职业技校学生预防艾滋病健康教育效果评价

目的评价对职业技术学校学生进行性观念和艾滋病知识问卷调查效果,为在该类学校开展艾滋病健康教育提供依据。方法2006年5月,对临沂市2所职业技术学校的470名学生进行短期有关艾滋病知识的健康教育讲座,于教育前后进行有关知识知晓情况的问卷调查。结果培训后分别获得有效答卷392份、384份,同意婚前性行为、多性伴、同性性行为和商业性行为者所占比例培训前为4.85%~50.51%,培训后为5.21%~52.08%(P>0.05);多数人对艾滋病的一般知识和预防知识有一定了解,培训后的知晓率、正确对待艾滋病病毒感染者所占比例较培训前明显提高(P<0.01或P<0.05)。对艾滋病非传播途径的知晓率也有所提高,但仍然很低。结论职业技术学生的性观念中存在着传播艾滋病和性病的高危因素。短期知识讲座和宣传对提高学生的性卫生知识和艾滋病相关知识有较明显的作用。     

Bridging the gap between community health and K-12 schools

The topic of this article is program planning for K-12 school health programs collaborating with community agencies, businesses, colleges, and organizations. Community involvement was listed as one of the weakest areas of school health efforts in a national coordinated school health study [1]. This article presents the 5-year results demonstrating the outcomes of K-12 schools program planning aimed at community involvement in the coordinated school health model. Directors of the Departments of Education and Health in South Dakota initiated training for school personnel in the coordinated school health model through development of councils in the schools starting in 2000. The expectations of the councils were to design a program plan to support the health of students and staff in their school. The short-term results of a 5-year evaluation indicated the greatest area of gain was in community health involvement to improve student and staff health.     

Community participation for perinatal health in Istanbul

This study aimed to evaluate the success of a project in achieving community participation in efforts to improve perinatal health. A 10-step structured process was used to work with a community in Istanbul, Turkey. To evaluate the success of the project in achieving community participation, five key indicators were selected: (i) participation of the community group in decision making; (ii) gains in knowledge and skills of the community group; (iii) continuity of the community group; (iv) continuation of the health program by the community group; and (v) initiation of new support and advocacy activities. From the beginning, community members participated in all decisions regarding the group activities. In the early months, project staff had more of a guiding role, but, over time, the community members became active decision-makers. Over the course of the project they learned how to identify community health problems, and to design, implement and evaluate interventions to address those problems. Four years later, meetings and activities of the group are continuing. The antenatal education course developed by the group continues to be offered at a local community centre. Community members are now completely responsible for promoting the course, communication with participants, planning the courses, making preparations for the sessions, as well as teaching non-technical topics. Course participants have developed ongoing support networks and have begun to advocate for better perinatal health services in the community. Working with a community is an intensive, time-consuming process. The results of this project indicate that the benefits, both in terms of health outcomes and in terms of increases in community capacity, can be well worth the effort.     

Analysis of food irradiation education for elementary,middle, and high school students for three years in South Korea

BACKGROUND/OBJECTIVES

The current South Korean government policy on food irradiation technology should be reformed based on an in-depth investigation of the communications aspect, because the issue is no longer of a technological nature, given the proven safety and efficacy of the processes.

SUBJECTS/METHODS

The target population of the education program consisted of elementary, middle, and high school students attending 310 schools in South Korea (2013: 63 schools, 2014: 104 schools, 2015: 143 schools). Data subjected to analysis were 13,327 pre-education and 12,641 post-education questionnaires received from 7,582 elementary, 2,671 middle, and 3,249 high school students who participated in the education program from May 2012 to April 2015 (n = 12,831), after the exclusion of inadequately filled-in questionnaires.

RESULTS

Analysis of the three-year educational effect trend was conducted by comparing levels of variables before and after food radiation education. The analysis yielded the finding that the post-education levels were significantly higher for all variables. That is, for interest in education, perception (necessity, safety, subjective knowledge, and information acquisition), objective knowledge, and attitude, with the sole exception of objective knowledge in 2013.

CONCLUSIONS

Given that post-education levels of perception, knowledge, and attitude concerning irradiated foods increased considerably compared to pre-education levels, behavior change should be induced by providing continuous education to enhance, these primary variables.     

