A Multi-Disciplinary Approach to Establishing a Community Wellness Program

Chronic disease is a leading cause of morbidity and mortality in the United States. One-half of U.S. adults have at least one chronic disease condition and 25% have multiple chronic conditions that can lead to a restriction in an ability to do basic daily living activities. Low-income adults have a high incidence of chronic disease that increases with aging due to ongoing psychological stress, higher risk exposure, less healthy living conditions, and limited access to health services. Community-based wellness programs, in collaboration with academic institutions, can serve this population by providing access to health services, quality educational and activity-based experiences, and continual assessment and support. Using a multidisciplinary approach, the expertise of numerous faculty, students, and staff can be used to help mitigate a myriad of health conditions presented by this population. This article shares one university’s creation, development, and delivery of an on-campus, multidisciplinary community wellness program for low-income adults.

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Expanding the use of community health workers in urban settings: a potential strategy for progress towards universal health coverage

Health Policy and Planning ◽

10.1093/heapol/czz133 ◽

2019 ◽

Cited By ~ 3

Author(s):

Brian Wahl ◽

Susanna Lehtimaki ◽

Stefan Germann ◽

Nina Schwalbe

Keyword(s):

Health Services ◽

Community Health ◽

Low Income ◽

Urban Areas ◽

Access To Health Services ◽

Middle Income ◽

Urban Settings ◽

Middle Income Countries ◽

Access To Health ◽

Low And Middle Income

Abstract Community health worker (CHW) programmes have been used for decades to improve access to health services in rural settings in low- and middle-income countries. With more than half of the world’s population currently living in urban areas and this population expected to grow, equitable access to health services in urban areas is critically important. To understand the extent to which CHW programmes have been successfully deployed in low-income urban settings, we conducted a review of the literature between 2000 and 2018 to identify studies evaluating and describing CHW programmes implemented fully or partially in urban or peri-urban settings. We identified 32 peer-reviewed articles that met our inclusion criteria. Benefits have been documented in several urban settings in low- and middle-income countries including those to address TB/HIV, child health, maternal health and non-communicable diseases through a variety of study designs.

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Supporting Chronic Disease Healthcare Through Remote Emotional Freedom Techniques (EFT) Treatment and Self-care: An Evaluation Using the WHO Determinants of Health

Energy Psychology Journal ◽

10.9769/epj.2016.8.1.mk ◽

2016 ◽

Vol 8 (1) ◽

pp. 55-66

Author(s):

Mahima Kalla ◽

Keyword(s):

Social Support ◽

Chronic Disease ◽

Health Services ◽

Self Care ◽

Determinants Of Health ◽

World Health ◽

Access To Health Services ◽

Access To Health ◽

Chronic Disease Patients ◽

Emotional Freedom Techniques

Abstract: The United Nations World Health Organization (WHO) defines determinants that influence people’s health, such as income, education, social support, physical environment, access to health services, personal behaviors, and gender. This study explores delivery of a therapeutic intervention called Emotional Freedom Techniques (EFT) and self-administration of EFT in chronic disease patients from the perspective of the WHO determinants of health. Sixteen participants, including eight EFT practitioners and eight chronic disease patients, described their experiences of EFT in semi-structured interviews. Data was analyzed using Interpretative Phenomenological Analysis (IPA) methodology. Four major themes were identified: practitioner and client experiences of online EFT therapy, experiences of telephone EFT therapy, experiences in online support groups, and the use of EFT for self-care. Participant accounts illustrated EFT’s value in alleviating barriers to access to health services and facilitating self-care in chronic disease patients. Online and telephone delivery of EFT offered a useful alternative for residents of remote and rural areas without access to mental health services. EFT is effective in groups using online videoconferencing platforms to provide a social support network. Additionally, EFT is favored by the study’s participants for selfcare, maintaining positive mood, and for general well-being.

