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Capacity enhancement of hepatitis C virus treatment through integrated, community-based care.

https://arctichealth.org/en/permalink/ahliterature159237
Source
Can J Gastroenterol. 2008 Jan;22(1):27-32
Publication Type
Article
Date
Jan-2008
Author
Warren D Hill
Gail Butt
Maria Alvarez
Mel Krajden
Author Affiliation
British Columbia Centre for Disease Control, Vancouver, Canada.
Source
Can J Gastroenterol. 2008 Jan;22(1):27-32
Date
Jan-2008
Language
English
Publication Type
Article
Keywords
Antiviral agents - therapeutic use
British Columbia
Cohort Studies
Community Health Services - manpower - organization & administration
Counseling
Delivery of Health Care, Integrated - organization & administration
Female
Geographic Information Systems - statistics & numerical data
Health Services Accessibility - statistics & numerical data
Hepatitis C - drug therapy - prevention & control
Humans
Interferons - therapeutic use
Male
Middle Aged
Patient Education as Topic
Physician-Nurse Relations
Public health nursing
Ribavirin - therapeutic use
Treatment Outcome
Abstract
An estimated 250,000 Canadians are infected with the hepatitis C virus (HCV). The present study describes a cohort of individuals with HCV referred to community-based, integrated prevention and care projects developed in British Columbia. Treatment outcomes are reported for a subset of individuals undergoing antiviral therapy at four project sites.
Four demonstration projects based on a public health nurse and physician partnership were established in rural and small urban centres in British Columbia. Comprehensive medical assessments determined whether individuals received treatment, or counselling and education. Outcomes of the treatment group were compared with published randomized controlled trials. Client demographics were mapped using geographical information systems applications.
A total of 1795 individuals were referred to the clinics for medical assessment between September 2001 and December 2005. After assessment, 26% were eligible for therapy, while 74% received counselling and education. Wait times decreased annually, with one-half of all referrals assessed within 30 days. Combination antiviral therapy was initiated in 363 clients with interferon plus ribavirin (n=36) or pegylated interferon plus ribavirin (n=327). Treatment outcomes were available for 205 individuals. The overall rate of sustained virological response was 61% (126 of 205 individuals). The number of individuals assessed at each site represented, on average, 20% of the total cumulative reported HCV cases in the catchment areas.
The study findings illustrate how a public health nurse and physician partnership can service a population with complex medical needs while simultaneously increasing local capacity. Treatment outcomes were comparable with published clinical trials.
Notes
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PubMed ID
18209777 View in PubMed
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Engaging diverse underserved communities to bridge the mammography divide.

https://arctichealth.org/en/permalink/ahliterature137703
Source
BMC Public Health. 2011;11:47
Publication Type
Article
Date
2011
Author
Kimberly K Engelman
Ana Paula Cupertino
Christine M Daley
Trish Long
Angelia Cully
Matthew S Mayo
Edward F Ellerbeck
Mugur V Geana
Allen Greiner
Author Affiliation
Department of Preventive Medicine and Public Health, University of Kansas Medical Center, Kansas City, KS, USA. kengelma@kumc.edu
Source
BMC Public Health. 2011;11:47
Date
2011
Language
English
Publication Type
Article
Keywords
Alaska
Breast Neoplasms - ethnology - prevention & control
Community Health Services - manpower - organization & administration - standards
Early Detection of Cancer
Female
Health Behavior
Health Plan Implementation
Health Promotion - methods
Health Services Accessibility
Healthcare Disparities - standards
Hispanic Americans
Humans
Indians, North American
Kansas
Mammography - utilization
Mass Screening
Medically underserved area
Patient Acceptance of Health Care - ethnology - psychology
Rural Population
Abstract
Breast cancer screening continues to be underutilized by the population in general, but is particularly underutilized by traditionally underserved minority populations. Two of the most at risk female minority groups are American Indians/Alaska Natives (AI/AN) and Latinas. American Indian women have the poorest recorded 5-year cancer survival rates of any ethnic group while breast cancer is the number one cause of cancer mortality among Latina women. Breast cancer screening rates for both minority groups are near or at the lowest among all racial/ethnic groups. As with other health screening behaviors, women may intend to get a mammogram but their intentions may not result in initiation or follow through of the examination process. An accumulating body of research, however, demonstrates the efficacy of developing 'implementation intentions' that define when, where, and how a specific behavior will be performed. The formulation of intended steps in addition to addressing potential barriers to test completion can increase a person's self-efficacy, operationalize and strengthen their intention to act, and close gaps between behavioral intention and completion. To date, an evaluation of the formulation of implementation intentions for breast cancer screening has not been conducted with minority populations.
In the proposed program, community health workers will meet with rural-dwelling Latina and American Indian women one-on-one to educate them about breast cancer and screening and guide them through a computerized and culturally tailored "implementation intentions" program, called Healthy Living Kansas-Breast Health, to promote breast cancer screening utilization. We will target Latina and AI/AN women from two distinct rural Kansas communities. Women attending community events will be invited by CHWs to participate and be randomized to either a mammography "implementation intentions" (MI2) intervention or a comparison general breast cancer prevention informational intervention (C). CHWs will be armed with notebook computers loaded with our Healthy Living Kansas-Breast Health program and guide their peers through the program. Women in the MI2 condition will receive assistance with operationalizing their screening intentions and identifying and addressing their stated screening barriers with the goal of guiding them toward accessing screening services near their community. Outcomes will be evaluated at 120-days post randomization via self-report and will include mammography utilization status, barriers, and movement along a behavioral stages of readiness to screen model.
This highly innovative project will be guided and initiated by AI/AN and Latina community members and will test the practical application of emerging behavioral theory among minority persons living in rural communities.
Notes
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PubMed ID
21255424 View in PubMed
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Establishing a distributed campus: making sense of disruptions to a doctor community.

