scholarly journals The 4-Level Approach: Prevention of Suicidal Behaviour Through Community-Based Intervention

2021 ◽  
Vol 12 ◽  
Author(s):  
Ulrich Hegerl ◽  
Ines Heinz ◽  
Ainslie O'Connor ◽  
Hannah Reich
Keyword(s):  
Public Health ◽  
Primary Care ◽  
High Risk ◽  
Suicidal Behaviour ◽  
Lessons Learned ◽  
Community Based Interventions ◽  
Community Based ◽  
Four Levels ◽  
The Many ◽  
Different Levels

Due to the many different factors contributing to diagnostic and therapeutic deficits concerning depression and the risk of suicidal behaviour, community-based interventions combining different measures are considered the most efficient way to address these important areas of public health. The network of the European Alliance Against Depression has implemented in more than 120 regions within and outside of Europe community-based 4-level-interventions that combine activities at four levels: (i) primary care, (ii) general public, (iii) community facilitators and gatekeepers (e.g., police, journalists, caregivers, pharmacists, and teachers), and (iv) patients, individuals at high risk and their relatives. This review will discuss lessons learned from these broad implementation activities. These include targeting depression and suicidal behaviour within one approach; being simultaneously active on the four different levels; promoting bottom-up initiatives; and avoiding any cooperation with the pharmaceutical industry for reasons of credibility.

scholarly journals (A253) Integrated Community-Based Interventions to Overcome a Deadly Cholera Outbreak in Zimbabwe

2011 ◽  
Vol 26 (S1) ◽  
pp. s69-s70
Author(s):  
M.N. Yao
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
Behavior Change ◽  
Water Purification ◽  
Epidemiological Data ◽  
Lessons Learned ◽  
Cholera Outbreak ◽  
Community Based Interventions ◽  
Community Based ◽  
Health Threats

An unprecedented cholera outbreak affected Zimbabwe from August 2008 to July 2009 with 98,592 cases and 4,288 deaths, in 54 out of 62 districts. The main strategy used to overcome the outbreak was an integrated community-based interventions package. The present work is a case study to describe the strategy and lessons learned for future humanitarian crises and preparedness. The methodology was based on the review of epidemiological reports, assessment and surveys' reports, minutes of joint Health and Water Sanitation and Hygiene (WASH) Clusters' meetings, and direct observation as Health Cluster Coordinator. Epidemiological data showed an increasing number of cases in rural areas with community deaths representing 66% of the 1,948 deaths from 61,304 cases on 31 January 2009. Risk factors identified in communities were: lack of awareness about the disease, cultural and religious behaviors, lack of potable water with weak sanitation, lack and inappropriate use of water purification tablets, and lack of soap and water containers for effective behavior change. There also was late arrival to cholera to the few treatment centers by rural populations. In addition to treatment centers, a package of interventions was implemented by multi-sectoral stakeholders. The package included: health and WASH education tools and practice sessions for healthy and hygienic behavior change and for an effective use of oral rehydration salt as first aid measure; community-based surveillance with an early warning system and response teams; and distribution of containers and water purification tablets with drilling of water points. Epidemiological data showed a significant decrease of cholera cases where the full package was implemented. This work showed that an integrated package of interventions jointly targeting risk factors can be effective on public health threats in rural communities. Community-based preparedness and response should then take into account an integrated joint intervention package to mitigate public health threats.

scholarly journals Linkage to primary-care public health facilities for cardiovascular disease prevention: a community-based cohort study from urban slums in India

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e045997
Author(s):  
Abhijit Pakhare ◽  
Ankur Joshi ◽  
Rasha Anwar ◽  
Khushbu Dubey ◽  
Sanjeev Kumar ◽  
...  
Keyword(s):  
Public Health ◽  
Primary Care ◽  
Multivariate Analysis ◽  
Urban Slum ◽  
Primary Care Providers ◽  
Health Facilities ◽  
Care Providers ◽  
Community Based ◽  
Public Health Facilities ◽  
Care Facilities

