Collaborative community empowerment: an illustration of a six-step process

This article illustrates a method used in a community empowerment project where community members and university facilitators collaborated to increase the capacity of the community. The method may have practical uses in collaborations with community groups. The six-step process enabled the community groups to accomplish their short-term community goals: developing effective after-school programs and resolving problems of damaged homes and blighted properties in a relatively short time and continuing on their collaborative work. Having a social ecological model as a conceptual framework was helpful for the community to assess their status and develop action plans. Consistent community meetings, open communication, focused community leadership, community networking, and collaboration of community organizations and a university were the factors that reinforced the empowerment process. Challenges such as maximizing limited resources and generating more participation from the community need to be resolved while the reinforcing factors are cultivated.     

Capturing contrasted realities: integrating multiple perspectives of Danish community life in health promotion

Communities in health literature are often treated as homogeneous entities, in which community members are believed to share needs, goals, resources and social and cultural values. This perception of community is too narrow to grasp the complexity and dynamics of community life and neglect the different ways community members use, perceive and interact in their community. In this study, we outline a theoretical approach that embraces community diversity, by focusing on how community life is being practiced by its members and how they interact with each other. Adopting this theoretical approach, ethnographic fieldwork was conducted in a multi-ethnic and socially deprived neighbourhood in Denmark, which had undergone a long process of community building. We found five major ways of community practices based on interactions (i) in specific community spaces, (ii) related to specific activities, (iii) in sharing experiences of community history, (iv) on loyalty within one's social networks and (v) on sharing ethnicity. Distinguishing between different modes of interacting in community, offers a holistic perspective that includes those 'invisible' community members who usually do not participate in community development programmes. We argue that working with a more thorough understanding of the contrasting realities of community life is particularly useful for health professionals who are engaged in community organizing and in encouraging members to participate in building healthy communities.     

Community characteristics as predictors of perceived HMO quality

We model the impact of community characteristics on people's perceptions of the quality of their health care experiences in HMOs. We focus on three community characteristics: sense of community, population density, and population diversity. Sense of community refers to people's perception of interconnection, shared responsibility, and common goals. Population density and population diversity are community characteristics that affect transactions costs in terms of time and energy, and affect people's perceptions of their community. We use data from a 1993 Florida poll to estimate the relationship between HMO members' perceptions of problems with health care experiences (cost, choice, access, satisfaction) and community characteristics. We find that all three community variables are significantly associated with perceptions of health care problems. We also find that effects of community variables operate differently for those in HMOs vs. those under traditional insurance. This study is consistent with research showing that community characteristics impact the health status of community institutions. Results suggest that providers may be able to improve care by being more responsive to individuals' need for community, that providers and communities can mutually gain by collaborating to improve community health, and that it may be cost-beneficial to factor community issues more strongly into health care policy.     

社区卫生服务机构顾客忠诚现状及探讨

大力发展社区卫生服务,构筑以社区卫生服务为基础的城市卫生服务体系,是近年以至今后我国卫生发展的主要方向之一。引导居民选择社区卫生服务机构,建立社区卫生服务机构的顾客忠诚是社区发展的客观需要。文章从社区卫生服务机构的顾客忠诚界定出发,通过分析社区忠诚现状和问题,探讨了社区卫生服务机构顾客忠诚的意义、特征和培养策略,旨在为健康地发展社区卫生服务提供参考。     

宁波市鄞州区首南街道社区居民健康服务需求情况调研分析

健康关乎社会居民自身权益,是重要的民生问题.在对鄞州区首南街道社区居民的健康服务需求情况进行实地调研的基础上,提出了提高社区居民的健康意识、完善社区健康服务保障体系、提高社区居民健康经济保障程度和调整社区健康服务的内容等建议,由此提高社区居民的总体健康水平.     

新疆克拉玛依区社区卫生服务的发展框架

在对新疆克拉玛依市社区卫生服务内外环境分析的基础上，提出了克拉玛依区社区卫生服务发展的框架，包括对社区卫生资源的总体配置与布局、社区卫生服务与人才培养和完善社区服务服务中心功能的重要举措；并提出了社区卫生服务发展的保障措施。提出的社区卫生服务发展框架对我国边疆地区社区卫生服务的发展具有参考意义。     