Urban women educate their community on HIV / STDs,family planning and reproductive health

To broaden the context of HIV/AIDS prevention interventions in an urban slum in Rio de Janeiro, Brazil, a model program was developed that involved training 12 low-income women to serve as paid community health agents. The 4-month training course covered the health education topics of reproduction, HIV/AIDS, family planning (FP), and reproductive health and was guided by the belief that women's vulnerability to HIV/AIDS is embedded in gender relations and that health education should be bolstered with promotion of individual autonomy among trainees. Trainees also conducted simple research to analyze the needs of their community and assessed and produced the health education materials they would use in the community. The HIV/AIDS intervention model developed by the women takes the form of three community meetings on 1) gender relations, 2) sexuality and HIV/AIDS prevention, and 3) AIDS. Women who attend the meetings are given cards that simplify their acceptance as FP clients at local health centers. The training empowered the 12 women and led to positive improvements in their lives. Because their community is controlled by drug dealers, the women had to overcome restrictions on their interactions with their neighbors. The training gave the women the courage to do this and to be recognized and accepted in their communities. While the paid project is completed, the women have continued offering educational sessions. Currently, the project staff is seeking funding to find ways to replicate this intervention model at a lower cost.     

Integrating the Life Course into MCH Service Delivery: From Theory to Practice

To describe the efforts of a community-based maternal and child health coalition to integrate the life course into its planning and programs, as well as implementation challenges and results of these activities. Jacksonville-Duval County has historically had infant mortality rates that are significantly higher than state and national rates, particularly among its African American population. In an effort to address this disparity, the Northeast Florida Healthy Start Coalition embraced the life course approach as a model. This model was adopted as a framework for (1) community needs assessment and planning; (2) delivery of direct services, including case management, education and support in the Magnolia Project, its federal Healthy Start program; (3) development of community collaborations, education and awareness; and, (4) advocacy and grass roots leadership development. Implementation experience as well as challenges in transforming traditional approaches to delivering maternal and child health services are described. Operationalizing the life course approach required the Coalition to think differently about risks, levels of intervention and the way services are organized and delivered. The organization set the stage by using the life course as a framework for its required local planning and needs assessments. Based on these assessments, the content of case management and other key services provided by our federal Healthy Start program was modified to address not only health behaviors but also underlying social determinants and community factors. Individual interventions were augmented with group activities to build interdependence among participants, increasing social capital. More meaningful inter-agency collaboration that moved beyond the usual referral relationships were developed to better address participants’ needs. And finally, strategies to cultivate participant advocacy and community leadership skills, were implemented to promote social change at the neighborhood-level. Transforming traditional approaches to delivering maternal and child health services and sustaining change is a long and laborious process. The Coalition has taken the first steps; but its efforts are far from complete. Based on the agency’s initial implementation experience, three areas presented particular challenges: staff, resources and evaluation. The life course is an important addition to the MCH toolbox. Community-based MCH programs should assess how a life course approach can be incorporated into existing programs to broaden their focus, and, potentially, their impact on health disparities and birth outcomes. Some areas to consider include planning and needs assessment, direct service delivery, inter-agency collaboration, and community leadership development. Continued disparities for people of color, despite medical advances, demand new interventions that purposefully address social inequities and promote advocacy among groups that bear a disproportionate burden of infant mortality. Successful transformation of current approaches requires investment in staff training to garner buy-in, flexible resources and the development of new metrics to measure the impact of the life course approach on individual and programmatic outcomes.     

