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1.
Kathleen M. Quinlan Amy Slonim Fran C. Wheeler Suzanne M Smith 《Preventing chronic disease》2010,7(2)
Introduction
Competencies are the cornerstone of effective public health practice, and practice specialties require competencies specific to their work. Although more than 30 specialty competency sets have been developed, a particular need remained to define competencies required of professionals who practice chronic disease prevention and control. To that end, the National Association of Chronic Disease Directors (NACDD) engaged a group of stakeholders in developing competencies for chronic disease practice.Methods
Concept mapping was blended with document analysis of existing competencies in public health to develop a unique framework. Public health experts reviewed the results, providing extensive and richer understanding of the issues.Results
The final product presents an integrated picture that highlights interrelationships among the specific skills and knowledge required for leading and managing state chronic disease programs. Those competencies fall into 7 clusters: 1) lead strategically, 2) manage people, 3) manage programs and resources, 4) design and evaluate programs, 5) use public health science, 6) influence policies and systems change, and 7) build support.Conclusion
The project yielded a framework with a categorization scheme and language that reflects how chronic disease practitioners view their work, including integrating communications and cultural competency skills into relevant job functions. Influencing policies and systems change has distinct relevance to chronic disease practice. We suggest uses of the competencies in the field. 相似文献2.
Global health competencies according to nursing faculty from
Brazilian higher education institutions
Carla Aparecida Arena Ventura Isabel Amélia Costa Mendes Lynda Law Wilson Simone de Godoy Irene Tamí-Maury Rosa Zárate-Grajales Susana Salas-Segura 《Revista latino-americana de enfermagem》2014,22(2):179-186
3.
Objectives
Continuity of operations planning focuses on an organization’s ability to deliver essential services before, during and after an emergency. Public health leaders must make decisions based on information from many sources and their information needs are often facilitated or hindered by technology. The aim of this study is to provide a systematic review of studies of technology projects that address public health continuity of operations planning information needs and to discuss patterns, themes, and challenges to inform the design of public health continuity of operations information systems.Methods:
To return a comprehensive results set in an under-explored area, we searched broadly in the Medline and EBSCOHost bibliographic databases using terms from prior work in public health emergency management and continuity of operations planning in other domains. In addition, we manually searched the citation lists of publications included for review.Results:
A total of 320 publications were reviewed. Twenty studies were identified for inclusion (twelve risk assessment decision support tools, six network and communications-enabled decision support tools, one training tool and one dedicated video-conferencing tool). Levels of implementation for information systems in the included studies range from proposed frameworks to operational systems.Conclusion:
There is a general lack of documented efforts in the scientific literature for technology projects about public health continuity of operations planning. Available information about operational information systems suggest inclusion of public health practitioners in the design process as a factor in system success. 相似文献4.
5.
Lee Strunin Maisha Douyon Maria Chavez Doris Bunte C. Robert Horsburgh 《Preventing chronic disease》2010,7(2)
Background
Although physical inactivity is a concern for all adolescents, physical activity levels are especially low among minority adolescents and minimal among girls from low-income families. After-school programs can reduce high-risk behaviors and strengthen schools, families, and communities.Context
We conducted an operational research project that provided free access to a program of regular, organized physical activity combined with health education sessions for adolescent girls in 2 public housing developments in Boston, Massachusetts.Methods
From July 2002 through October 2005, at each of 2 public housing sites, the GirlStars program participants met each week for two 2-hour sessions, 1 dedicated to physical activity and 1 dedicated to health education. Sessions were led by the project coordinator and a resident assistant at each development.Outcome
Participants in the GirlStars program increased their health knowledge, self-confidence, and decision-making skills, but rates of participation were low. Factors that affected participation included safety concerns, lack of community support for the program, interpersonal conflicts, attrition in staff, and conflicts with other activities.Interpretation
Programs in public housing developments that address these barriers to recruitment and retention may be more successful and reach more girls. 相似文献6.
