-one peer support in mental health services was produced with good psychometric properties. Fidelity is assessed in four principle-based domains; building trusting relationships based on shared lived experience; reciprocity and mutuality; leadership, choice and control; building strengths and making connections to community. Conclusions The index offers potential to improve the evidence base for peer support in mental health services, enabling future trials to assess fidelity of interventions to peer support principles, and service providers a means of ensuring that peer support retains its distinctive qualities as it is introduced into mental health services.

scholarly journals The Meanings of Mental Health Recovery for African and Caribbean Men in the UK

2021 ◽  
Vol 4 (1) ◽  
pp. e83-e95
Author(s):  
Kris Southby ◽  
Frank Keating ◽  
Stephen Joseph
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Interpretative Phenomenological Analysis ◽  
Mental Distress ◽  
Service Providers ◽  
Phenomenological Approach ◽  
Mental Health Recovery ◽  
Social Suffering ◽  
The Uk

Racial disparities for African and Caribbean men are nowhere as stark as in mental health services and outcomes. Men from these communities who have been in contact with mental health services seemed to be stuck in a stalled cycle of recovery. This paper reports the findings from a study that aimed to explore how African and Caribbean men and their supporters conceptualise mental health recovery at the intersections of masculinity, racialised identities and mental distress. It illuminates the perspectives of service users,family, carers and practitioners on recovery in relation to ethnicity and culture.Owing to the exploratory nature of this study, a qualitative design using a phenomenological approach was adopted to capture the dynamics of recovery processes and outcomes for African and Caribbean men across two study sites. Interviews were conducted with African and Caribbean men, their supporters and service providers. Interpretive Phenomenology Analysis (IPA; Smith J, Flowers P, Larkin M. Interpretative phenomenological analysis: Theory method and research. London: SAGE; 2009) was used to offer insights into how recovery was understood and experienced by study participants.Seven overarching themes emerged from the data in relation to the meanings of recovery: recovering from social suffering, leading a normal life, (re)gaining control and agency, a sense of hope, (re)gaining identity, reduced medical involvement, and recovery being a healing journey. The paper concludes that recovery is an ongoing process, not merely a narrow outcome to be achieved for men. The paper advances previous understandings by conceptualising mental health recovery for African and Caribbean men as a journey towards addressing individual and collective “social suffering” that occurs at the intersections of masculinity, “race” and mental distress, and moving to a better social location.

Transition from higher education to National Health Service for visually impaired physiotherapists: An interpretative phenomenological exploration

2013 ◽  
Vol 31 (1) ◽  
pp. 32-46 ◽  
Author(s):  
Karen Atkinson ◽  
Jane Owen Hutchinson
Keyword(s):  
Higher Education ◽  
National Health Service ◽  
Health Service ◽  
Lived Experience ◽  
National Health ◽  
Health Care Professionals ◽  
Visually Impaired ◽  
Phenomenological Approach ◽  
Structured Interviews ◽  
Wide Range

This idiographic study aims to hear the voices of a small group of visually impaired physiotherapists to explore their lived experience 1 of transition from higher education (HE) into employment. The findings are based on six semi-structured interviews analysed using an interpretative phenomenological approach. Participants were visually impaired physiotherapists who are either working, or have worked, in the National Health Service (NHS). A number of interrelated themes emerged concerning the work of the disabled self, compensation, stigma and passing, disclosure, barriers, disempowerment, and positive experiences. These appear to be linked to a reluctance by participants to engage with their disability identity. The experiences and perceptions of participants do not provide evidence of a commitment to disability-related support for disabled health-care professionals. The results of this study indicate that a wide range of both personal and institutional barriers still exist in the NHS.

scholarly journals Family planning practice among Christian health service providers in Ghana: a case study

2017 ◽  
Vol 4 (2) ◽  
pp. 80-86 ◽  
Author(s):  
James Duah ◽  
Peter Yeboah
Keyword(s):  
Family Planning ◽  
Health Outcomes ◽  
National Health ◽  
Service Providers ◽  
Cultural Beliefs ◽  
Religious Faith ◽  
Marginalized Communities ◽  
Health Service Providers ◽  
Health Association

Introduction: The interphase of faith and practicing health professionally often presents a challenge. To navigate between the two requires tact, experience and professionalism. Such is the case of the Christian Health Association of Ghana. Objective: This case report presents overview of how the Christian Health Association has provided family planning services for marginalized communities in Ghana by Church denominations some of whose faith abhor them from practicing certain forms of family planning. Background: CHAG is a Network of 300 Health Facilities and Health Training Institutions owned by 25 different Christian Church Denominations. CHAG provides health care to the vulnerable, deprived, and marginalized population groups in all 10 Regions of Ghana. As implementing partner of the Ministry of Health, CHAG is mandated to implement key policies to achieve national health outcomes including family planning. Some members do not accept artificial family planning on the account of religious faith. This often presents a challenge in addressing the need to provide family planning service as required. This challenge is further complicated by the fact that the CHAG secretariat is steward that should protect the interest of member institutions as well as that of the ministry. Strategy: CHAG tailors the provision of family planning interventions to the confines of denominational, socio-cultural, religious acceptability and client needs. Results: Over a period of three years, proportion of family planning acceptors who are adolescents (10-19 years) increased from 13.7% to 17.0%, total family planning acceptors increased from 67,312 to 73,648 and total couple years of protection from 71,296 to 92,852. Male sterilization increased contrary to cultural beliefs. Importantly, CHAG as an implementing partner is able to satisfy its obligation of providing service to achieve national health outcomes. Conclusion: Protecting the interest of Christian health institutions and that of government may conflict at some point. Being tactful and allowing work within the confines of faith and obligations always helps in achieving desired results.

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