Community-Based Elder Care: A Model for Working With the Marginally Housed Elderly

2007 ◽  
Vol 8 (2) ◽  
pp. 96-99 ◽  
Author(s):  
Loan Mai ◽  
Judy Eng
Keyword(s):  
Elder Care ◽  
Service Providers ◽  
Emotional Health ◽  
Interdisciplinary Teams ◽  
Community Based ◽  
Geriatric Population ◽  
Motor Functioning ◽  
Health Maintenance ◽  
Service Engagement ◽  
Marginally Housed

The community-based elder care (C-BEC) model is a critical treatment leverage that can be used to serve the older geriatric population who live in marginal housing tenements and who have little to nonexistent formal or informal support systems. Service engagement includes a model of care encompassing health maintenance with ongoing assessment of several specific dimensions. These dimensions include motor functioning, environmental barriers, emotional health, supportive services, and adherence motivation. All of these effect outcome and treatment course, despite a variety of medical diagnosis, level of functioning, and supportive needs. From evaluation of the individuals described in this article, considerations for collaborative treatment relationships, interdisciplinary teams, and service assessments are recognized as focal points of change that can be facilitated with C-BEC. The model is replicable and recommended for service providers working with an ambulatory, homebound, frail, and older aged population.

Beyond Responsivity: Client Service Engagement in a Reentry Demonstration Program

2018 ◽  
Vol 62 (13) ◽  
pp. 4295-4313 ◽  
Author(s):  
Nicole M. Sachs ◽  
Joel Miller
Keyword(s):  
Learning Style ◽  
Service Providers ◽  
Case Managers ◽  
Demonstration Program ◽  
Community Based ◽  
Service Engagement ◽  
And Gender ◽  
Dispositional Factors ◽  
Employment Needs ◽  
Responsivity Principle

The specific responsivity principle advises us to provide offenders with treatment that takes into account their responsiveness to treatment, tied for example to their learning style, motivation, and gender. We examine challenges to service engagement and attendance in a community-based program in a reentry setting, and consider how far they correspond with these factors. Drawing on qualitative accounts of parolee engagement in services provided by parolees, service providers, case managers, and parole officers, we identify a number of difficulties faced by clients. These include logistical factors that affect clients’ physical ability to enroll in or attend programming (such as documentation, employment needs, and transportation problems) as well as elements of program and service delivery (such as client–provider matching, therapeutic style, and curriculum factors). We conclude that we should look beyond responsivity and consider logistical factors alongside the better-recognized psychological and dispositional factors, to understand client engagement in the context of reentry.

scholarly journals Implementing community-based health promotion in socio-economically disadvantaged areas: a qualitative study

2019 ◽  
Vol 42 (4) ◽  
pp. 839-847
Author(s):  
Emma R Lawlor ◽  
Margaret E Cupples ◽  
Michael Donnelly ◽  
Mark A Tully
Keyword(s):  
Health Promotion ◽  
Economically Disadvantaged ◽  
Local Community ◽  
Service Providers ◽  
Economic Status ◽  
Structured Interviews ◽  
Community Based ◽  
Related Factors ◽  
Service Engagement ◽  
Health Initiatives

Abstract Background There is a gradient relationship between socio-economic status and health. We investigated the views and perceptions of health promotion service providers regarding factors that affect lack of engagement in public health initiatives by residents in socio-economically disadvantaged (SED) communities. Methods We conducted semi-structured interviews with a purposive sample of key providers (n = 15) of community-based health promotion services to elicit their views about engagement-related factors and their experiences of the provision, delivery and impact of health promotion in SED areas. Interviews were analysed using thematic analysis. Results Failure to (i) recognise within SED communities, socio-cultural norms of health-related behaviour and (ii) communicate to local residents an understanding of complex lifestyle influences appeared to affect adversely service engagement and contribute to the development of negative attitudes towards health promotion. Engagement is more likely when services are delivered within familiar settings, peer support is available, initiatives are organized within existing groups, external incentives are offered and there are options regarding times and locations. Collaborative working between providers and communities facilitates efficient, context-sensitive service delivery. Conclusions Knowledge of a local community and its socio-environmental context alongside a collaborative, facilitative and tailored approach to delivery are required to ensure successful engagement of SED communities in health promotion.