Fernanda Luppino Miccas Sylvia Helena Souza da Silva Batista 《Revista de saúde pública》2014,48(1):170-185
OBJECTIVE
To undertake a meta-synthesis of the literature on the main concepts and practices related to permanent education in health.METHODS
A bibliographical search was conducted for original articles in the PubMed, Web of Science, LILACS, IBECS and SciELO databases, using the following search terms: “public health professional education”, “permanent education”, “continuing education”, “permanent education health”. Of the 590 articles identified, after applying inclusion and exclusion criteria, 48 were selected for further analysis, grouped according to the criteria of key elements, and then underwent meta-synthesis.RESULTS
The 48 original publications were classified according to four thematic units of key elements: 1) concepts, 2) strategies and difficulties, 3) public policies and 4) educational institutions. Three main conceptions of permanent education in health were found: problem-focused and team work, directly related to continuing education and education that takes place throughout life. The main strategies for executing permanent education in health are discussion, maintaining an open space for permanent education, and permanent education clusters. The most limiting factor is mainly related to directly or indirect management. Another highlight is the requirement for implementation and maintenance of public policies, and the availability of financial and human resources. The educational institutions need to combine education and service aiming to form critical-reflexive graduates.CONCLUSIONS
The coordination between health and education is based as much on the actions of health services as on management and educational institutions. Thus, it becomes a challenge to implement the teaching-learning processes that are supported by critical-reflexive actions. It is necessary to carry out proposals for permanent education in health involving the participation of health professionals, teachers and educational institutions. 相似文献7.
Gabriel Rodríguez Luz Angélica-Mu?oz Luiza Akiko Komura Hoga 《Revista latino-americana de enfermagem》2014,22(2):187-196
Objective
to explore the cultural experiences of nurses who immigrated to Chile. The study''s theoretical framework was the Purnell Model for Cultural Competence.Method
Leininger''s Observation-Participation-Reflection method was developed at two hospitals in the city of Santiago, and ethnographic interviews were held with 15 immigrant nurses.Results
among Purnell''s 12 domains, the following were identified: Overview/heritage, Communication, Workforce issues, Family roles and organization, Biocultural ecology and Health-care practices. The difficulties were related to the language and its semantic meaning, the new responsibilities and the difficult relationship with colleagues. "In search of better horizons - the decision to immigrate", "Gaining confidence and establishing a support network - employability and professional performance" and "Seeking for people''s acceptance - professional adaptation in a new cultural scenario" are cultural themes that represent their experiences.Conclusions
the competence to offer cultural care demands the development of public policies and continuing education programs at health institutions, specifically focused on immigrant nurses. 相似文献8.
Peer Reviewed: Employer Adoption of Evidence-Based Chronic Disease Prevention Practices: A Pilot Study
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Jeffrey R Harris Jeffrey Cross Peggy A Hannon Eustacia Mahoney Sarah Ross-Viles Alan Kuniyuki 《Preventing chronic disease》2008,5(3)
Background
We conducted a pilot test of American Cancer Society Workplace Solutions, an intervention that takes a marketing approach to increasing employers'' adoption of evidence-based practices to prevent and control chronic diseases among their employees.Context
We delivered the intervention and assessed the changes in practices of 8 large employers in the Pacific Northwest.Methods
Workplace Solutions recommends 15 employer practices in 5 categories: 1) health insurance benefits, 2) policies, 3) workplace programs, 4) health-promoting communication, and 5) tracking of employee health behaviors to measure progress. The intervention includes 4 meetings with employers over 2 months and begins with a questionnaire-based assessment of employer practices. Tailored recommendations follow, along with practice-specific implementation assistance on requested topics. We tested the intervention in a before–after study without a comparison group.Consequences
The employers ranged in size from 7500 to 115,522 employees and included private companies and public employers. Seven of the eight employers implemented more of the recommended practices at follow-up (an average of 13 months after the intervention) than at baseline. Overall, implementation of the practices increased from 38% at baseline to 61% at follow-up (P = .02).Interpretation
Workplace Solutions is a promising new approach to bringing evidence-based best practices for preventing chronic disease to large numbers of adults. 相似文献9.