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Telemedicine adoption issues in the United States and Brazil: Perception of healthcare professionals

Health Informatics Journal ◽

10.1177/1460458220902957 ◽

2020 ◽

Vol 26 (4) ◽

pp. 2344-2361 ◽

Cited By ~ 1

Author(s):

Edimara Luciano ◽

M Adam Mahmood ◽

Parand Mansouri Rad

Keyword(s):

United States ◽

Health Services ◽

Rural Areas ◽

Healthcare Professionals ◽

Critical Role ◽

The United States ◽

Security And Privacy ◽

Access To Health Services ◽

Security Breaches ◽

Access To Health

Telemedicine has recently garnered more attention from healthcare professionals because it provides access to health services to patients in rural areas while making patient healthcare information more vulnerable to security breaches. The objective of this research is to identify factors that play a critical role in possible adoption of telemedicine in the United States and Brazil. A model with eight hypotheses was used to establish a research framework. A survey was conducted involving healthcare professionals in the aforementioned countries. The results show that telemedicine adoption is influenced by policies and culture in both countries and influenced by security and privacy in the United States. It can be inferred from the research that perceptions of the American and Brazilian healthcare professionals are similar in telemedicine issues covered in this research. These healthcare professionals, however, disagree on how patients’ privacy should be preserved in the two countries.

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Racial/Ethnic Disparities in Chronic Diseases of Youths and Access to Health Care in the United States

BioMed Research International ◽

10.1155/2013/787616 ◽

2013 ◽

Vol 2013 ◽

pp. 1-12 ◽

Cited By ~ 38

Author(s):

James H. Price ◽

Jagdish Khubchandani ◽

Molly McKinney ◽

Robert Braun

Keyword(s):

United States ◽

Health Disparities ◽

Health Services ◽

Chronic Diseases ◽

Access To Health Care ◽

Ethnic Disparities ◽

The United States ◽

Access To Health Services ◽

Access To Health ◽

Racial Ethnic

Racial/ethnic minorities are 1.5 to 2.0 times more likely than whites to have most of the major chronic diseases. Chronic diseases are also more common in the poor than the nonpoor and this association is frequently mediated by race/ethnicity. Specifically, children are disproportionately affected by racial/ethnic health disparities. Between 1960 and 2005 the percentage of children with a chronic disease in the United States almost quadrupled with racial/ethnic minority youth having higher likelihood for these diseases. The most common major chronic diseases of youth in the United States are asthma, diabetes mellitus, obesity, hypertension, dental disease, attention-deficit/hyperactivity disorder, mental illness, cancers, sickle-cell anemia, cystic fibrosis, and a variety of genetic and other birth defects. This review will focus on the psychosocial rather than biological factors that play important roles in the etiology and subsequent solutions to these health disparities because they should be avoidable and they are inherently unjust. Finally, this review examines access to health services by focusing on health insurance and dental insurance coverage and access to school health services.

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The effects of medicines availability and stock-outs on household’s utilization of healthcare services in Dodoma region, Tanzania

Health Policy and Planning ◽

10.1093/heapol/czz173 ◽

2020 ◽

Vol 35 (3) ◽

pp. 323-333 ◽

Cited By ~ 1

Author(s):

August Kuwawenaruwa ◽

Kaspar Wyss ◽

Karin Wiedenmayer ◽

Emmy Metta ◽

Fabrizio Tediosi

Keyword(s):