CHALLENGES TO BUILDING AUTHENTIC PARTNERSHIPS: LESSONS FROM BHAMBAYI, KWAZULU-NATAL, SOUTH AFRICA

2017 ◽  
Vol 26 (2) ◽  
pp. 124-140 ◽  
Author(s):  
Tanusha Raniga ◽  
Barbara Simpson ◽  
Ntokozo Mthembu
Keyword(s):  
South Africa ◽  
Social Services ◽  
Service Providers ◽  
Informal Settlement ◽  
Mutual Trust ◽  
Open Communication ◽  
Community Based ◽  
Individual Interviews ◽  
Kwazulu Natal ◽  
Qualitative Phase

In contemporary South Africa, partnerships between service providers in government, non-governmental organisations, the private sector and community based organisations have been identified as a means to strengthen communities and the sustainability of social services. However, the unequal power relations that exists between and within these organisations often leads to fragmentation, duplication, and lack of coordination of social services. Using Fowler’s (1998) conceptualisation of authentic partnerships, this qualitative phase of a larger study explored the challenges of building authentic partnerships in Bhambayi, a predominantly informal settlement in KwaZulu-Natal, South Africa. Individual interviews and a focus group held with nine service providers revealed that intraorganisational challenges, cross-boundary and inter-organisational relations as well as political influences were obstacles to the development of authentic partnerships. The article suggests that open communication, clarity of roles and mutual trust between service providers is vital.

A Community-based Addiction Rehabilitation Electronic System to Improve Recovery Outcomes in Patients with Drug Use Disorder: Protocol for a Randomized Controlled Trial (Preprint)

2018 ◽  
Author(s):  
Zhe WANG ◽  
Shujuan CHEN ◽  
Junning CHEN ◽  
Chunfeng XU ◽  
Zhikang CHEN ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Drug Use ◽  
Illicit Drug ◽  
Service Providers ◽  
Controlled Trial ◽  
Electronic System ◽  
Community Based ◽  
Randomized Controlled ◽  
Community Rehabilitation ◽  
Drug Use Disorder

BACKGROUND Relapse is very common in patients with illicit drug use disorder and contributes to a series of bad consequences that substantially impact their physical and social functions. Due to the limited existence of effective addiction treatment, the majority of patients with drug use disorder could not access help when needing. Mobile health (mHealth) offers a potential solution to improving recovery outcome for patients in community. OBJECTIVE This paper is a protocol for a randomized controlled trial (RCT) of a smart phone application called community-based addiction rehabilitation electronic system (CAREs). This interactive system consists of an APP for clients and a webpage for service providers, with the aim of teaching clients craving and emergency coping skills and helping service providers to improve their work efficiency and effectiveness in community. METHODS A randomized controlled trial (RCT) will be conducted. Sixty drug illicit users who are newly ordered to undergo community rehabilitation will be recruited from the community in Shanghai. Participants will be 1:1 randomly assigned to receive integrated community rehabilitation by using CAREs or only receiving routine community rehabilitation for 6 months. Corresponding anti-drug social workers will provide service and monitor their drug use behavior in accordance with the routine work-flow. Outcomes will be assessed at baseline and in the 6th month. The primary study outcome is the performance on illicit drug urine test which will be carried on regularly twice per week during the study period. Secondary study outcomes include longest duration of sustained abstinence, days that participants interact with anti-drug social workers, and the decrease rate of addiction-related issues severity index. RESULTS Recruitment is currently underway with the aim of recruiting 60 subjects with drug use disorder. Recruitment will continue until the end of 2018. CONCLUSIONS This is the first known trial of a smartphone-based psychotherapy program for improving recovery outcomes in illicit drug users in community. The study provides evidence for the feasibility and effectiveness of the "CAREs" system through comparing the results of the intervention group with the control group. This paper describes the design and methodology of the study. CLINICALTRIAL ClinicalTrials.gov NCT03451344, https://clinicaltrials.gov/ct2/show/NCT03451344

scholarly journals Engaging young people in the design of a sexual reproductive health intervention: Lessons learnt from the Yathu Yathu (“For us, by us”) formative study in Zambia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Melvin Simuyaba ◽  
Bernadette Hensen ◽  
Mwelwa Phiri ◽  
Chisanga Mwansa ◽  
Lawrence Mwenge ◽  
...  
Keyword(s):  
Young People ◽  
Reproductive Health ◽  
Iterative Process ◽  
Service Use ◽  
Service Providers ◽  
Peer Pressure ◽  
Post Exposure Prophylaxis ◽  
Community Based ◽  
Research Activities ◽  
Lessons Learnt