Problem
High out-of-pocket payments and user fees with unfunded exemptions limit access to health services for the poor. Health equity funds (HEF) emerged in Cambodia as a strategic purchasing mechanism used to fund exemptions and reduce the burden of health-care costs on people on very low incomes. Their impact on access to health services must be carefully examined.Approach
Evidence from the field is examined to define barriers to access, analyse the role played by HEF and identify how HEF address these barriers.Local setting
Two-thirds of total health expenditure consists of patients’ out-of-pocket spending at the time of care, mainly for self-medication and private services. While the private sector attracts most out-of-pocket spending, user fees remain a barrier to access to public services for people on very low incomes.Relevant changes
HEF brought new patients to public facilities, satisfying some unmet health-care needs. There was no perceived stigma for HEF patients but many of them still had to borrow money to access health care.Lessons learned
HEF are a purchasing mechanism in the Cambodian health-care system. They exercise four essential roles: financing, community support, quality assurance and policy dialogue. These roles respond to the main barriers to access to health services. The impact is greatest where a third-party arrangement is in place. A strong and supportive policy environment is needed for the HEF to exercise their active purchasing role fully. 相似文献10.
11.
Objectives:
Develop a website, the OLC, which supports those people who work on promoting a healthy weight and tackling obesity. Research shows that original networks where sharing of information and peer interaction take place create solutions to current public health challenges.Methods:
Considerations that are relevant when building a new information service as well as the technical set up and information needs of users were taken into account prior to building the OLC and during continuous development and maintenance.Results:
The OLC provides global news, resources and tools and link out to other networks, websites and organisations providing similar useful information. The OLC also uses social networking tools to highlight new and important information.Discussion:
Networks contribute to a stronger community that can respond to emerging challenges in public health. The OLC improves connections of people and services from different backgrounds and organisations. Some challenges exist in the technical set up and also because of other aspects, e.g. public health information and differing information needs.Conclusion:
Public health work programmes should include networking opportunities where public policy can be disseminated. The provision of necessary tools and resources can lead to better decision-making, save time and money and lead to improved public health outcomes. 相似文献12.
Elsheikh Badr Nazar A Mohamed Muhammad Mahmood Afzal Khalif Mohamud Bile 《Bulletin of the World Health Organization》2013,91(11):868-873
Problem
Human resources for health (HRH) in the Sudan were limited by shortages and the maldistribution of health workers, poor management, service fragmentation, poor retention of health workers in rural areas, and a weak health information system.Approach
A “country coordination and facilitation” process was implemented to strengthen the national HRH observatory, provide a coordination platform for key stakeholders, catalyse policy support and HRH planning, harmonize the mobilization of resources, strengthen HRH managerial structures, establish new training institutions and scale up the training of community health workers.Local setting
The national government of the Sudan sanctioned state-level governance of the health system but many states lacked coherent HRH plans and policies. A paucity of training institutions constrained HRH production and the adequate and equitable deployment of health workers in rural areas.Relevant changes
The country coordination and facilitation process prompted the establishment of a robust HRH information system and the development of the technical capacities and tools necessary for data analysis and evidence-based participatory decision-making and action.Lessons learnt
The success of the country coordination and facilitation process was substantiated by the stakeholders’ coordinated support, which was built on solid evidence of the challenges in HRH and shared accountability in the planning and implementation of responses to those challenges. The support led to political commitment and the mobilization of resources for HRH. The leadership that was promoted and the educational institutions that were opened should facilitate the training, deployment and retention of the health workers needed to achieve universal health coverage. 相似文献13.