职业中专学生预防艾滋病健康教育短期培训的效果评价

[目的]评价对职业中专学生进行艾滋病健康教育短期培训的效果,为在该类学校开展艾滋病健康教育提供依据。[方法]2006年5月,对临沂市2所中等技术学校的470名学生进行短期有关艾滋病知识的健康教育讲座,于教育前后进行有关知识知晓情况的问卷调查。[结果]培训前、后分别获得有效答卷392份、384份,同意婚前性行为、多性伴、同性性行为和商业性性行为者所占比例培训前为4.85%~50.51%,培训后为5.21%~52.08%(P>0.05);多数人对艾滋病的一般知识和预防知识有一定了解,培训后的知晓率、正确对待艾滋病病毒感染者所占比例较培训前明显提高(P<0.01或P<0.05);对艾滋病非传播途径的知晓率也有所提高,但仍然不高。[结论]职业中专学生的性观念存在着传播艾滋病和性病的高危因素,开展短期的知识讲座对提高学生的艾滋病相关知识有明显的作用。     

COMMENTARY: A BLIND EYE: COMMUNITY HEALTH SERVICES IN REMOTE AREAS OF AUSTRALIA

Community health services to remote Australian communities are frequently overlooked by health policy and planning authorities, despite the particular health and social problems confronting these communities. Nurses are the main providers of health care in isolated regions where they must perform an extended primary health care role. It is assumed that a nurse in the community can fulfil multiple and continuous roles in clinical care, and public health. In the absence of administrative expertise the isolated community health service functions more often by reflex action than design. Essential factors in the development of health services to remote communities include evaluation of current practices and staff utilisation. Greater accountability for funding would enforce regular reviews. Deliberate health services planning must be flexible to community changes and consider appropriate alternatives to the prevailing curative focus.     

健康教育在妊娠期糖尿病孕妇中的应用及效果分析

目的通过对妊娠期糖尿病（GDM）妇女的健康教育,观察GDM孕妇血糖控制的效果。方法2006年1月-2009年1月对在我医疗中心进行产前检查并分娩的308例GDM孕妇实施健康教育．并比较教育前后孕妇对糖尿病知识掌握情况、行为改变及血糖监测值的变化情况。结果实施健康教育前后孕妇知识掌握情况比较,差异有统计学意义（P〈0．01）：教育后孕妇建立健康行为（饮食控制、适当运动、监测体重、定期血糖监测及定期产检）较教育前人数明显增加。教育前后比较。差异有统计学意义（P〈0．01）;教育后血糖监测值（空腹血糖、餐后2h血糖）明显低于教育前血糖值．教育前后比较．差异有统计学意义（P〈0．01）。结论健康教育可使GDM孕妇的认知、态度和行为发生变化,提高了孕妇的保健意识．有效地控制了血糖水平．减少了并发症的发生．达到良好的妊娠结局。     

The folic acid message – can training make a difference?

Aim: To evaluate the effectiveness of training sessions for health professionals concerning folic acid in pregnancy. Methods: Training sessions were held for Community Health Professionals to disseminate the current Department of Health recommendations about folic acid. The professions targeted were those who were more likely to come into contact with women of child-bearing age, e.g. midwives, health visitors, practice nurses and family planning staff. Altogether 24 1-h training sessions were held reaching 189 staff. Each session consisted of factual information, a brainstorming session about what pregnant women eat and a nutrition game involving calculating a day's intake of folic acid. Questionnaires were used to evaluate the level of knowledge before and after training. Feedback about the sessions was also obtained from participants. Results: With every group trained there was an improvement in knowledge. The greatest change was that staff realized how difficult it is to consume the recommended amount of folic acid from food alone. Before the training session 42% of the health professionals thought that women could eat enough folic acid and after the training this had fallen to just 1%. Conclusion: The training sessions produced positive changes. In addition, the process of evaluation, which is increasingly recognized as important for dietitians, was found to be rewarding.     

Teaching medical students epidemiology: utilizing a state health department

An epidemiology teaching course for third-year medical students was developed at the University of Vermont's College of Medicine by staff members of the Vermont Department of Health in conjunction with clinical faculty members. The course consists of analyses of actual community health problems encountered by the health department, evaluation of published clinical studies, and design of studies on current public health issues in Vermont. In the course's first year, 54 percent of the students gave it an overall assessment of average or above average. A striking improvement was found in the second year; 98 percent of the students rated their overall assessment as average or better. Sessions rated the best by students were the critical appraisal of clinical studies, followed by sessions on study design and outbreak investigations. The Vermont course communicates epidemiologic concepts to students by stressing their clinical relevance and by putting the concepts into a recognizable public health context. Students are required to grapple with epidemiologic issues as participants. This approach to teaching epidemiology combines faculty having both public health and clinical perspectives, emphasizes relevance to future practice, and requires students to actively work through epidemiologic problems. The Vermont experience has shown that combining health department and clinical faculty resources can result in a useful format for teaching epidemiology to medical students.     