Health Services ◽

Health Facility ◽

Healthcare Utilization ◽

Low Income ◽

Essential Medicines ◽

Access To Health Services ◽

Cross Sectional ◽

Access To Health ◽

Catchment Areas ◽

Medicine Availability

Abstract Low- and middle-income countries have been undertaking health finance reforms to address shortages of medicines. However, data are lacking on how medicine availability and stock-outs influence access to health services in Tanzania. The current study assesses the effects of medicine availability and stock-outs on healthcare utilization in Dodoma region, Tanzania. We conducted a cross-sectional study that combined information from households and healthcare facility surveys. A total of 4 hospitals and 89 public primary health facilities were surveyed. The facility surveys included observation, record review over a 3-month period prior to survey date, and interviews with key staff. In addition, 1237 households within the health facility catchment areas were interviewed. Data from the facility survey were linked with data from the household survey. Descriptive analysis and multivariate logistic regressions models were used to assess the effects of medicine availability and stock-outs on utilization patterns and to identify additional household-level factors associated with health service utilization. Eighteen medicines were selected as ‘tracers’ to assess availability more generally, and these were continuously available in ∼70% of the time in facilities across all districts over 3 months of review. The main analysis showed that household’s healthcare utilization was positively and significantly associated with continuous availability of all essential medicines for the surveyed facilities [odds ratio (OR) 3.49, 95% confidence interval (CI) 1.02–12.04; P = 0.047]. Healthcare utilization was positively associated with household membership in the community health insurance funds (OR 1.97, 95% CI 1.23–3.17; P = 0.005) and exposure to healthcare education (OR 2.75, 95% CI 1.84–4.08; P = 0.000). These results highlight the importance of medicine availability in promoting access to health services in low-income settings. Effective planning and medicine supply management from national to health facility level is an important component of quality health services.

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Dificuldades no acesso aos serviços de saúde por lésbicas, gays, bissexuais e transgêneros

Revista de Enfermagem UFPE on line ◽

10.5205/1981-8963.2020.243211 ◽

2020 ◽

Vol 14 ◽

Author(s):

Alef Diogo da Silva Santana ◽

Marcos Soares de Lima ◽

Jefferson Wildes da Silva Moura ◽

Isabel Cristina Sibalde Vanderley ◽

Ednaldo Cavalcante de Araújo

Keyword(s):

