Measuring the diffusion of innovative health promotion programs

Once a health promotion program has proven to be effective in one or two initial settings, attempts may be made to transfer the program to new settings. One way to conceptualize the transference of health promotion programs from one locale to another is by considering the programs to be innovations that are being diffused. In this way, diffusion of innovation theory can be applied to guide the process of program transference. This article reports on the development of six questionnaires to measure the extent to which health promotion programs are successfully disseminated: Organizational Climate, Awareness-Concern, Rogers's Adoption Variables, Level of Use, Level of Success, and Level of Institutionalization. The instruments are being successfully used in a study of the diffusion of health promotion/tobacco prevention curricula to junior high schools in North Carolina. The instruments, which measure the four steps of the diffusion process, have construct validity since they were developed within existing theories and are derived from the work of previous researchers. No previous research has attempted to use instruments like these to measure sequentially the stages of the diffusion process.     

Establishing an innovative model of nutrition and dietetic care for a mental health service through collaboration with non-nutrition healthcare workers

Aim:  To describe the process of the development of the Web-based resources to extend nutrition care to mental health patients through existing non-nutrition mental healthcare professionals (case-managers).
Methods:  A formative approach was used to identify nutrition-related issues faced by both patients and staff through a synthesis of literature review, professional experience and clinical observations. Decision-making tools to assist case-managers in selecting resources were developed to guide case-managers' choice of effective evidence-based health education materials on the hospital intranet. Practical training was provided for case-managers during their orientation to the new website and the tools and resources it housed.
Results:  A Web-based nutrition site was created on the Royal Brisbane and Women's Hospital intranet. The website consisted of a Nutrition Referral Action Plan (a patient support triaging flowchart), a Nutrition Support Action Plan (action-based nutrition support tool to guide resource selection) and thirteen action-based nutrition education resources.
Conclusion:  By maximising established patient contact through existing health professionals, a Web-based approach to nutrition service delivery was an innovative method for delivering patient information. This collaborative action-based strategy has the potential to raise the nutrition profile in mental health and extend nutrition services to at-risk patients not previously receiving nutrition care.     

Evaluating the effectiveness of an innovative community/public health nursing simulation: a mixed methods study

Aim

The purpose of this study was to evaluate the design and effectiveness of an innovative community/public health nursing simulation.

Subject and methods

This mixed methods study (N?=?143) consisted of community health nursing students from two cohorts at a Midwestern, urban, public university at the end of fall 2018 (n?=?89) and winter 2019 (n?=?54) semesters. The simulation was conducted at a local simulation center. The topic was sexually transmitted diseases (STDs)/sexually transmitted infections (STIs). After being consented, students completed a pretest; the prebrief occurred next, and then the simulation was conducted, followed by the debrief. Students then completed a posttest and simulation design evaluation scale. Quantitative data were analyzed using Statistical Package for the Social Sciences (SPSS); qualitative data underwent thematic analysis.

Results

The results showed that the majority of participants’ knowledge increased as a result of the simulation experience, and indicated what they learned and felt was most helpful. The findings also revealed that the majority of participants positively evaluated the simulation design.

Conclusion

This research provides support for the effectiveness of this innovative community/public health nursing simulation in increasing students’ knowledge about community/public health nursing, and improving community health nursing education.

     

Mining treatment termination data in an adolescent mental health service: a quantitative study

This study utilizes available clinical information from client records to explore patterns of termination from mental health treatment among adolescents at an urban outpatient mental health center. The analysis focuses on how and why adolescents terminate from treatment and identifies variables associated with "acknowledged" and "unacknowledged" terminations. Findings indicate that termination was acknowledged infrequently, often a brief process that occurred almost as frequently by telephone as in the context of treatment. Contrary to "practice wisdom" concerning treatment termination, adolescents who "dropped out" without a "clinical process" reported considerably more engagement in treatment than those who acknowledged the termination of treatment. Recommendations for a more "open door" policy and a more flexible practice with adolescents are discussed.     

社区卫生服务中心实施品牌战略的探讨

介绍了上海市闸北区临汾社区卫生服务中心在体制创新和加强质量管理的基础上,大胆实施社区卫生服务品牌战略,通过设计独特醒目的视觉标识,创新鲜明的服务理念,造就良好舒适的就医环境,建立素质过硬的人员队伍,提供特色鲜明、优质、独特的卫生服务,开展适度的宣传策略等举措,提高了社区卫生服务中心的知名度和美誉度,促进了人才培养和科学研究,取得了明显的经济效益和社会效益.     

