Theoretical basis and program design of a school-based mental health intervention for traumatized immigrant children: a collaborative research partnership

This article describes a collaborative research model for school-based mental health services that targets children who are recent immigrants with violence-related mental health symptoms. The model describes a conceptual framework used in the establishment of an academic-community partnership during the development, evaluation, and implementation of the Mental Health for Immigrants Program (MHIP), a school-based mental health intervention. The article discusses the challenges that occurred and provides specific examples of how a participatory research partnership may work together through all program phases—design through implementation and program evaluation—to meet a specific community's needs and produce generalizable knowledge. The challenges and limitations of collaborative research approaches also are discussed, with particular emphasis on the role of participatory research in the development and evaluation of school-based mental health programs.     

Social cohesion through football: a quasi-experimental mixed methods design to evaluate a complex health promotion program

Social isolation and disengagement fragments local communities. Evidence indicates that refugee families are highly vulnerable to social isolation in their countries of resettlement. Research to identify approaches to best address this is needed. Football United is a program that aims to foster social inclusion and cohesion in areas with high refugee settlement in New South Wales, Australia, through skills and leadership development, mentoring, and the creation of links with local community and corporate leaders and organisations. The Social Cohesion through Football study's broad goal is to examine the implementation of a complex health promotion program, and to analyse the processes involved in program implementation. The study will consider program impact on individual health and wellbeing, social inclusion and cohesion, as well as analyse how the program by necessity interacts and adapts to context during implementation, a concept we refer to as plasticity. The proposed study will be the first prospective cohort impact study to our knowledge to assess the impact of a comprehensive integrated program using football as a vehicle for fostering social inclusion and cohesion in communities with high refugee settlement.     

Measuring key integration outcomes: a case study of a large urban health center

BACKGROUND: Health care reform, through innovative health delivery systems, has been a high priority to address staff shortages, increasingly complex care needs of the aging population, and fragmentation of care. Community health centers have been promoted as one service delivery model with large potential for integration and collaboration. The South Calgary Health Centre (SCHC) opened in June 2004 with the mandate to provide a new model for accessible, accountable, integrated, and community-based health services. PURPOSE: The primary objective was to determine the performance of the SCHC; and further, to establish the value of the evaluation framework used in measuring organizational performance of an integrated service delivery model. METHODOLOGY: Multiple stakeholders were involved in the evaluation in a utilization-focused, participatory way. A comprehensive evaluation framework was developed and implemented to assess the performance of the SCHC at system, provider, and patient levels. Functional, clinical, and community integration were key systems outcomes within this framework. Case-study methodology with mixed methods drawing on multiple data sources (both qualitative and quantitative) was used. FINDINGS: The evaluation findings suggest that the center is functioning well and that staff and client satisfaction are high. Although the model has not achieved all that was originally intended (i.e., fully realized clinical integration), participants felt that the model has been successful and has great potential for integration. The comprehensive evaluation framework developed for this project proved useful in assessing different aspects of integration as well as provider and client perceptions of the center's performance. PRACTICE IMPLICATIONS: Evaluation findings and recommendations have been used to inform operations at the SCHC and for the planning of future health centers. The evaluation framework may help to standardize evaluation approaches across projects and can be used for monitoring progress of the SCHC as well as future evaluations of integrated service delivery models.     

Using the Model of Human Occupation to Conceptualize an Occupational Therapy Program for Blind Persons in South Africa

The diversity within South African society encourages innovative occupational therapy practice. This paper illustrates how the Model of Human Occupation (MOHO) was used as a guiding framework for an innovative program for unemployed blind adults. The program allowed these clients to participate in income-generating projects and illustrates how factors related to South Africa's cultural, economic, and social conditions influence the use of MOHO in occupational therapy practice.     