Elsa Maria de Oliveira Pinheiro de Melo Pedro Lopes Ferreira Regina Aparecida Garcia de Lima Débora Falleiros de Mello 《Revista latino-americana de enfermagem》2014,22(3):432-439
Objective
to analyze the answers of parents and health care professionals concerning the involvement of parents in the care provided to hospitalized children.Method
exploratory study based on the conceptual framework of pediatric healthcare with qualitative data analysis.Results
three dimensions of involvement were highlighted: daily care provided to children, opinions concerning the involvement of parents, and continuity of care with aspects related to the presence and participation of parents, benefits to the child and family, information needs, responsibility, right to healthcare, hospital infrastructure, care delivery, communication between the parents and health services, shared learning, and follow-up after discharge.Conclusion
the involvement of parents in the care provided to their children has many meanings for parents, nurses and doctors. Specific strategies need to be developed with and for parents in order to mobilize parental competencies and contribute to increasing their autonomy and decision-making concerning the care provided to children. 相似文献14.
Background
The WorkWell initiative of Thurston County, Washington, established by Steps to a Healthier Washington in Thurston County (Thurston County Steps), focuses on recognizing and supporting local employers who make a commitment to address workforce health issues by implementing programs within their organizations to help adults reach Healthy People 2010 objectives. This article reports on the WorkWell initiative and resulting WorkWell program.Context
The WorkWell initiative was developed to address the needs of private and public employers in Thurston County, Washington, to reduce the prevalence of chronic diseases through policy, practice, and environmental changes.Methods
Thurston County Steps recruited local employers to participate in advisory work groups to identify healthy workplace interventions that would be feasible for the employers and initiate a shift in organizational culture. The WorkWell initiative developed 2 distinct approaches — 1 for private sector (designation program) and another for public sector (action planning).Consequences
Twenty-six employers with approximately 4,700 employees were recognized with WorkWell Healthy Workplace designations for implementing changes that included encouraging stairwell use, providing low- or no-cost healthy meals for employees, and providing healthy foods at meetings. Four public agencies with approximately 4,400 employees have participated in an assessment and action planning process to help government employers focus their efforts and resources to support workforce health promotion.Interpretation
Unique partnerships between Thurston County Steps and other employers, private and public, demonstrate the important role employers can play in reducing chronic disease to improve a community''s overall health. 相似文献15.
Peer Reviewed: The Role of State Health Departments in Supporting Community-based Obesity Prevention
Background
Recent national attention to obesity prevention has highlighted the importance of community-based initiatives. State health departments are in a unique position to offer resources and support for local obesity prevention efforts.Community Context
In North Carolina, one-third of children are overweight or obese. North Carolina''s Division of Public Health supports community-based obesity prevention by awarding annual grants to local health departments, providing ongoing training and technical assistance, and engaging state-level partners and resources to support local efforts.Methods
The North Carolina Division of Public Health administered grants to 5 counties to implement the Childhood Obesity Prevention Demonstration Project; counties simultaneously carried out interventions in the community, health care organizations, worksites, schools, child care centers, and faith communities.Outcome
The North Carolina Division of Public Health worked with 5 local health departments to implement community-wide policy and environmental changes that support healthful eating and physical activity. The state health department supported this effort by working with state partners to provide technical assistance, additional funding, and evaluation.Interpretation
State health departments are well positioned to coordinate technical assistance and leverage additional support to increase the strength of community-based obesity prevention efforts. 相似文献16.
The Precautionary Principle in the Context of Mobile Phone and Base Station Radiofrequency Exposures
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Background
No health hazard has been established from exposure to radiofrequency fields up to the levels recommended by the International Commission on Non-Ionizing Radiation Protection. However, in response to public concern and the perceived level of scientific uncertainty, there are continuing calls for the application of the precautionary principle to radiofrequency exposures from mobile phones and base stations.Objective
We examined the international evolution of calls for precautionary measures in relation to mobile phones and base stations, with particular focus on Australia and the United Kingdom.Results
The precautionary principle is difficult to define, and there is no widespread agreement as to how it should be implemented. However, there is a strong argument that precautionary measures should not be implemented in the absence of reliable scientific data and logical reasoning pointing to a possible health hazard. There is also experimental evidence that precautionary advice may increase public concern.Conclusion
We argue that conservative exposure standards, technical features that minimize unnecessary exposures, ongoing research, regular review of standards, and availability of consumer information make mobile communications inherently precautionary. Commonsense measures can be adopted by individuals, governments, and industry to address public concern while ensuring that mobile networks are developed for the benefit of society. 相似文献17.