Family,Maternal, and Child Health Through Photovoice

OBJECTIVE: (1) To introduce photovoice, a participatory action research methodology, for use by MCH program managers to enhance community health assessments and program planning efforts, (2) to enable community people to use the photovoice methodology as a tool to record, reflect, and communicate their family, maternal, and child health assets and concerns, and (3) to educate community leaders about family, maternal, and child health issues from a grassroots perspective. METHODS: Photovoice is based upon the theoretical literature on education for critical consciousness, feminist theory, and community-based approaches to documentary photography. Picture This Photovoice project took place in Contra Costa, an economically and ethnically diverse county in the San Francisco Bay area. Sixty county residents of ages 13-50 participated in 3 sessions during which they received training from the local health department in the techniques and process of photovoice. Residents were provided with disposable cameras and were encouraged to take photographs reflecting their views on family, maternal, and child health assets and concerns in their community, and then participated in group discussions about their photographs. Community events were held to enable participants to educate MCH staff and community leaders. RESULTS: The photovoice project provided MCH staff with information to supplement existing quantitative perinatal data and contributed to an understanding of key MCH issues that participating community residents would like to see addressed. Participants' concerns centered on the need for safe places for children's recreation and for improvement in the broader community environment within county neighborhoods. Participants' definitions of family, maternal, and child health assets and concerns differed from those that MCH professionals may typically view as MCH issues (low birth weight, maternal mortality, teen pregnancy prevention), which helped MCH program staff to expand priorities and include residents' foremost concerns. CONCLUSIONS: MCH professionals can apply photovoice as an innovative participatory research methodology to engage community members in needs assessment, asset mapping, and program planning, and in reaching policy makers to advocate strategies promoting family, maternal, and child health as informed from a grassroots perspective.     

Administration/consultation: The staff interview

Summary The staff interview and the above admonishments to be observant do not of course provide an exhaustive evaluation of an agency, they are though important elements too often overlooked. The inclusion of staff input and observational data have proven themselves experientially to be valuable in organizational evaluation and the planning process. Mills, Micheal M., ACSW—Has worked in a variety of Community and institutional mental health settings. He is currently an instructor of social work at Ohio University, Athens, Ohio.     

Integration of theory, practitioner standards, literature findings, and baseline data: a case study in planning breast self-examination education

Delineation of the planning process necessary for designing sound education programs aimed at changes in health behavior continues to be a primary concern of health educators. Careful planning will ultimately maximize the application of existing evidence and identify areas in need of further research and evaluation. This paper discusses the preliminary and refinement planning phases involved in the design of an educational program for a three-year breast self-examination demonstration/evaluation project. The initial phase involved review of empirical data of previous studies, and application of behavioral science theory and standards of professional practice. The refinement phase involved the application of results from a community diagnostic baseline survey of the target population. Factors found to correlate with BSE practice were integrated into the educational strategies: group sessions in classes and informal workshops, a breast exam clinic, and mass media activities.     

A breast cancer screening educational intervention targeting medical office staff

There is persistent evidence that breast cancer screening techniques remain under-utilized. While physicians cite lack of time as a barrier to the provision of preventive services, nurses and other medical office staff are in an ideal position to educate women and motivate adherence to screening recommendations. This paper describes the design, implementation and process evaluation of a breast cancer screening educational program targeting primary care medical office staff. This intervention was conducted in two Washington State counties as part of a larger community organization study. The PRECEDE model, educational outreach principles and focus groups were used to guide the program development. Consistent with 'academic detailing' concepts, the sessions were delivered at health care facilities. The program included a review of breast cancer-related data and screening methods, an overview of the nurse's role as a 'change agent' and breast self-examination instructor, and a discussion of women's barriers to mammography. Community-level penetration was relatively high, with sessions being completed by approximately 50% of the eligible staff. Overall, participants were positive about the value of the program. Medical office-based educational sessions have the potential of reaching a large proportion of primary health care workers and increasing disease prevention in communities.     