城市基本公共卫生服务项目实施过程情况分析

目的 对基本公共卫生服务过程进行分析,获取其执行过程中存在的问题。方法对黑龙江、安徽和广东省29家社区卫生服务机构,采用深入访谈法和问卷调查进行数据收集。结果 政府基本公共卫生服务经费拨款为15元/人的占51.72%;3个省社区平均每万人口数与公卫医师的配比为0.25、0.25、0.35,正式编制人员数仅占44.15%;在9项基本公共卫生服务中,建立居民健康档案、健康教育、老年人保健和慢性病管理的覆盖率达到了100%,慢性病患者的管理率仅约为40%及重性精神病管理率低于10%,新生儿访视率、孕产妇产前管理率和产后访视率均约为20%;居民对基本公共卫生服务项目的知晓率仅为42.62%。结论 所调查社区卫生服务机构基本公共卫生服务项目开展不均衡,在\     

加强社区医学科学研究 提升卫生服务内涵质量

为进一步培养和提高社区卫生服务医务人员的综合素质，提升社区卫生服务中心的工作水平。作者阐述了社区卫生服务医务人员课题研究的意义，总结了社区卫生服务医务人员课题研究设计的现状，指出了社区卫生服务医务人员课题研究设计方面的问题，并对如何提高社区卫生服务医务人员素质和课题设计提出建议。     

社区卫生服务工作初探

选取西宁市城中区作为样本,通过创建全国社区卫生服务示范区工作,基本构筑了城市社区居民新型基本医疗卫生保障体系。初步探讨了城市社区卫生服务工作模式,使社区卫生服务综合能力得到明显提高,社会效益和经济效益同步提高,社区居民健康保健意识和参与意识增强。     

Defining excellence in health service management: evidence from an international study

Health service executives are striving to implement the best managerial practices amid the major turbulence and restructuring which is prevalent in many health care systems today. All too often, guidance about what the best practices are needs to be sought from studies contained within the general management literature. It is problematical whether this literature is applicable to health service organizations. This article reports the results of a study which examined the views of 93 executives in 14 hospitals in Britain, Canada and the United States about what constitutes managerial excellence. The hospitals were selected on the basis of their reputed success in health service management. Using grounded theory methodology, eight factors of excellence were derived from the interview data which were supplemented by data made available from hospital documentation supplied by participants. The results of this study are compared with those of Peters and Waterman (1982). This is the most frequently cited study of managerial excellence in the general management literature. The main conclusions drawn are that a current definition of health service management excellence has been identified; there was a high degree of unanimity among participant executives about the constituents of success and excellence in health service management; and, that there are some marked differences between this definition of excellence and that propounded by Peters and Waterman (1982). The implications of this definition of excellence for health service executives are discussed.     

The health status of an ambulance service

The purpose of the study was to evaluate the current healthstatus of male ambulance personnel based in Belfast, takingthe opportunity to compare results with those from a comparablelocal survey of the general population. Risk factors for coronaryheart disease were assessed. Ninety-three men were studied.Blood pressure values were significantly higher (P<0.05)in the present study than in a comparable local survey of thegeneral population, with 23 per cent of systolic values beingover 140 mmHg and 27 per cent of diastolic readings being over90 mmHg. The incidence of self-reported smoking was also higherin the ambulance service (36 per cent) compared with the localpopulation (31 per cent). Computation of body mass indices forambulancemen showed that 52 per cent of personnel fell outsidethe acceptable range of 20–25 kg/m² with 10 per cent beinggreater than 30 kg/m², recognized as the threshold of clinicalobesity. With regard to serum cholesterol, 52 per cent of personnelexceeded the desirable threshold of 5.2 mmol/l, while 18 percent were above 6.4 mmol/l. In addition, the high density lipoproteinfraction was significantly lower (P<0.05) in the ambulancemencompared with the general population (mean±SEM: 1.10±0.3vs. 1.18±0.01, respectively). Although 54 per cent ofthe sample claimed to be physically active, only 35 per centreportedly took sufficient exercise to be of benefit to theirhealth. Cardiorespiratory fitness was significantly higher inthis group. The ambulance service nationally remains the onlyemergency service without a strategy for health and fitness.The results of the present study justify consideration of sucha programme.     

Evaluation of planning and implementation for an innovative health centre

The South Calgary Health Centre, a new venture for the Calgary Health Region, was mandated to be an accessible, integrated, community-based health services facility. A comprehensive evaluation provided details on planning and implementation. Functional integration was a large focus of the planning and was operationalized as central admitting, shared charts, shared space and co-location of clinical services with no history of integration. Challenges are discussed and recommendations for future health centres developed.