Health Services ◽

Web Of Science ◽

Hierarchical Classification ◽

The United States ◽

Access To Health Services ◽

Final Sample ◽

Access To Health ◽

Politica Publica ◽

Lgbt People ◽

And Gender

Objetivo: analisar as dificuldades de acesso aos serviços de saúde pelas pessoas LGBT. Método: trata-se de um estudo bibliográfico, descritivo, do tipo revisão integrativa da literatura. Realizou-se a busca em janeiro de 2019 nas bases de dados: MEDLINE, Web of Science e SCOPUS. Pesquisaram-se artigos com delimitação atemporal. Avaliaram-se os artigos segundo o critério AHRQ e sua elegibilidade pelo CASP. Analisaram-se os dados no software IRAMUTEQ a partir da Classificação Hierárquica Descendente. Resultados: destaca-se que a amostra final foi composta por dez artigos, entre eles, 70% encontraram-se disponíveis na SCOPUS; 10%, na Web of Science e 20%, na MEDLINE. Notou-se que, referente à nacionalidade dos estudos, 10% foram da Alemanha; 10%, do Brasil; 10%, da Argentina; 20%, do Canadá; 20%, da África do Sul e 30%, dos Estados Unidos da América. Verificou-se que os anos de publicação dos estudos foram entre 2013 e 2018. Conclusão: evidencia-se que o acesso aos serviços de saúde pela população LGBT é permeado por constrangimentos e preconceitos. Ressalta-se que a exclusão, desamparo, omissão e indiferença ao acesso são sentimentos expressados por este público, mesmo existindo políticas públicas específicas. Descritores: Serviços de Saúde; Minorias Sexuais e de Gênero; Acesso aos Serviços de Saúde; Enfermagem; Vulnerabilidade em Saúde; Política Pública.AbstractObjective: to analyze the difficulties of access to health services by LGBT people. Method: this is a descriptive bibliographic study of the integrative literature review type. The search was performed in January 2019 in the databases: MEDLINE, Web of Science and SCOPUS. We searched for articles with timeless delimitation. The articles were evaluated according to the AHRQ criteria and their eligibility by CASP. Data was analyzed in the IRAMUTEQ software from the Descending Hierarchical Classification. Results: it is noteworthy that the final sample consisted of ten articles, among them, 70% were available at SCOPUS; 10% on Web of Science and 20% on MEDLINE. Regarding the nationality of the studies, 10% were from Germany; 10% from Brazil; 10% from Argentina; 20% from Canada; 20% from South Africa and 30% from the United States of America. It was found that the years of publication of the studies were between 2013 and 2018. Conclusion: it is evident that access to health services by the LGBT population is permeated by constraints and prejudices. It is emphasized that exclusion, helplessness, omission and indifference to access are feelings expressed by this public, even though there are specific public policies. Descriptors: Health Services; Sexual and Gender Minorities; Health Services Accessibility; Nursing; Health Vulnerability; Public Policy.ResumenObjetivo: analizar las dificultades de acceso a los servicios de salud por parte de las personas LGBT. Método: este es un estudio bibliográfico descriptivo del tipo revisión integradora de literatura. La búsqueda se realizó en enero de 2019 en las bases de datos MEDLINE, Web of Science y SCOPUS. Buscamos artículos con delimitación atemporal. Los artículos fueron evaluados de acuerdo con los criterios AHRQ y su elegibilidad por CASP. Los datos se analizaron en el software IRAMUTEQ de la Clasificación Jerárquica Descendente. Resultados: cabe destacar que la muestra final consistió en 10 artículos, entre ellos, 70% estaban disponibles en SCOPUS, 10% en Web of Science y 20% en Medline. Con respecto a la nacionalidad de los estudios, el 10% provino de Alemania, el 10% de Brasil, el 10% de Argentina, el 20% de Canadá, el 20% de Sudáfrica y el 30% de los Estados Unidos de América. Se descubrió que los años de publicación de los estudios fueron entre 2013 y 2018. Conclusión: es evidente que el acceso a los servicios de salud por parte de la población LGBT está impregnado de restricciones y prejuicios. Es de destacar que la exclusión, la impotencia, la omisión y la indiferencia al acceso son sentimientos expresados por este público, a pesar de que existen políticas públicas específicas. Descriptores: Servicios de Salud; Minorías Sexuales y de Género; Accesibilidad a los Servicios de Salud; Enfermería; Vulnerabilidad en Salud; Política Pública.

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Understanding Determinants of Cardiovascular Health in a Mexican American Community

Health Promotion Practice ◽

10.1177/1524839917698095 ◽

2017 ◽

Vol 18 (4) ◽

pp. 534-544 ◽

Cited By ~ 2

Author(s):

Karen A. Larimer ◽

Meg Gulanick ◽

Sue Penckofer

Keyword(s):

Health Services ◽

Low Income ◽

Public Transportation ◽

Mexican American ◽

Hispanic Americans ◽

Determinants Of Health ◽

Grocery Stores ◽

Access To Health Services ◽

Cvd Risk ◽

Access To Health

Cardiovascular disease (CVD) is the leading cause of death in Hispanic Americans. Social and physical determinants of health unique to this community must be understood before interventions can be designed and implemented. This article describes a CVD risk assessment conducted in a primarily Mexican American community, using Healthy People 2020 as a model. Social (language, culture, awareness of CVD, and socio-economic status) and physical (presence and use of recreation areas, presence of grocery stores, public transportation, and environmental pollution) determinants of health as well as access to health services were assessed. Fifteen community leaders were interviewed using guided interviews. Database searches and direct observations were conducted. Using these methods provided comprehensive assessment of social and physical determinants of health, and access issues that were unique to the community studied. Findings demonstrated greater awareness of diabetes than CVD as a health problem, with little knowledge of CVD risk factors. Lack of access to health services (lack of insurance, lack of a medical home) and presence of cultural and socioeconomic barriers such as language, unemployment, low income, and lack of insurance were identified. The physical determinants such as environment presented fewer barriers, with adequate access to fruits and vegetables, transportation, and parks. Results revealed target areas for intervention.

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