Objectives:This study aimed to evaluate the clinical effectiveness,durability,and acceptability of a Korean medicine-based online mental health self-care program for mothers.Methods:This non-randomized comparative stu...Objectives:This study aimed to evaluate the clinical effectiveness,durability,and acceptability of a Korean medicine-based online mental health self-care program for mothers.Methods:This non-randomized comparative study evaluated the clinical effectiveness,durability,and acceptability of a Korean medicine-based online mental health self-care program for mothers.Group 1(regular version)included 120 participants who attended one live session per week for 5 weeks,while Group 2(shortened version)included 30 participants who completed five recorded sessions within 1 week.A total of 112 participants(93.3%)in Group 1 and all 30 participants(100%)in Group 2 completed the program and surveys.Results:Within-group analyses demonstrated significant improvements for depression(ΔCESD-10[Center for Epidemiological Studies Depression Scale-10]=−2.38±2.10,p<0.001;Cohen’s d=1.10),anxiety(ΔGAD-7[Generalized Anxiety Disorder Scale-7]=−3.82±3.20,p<0.001;d=0.93),and stress(ΔPSS[Perceived Stress Scale]=−6.44±4.50,p<0.001;d=1.12)in Group 1.Between-group analysis of covariance(ANCOVA)of postintervention scores showed significant differences favoring Group 1 in CESD-10(p<0.001)and GAD-7(p=0.025).These improvements were largely maintained through the 12-week follow-up(all p<0.001),indicating both statistical and clinical significance.The average willingness-to-pay per session was 8562.5±3609 KRW,and overall satisfaction was high.Conclusion:These findings demonstrate that the regular 5-week Korean medicine-based online program is effective,cost-effective,and capable of sustaining improvements in maternal mental health,supporting its potential use in community-based care strategies.展开更多
Objective:To investigate the impact of programmed harmonious nursing combined with hierarchical management on nursing quality and satisfaction in a health management center.Methods:A total of 100 patients who received...Objective:To investigate the impact of programmed harmonious nursing combined with hierarchical management on nursing quality and satisfaction in a health management center.Methods:A total of 100 patients who received care at this health management center from January 2024 to January 2025 were selected as subjects.Using a random number table method,they were divided into an observation group(n=50)and a control group(n=50).The control group followed traditional methods,while the observation group integrated programmed harmonious nursing with hierarchical management.Comparative analysis was conducted on nursing quality scores,adverse event occurrence rates,and patient satisfaction between the two groups.Results:The observation group showed significantly improved nursing quality scores(P<0.05)and markedly reduced incidence of adverse events(P<0.05),with statistically significant differences compared to pre-treatment conditions(P<0.05).Conclusion:The combination of hierarchical management and programmed harmonious nursing demonstrates effectiveness in enhancing medical service quality,reducing adverse reactions,and improving patient satisfaction—a method worthy of promotion.展开更多
Objective To investigate the social mental state of drug addicts in a compulsive drug abuse treatment center; evaluate the effectiveness of integrated program for the prevention of abuse relapse and improvement of dru...Objective To investigate the social mental state of drug addicts in a compulsive drug abuse treatment center; evaluate the effectiveness of integrated program for the prevention of abuse relapse and improvement of drug addicts＇ psychological health. Methods The study subjects were addicts from the Wuhan Compulsive Drug Abuse Treatment Center between October 2003 and June 2004, who satisfied the inclusion criteria. A non-randomized control-intervention study design was adopted. Volunteers willing to take part in intervention were put into the intervention group with their full awareness and willingness to prevent drug abuse relapse. The control group was composed of the addicts who were willing to prevent relapse and to be followed up after their discharge. Results The effectiveness of the integrated intervention program in promoting addicts＇ psychological health： before the intervention, the scores of Self-Rating Anxiety Scale （SAS）, the positive and negative dimensionalities of Simple Coping Style Questionnaire （SCSQ） and Chinese Perceived Stress Scales （CPSS） had no significant differences between the intervention group and the control group. After the intervention, except that the SCSQ＇s positive dimensionality in the intervention group was significantly higher than that in the control group, other indices in the intervention group were lower. Before and after the intervention, the psychological health level in both the groups was lower than that in the normal population; there were significant differences between addicts and normal subjects in regards with all of the indices above. Conclusion Drug abuse was associated closely with addicts＇ social mental factors. The integrated intervention program can alleviate anxiety and stress, reduce co-morbid mental disorders and effectively improve their coping style. In conclusion, the program can promote addicts＇ psychological health significantly.展开更多