Faith wellness collaboration: a community-based approach to address type II diabetes disparities in an African-American community

Community-based participatory action research was utilized to form a collaboration that developed a Health Ministry program in four Northeastern urban Black Churches, in which they designed and implemented a culturally competent Type II Diabetes self management education program. Minister sponsorship and a program coordinator synchronized the four Health Ministries' development and diabetes program planning. A case study design, and participant observations and a focus group methodology were used to explore the faith-based community residents' collaboration development, and design and implementation of the health promotion program. The implementation process can be described as occurring in four essential elements: (1) the development of the health ministry in each of the four churches; (2) the process in which the four ministries coordinated their activities to create the diabetes education program; (3) the process of delivering the diabetes education program; and (4) the challenges in promoting the diabetes education program across the community. Practice implications, as well as cultural competency issues related to social work practice with faith-based organizations and African-American communities, are also presented.     

Social participation in health services: concepts of users and community leaders in two municipalities of Northeastern Brazil

Social participation in management of the health care system at different levels of government is one of the key policies promoted by the Unified National Health System (SUS) in Brazil. As with any new policy, success hinges on several factors such as stakeholders' interests and opinions, which have not always been considered in the past. This paper analyzes the underlying concepts of two groups of stakeholders with respect to social participation in health and the potential influence of these concepts on the effectiveness of policy implementation. A case study of two municipalities in Northeast Brazil was conducted using a combination of qualitative and quantitative social science research methods. Health services users and community leaders were interviewed. Various concepts were found in which the participatory approach to health policies was only partially reflected. Likely influences on stakeholders' concepts of social participation in health are the evolution of the broader Brazilian social context and the traditional performance of health services. Particular attention should be paid to stakeholders' opinions and concepts if policy effectiveness is to be improved.     

Implementing a Mental Health Ministry Committee in Faith-Based Organizations: The Promoting Emotional Wellness and Spirituality Program

Social workers have successfully collaborated with African-American faith-based organizations to improve health outcomes for numerous medical conditions. However, the literature on Faith-Based Health Promotion for major depression is sparse. Thus, the authors describe a program used to implement a Mental Health Ministry Committee in African-American churches. Program goals are to educate clergy, reduce stigma, and promote treatment seeking for depression. Key lessons learned are to initially form partnerships with church staff if there is not a preexisting relationship with the lead pastor, to utilize a community-based participatory approach, and to have flexibility in program implementation.     

Health is Wealth: Methods to Improve Attendance in a Lifestyle Intervention for a Largely Immigrant Filipino-American Sample

Diabetes prevention requires lifestyle changes, and traditional educational programs for lifestyle changes have had low attendance rates in ethnic populations. This article describes the development and implementation of an educational program, emphasizing retention strategies, cultural tailoring and community participation. Community-based participatory research approaches were used to adapt and test the feasibility of a culturally tailored lifestyle intervention (named Health is Wealth) for Filipino-American adults at risk for diabetes (n = 40) in order to increase program attendance. A unique feature of this program was the flexibility of scheduling the eight classes, and inclusion of activities, foods and proverbs consistent with Filipino culture. We found that with this approach, overall program attendance for the experimental and wait-listed control groups was 88% and participant satisfaction was high with 93% very satisfied. Flexible scheduling, a bilingual facilitator for the classes, and the community-academic partnership contributed to the high attendance for this lifestyle intervention.     

Collective health and regional integration in Latin America: An opportunity for building a new international health agenda

ABSTRACT

From its origins, the Latin American Social Medicine and the Collective Health (LASM/CH) movements have focused on thinking about health from and for the region. After the implementation of neoliberal policies, social improvements and the geopolitical strengthening of the region became the roots of new regional integration projects in South America. The objective of this article is twofold. First, we explore the legacy of long-standing efforts in the region that address the social and political dimensions of health, associated with the LASM/CH movements and their influence on the contemporary regional health agenda. Second, we analyze the UNASUR Health policy, its role in the construction of a regional health agenda, and the principles of South-South cooperation it supports. In order to accomplish this, a qualitative analysis was conducted, involving primary and secondary data. Through UNASUR, a new framework of regional health integration and regional health diplomacy emerged in South America and a ‘window of opportunity’ opened for the ideas of Social Medicine and Collective Health to occupy a dominant place on the regional health agenda. It is possible to observe a confluence between the principles and values of these movements and those of the main constituent bases of UNASUR Health.     

