scholarly journals The feasibility and potential use of case-tracked client journeys in primary healthcare: a pilot study

BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e024419 ◽  
Author(s):  
Elsa Barton ◽  
Toby Freeman ◽  
Fran Baum ◽  
Sara Javanparast ◽  
Angela Lawless

ObjectivesTo determine the feasibility of case-tracking methods in documenting client journeys at primary healthcare (PHC) services in order to investigate the comprehensiveness of service responses and the experiences of clients.DesignProspective pilot study. Quantitative and qualitative case management data were collected from staff via questionnaire or interview.SettingFive Australian multidisciplinary PHC services were involved including four South Australian state-managed and one Northern Territory Aboriginal community-controlled PHC service.ParticipantsClients using services for depression (95) or diabetes (185) at the PHC services were case tracked over a 12-month period to allow construction of client journeys for these two conditions. Clients being tracked were invited to participate in two semi-structured interviews (21) and complete a health log.ResultsThough a number of challenges were encountered, the case-tracking methods were useful in documenting the complex nature of client journeys for those with depression or diabetes accessing PHC services and the need to respond to the social determinants of health. A flexible research design was crucial to respond to the needs of staff and changing organisational environments.ConclusionsThe client journeys provided important information about the services’ responses to depression and diabetes, and about aspects unique to comprehensive PHC such as advocacy and work that takes into account the social determinants of health.

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
O. Pearson ◽  
◽  
K. Schwartzkopff ◽  
A. Dawson ◽  
C. Hagger ◽  
...  

Abstract Background Indigenous populations globally are continually striving for better health and wellbeing due to experiencing significant health and social inequities. The social determinants of health are important contributors to health outcomes. Comprehensive primary health care that is governed and delivered by Indigenous people extends beyond the biomedical model of care to address the social determinants of health. Aboriginal Community Controlled Health Organisations (ACCHOs) are known to provide culturally informed, holistic health services that directly and indirectly address the social determinants of health. The range and extent of their activities in addressing the social determinants of health, however, is not well documented. Methods The most recent ACCHO annual reports were retrieved online or by direct correspondence. For coding consistency, a dictionary informed by the World Health Organization’s Conceptual Framework for Action on the Social Determinants of Health was developed. A document and textual analysis of reports coded ACCHO activities and the determinants of health they addressed, including intermediary determinants, socio-economic position and/or socio-political context. Summary statistics were reported. Representative quotes illustrating the unique nature of ACCHO service provision in addressing the social determinants of health were used to contextualise the quantitative findings. Results Sixty-seven annual reports were collected between 2017 and 2018. Programs were delivered to population groups across the life span. Fifty three percent of reports identified programs that included work at the socio-political level and all annual reports described working to improve socioeconomic position and intermediary determinants of health through their activities. Culture had a strong presence in program delivery and building social cohesion and social capital emerged as themes. Conclusions This study provides evidence of the considerable efforts of the ACCHO sector, as a primary health care provider, in addressing the social determinants of health and health inequity experienced by Indigenous communities. For the Aboriginal and Torres Strait Islander population, ACCHOs not only have an essential role in addressing immediate healthcare needs but also invest in driving change in the more entrenched structural determinants of health. These are important actions that are likely to have an accumulative positive effect in closing the gap towards health equity.


2020 ◽  
Author(s):  
Odette Pearson ◽  
Kate Schwartzkopff ◽  
Anna Dawson ◽  
Christina Hagger ◽  
Agape Karagi ◽  
...  

Abstract Background: Indigenous populations globally are continually striving for better health and wellbeing due to experiencing significant health and social inequities. The social determinants of health are important contributors to health outcomes. Comprehensive primary health care that is governed and delivered by Indigenous people extends beyond the biomedical model of care to address the social determinants of health. Aboriginal Community Controlled Health Organisations (ACCHOs) are known to provide culturally informed, holistic health services that directly and indirectly address the social determinants of health. The range and extent of their activities in addressing the social determinants of health, however, is not well documented. Methods: The most recent ACCHO annual reports were retrieved online or by direct correspondence. For coding consistency, a dictionary informed by the World Health Organization’s Conceptual Framework for Action on the Social Determinants of Health was developed . A document and textual analysis of reports coded ACCHO activities and the determinants of health they addressed, including intermediary determinants, socio-economic position and/or socio-political context. Summary statistics were reported. Representative quotes illustrating the unique nature of ACCHO service provision in addressing the social determinants of health were used to contextualise the quantitative findings. Results: Sixty-seven annual reports were collected between 2017 and 2018. Programs were delivered to population groups across the life span. Fifty three percent of reports identified programs that included work at the socio-political level and all annual reports described working to improve socioeconomic position and intermediary determinants of health through their activities. Culture had a strong presence in program delivery and building social cohesion and social capital emerged as themes. Conclusions: This study provides evidence of the considerable efforts of the ACCHO sector, as a primary health care provider, in addressing the social determinants of health and health inequity experienced by Indigenous communities. For the Aboriginal and Torres Strait Islander population, ACCHOs not only have an essential role in addressing immediate healthcare needs but also invest in driving change in the more entrenched structural determinants of health. These are important actions that are likely to have an accumulative positive effect in closing the gap towards health equity.


