The Norwegian "Campaign Against Home Accidents" was launched nationwide during 1988 to 1991, with the goal of reducing the incidence of home accidents by 20%. The aim of the campaign was to urge primarily the municipal health services to form local accident prevention groups and to implement local measures for prevention of home accidents. On the basis of two surveys, after one year and at the end of the national campaign, an evaluation was carried out concerning the participation of the municipal health services in the campaign and the impact of the campaign on local accident prevention activities. The results indicate that the national campaign engaged the majority of the municipalities and stimulated local accident prevention work to some extent. Most local activities were health education measures, whereas environmental intervention were less commonly reported. Involvement in the campaign was the variable most related to level of accident prevention activities at the end of the campaign period. However, the relationship was only modest. Restricted economical resources, too little emphasis on environmental change, lack of political involvement and insufficient use of coalition partners at the community level are suggested as the major explanations for the limited effect of the campaign.
Injuries due to accidents are a serious public health problem in Sweden as in the rest of the world. In Sweden injuries are the most frequent cause of death among people under the age of 50. More than 75% of all injuries occur in the home or surrounding area. Most accidents strike children, teenagers, and the elderly. Many accidents can be avoided. Prevention is therefore important. A community intervention programme for the prevention of accidents has been developed in the municipality of Sollentuna in Stockholm County. During the planning phase, a basic analysis of the local community was found to be useful, i.e. a Community Diagnosis, which includes three stages: description, analysis, and a health action programme. This report concentrates on the first two stages. To make a community diagnosis, some basic data are needed. In this report the relevance of the existing registers to the Community Diagnosis model is discussed. It is also shown how the Community Diagnosis model helped in the planning phase: the community profile demonstrated whom the prevention should be aimed at, the health profile emphasized the importance of accident prevention, the health risk profile showed where to change the environment, and last, the organizational profile elucidated how preventive work should be organized.
Participation in physical activity is important for the positive development and well-being of youth. A community- academic partnership was formed to improve access to physical activity for youth in one disadvantaged community in Ottawa, Canada. After consulting this community, a new hip-hop dance intervention was implemented. Adolescents aged 11 to 16 years participated in one of two 3-month sessions. A girls-only and a boys-and-girls format were offered both sessions. This article investigates the implementation of the intervention from the perspective of the youth participants, parents, staff, and researchers. Multiple methods were used, including document review, observation, questionnaire, focus groups, and interviews. Overall, the consistency and quality of program implementation were moderately satisfactory; however, important concerns were noted and this program appeared to be only partially delivered as planned. These findings will be discussed in terms of suggestions for improving the implementation of this intervention and similar recreation programs prioritizing disadvantaged communities.
In an attempt to reduce the harmful emotional effects of separation for young children, hospitals in recent years have liberalized visiting hours, but parents have not taken advantage of their new privileges. The study described here sought to increase mothers' participation in their children's hospitalization by overcoming some of the psychological barriers believed to exist. The mothers of 48 children aged 1 to 5, to be admitted for elective surgery to a large, metropolitan pediatric hospital, constituted the primary sample and were divided into experimental and control groups. Mothers in the experimental group had an extra half-hour session in a pre-admission interview focusing on visiting, and specific suggestions were made about frequency and timing of visits, as well as the role of the mother during her visits. During the experimental period weekly meetings were held with the nursing staff to enlist their support for this change in visiting patterns. Results indicate that duration of visits, timing of visits, and behavior during them were all significantly modified for the experimental group of mothers. In contrast, the nurses did not significantly change their relationship with the mothers or the children. Clinical possibilities and limitations of such a program are discussed.
An evaluability assessment was conducted to plan a community-based, multi-strategy approach to physical activity promotion (MSAPAP) to maximize young children's physical activity in an ethno-racially and socio-economically diverse city. This assessment involved consultation with various stakeholders to develop a program logic model to diagrammatically describe the MSAPAP. First, published literature regarding physical activity was reviewed to describe interventions designed to increase children's physical activity and to identify factors that contributed to program effectiveness. Secondly, key informants from mainstream service organizations and smaller community-based agencies were interviewed to determine their views on how to increase physical activity among children and families. A workgroup developed a draft logic model based on the results of the literature review and community needs assessment results. Thirdly, stakeholders were consulted about the draft model. This consisted of 12 focus groups with members of school boards (two sessions), members of community organizations (three sessions), lay home visitors who provide support to mothers of young children in ethno-racially diverse communities (one session), and parents from six cultural groups (six sessions). The logic model was revised based on the findings from this consultation. The final logic model shows children aged 3-8 years as the main target group, and parents and various community members who influence children as intermediate target groups. The MSAPAP is depicted as six strategies, which are clusters of program activities that are conceptually similar: community engagement, community assessment, accessibility, promotion, education and skill development, and inclusive programming. The logic model shows the 'cause and effect' relationships among program activities, shorter-term outcome objectives (e.g. to reduce user fees for physical activity programs) and longer-term outcome objectives (e.g. to increase the proportion of children who are physically active). The extensive community involvement in planning the MSAPAP facilitated a subsequent plan to develop, implement and evaluate selected program activities in the MSAPAP.
During the 1980s the community became the object of new interest and enthusiasm among many health promotion practitioners and researchers, and the principle of community participation was put on the research agenda. However, recent evaluations of major community health promotion programs have questioned the value of community interventions. This paper argues that the community level need not be of less importance in future health promotion initiatives. It is discussed whether the cultural dimension and the significance of local identities, neglected in most community health promotion programs, should receive more attention when local inhabitants are invited to participate in health promotion or disease prevention activities. Results from a study of injury prevention projects in small Norwegian municipalities indicate that the inhabitants' identification with local spatial subarenas might play an important role when they decide to become involved in injury prevention. Contemporary sociological approaches to the community, focusing on developments of local identities in processes of globalization, have formed a theoretical frame of reference in this study.
The realities of doing field research with high-risk, minority, or indigenous populations may be quite different than the guidelines presented in research training. There are overlapping and competing demands created by cultural and research imperatives. A National Institute on Drug Abuse (NIDA)-funded study of American Indian youth illustrates competing pressures between research objectives and cultural sensitivity. This account of the problems that were confronted and the attempts made to resolve them will hopefully fill a needed gap in the research literature and serve as a thought-provoking example for other researchers. This study built cross-cultural bridges. Researchers worked as a team with stakeholders to modify the instruments and methods to achieve cultural appropriateness. The researchers agreed to the communities' demands for increased service access and rights of refusal for all publications and presentations. Data indicate that these compromises did not substantially harm the first year of data collection completeness or the well-being of the youth. To the contrary, it enhanced the ability to disseminate results to those community leaders with the most vested interests. The conflicts between ideal research requirements and cultural demands confronted by the researchers and interviewers in the American Indian community were not necessarily different from issues faced by researchers in other communities. Of major import is the recognition that there are no easy answers to such issues within research.
Cites: J Am Acad Child Adolesc Psychiatry. 2000 Aug;39(8):1032-910939232
Little has been written about how repeated hospitalizations affect family life when the context is chronic rather than acute illness. This article presents findings from a qualitative study designed to explore parents' views when their chronically ill children were hospitalized. These findings address the problems arising when the family's frame of reference is oriented toward their experience with long-term illness and the frame of reference of the professional health care provider in the hospital is oriented toward acute disease. It is suggested that unacknowledged discrepancies in viewpoints may cause the relationships between family members and professional health care providers to become adversarial, a situation which negatively affects both the effectiveness of care and perceived satisfaction with care.