Successful health promotion programs are characterized in part, by the willingness of audiences to engage, participate, and adopt healthier behaviors. But presentation of messages that reach and resonate with the inte...Successful health promotion programs are characterized in part, by the willingness of audiences to engage, participate, and adopt healthier behaviors. But presentation of messages that reach and resonate with the intended audience remains challenging. This is due in part to the variety of mindsets—viewpoints, attitudes, and beliefs—within a population. These mindsets play an essential role in understanding and predicting behaviors and lifestyle factors associated with health or chronic diseases. The purpose of this study is to demonstrate how a specific survey-based method of mindset segmentation can distinguish predominant mindsets and then be used to create, adapt, and/or market health programs to appeal to these mindsets. Steps in survey construction, distribution, and analysis are described. Interpretation of the results, yielding three primary mindsets, is the critical outcome of this segmentation method. The applications of this interpretation to community health education programs are suggested. This approach has potential to inform, enhance, or customize programs, tailoring activities, methods, and messages to the preferences of the community.展开更多
ObjectiveTo evaluate the impact of Antimicrobial Stewardship Programs(ASPs)on antibiotic use and drug resistance.MethodsThis was a retrospective,multicenter,management intervention study.The data from 85 maternity hos...ObjectiveTo evaluate the impact of Antimicrobial Stewardship Programs(ASPs)on antibiotic use and drug resistance.MethodsThis was a retrospective,multicenter,management intervention study.The data from 85 maternity hospitals(maternal and child health care hospitals)in Hubei province from 2012 to 2019 were collected.The indicators related to antimicrobial drug use included the utilization rate of different grades of antimicrobial drugs,the intensity of antimicrobial agent use,the rational use of prophylactic antimicrobial agents before class I surgical incision,and pathogenic detection and consultation rates before antimicrobial drug use.ResultsSince the implementation,the purchase of antimicrobial agents in hospitals has been maintained within the prescribed range,and the defined daily dose system(DDDs)of antimicrobial agents has been reduced,prophylactic use and accurate treatment of antimicrobial agents related to class I surgical incision have been more reasonable.With the implementation of ASPs,the detection rate of imipenem-resistant Acinetobacter baumannii,cefotaxime-resistant Escherichia coli,and methicillin-resistant Staphylococcus aureus has been decreased in China from national bacterial resistance surveillance data.ConclusionASPs have positive effects on antibiotic use and drug resistance in 85 maternity hospitals(maternal and child health care hospitals).展开更多
Previous main body of research on end-life-care in South Korea has focused on developing services quality in hospital settings or service payment system in National Health Insurance Program. The delivery system of hos...Previous main body of research on end-life-care in South Korea has focused on developing services quality in hospital settings or service payment system in National Health Insurance Program. The delivery system of hospice and palliative care services has evolved in diverse ways but there is little research on reviewing the past history of development and whole picture of them so far. So, the aim of this study is to review the old hospice and palliative care system and also to introduce the current one supported by the National Health Insurance Program in South Korea. The palliative care or hospice services in South Korea have been available in diverse settings and provided by different organizations (i.e. catholic hospitals or charity organizations). Finally, it was set up in 2004 that the hospice team or official Palliative Care Units (PCUs) was established in hospitals, in order to meet the end-of-life care for the patients with terminal cancer under the Cancer Control Act. The current hospice and palliative care services such as pain management, bereavement services, and counselling can be reimbursed by National Health Insurance program since 2008. Nevertheless hospice and palliative care services are available to dying patients, yet the utilization rate of hospice and palliative care services or the length of stay in the palliative care unit (PCU) is still relatively short compared to other country systems. South Korea is undergoing several efforts to expand the services in PCU along with the development of quality indicators for PCU. Hospice and palliative care services are still new in the health care system and unfamiliar to the public so it requires raising awareness for medical professionals and the public as well as further research.展开更多