2020 ◽  
Author(s):  
Odette Pearson ◽  
Kate Schwartzkopff ◽  
Anna Dawson ◽  
Christina Hagger ◽  
Agape Karagi ◽  
...  

Abstract Background Indigenous populations globally are continually striving for better health and wellbeing due to experiencing significant health and social inequities. The social determinants of health are important contributors to health outcomes. Comprehensive primary health care that is governed and delivered by Indigenous people extends beyond the biomedical model of care to address the social determinants of health. Aboriginal Community Controlled Health Organisations (ACCHOs) are known to provide culturally informed, holistic health services that directly and indirectly address the social determinants of health. The range and extent of their activities in addressing the social determinants of health, however, is not well documented.Methods The most recent ACCHO annual reports were retrieved online or by direct correspondence. For coding consistency, a dictionary informed by the World Health Organization’s Conceptual Framework for Action on the Social Determinants of Health was developed. A document and textual analysis of reports coded ACCHO activities and the determinants of health they addressed, including intermediary determinants, socio-economic position and/or socio-political context. Summary statistics were reported. Representative quotes illustrating the unique nature of ACCHO service provision in addressing the social determinants of health were used to contextualise the quantitative findings.Results Sixty-seven annual reports were collected between 2017 and 2018. Programs were delivered to population groups across the life span. Fifty three percent of reports identified programs that included work at the socio-political level and all annual reports described working to improve socioeconomic position and intermediary determinants of health through their activities. Culture had a strong presence in program delivery and building social cohesion and social capital emerged as themes.Conclusions This study provides evidence of the considerable efforts of the ACCHO sector, as a primary health care provider, in addressing the social determinants of health and health inequity experienced by Indigenous communities. For the Aboriginal and Torres Strait Islander population, ACCHOs not only have an essential role in addressing immediate healthcare needs but also invest in driving change in the more entrenched structural determinants of health. These are important actions that are likely to have an accumulative positive effect in closing the gap towards health equity.


2018 ◽  
Vol 32 (4) ◽  
pp. 505-508 ◽  
Author(s):  
Sandra D. Lane ◽  
Robert H. Keefe ◽  
Robert A. Rubinstein ◽  
Meghan Hall ◽  
Kathleen A. Kelly ◽  
...  

2008 ◽  
Vol 37 (3) ◽  
pp. 26-32 ◽  
Author(s):  
Gavin Mooney ◽  
Nubong G. Fohtung

This article focuses on the measurement of the social determinants of health, and specifically on issues relating to two key variables relevant to the analysis of public health information: poverty and inequality. Although the paper has been written from the perspective of economics, the discipline of the two authors, it is also of relevance to researchers in other disciplines. It is argued that there is a need to ensure that, when considering measurement in this largely neglected area of research, sufficient thought is given to the relationships that are being examined or assessed. We argue further that any attempt at measurement in this area must take into account the historical backdrop and the complex nature of the relationships between these key variables.


Author(s):  
Daiane Broch ◽  
Deise Lisboa Riquinho ◽  
Letícia Becker Vieira ◽  
Adriana Roese Ramos ◽  
Vanessa Aparecida Gasparin

Abstract Objective: To understand the social determinants of health from the perspective of the work of community health agents. Method: A qualitative study conducted in a Health District Management in the city of Porto Alegre/Rio Grande do Sul, Brazil, through focus groups and semi-structured interviews with community health agents. The analysis took place through thematic categorization, and the social determinants of health were adopted as the analytical category. Results: Twenty-five (25) community health agent workers participated. Overlapping individual and collective themes emerged, from violence and drug trafficking to lack of sanitation, improperly disposed garbage, illiteracy and the health problems themselves. Conclusion: The study revealed a complex relationship between the work of community health agents and the social determinants of health, reinforcing the need for a cohesive health team with intersectoral initiatives to address the different demands of the territories which are worked and lived in.


2020 ◽  
Author(s):  
Odette Pearson ◽  
Kate Schwartzkopff ◽  
Anna Dawson ◽  
Christina Hagger ◽  
Agape Karagi ◽  
...  