ObjectivesHypertension and diabetes mellitus are important risk factors for cardiovascular diseases (CVDs). Once identified with these conditions, individuals need to be linked to primary healthcare system for initiation of lifestyle modifications, pharmacotherapy and maintenance of therapies to achieve optimal blood pressure and glycaemic control. In the current study, we evaluated predictors and barriers for non-linkage to primary-care public health facilities for CVD risk reduction.MethodsWe conducted a community-based longitudinal study in 16 urban slum clusters in central India. Community health workers (CHWs) in each urban slum cluster screened all adults, aged 30 years or more for hypertension and diabetes, and those positively screened were sought to be linked to urban primary health centres (UPHCs). We performed univariate and multivariate analysis to identify independent predictors for non-linkage to primary-care providers. We conducted in-depth assessment in 10% of all positively screened, to identify key barriers that potentially prevented linkages to primary-care facilities.ResultsOf 6174 individuals screened, 1451 (23.5%; 95% CI 22.5 to 24.6) were identified as high risk and required linkage to primary-care facilities. Out of these, 544 (37.5%) were linked to public primary-care facilities and 259 (17.8%) to private providers. Of the remaining, 506 (34.9%) did not get linked to any provider and 142 (9.8%) defaulted after initial linkages (treatment interrupters). On multivariate analysis, as compared with those linked to public primary-care facilities, those who were not linked had age less than 45 years (OR 2.2 (95% CI 1.3 to 3.5)), were in lowest wealth quintile (OR 1.8 (95% CI 1.1 to 2.9), resided beyond a kilometre from UPHC (OR 1.7 (95% CI 1.2 to 2.4) and were engaged late by CHWs (OR 2.6 (95% CI 1.8 to 3.7)). Despite having comparable knowledge level, denial about their risk status and lack of family support were key barriers in this group.ConclusionsThis study demonstrates feasibility of CHW-based strategy in promoting linkages to primary-care facilities.

scholarly journals Reducing unscheduled hospital care for adults with diabetes following a hypoglycaemic event: which community-based interventions are most effective? A systematic review

2021 ◽  
Author(s):  
Aoife Watson ◽  
Donna McConnell ◽  
Vivien Coates
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Integrated Care ◽  
Hospital Care ◽  
Hospital Admissions ◽  
Community Based Interventions ◽  
Community Based ◽  
Integrated Care Pathways ◽  
Effective Community ◽  
Balance Of Care

Abstract Aim To determine which community-based interventions are most effective at reducing unscheduled hospital care for hypoglycaemic events in adults with diabetes. Methods Medline Ovid, CINAHL Plus and ProQuest Health and Medical Collection were searched using both key search terms and medical subject heading terms (MeSH) to identify potentially relevant studies. Eligible studies were those that involved a community-based intervention to reduce unscheduled admissions in adults with diabetes. Papers were initially screened by the primary researcher and then a secondary reviewer. Relevant data were then extracted from papers that met the inclusion criteria. Results The search produced 2226 results, with 1360 duplicates. Of the remaining 866 papers, 198 were deemed appropriate based on titles, 90 were excluded following abstract review. A total of 108 full papers were screened with 19 full papers included in the review. The sample size of the 19 papers ranged from n = 25 to n = 104,000. The average ages within the studies ranged from 41 to 74 years with females comprising 57% of the participants. The following community-based interventions were identified that explored reducing unscheduled hospital care in people with diabetes; telemedicine, education, integrated care pathways, enhanced primary care and care management teams. Conclusions This systematic review shows that a range of community-based interventions, requiring different levels of infrastructure, are effective in reducing unscheduled hospital care for hypoglycaemia in people with diabetes. Investment in effective community-based interventions such as integrated care and patient education must be a priority to shift the balance of care from secondary to primary care, thereby reducing hospital admissions.

scholarly journals Primary care-public health linkages: Older primary care patients with prediabetes & type 2 diabetes encouraged to attend community-based senior centers

2016 ◽  
Vol 4 ◽  
pp. 283-288 ◽  
Author(s):  
Polly H. Noël ◽  
Michael L. Parchman ◽  
Erin P. Finley ◽  
Chen-Pin Wang ◽  
Mary Bollinger ◽  
...  
Keyword(s):  
Public Health ◽  
Type 2 Diabetes ◽  
Primary Care ◽  
Community Based ◽  
Senior Centers ◽  
Primary Care Patients

Psychological Science Into Practice During the COVID-19 Pandemic

2021 ◽  
Vol 26 (4) ◽  
pp. 387-396
Author(s):  
Eleni Karayianni ◽  
Tom Van Daele ◽  
Jasminka Despot-Lučanin ◽  
Josip Lopižić ◽  
Nicholas Carr
Keyword(s):  
Public Health ◽  
Mental Health ◽  
Professional Growth ◽  
European Federation ◽  
Evidence Based ◽  
Community Based Interventions ◽  
Community Based ◽  
The Public ◽  
The Third ◽  
Psychological Science