This proposal focuses on the prevalence of teenage pregnancy issue in NJ and illustrates the benefits of school-based health clinics and educational programs which should be implemented for teenage pregnancy and child...This proposal focuses on the prevalence of teenage pregnancy issue in NJ and illustrates the benefits of school-based health clinics and educational programs which should be implemented for teenage pregnancy and childbearing.Without the early intervention of educational programs and preventive medical services which should be implemented in school areas,teen pregnancy and childbearing can have physical and emotional health influences on teen mothers,their babies and other family members,and the worst consequence should be abortion.What’s more,teenage pregnancy and childbearing have substantial economic consequence for state.The annual estimated cost associated with teen childbearing (teens 19 and younger) in NJ to taxpayers is at least $167 million in 2004 (24% federal costs and 76% state and local costs).Studies demonstrated that a much larger amount of money is spent on the consequences of teenage pregnancy than on prevention.NJ has an opportunity to invest in prevention and reduce not only the monetary but also the societal costs to our youth burdened by the often overwhelming responsibilities of teenage pregnancy and parenting.According to the 15 years follow-up research and data analyzing,two models of success which specifically implemented in South Carolina high schools and Chicago public schools have been proved to effectively reduce incidence of repeat pregnancy and emergency room visits,reduce incidence of teen mothers smoking during pregnancy,improve emotional outcomes among teen mothers,decrease incidence of teen mothers drug impairment,arrest,conviction,or jail time and reduce use of food stamps and other public assistances,which can consequently increase the state public health costs.In order to support teen mothers’ academic,physical,emotional and social needs in a stable and consistent school environment,the plan which titled "Physical and Mental Health Promotion for NJ Teen Mothers" is effective and practical enough to arouse the attention of some relevant departments.It’s worth patron to fund the plan because supporting teenage pregnancy at early stage can subsequently benefit the national and state economy and teen mothers.展开更多
Objectives: The aim of this study was to implement a health education program for education of preconception care (PCC) for female workers of reproductive age through a seminar and to evaluate the program based on PCC...Objectives: The aim of this study was to implement a health education program for education of preconception care (PCC) for female workers of reproductive age through a seminar and to evaluate the program based on PCC knowledge and awareness and behaviors before the seminar and at 3 and 6 months after the seminar. Methods: A small group health education seminar was implemented using leaflets for 84 female workers of reproductive age, age 20 to 35 years old, and an intervention by group discussion and feedback was provided. Of these participants, 60 (71%) who provided valid survey responses were included in the analysis. The primary outcome indicators were PCC knowledge, PCC awareness and behaviors, and a food frequency questionnaire, and the secondary outcome indicators were self-efficacy and the health awareness and stress management subscales of the Health-Promotion Lifestyle Profile scale. The survey was conducted three times, before the seminar and at 3 and 6 months after the seminar, and the results were compared. Results: The percentage of individuals with PCC knowledge was significantly increased at 3 months after the seminar as compared with before the seminar, and it remained at this level even at 6 months after the seminar. The percentage of individuals with PCC awareness and behaviors was significantly increased for the items actively eat foods containing folic acid, prevent sexually transmitted diseases, and conduct self-examinations for breast cancer at 3 months after the seminar and for the items eat well-balanced meals, make the mind active, prevent sexually transmitted diseases, and conduct self-examinations for breast cancer at 6 months after the seminar. Furthermore, the score for the health awareness subscale of the Health-Promotion Lifestyle Profile scale was significantly increased at 6 months after the seminar. Conclusion: The health education program established PCC knowledge at 6 months after the seminar and improved some PCC awareness and behaviors. Therefore, it was suggested that the program would be effective for education of PCC for female workers of reproductive age.展开更多