Abstract Background: Indigenous populations globally are continually striving for better health and wellbeing due to experiencing significant health and social inequities. The social determinants of health are important contributors to health outcomes. Comprehensive primary health care that is governed and delivered by Indigenous people extends beyond the biomedical model of care to address the social determinants of health. Aboriginal Community Controlled Health Organisations (ACCHOs) are known to provide culturally informed, holistic health services that directly and indirectly address the social determinants of health. The range and extent of their activities in addressing the social determinants of health, however, is not well documented.Methods: The most recent ACCHO annual reports were retrieved online or by direct correspondence. For coding consistency, a dictionary informed by the World Health Organization’s Conceptual Framework for Action on the Social Determinants of Health was developed. A document and textual analysis of reports coded ACCHO activities and the determinants of health they addressed, including intermediary determinants, socio-economic position and/or socio-political context. Summary statistics were reported. Representative quotes illustrating the unique nature of ACCHO service provision in addressing the social determinants of health were used to contextualise the quantitative findings. Results: Sixty-seven annual reports were collected between 2017 and 2018. Programs were delivered to population groups across the life span. Fifty three percent of reports identified programs that included work at the socio-political level and all annual reports described working to improve socioeconomic position and intermediary determinants of health through their activities. Culture had a strong presence in program delivery and building social cohesion and social capital emerged as themes.Conclusions: This study provides evidence of the considerable efforts of the ACCHO sector, as a primary health care provider, in addressing the social determinants of health and health inequity experienced by Indigenous communities. For the Aboriginal and Torres Strait Islander population, ACCHOs not only have an essential role in addressing immediate healthcare needs but also invest in driving change in the more entrenched structural determinants of health. These are important actions that are likely to have an accumulative positive effect in closing the gap towards health equity.


2018 ◽  
Vol 86 (24) ◽  
Author(s):  
Camilla Costa Cypriano Schmitz ◽  
Ivonete Teresinha Shulter Buss Heinemann ◽  
Michelle Kuntz Durand

Pesquisa qualitativa, exploratório-descritiva que objetiva desvelar a atuação dos profissionais da Atenção Primáriaà Saúde acerca dos Determinantes Sociais de Saúde das práticas de promoção da saúde. A coleta de dados foirealizada de julho a outubro de 2015, com entrevistas semiestruturadas. Participaram 25 profissionais queatuavam na rede de Atenção Primária em Saúde do Município de Florianópolis, SC. Os dados foram analisados apartir da análise temática de Minayo e discutidos à luz da Promoção da Saúde e dos Determinantes Sociais. Osresultados indicaram que, tanto a academia quanto os gestores estão investindo na formação para a promoçãoda saúde, porém, ainda muito focada nos estilos de vida e pouco articulada com os Determinantes Sociais deSaúde. Os profissionais relataram atuar muito pouco sobre os dados determinantes e alguns não sabem o conceitode Determinação Social da Saúde. Observa-se que há carência de métodos que auxiliem a avaliação e efetividadeda atuação sobre a promoção da saúde, porém, os profissionais já conseguem visualizar mudanças positivas nasaúde da população. Conclui-se que os trabalhadores da Atenção Primária à Saúde têm consciência da necessidadede realizar e manter as práticas de promoção em sua rotina diária, a partir da interdisciplinaridade eintersetorialidade, considerando os Determinantes Sociais de Saúde da população.Palavras-chave: Promoção da Saúde; Determinantes Sociais da Saúde; Atenção Primária à Saúde; Estratégia Saúdeda Família.AbstractExploratory-descriptive qualitative research, which aims to reveal the performance of Primary Health Careprofessionals about the Social Determinants of Health promotion practices. Data collection was carried out fromJuly to October 2015, with semi-structured interviews. Participated 25 professionals who acted on the network ofPrimary Health Care in the city of Florianópolis, SC. Data were analyzed from the thematic analysis of Minayo anddiscussed in the light of the health promotion and social determinants. The results indicated that both theAcademy and managers, are investing in training for the health promotion, however, still very focused on lifestylesand little coordinated with the Social Determinants of Health. The professionals have reported too little acting ondeterminants data and some do not know the Social Determination of Health concept. It is observed that there isa lack of methods to aid the evaluation and effectiveness of action on health promotion, however, professionalscan show positive changes in the population’s health. It is concluded that the Primary Health Care workers areaware of the need to achieve and maintain promotional practices in your daily routine, from the interdisciplinaryand intersectoral approach, considering the Social Determinants of Health of the population.Keywords: Health Promotion; Social Determinants of Health; Primary Health Care; Family Health Strategy


2021 ◽  
Vol 74 (6) ◽  
Author(s):  
Alexa Pupiara Flores Coelho Centenaro ◽  
Carmem Lúcia Colomé Beck ◽  
Rosângela Marion da Silva ◽  
Andressa de Andrade ◽  
Marta Cocco da Costa ◽  
...  

ABSTRACT Objectives: to know how the social determinants of health relate to the context of life and work of recyclable waste pickers. Methods: a qualitative study, derived from Convergent-Care Research, conducted with waste pickers from two recycling associations in the South of Brazil. We used systematic participant observation, semi-structured interviews, and convergence groups. The analysis followed the steps of Seizure, Synthesis, Theorization, and Transfer. Results: advanced age, precarious self-care, gender inequalities, violence, and family conflicts have shown to be elements linked to the individual, behavioral, and social network determinants. Determinants connected to living and working conditions were related to poor access to education and formal work, as well as to the daily occupational risks in recycling. The lack of labor rights and public policies represented macro-determinants. Final Considerations: social and economic deficiencies are potentiated in the context of life and work of waste pickers, strongly related to their determinants.


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