Abstract. The public health outbreak of the COVID-19 virus has hit all aspects of life as we know it. We found ourselves trying to solve several concurrent crises that have afflicted us. The European Federation of Psychologists’ Associations (EFPA) launched the Psychologists’ Support Hub to share resources among its members and beyond and promote the continuing adoption of psychological science to battle the pandemic. In the greater context of evidence-based practice (EBP), the best available evidence is what we turn to for help in our decision-making on how best to address different challenges. However, there are challenges in implementing EBP when the science is limited, and we are still expected to be effective and efficient as professionals. The article outlines the need for EBP during the pandemic. Three vignettes display how that can be done while identifying obstacles and recommending ways forward in the future. The first one relates to the development of e-mental health services in Belgium following the March 2020 lockdown. The second describes addressing the needs of older adults in Croatia when it was hit by two crises simultaneously – the March 2020 lockdown and a destructive earthquake. The third looks at how targeted community-based interventions in Norway directed at social change can positively impact times of crisis. Overall, the pandemic presents a unique opportunity for professional growth for researchers, trainers, practitioners, and policymakers alike. EFPA can play a pivotal role in EBP adoption.

Building a Public Health Law and Policy Curriculum to Promote Skills and Community Engagement

2016 ◽  
Vol 44 (S1) ◽  
pp. 30-34 ◽  
Author(s):  
Amy T. Campbell
Keyword(s):  
Public Health ◽  
Service Learning ◽  
Learning Strategy ◽  
Lessons Learned ◽  
Law Students ◽  
Health Law ◽  
Community Based ◽  
Public Health Law ◽  
Building Process ◽  
Effective Community

This article describes implementation of a longitudinal curriculum in public health law, building on doctrinal coursework with skills-based coursework and opportunities for interdisciplinary, community-based engagement and service learning. It specifically describes development of a Policy Practicum, giving an example of how law students can learn policy skills and skills of effective community coalition work through a healthy homes partnership, highlighting areas where the curriculum can incorporate interdisciplinary education. It offers lessons learned during the curriculum-building process, and concludes with a more intensive service-learning strategy through the development of a Policy Lab.

Framing Community-Based Interventions for Gun Violence: A Review of the Literature

2019 ◽  
Vol 44 (4) ◽  
pp. 259-270 ◽  
Author(s):  
Monte-Angel Richardson
Keyword(s):  
Public Health ◽  
Work Practice ◽  
Social Work Practice ◽  
Gun Violence ◽  
Health Concern ◽  
Review Of The Literature ◽  
Public Health Concern ◽  
Community Based Interventions ◽  
Community Based ◽  
Community Based Research

Abstract Social workers are uniquely situated to lead community-based efforts to reduce gun violence, which has been identified as a prevalent and pressing public health concern. The current literature, however, has not addressed the frameworks guiding community-based interventions for gun violence. In the present article, a systematic literature review examines frameworks used to support community-based interventions for gun violence and to evaluate their outcomes. The search found 13 articles—unique to gun violence interventions—organized by the frameworks shaping perceptions of gun violence and community-based research. The review assessed frameworks based on their relationship to intervention stage and study outcomes. Findings suggest that these community-based gun violence interventions are shaped by systems, public health, and community mobilization frameworks. The article discusses frameworks found to be associated with successful community-based interventions and explains how the findings are relevant to future social work practice and research.

Teaching Graduate Students to Evaluate Public Health Programs Through Community-Based Learning

2019 ◽  
Vol 6 (2) ◽  
pp. 119-127
Author(s):  
Brenda M. Joly
Keyword(s):  
Public Health ◽  
Program Evaluation ◽  
Core Competency ◽  
Learning Opportunities ◽  
Lessons Learned ◽  
Health Programs ◽  
Community Based ◽  
Public Health Programs ◽  
Public Health Professionals ◽  
Community Based Learning

Public health professionals are increasingly called on to demonstrate program evaluation skills, a core competency for the field. Learning opportunities that are connected to community organizations with identified evaluation needs give students meaningful opportunities to build and test new skills. When thoughtfully implemented, community-based learning benefits both the student and the community, yet there are several important considerations for designing a course that incorporates this feature. This article describes one approach for teaching graduate public health students how to conceptualize and write a comprehensive program evaluation plan for a community agency, based on the needs, priorities, and capacity of that agency. Lessons learned and recommendations for adopting this model are discussed.