Faith Wellness Collaboration: A Community-Based Approach to Address Type II Diabetes Disparities in an African-American Community

Community-based participatory action research was utilized to form a collaboration that developed a Health Ministry program in four Northeastern urban Black Churches, in which they designed and implemented a culturally competent Type II Diabetes self management education program. Minister sponsorship and a program coordinator synchronized the four Health Ministries' development and diabetes program planning. A case study design, and participant observations and a focus group methodology were used to explore the faith-based community residents' collaboration development, and design and implementation of the health promotion program. The implementation process can be described as occurring in four essential elements: (1) the development of the health ministry in each of the four churches; (2) the process in which the four ministries coordinated their activities to create the diabetes education program; (3) the process of delivering the diabetes education program; and (4) the challenges in promoting the diabetes education program across the community. Practice implications, as well as cultural competency issues related to social work practice with faith-based organizations and African-American communities, are also presented.     

科学构建我国疾病预防控制绩效考核框架

介绍了科学构建疾病预防控制绩效考核框架的研究思路、方法与基本步骤：首先运用系统论和卫生系统宏观模型等方法初步形成考核的系统框架,包括社会环境、工作基础、工作过程、系统结果和健康结果5个维度;在此基础上借鉴层次结构分析理论和卫生系统宏观模型＂子模—概念/维度—指标＂的思路,实现对考核框架的层次化和条理化;经过反复的专家咨询与论证,确保了构建的考核框架与疾病预防控制工作紧密结合,实现对疾病预防控制绩效的系统表达,为确立绩效考核指标体系勾勒了框架范围。     

The Health Action Fund: a community-based approach to enhancing health

This article is based on a program that was developed by the Center for Healthy Communities (CHC), a community-academic partnership in Dayton, Ohio, that continues to act as a force for change in health professions' education and health delivery, stressing the philosophy of "doing with" instead of "doing for" or "doing to." The Health Action Fund is a grassroots health communications and social marketing program that targets community groups who are involved often in health promotion activities developed by large agencies. However, rather than taking the traditional approach to health promotion and prevention where program development and implementation is left to professionals, a different approach was taken that encourages members of neighborhoods, a community group, or a church to identify a problem and then develop a way to address that problem for their group. The program focuses on neighbors helping neighbors where communities take the lead in health promotion and prevention activities. We discuss in detail the project's innovation, challenges and how they have been addressed, qualitative and quantitative improvements made to the program, and how the program serves as a model for other communities.     

Implementing the Public Health Social Work Forward Plan: a research-based prevention curriculum for schools of social work.

In 1985, the Division of Maternal and Child Health of the U.S. Public Health Service funded a major working conference entitled "Public Health Social Work in Maternal and Child Health: A Forward Plan." Curriculum recommendations for schools of social work were made, including a recommendation for the integration of health and mental health content in the education of social workers within a public health conceptual framework. In 1986, the National Institute of Mental Health funded a three-year program to develop and evaluate a research-based prevention training curriculum for dissemination to schools of social work and other primary care professional schools. This article examines the Michigan Prevention Training and Curriculum Development Project from the perspective of the recommendations of the Public Health Social Work Forward Plan.     

Implementation of a school environment intervention to increase physical activity in high school girls

Physical activity levels begin to decline in childhood and continue falling throughout adolescence, with girls being at greatest risk for inactivity. Schools are ideal settings for helping girls develop and maintain a physically active lifestyle. This paper describes the design and implementation of 'Lifestyle Education for Activity Program', or LEAP. LEAP used a health team approach with participatory strategies to provide training and support, instructional capacity building and opportunities to adapt school instructional program and environmental supports to local needs. The social-ecological model, based on social cognitive theory, served as the organizing framework for the LEAP intervention and elements of the coordinated school health program model as intervention channels. For the 12 intervention schools, LEAP staff documented 191 visits and interactions with 850 individuals over the 2-year period. Teachers reported successful implementation of most components of the intervention and demonstrated optimism for sustainability. These results indicate that a facilitative approach to intervention implementation can be used successfully to engage school personnel, and to change instructional programs and school environments to increase the physical activity level of high school girls.     