Abstract Background Meeting the sexual and reproductive health (SRH) needs of adolescents and young people (AYP) requires their meaningful engagement in intervention design. We describe an iterative process of engaging AYP to finalise the design of a community-based, peer-led and incentivised SRH intervention for AYP aged 15–24 in Lusaka and the lessons learnt. Methods Between November 2018 and March 2019, 18 focus group discussions, eight in-depth interviews and six observations were conducted to assess AYP’s knowledge of HIV/SRH services, factors influencing AYP’s sexual behaviour and elicit views on core elements of a proposed intervention, including: community-based spaces (hubs) for service delivery, type of service providers and incentivising service use through prevention points cards (PPC; “loyalty” cards to gain points for accessing services and redeem these for rewards). A total of 230 AYP (15 participated twice in different research activities) and 21 adults (only participated in the community mapping discussions) participated in the research. Participants were purposively selected based on age, sex, where they lived and their roles in the study communities. Data were analysed thematically. Results Alcohol and drug abuse, peer pressure, poverty, unemployment and limited recreation facilities influenced AYP’s sexual behaviours. Adolescent boys and young men lacked knowledge of contraceptive services and all AYP of pre and post exposure prophylaxis for HIV prevention. AYP stated a preference for accessing services at “hubs” located in the community rather than the health facility. AYP considered the age, sex and training of the providers when choosing whom they were comfortable accessing services from. PPCs were acceptable among AYP despite the loyalty card concept being new to them. AYP suggested financial and school support, electronic devices, clothing and food supplies as rewards. Conclusions Engaging AYP in the design of an SRH intervention was feasible, informative and considered responsive to their needs. Although AYP’s suggestions were diverse, the iterative process of AYP engagement facilitated the design of an intervention that is informed by AYP and implementable. Trial registration This formative study informed the design of this trial: ClinicalTrials.gov, NCT04060420. Registered 19 August, 2019.

scholarly journals All Is Good, but Not Really: Daily Reports of Satisfaction With Home- and Community-Based Services

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 639-640
Author(s):  
Jyoti Savla ◽  
Karen Roberto ◽  
Aubrey Knight ◽  
Rosemary Blieszner ◽  
Brandy Renee McCann ◽  
...  
Keyword(s):  
Service Use ◽  
Service Providers ◽  
Theory And Practice ◽  
Community Based ◽  
Daily Diaries ◽  
Rural Caregivers ◽  
Service Expectations ◽  
Extensive Body ◽  
Barriers To Health ◽  
Community Based Services

Abstract An extensive body of literature documents correlates of and barriers to health service use, yet much less is known about satisfaction with home- and community-based services for persons with dementia (PwD). Daily diary data from 122 rural caregivers (CG) of PwD (814 daily diaries) were used to assess everyday service use experiences. At the last diary interview, CG identified areas where service use expectations were and were not being met. CGs reported problems with services used on fewer than 5% of study days (e.g., service provider was delayed because of car trouble). In contrast, 82% of CG identified areas where service expectations were not being met. Their most common concerns were lack of control over service availability and lack of adequate training among service providers. Recommendations for alternative ways for capturing service use satisfaction will be offered, and implications for theory and practice will be discussed.

scholarly journals Physical Mistreatment in Persons with Alzheimer’s Disease

2013 ◽  
Vol 2013 ◽  
pp. 1-10 ◽  
Author(s):  
Carla VandeWeerd ◽  
Gregory J. Paveza ◽  
Margaret Walsh ◽  
Jaime Corvin
Keyword(s):  
Risk Factors ◽  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Conflict Resolution ◽  
Physical Violence ◽  
Emotional Health ◽  
Alcohol Problems ◽  
Community Based ◽  
Conflict Resolution Strategy ◽  
Resolution Strategy

Physical mistreatment has been estimated to affect 2 million older persons each year and dramatically affects health outcomes. While researchers have attempted to examine risk factors for specific forms of abuse, many have been able to focus on only victim or perpetrator characteristics, or a limited number of psychosocial variables at any one time. Additionally, data on risk factors for subgroups such as persons with Alzheimer’s disease who may have heightened and/or unique risk profiles has also been limited. This paper examines risk for physical violence in caregiver/patient dyads who participated in the Aggression and Violence in Community-Based Alzheimer’s Families Grant. Data were collected via in-person interview and mailed survey and included demographics as well as measures of violence, physical and emotional health, and health behaviors. Logistic regression analysis indicated that caregivers providing care to elders with high levels of functional impairment or dementia symptoms, or who had alcohol problems, were more likely to use violence as a conflict resolution strategy, as were caregivers who were providing care to elders who used violence against them. By contrast, caregivers with high self-esteem were less likely to use violence as a conflict resolution strategy. Significant interaction effects were also noted.

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