社区卫生服务机构综合评价的质性研究

目的 了解社区卫生服务管理人员对社区卫生服务机构综合评价过程的感受、看法、观点、建议,为社区卫生服务机构考核管理科学化、规范化提供借鉴.方法 通过访谈形式,访问了12名社区卫生服务中心主任,将获得的资料进行分析、整理,提出问题.结果 社区卫生服务机构管理人员对年度考评的重要性高度认可;考评中的问题主要集中在考评方法、指标、内容、方式等方面;在社区卫生服务发展的建议方面主要集中在政策落实、人才建设及经费到位等.结论 综合评价对社区卫生服务机构的发展方向有引导作用;人才素质和稳定是发展社区卫生服务的关键;深圳社区卫生服务中心考评从探索阶段正在向规范阶段发展.     

Informing Neighborhood Health

ABSTRACT

The purpose of the Informing Neighborhood Health project is to facilitate access to electronic health information resources at select community faith-based clinics. The project partners Texas Woman's University, Houston Academy of Medicine-Texas Medical Center Library, and five community faith-based clinics located in Houston, Texas, that primarily serve the homeless and working poor. The clinics include San Jose Clinic, Good Neighbor Healthcare Center, Eastwood Health Clinic, the Children's Clinic at Northwest Assistance Ministries, and Bering Omega Community Services. The Informing Neighborhood Health project placed Internet-connected workstations at each participating clinic. The project also provided training for select clinic staff members that focused on a variety of electronic health information resources. A post-training evaluation was administered at the end of each training session. In addition, site visits and interviews were conducted at each participating clinic once project workstations were operational and staff members had attended training sessions. A final project focus group was conducted with administrators from each participating clinic. Clinic staff members have incorporated use of project workstations into existing workflow processes and are using electronic information resources to make better informed health care decisions for their clients.     

The community health volunteer scheme in India: An evaluation

In this paper, we have placed the discussion of community health volunteer (CHV) scheme within the larger context of the evolution of primary health care organization in India. Drawing on a national evaluation study and a micro village level study, we have outlined the key issues in the design and implementation of the CHV scheme. These issues relate to the range and quality of services, the characteristics of clients served, nature of health problems attended, community participation, extent of help rendered by CHV to PHC staff, and problems of logistics and supply of manuals, kits and medicines.Our analysis shows that the CHV scheme has succeeded in bringing primary curative care to the doorsteps of the people. To a smaller extent, it has also helped in improving related services such as family planning, immunization and detection and treatment of malaria. Both the village community and the field staff of the regular health care organization find the CHV as a useful link between the community and the primary health center. Also CHVs are not confining to only a privileged few but they are catering to a cross-section of different caste and class groups in the village community.     

The U.S. Department of Housing and Urban Development BUILD Las Vegas 2019 Event: Lessons Learned in Public Health Community Engagement

The U.S. Department of Housing and Urban Development (HUD) BUILD Las Vegas 2019 event brought together Las Vegas Lead Hazard Control and Healthy Homes Program (LVLHCHHP) staff, community leaders, and volunteers from multiple organizations for a neighborhood clean-up and community resource fair in a low-income, historic west Las Vegas neighborhood. In preparation for the event, LVLHCHHP staff encountered a lack of published guidance regarding past BUILD events or planning of community-based public health events. To address this gap in the literature, this brief report offers lessons learned from the process of planning and evaluating the HUD BUILD Las Vegas 2019 event. These include taking early planning measures, centering the focus on community needs, and forming strategic partnerships, which can provide a valuable foundation for future events that want to integrate community engagement with public health.

     

Policy planning for community mental health programs

Conclusion Policy planning as presented is not deeper involvement in the operations of a program; indeed, many boards are too deeply involved now. Policy planning does require a change in the style of administration: its emphasis is less on day-to-day control and more on policy guidance, monitoring staff conformance to policy, and performance auditing and evaluation. Editor's Note: Mr. Price has based the following article on his experiences as a consultant to community mental health centers and other health and social service agencies and on his book,Manual on Governance and Policy Planning for CMHC Board Members.