Qualität in Prävention und Gesundheitsförderung

Following the principles of participatory health research, a collaborative study was conducted by the German Federal Association for Prevention and Health Promotion (BVPG) and the Institute for Social Health at the Catholic University of Applied Sciences Berlin (KHSB). The purpose of the study was to create a framework for the members of the BVPG for taking joint action on developing the quality of health promotion and prevention measures. The 129 members of the BVPG are mainly nongovernmental organizations responsible for the implementation and coordination of prevention and health promotion interventions at the state and national levels. One of the explicit goals of the BVPG is to support the development of quality in prevention and health promotion. A theoretical sample was drawn of 14 member organizations to participate in individual interviews and a Delphi process to gather data on their current quality development practice, their need for further support, and their ideas for a common framework. Selected results from the interviews and the proposed framework are presented here.     

Bienestar: A Diabetes Risk-Factor Prevention Program

ABSTRACT: The Bienester Health Program, a diabetes risk-factor prevention pilot program, targeted fourth grade Mexican American children. The primary goals are to decrease the two established risk factors for diabetes — overweight and dietary fats. Since the health program is based on Social Cognitive Theory, on social systems structure, and on culturally relevant material, it considers the child's social systems on both its health program and process evaluation. Learning activities were developed for four social systems that potentially influence children's health behaviors (parent, classroom, school cafeteria, and after-school care). Preliminary results show that the Bienestar Health Program significantly decreased dietary fat, increased fruit and vegetable servings, and increased diabetes health knowledge.     

Findings from a Community-based Participatory Prevention Research Intervention Designed to Increase Social Capital in Latino and African American Communities

A community-based participatory research intervention, Poder es Salud/Power for Health, employed Community Health Workers who used popular education to identify and address health disparities in Latino and African American communities in a metropolitan area in the United States. We assessed participants’ social capital, self-rated health, and depressive symptoms at baseline and the end of the intervention. Social support and self-rated health improved while depressive symptoms decreased. Public health interventions involving diverse communities that are designed to build upon assets, such as existing levels of social capital, may improve health in those communities.     

Theories and intervention approaches to health-behavior change in primary care

CONTENT: Providers typically rely on health information and their professional status to convince patients to change. Health-behavior theories and models suggest more effective methods for accomplishing patient compliance and other behavior change related to treatment regimens. Behavior modification stresses the remediation of skill deficits or using positive and negative reinforcement to modify performance. Like behavior modification, the Health Belief Model stresses a reduction of environmental barriers to behavior. Social Learning Theory suggests that perceptions of skills and reinforcement may more directly determine behavior. Self-management models put the above theories into self-change actions. Social support theories prioritize reinforcement delivered through social networks, whereas the Theory of Reasoned Action emphasizes perceptions of social processes. Finally, the Transtheoretical Model speaks of the necessity to match interventions to cognitive-behavioral stages. Strategies derived from each of these theories are suggested herein.     

Innovative Graduate Research Education for Advancement of Implementation Science in Adolescent Behavioral Health

An innovative approach to research education that integrates the theory and principles of implementation science, participatory research, and service learning in the area of adolescent behavioral health is presented. Qualitative interviews and surveys of program participants have been conducted to assess the program’s curricula, service-learning partnerships, student (scholar) satisfaction, and views of community partnerships and academic mentors. The Institute has experienced the successful completion of its first and second cohorts and enrollment of a third cohort of scholars. Community partners are utilizing results of service-learning projects to influence agency operations. Institute scholars have identified research and service learning experiences as key factors in the decision to apply to the Institute graduate certificate program. The availability of tuition support is identified as valuable but not ranked as the most important reason for scholar interest in the program. Academic mentors report positive relationships with community agencies. Future iterations of the program will expand options for distance learning and alternatives to traditional graduate education for community-based scholars. Community partner agency capacity for participation is expected to change over time. Methods are being identified to both sustain existing partnerships and develop new community partnership relationships.