https://arctichealth.org/en/permalink/ahliterature143762
Source
Med Educ. 2010 Mar;44(3):256-62
Publication Type
Article
Date
Mar-2010
Author
Neil Hanlon
Laura Ryser
Jennifer Crain
Greg Halseth
David Snadden
Author Affiliation
Geography Program, University of Northern British Columbia, Prince George, British Columbia V2N 4Z9, Canada. hanlon@unbc.ca
Source
Med Educ. 2010 Mar;44(3):256-62
Date
Mar-2010
Language
English
Publication Type
Article
Keywords
British Columbia
Community Health Services - manpower - organization & administration
Education, Medical, Undergraduate - methods - organization & administration
Family Practice
Humans
Interprofessional Relations
Medically underserved area
Program Evaluation
Qualitative Research
Rural Health Services - manpower - organization & administration
Abstract
In August 2004, the Northern Medical Program (NMP), a distributed campus of the Faculty of Medicine at the University of British Columbia, Canada, admitted its first students. Situated at the University of Northern British Columbia in Prince George, the NMP created new opportunities, challenges, stresses and changes for the approximately 180 local specialists and family doctors. This study examines the initial impacts of the NMP on doctors practising in its host community.
Qualitative interview methods were used. A purposive sample was drawn from: (i) doctors who had involvement with the NMP, and (ii) doctors who were not involved with the NMP. Data were collected from May to September 2007 using a semi-structured interview guide. Interviews were audiotaped, transcribed and checked by participants. Analysis involved identifying, coding and categorising key emergent themes until saturation.
Prior to the implementation of the NMP, doctors in Prince George had formed cohesive networks, in the face of adverse conditions, that functioned effectively as a form of social capital. The introduction of new doctors and resources through the NMP disrupted this sense of community cohesiveness. Over time, however, the NMP has created new mechanisms by which doctors interact and develop partnerships.
The study confirms the value of a social capital framework for understanding a medical community's adaptation to change. At this early point, it appears the NMP has created new mechanisms by which doctors can interact and develop the partnerships and relationships necessary to renew a sense of community cohesion.
PubMed ID
20444056 View in PubMed
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Growing your own: community health workers and jobs to careers.

https://arctichealth.org/en/permalink/ahliterature133728
Source
J Ambul Care Manage. 2011 Jul-Sep;34(3):234-46
Publication Type
Article
Author
Brandy Farrar
Jennifer Craft Morgan
Emmeline Chuang
Thomas R Konrad
Author Affiliation
Institute on Aging, University of North Carolina at Chapel Hill, Chapel Hill, NC 27514, USA. bfarrar@schsr.unc.edu
Source
J Ambul Care Manage. 2011 Jul-Sep;34(3):234-46
Language
English
Publication Type
Article
Keywords
Alaska
Career Choice
Community Health Services - manpower - organization & administration
Community Health Workers - education - supply & distribution
Delivery of Health Care - manpower
Health Services Needs and Demand - statistics & numerical data
Humans
Massachusetts
New York
Program Development
Qualitative Research
Abstract
This article evaluates the implementation and impact of 5 workforce development programs aimed at achieving skills upgrades, educational advancement, and career development for community health workers (CHWs). Quantitative and qualitative case study data from the national evaluation of the Jobs to Careers: Transforming the Front Lines of Health Care initiative demonstrate that investing in CHWs can achieve measurable worker (eg, raises) and programmatic (eg, more skilled workers) outcomes. To achieve these outcomes, targeted changes were made to the structure, culture, and work processes of employing organizations. These findings have implications for other health care employers interested in developing their CHW workforce.
PubMed ID
21673522 View in PubMed
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[Hallingdal Infirmary. A health care level which adjusts to nursing needs].

https://arctichealth.org/en/permalink/ahliterature238803
Source
Sykepleien. 1985 May 6;72(8):6-10
Publication Type
Article
Date
May-6-1985

20 records – page 1 of 2.