Health care reform can provide opportunities for collaboration between universities and the public at large. An advanced community nursing class within a post-RN program at a university combined resources with a nearby rural community to complete a community health and social needs assessment. The partners in the project included the local hospital, health unit, and the university; funding was secured from the Regional Center for Health Promotion and Community Studies and the two health agency partners also made a financial donation. Community liaisons who were both registered nurses and residents of the community, we instrumental in completing tasks and activities related to the project. The students were taught the various data collection methods and participated in class assignments refining the necessary skills required for the actual assessment. This project benefited the community by providing baseline health status and social needs data in an era of dramatic health care reform while simultaneously affording undergraduate nursing students the opportunity to apply theory to practice.
OBJECTIVE: Despite good evidence and clinical practice guidelines, studies document that treatment of type 2 diabetes is less than optimal. Lack of resources or limited access may put patients in rural communities at particular risk for suboptimal care. RESEARCH DESIGN AND METHODS: We conducted a prospective, before/after study with concurrent controls to assess the effectiveness of a multidisciplinary diabetes outreach service (intervention) for improving the quality of care for rural patients with type 2 diabetes. Our intervention consisted of six monthly visits by a traveling team of specialist physicians, nurses, dieticians, and a pharmacist. The core of this service was specialist-to-rural primary care physician academic group detailing. Two comparable regions in Northern Alberta were randomly allocated to control or intervention. Data were collected before and 6 months after intervention in a representative volunteer sample. The primary outcome was a 10% improvement in any one of the following: blood pressure, total cholesterol, or HbA(1c). RESULTS: Our analysis included 200 intervention and 179 control subjects; 14 subjects were at all three primary outcome targets at baseline. The intervention was associated with a trend toward improvement in primary outcome at 6 months (44% intervention vs. 37% control; odds ratio 1.32, 95% CI 0.87-1.99). The intervention was associated with a significant improvement in blood pressure (42% intervention vs. 25% control, P = 0.004); however, there were only small, nonsignificant changes in cholesterol or HbA(1c). The intervention was associated with a significant increase in satisfaction with diabetes care. Multivariate adjustment for baseline differences between intervention and control subjects did not affect any of the main results. CONCLUSIONS: A diabetes outreach service has the potential to improve the quality of diabetes care for rural patients. Future studies need to involve longer timelines and larger sample sizes.
Networks can be used to develop shared frameworks that extend limited specialized healthcare services beyond tertiary level settings to provide services closer to home. This article provides an overview of networks, describes the context and purpose of the Southern Alberta Child & Youth Health Network, reports on early experiences with implementation of an Outreach Services Framework, and discusses implications from a network perspective.
Infection with the human immunodeficiency virus (HIV) is a complex and challenging issue for Aboriginal people in Canada. There is a need for HIV/AIDS prevention programs that address the specific needs of Canadian Aboriginal communities in a culturally accepted manner. The Feather of Hope Aboriginal AIDS Prevention Society provides culturally sensitive HIV prevention programs to Aboriginal communities in Alberta. The community development approach used by the Society emphasizes empowerment at the individual and group level. This approach is congruent with the shift to self-determination by Aboriginal people throughout Canada.
The Fort McMurray Demonstration Project in Social Marketing is a multifaceted program that applies the techniques of social marketing to health and safety. This paper describes the origins of the project and the principles on which it was based. VENUE: Fort McMurray, in the province of Alberta, Canada, was selected because the community had several community initiatives already underway and the project had the opportunity to demonstrate "value added."
The project is distinguished from others by a model that attempts to achieve mutually reinforcing effects from social marketing in the community as a whole and from workplace safety promotion in particular.
Specific interventions sponsored by the project include a media campaign on cable television, public activities in local schools, a community safety audit, and media appearance by a mascot that provides visual identity to the project, a dinosaur named "Safetysaurus." The project integrated its activities with other community initiatives.
The evaluation component emphasizes outcome measures. A final evaluation based on injury rates and attitudinal surveys is underway.
Baseline data from the first round of surveys have been compiled and published. In 1995, Fort McMurray became the first city in North America to be given membership in the World Health Organization's Safe Community Network.
OBJECTIVE: Aspects of oral health related quality of life (OHQOL) are attracting increased attention in dentistry. Knowledge in this field is limited, especially in terms of significant indicators and predictors of impaired OHQOL. The aim of this cross-sectional study was to examine the influence of various sociodemographic and clinical variables on OHQOL in the setting of outreach clinics in northern Alberta, Canada. METHODS: OHQOL was measured with the 49-item Oral Health Impact Profile questionnaire (OHIP-49), administered to adult patients attending 3 dental outreach clinics managed by the University of Alberta. Sociodemographic and clinical data were also collected. Data were analyzed using descriptive and multivariable methods. RESULTS: The OHIP-49 scores were comparatively low for a patient sample. After multivariable stepwise logistic regression analysis, only gender, missing anterior teeth and need for endodontic treatment remained as significant variables in the final model for impaired OHQOL. Missing anterior teeth (regardless of replacement) had the strongest effect. Subjects with this feature had an approximately 21-fold greater risk of impaired OHQOL relative to those who retained all of their anterior teeth. CONCLUSIONS: The clientele of these outreach clinics was generally young but had high treatment needs. OHQOL results can be useful in considering treatment strategies in similar rural environments, but the complexity of this indicator necessitates an individual patient-centred approach in clinical decision-making.