社区卫生服务培训需求评价

目的：研究社区卫生服务培训需求，方法：深入访谈与问卷调查相结合。共走访了成都和攀枝花市的卫生管理干部和社区医生18人，了解社区卫生服务开展状况，用分层定额抽样的方法抽取了3个成都市的社区，入户调查居民1041人，了解其卫生服务需求和利用情况，以及对社区卫生服务的态度。结果：社区卫生服务内容以常见病的诊疗为主，预防保健，计划生育等服务较少，且缺乏协调，社区卫生服务模式多样，社区医生与服务对象的关系及服务方式正在发生转变，社区医生未能完全适应此转变，医院对社区卫生服务的认识存在误区，社区卫生服务缺乏有效的激励机制，多数居民尚未能接受目前的社区卫生服务。结论：社区卫生服务培训应与社区卫生工作者的实践相结合，社区卫生服务培训应区阶段，分层次，有目的，有针对性地开展，培训对象应包括：管理干部，师资，社区医生和社区护士。     

妇幼卫生社区健康服务合作项目的做法和体会

上海市在实施“妇幼卫生社区健康服务合作项目”的过程中,及时总结经验,有利于项目的持续、深入开展。他们的具体做法：首先确定“社区项目”试点单位,签订项目责任书,确定“社区项目”工作计划,落实经费。他们的体会是：城市社区建设和发展是开展妇幼卫生社区服务的重要前提,两个系统保健和三级服务网络是开展妇幼卫生社区服务的重要基础,提高生命质量和生活质量是妇幼卫生社区服务的主要目标,多方合作,共同参与是开展社区服务的最佳模式     

农村社区卫生服务可持续发展对策研究

发展农村社区卫生服务有利于减轻县级医院的负担、控制农村医疗费用、合理配置农村卫生资源及推进农村公共卫生计划。然而,由于农村社区卫生服务发展的观念滞后、农村社区卫生资源缺乏且服务水平低下和农村社区卫生服务中基本医疗项目纳入新型农村合作医疗保障的比例偏低,以及农村社区卫生服务相关的制度建设滞后,我国农村社区卫生服务发展缓慢。为了实现农村社区卫生服务的可持续发展,要创新农村社区卫生服务观念、建立合理的农村社区卫生服务筹资机制、加强农村社区卫生服务人力资源队伍建设和提高农村社区卫生服务质量。     

社区卫生诊断开展现状及其在社区卫生工作中的作用探讨

社区卫生诊断是社区卫生服务的重要内容和关键环节．通过对社区卫生诊断的概念、发展现状、目的、内容、方法和工作步骤等内容的阐述,讨论了社区卫生服务诊断在社区卫生服务工作中的重要作用,并从卫生行政部门、社区卫生服务机构和社区卫生工作者3个层面说明如何利用社区卫生诊断资料。     

焦作市疾控进社区工作运行机制及其效果评估

[目的]探讨疾控部门进社区工作模式的建立及其提高社区公共卫生服务能力的效果。[方法]建立疾控进社区路径,制订各级疾控对社区卫生服务机构健教、传染病管理、计划免疫、慢病管理等工作技术规范及相关专业培训、业务指导、监督与考核工作制度,落实培训、督导工作计划,参与政府对社区工作绩效考核与反馈;实施社区公共卫生服务组织机构建设。[结果]搭建了多部门参与、协作管理的疾控进社区工作路径;制订了项目区域各级疾控进社区工作技术规范与工作制度;协助社区搭建公共卫生服务工作框架,提高社区公卫服务综合能力;提高了社区卫生服务机构的社会效益和经济效益;提升了社区、政府对疾控进社区工作的满意度。[结论]建立科学、有效、适宜、可行的疾控进社区工作机制,是履行其职责,发挥疾控技术指导作用的先导;疾控进社区可有效提高社区公共卫生服务综合能力,并具有良好的社区效益与经济效益。     