The application of the complexity theory to public health interventions: a review of the literature

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
P Contu ◽  
E Breton
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Promotion ◽  
Complexity Theory ◽  
Health Care Services ◽  
Health Interventions ◽  
Review Of The Literature ◽  
Community Based Interventions ◽  
Community Based ◽  
Care Services

Abstract Background There is a growing recognition of the limitations of a linear cause-and-effect rationality in planning and evaluating public health interventions. Although this perspective is amenable to programme planning and evaluation, it leaves aside a whole array of mechanisms of change triggered by interactions taking place in complex social systems. Generative causality is one and recognized under a number of works referring to the complexity paradigm. Here we review the state of knowledge on what is often referred to as the complexity theory (CT), and present the results of a review of the literature on its application in public health. Methods We searched PubMed for articles, commentaries, editorials published in English, French and Italian, using the keywords 'Complexity Theory' (also plural). We categorized the fields of application of the CT according to the three core WHO's Essential Public Health Operations, i.e., Health Promotion, Prevention and Protection. All papers addressing issues related to health care services (but not prevention) were included in the category “health care services” while others were tagged as “others”. Results We found 203 papers meeting our inclusion criteria. The largest share of the research output applying the CT was in health care services (n = 167), followed by Health Promotion (5), Prevention (3) and Protection (2). 26 papers were labelled others. In health promotion/ prevention, applications of the CT have yet to integrate most of its concepts. Most authors tap into both the linear and generative rationality perspectives. Conclusions Although regularly deemed as promising in uncovering mechanisms for change triggered by public health intervention, applications of the complexity theory remain uncommon and has made little inroads in the public health domain. This is particularly the case for health promotion where one would assume that participatory community-based interventions would be an incentive to integrate this perspective. Key messages Although deemed promising the complexity theory has made little inroads in public health. Health promotion with its participatory community-based interventions can benefit from its application.

scholarly journals Nurse perspectives on the implementation of routine telemonitoring for high-risk diabetes patients in a primary care setting

2016 ◽  
Vol 18 (01) ◽  
pp. 3-13 ◽  
Author(s):  
Bonnie M. Vest ◽  
Victoria M. Hall ◽  
Linda S. Kahn ◽  
Arvela R. Heider ◽  
Nancy Maloney ◽  
...  
Keyword(s):  
Primary Care ◽  
High Risk ◽  
Real World ◽  
Hospital Admissions ◽  
Lessons Learned ◽  
Diabetic Patients ◽  
Structured Interviews ◽  
Economic Context ◽  
Care Practices ◽  
Primary Care Practices

Aims The purpose of this qualitative evaluation was to explore the experience of implementing routine telemonitoring (TM) in real-world primary care settings from the perspective of those delivering the intervention; namely the TM staff, and report on lessons learned that could inform future projects of this type. Background Routine TM for high-risk patients within primary care practices may help improve chronic disease control and reduce complications, including unnecessary hospital admissions. However, little is known about how to integrate routine TM in busy primary care practices. A TM pilot for diabetic patients was attempted in six primary care practices as part of the Beacon Community in Western New York. Methods Semi-structured interviews were conducted with representatives of three TM agencies (n=8) participating in the pilot. Interviews were conducted over the phone or in person and lasted ~30 min. Interviews were audio-taped and transcribed. Analysis was conducted using immersion-crystallization to identify themes. Findings TM staff revealed several themes related to the experience of delivering TM in real-world primary care: (1) the nurse–patient relationship is central to a successful TM experience, (2) TM is a useful tool for understanding socio-economic context and its impact on patients’ health, (3) TM staff anecdotally report important potential impacts on patient health, and (4) integrating TM into primary care practices needs to be planned carefully. Conclusions This qualitative study identified challenges and unexpected benefits that might inform future efforts. Communication and integration between the TM agency and the practice, including the designation of a point person within the office to coordinate TM and help address the broader contextual needs of patients, are important considerations for future implementation. The role of the TM nurse in developing trust with patients and uncovering the social and economic context within which patients manage their diabetes was an unexpected benefit.

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