Background
The School Health Education Program (SHEP) is a collaboration of the John A. Burns School of Medicine and the State of Hawai‘i Department of Education that was founded to improve the health of Hawai‘i''s youth. This program allows premedical and medical students (collectively referred to as “medical students” from here on) to serve as health educators for high school students in six priority areas of health education.Objectives
To confirm the efficacy of this community health partnership program and to determine the factors resulting in its success.Methods
A total of 1714 students from seven of Hawai‘i''s public high schools were surveyed for improvement in their content knowledge and decision-making confidence after participating in SHEP presentations. A sub-group of 235 high school students were asked about their comfort level and trust in their interactions with medical students as compared to their health teachers.Results
The knowledge content and confidence in decision making increased significantly after participation in SHEP activities (p<.0001). High school students were found to be more comfortable and more trusting in learning about health topics from medical students as compared to health teachers (p<.0001). Reasons given included the medical students'' content knowledge as well as their presentation methods and positive attitude.Conclusions
The unique dual role of medical students as future physicians and as students allowed them to retain their credibility as health educators while developing a strong rapport with the high school students. Through SHEP, medical students can gain valuable experience through researching and teaching health topics while high school students receive additional health knowledge through this teaching. 相似文献18.
Introduction
Several organizations representing pharmacy and other health professions stress the importance of teaching public health topics as part of training future practitioners. The objective of our study was to assess the number of U.S. pharmacy schools that incorporate lifestyle modification topics into their curricula.Methods
We developed an electronic survey on lifestyle modification topics and sent it to each of the 89 pharmacy schools in the United States. The survey defined lifestyle modification topics as topics that address nutrition, exercise, weight loss, smoking cessation, and alcohol use.Results
Of 89 pharmacy schools contacted, 50 (56%) responded to the survey. Of the 50, four offer at least one required course in a lifestyle modification topic, seven offer at least one elective course, and one offers a required course that incorporates more than one lifestyle modification topic. Five required and nine elective courses were identified from the responses. Nutrition was the most commonly offered required course topic, followed by smoking cessation, exercise, weight loss, and alcohol use.Conclusion
Few pharmacy schools are addressing recommendations to promote public health education through formalized didactic courses. More courses on lifestyle modification topics should be offered to pharmacy students, who will be highly accessible to the public as pharmacists and will be able to offer education to enhance public health focused on the prevention of chronic diseases. 相似文献19.
Antonia J. Spadaro Jo Anne Grunbaum Demia S. Wright Diane C. Green Eduardo J. Simoes Nicola U. Dawkins Stephanie K. Rubel 《Preventing chronic disease》2011,8(3)
Introduction
The Centers for Disease Control and Prevention has administered the Prevention Research Centers Program since 1986. We quantified the number and reach of training programs across all centers, determined whether the centers'' outcomes varied by characteristics of the academic institution, and explored potential benefits of training and technical assistance for academic researchers and community partners. We characterized how these activities enhanced capacity building within Prevention Research Centers and the community.Methods
The program office collected quantitative information on training across all 33 centers via its Internet-based system from April through December 2007. Qualitative data were collected from April through May 2007. We selected 9 centers each for 2 separate, semistructured, telephone interviews, 1 on training and 1 on technical assistance.Results
Across 24 centers, 4,777 people were trained in 99 training programs in fiscal year 2007 (October 1, 2006-September 30, 2007). Nearly 30% of people trained were community members or agency representatives. Training and technical assistance activities provided opportunities to enhance community partners'' capacity in areas such as conducting needs assessments and writing grants and to improve the centers'' capacity for cultural competency.Conclusion
Both qualitative and quantitative data demonstrated that training and technical assistance activities can foster capacity building and provide a reciprocal venue to support researchers'' and the community''s research interests. Future evaluation could assess community and public health partners'' perception of centers'' training programs and technical assistance. 相似文献20.