关于加快社区卫生发展的几点思考

从建立社区卫生政策扶持体系、健全社区卫生服务网络、创新社区卫生服务机制、提高社区卫生服务能力四个方面着手探讨了加快社区卫生发展的对策和措施。     

Community needs and preferences for community pharmacy immunization services

This study explored the Saudi community’s needs and preferences related to community immunization services. Community member’s expectations about the services were assessed, and their concerns, attitudes, and beliefs around the pharmacist’s role in providing immunization were examined.MethodQualitative in-depth, semi-structured interviews were conducted with a convenience sample that comprised Saudi community members who visited Saudi community pharmacies. Interviews were audio-recorded, transcribed verbatim, and then translated. Data obtained were then thematically organized and analyzed using NVivo (QSR International) Software.ResultA total of 20 interviews were conducted for this study. Seven themes emerged from the interviews and were grouped into three major categories relating to the community pharmacy immunization service: (1) community needs for the service; (2) community expectations of the service; and (3) community concerns, and beliefs around the service. Participants expressed their need for such services and acceptance of immunization performed by community pharmacists, with the expectation that it would improve their immunization uptake and community health in general. However, some participants expressed concerns about community pharmacists current level of ability and skill in providing immunization, the lack of a private area for conducting the service, the lack of female community pharmacists, and the cost of the immunization service. Some participants advocated for supervision of such services by the Ministry of Health (MOH) and Saudization of community pharmacy staff.ConclusionThe research results clearly demonstrated the Saudi community’s need for community pharmacy immunization services, described their expectations, and highlighted their concerns relating to community pharmacy infrastructure and an appropriate level of training for community pharmacist-administered immunization.     

社区长期保健志愿者服务的技术支撑与组织协调

目的 发挥社区卫生服务中心在社区长期保健志愿者服务中的作用。方法 对上海市4家社区卫生服务中心的医务人员，就其以社区长期保健志愿者服务的认识及卫生服务中心所起的作用进行调查。结果 97．94％的医务人员认为社区志愿者能提供长期保健服务。志愿者提供的服务内容主要为：提供家庭医疗、护理咨询、对需要长期照顾的患者提供精神安慰、对照顾者提供健康咨询等。74．71％的医务人员认为志愿者服务可以收取少量费用，以奖励志愿者服务和补偿物质消耗。64．54％的医务人员认为社区长期保健志愿者队伍应由社区卫生服务中心负责组织。结论 社区长期保健志愿者服务有必要、也有可能，社区卫生服务中心应为长期保健志愿者服务提供技术支撑和组织协调。     

居民社区卫生服务知晓与利用的关系及其影响因素分析

[目的]探讨居民对社区卫生服务功能的知晓与社区卫生服务利用的关系及居民对社区卫生服务利用的影响因素。[方法]采用多阶段分层抽样方法,对江苏省1 141名城市居民进行问卷调查。[结果]居民对社区卫生服务功能的总知晓率和总利用率分别为74.93%、61.08%;居民对社区卫生服务的功能认识越全面,其利用程度越高;人口学因素、社会经济因素、疾病因素、社区卫生服务的可及性等因素对社区卫生服务利用都存在一定程度的影响。[结论]改善社区卫生服务利用程度,一方面要进行有效的宣传,另一方面要合理配置卫生资源,改善社区卫生服务的可及性。     

健康指导员对社区健康教育管理模式创新的研究

目的 科学验证将健康指导员策略应用于社区健康教育中所取得的实际效果,探索社区健康教育管理新模式,为有效开展社区健康教育提供科学依据.方法 选取两个社区作为研究现场,其中干预社区接受健康指导员与单纯健康教育干预相结合的综合干预,对照社区仅接受单纯的健康教育干预,对干预一年后两个社区相关指标进行分析比较.结果 干预社区居民的健康知识知晓率、健康行为形成率在干预后均明显提高,差异有统计学意义;而对照社区上述指标在干预前后差异无统计学意义.结论 健康指导员策略能成功地促使社区内各方面人员以主人翁精神参与其中,帮助建立起自治型社区健康教育管理新模式,在获取更好健康教育效果的同时,促进社区健康教育工作的可持续性发展.     

深圳市社区卫生服务人力资源状况及稳定性分析

目的:分析社区卫生服务工作人员的基本特征和工作人员的变动情况,评价社区卫生服务人员素质和稳定性。方法:采取描述性方法对社区卫生服务人力资源基本情况进行分析,测算工作人员流入和流出情况。结果:社区卫生服务工作人员以年轻女性为多,以中专学历和初级职称为主,多数人是临时聘用人员,而且人员流出和流入比例较大,工作人员稳定性较差。结论:深圳市社区卫生服务工作人员整体素质要进一步改善,需要加强培训,采取优惠措施提高人员稳定性,增强职工留在社区工作的信心。     

坚持“院办院管” 强化绩效管理 提高社区卫生服务中心服务能力

目的总结我院开展社区卫生服务工作12年并建立了10家社康中心的经验。方法分析医院所采取的"院办院管"的模式、社康中心实行收支两条线管理、规范运作、强化绩效管理、落实社区基本药物目录、医院专家定期下社区服务、推行弹性工作制和实施多项社区优惠等综合措施。结果社康中心整体服务能力不断提高,2009年由市、区卫生主管部门委托的第三方满意度评估,居民满意度达92.0%。结论采用加强内涵建设和强化绩效管理等措施,能有效地提升社区卫生服务中心的服务能力。