Objectives This study aimed to investigate the effect of a peer-training program for village health volunteers(VHVs)to improve chronic disease management among older adults in rural Thailand.Methods The study was guid...Objectives This study aimed to investigate the effect of a peer-training program for village health volunteers(VHVs)to improve chronic disease management among older adults in rural Thailand.Methods The study was guided by community-based participatory research(CBPR).The peer-training program was developed by engaging diverse stakeholders,including community organizations,healthcare services,VHVs,older adults with chronic illnesses,and folk scholars in remote communities with high healthcare needs.The peer-training program comprised a three-day training workshop that convened once a week for three weeks with the following six sessions:knowledge sharing,peer support and empowerment,health literacy and health behavior,the general caring procedure for older adults with chronic illnesses,information sharing and communication,and home visit.From January to April 2021,a total of 28 VHVs completed the peer training program in a rural area in Chiang Rai province,Thailand.The Health Literacy and Health Behavior-3E2S(HLHB-3E2S),the Management of Non-Communicable Diseases Questionnaire(MNCDQ),and a self-confidence questionnaire were used to survey pre(week 1)and post-intervention(week 12),respectively.Then VHVs were interviewed to collect attitudes,and opinions about the intervention.Results After the intervention,the HLHB-3E2S scores(49.39±5.54 vs.52.35±4.26,P=0.001),the MNCDQ scores(44.10±6.27 vs.50.60±4.84,P<0.001),and the self-confidence questionnaire scores(22.28±2.46 vs.23.21±1.81,P=0.01)of VHVs significantly increased.VHVS also reported that the peer-training program enhanced their healthcare services,including health education,chronic disease management,leadership skills,and improving their relationship with healthcare providers.Conclusion Peer training programs are a practical strategy to improve VHVs’capacities.Healthcare professionals should provide a continuous training program for VHVs with their peers to increase capacities,confidence,and satisfaction in caring for the older adults with chronic diseases in the community.展开更多
Objective: The pilot study was intended to test the feasibility of a multiple-component lifestyle intervention targeting African American adults in a weight control and cardiometabolic risk reduction program on diet, ...Objective: The pilot study was intended to test the feasibility of a multiple-component lifestyle intervention targeting African American adults in a weight control and cardiometabolic risk reduction program on diet, activity, and stress, using community-engagement principles. Methods: Applying mixed qualitative and quantitative measures, the intervention had a two-part sequential study design consisting of 12 weekly small group sessions that provided individual and group counseling in nutrition, exercise, and mindfulness, while incorporating focus group and interactive techniques to learn about barriers and acceptable practices for this population. The program was implemented at an African-American church in Nashville, Tennessee. Results: Thirty-four participants (aged 56.1 ± 11 years, body mass index (BMI) 36.7 ± 6.6 kg/m2) completed the intervention. Lifestyle changes after the 12 weekly sessions showed some positive trends including reduced sodium intake (from 2725.3 ± 326.5 to 2132 ± 330, mg/day, P = 0.008), increased walking steps (from 4392.1 ± 497.2 to 4895.3 ± 497.9, steps/day, not significant), and slightly decreased Perceived Stress Scale (PSS) scores (from 13.7 ± 1.4 to 12.4 ± 1.5, not significant). Body fat % among male participants decreased significantly (from 33.8 ± 2.6 to 28 ± 2.6, %, P = 0.043). Among cardiometabolic risk biomarkers, hemoglobin A1c (HbA1c) decreased significantly (from 6.6 ± 0.2 to 6.1 ± 0.2, %, P β = 2.4, P = 0.006). Twenty-one participants took part in focus groups during the program to identify barriers to healthy lifestyle changes. Primary barriers reported were price, time for preparing healthy meals, unfamiliarity with mindfulness activities, their health condition, and daily schedule available for physical activities. Conclusions: This church-based pilot intervention was proven feasible by showing modest progress in reducing adiposity and decreasing HbA1c levels. The focus group and interactive methods facilitated program direction. Future full-scale studies are warranted to identify key strategies that provide more personalized approaches and supportive environments to sustain a healthy lifestyle among these at risk minorities with limited resources.展开更多
Adolescence represents a sensitive time period during an individual’s development during which physical, psychological, and social risk factors for non-communicable diseases are established. As such, there is a neces...Adolescence represents a sensitive time period during an individual’s development during which physical, psychological, and social risk factors for non-communicable diseases are established. As such, there is a necessity to engage adolescents in planning and decision-making processes that will affect their future health. This paper describes the need for more innovative and transversal actions, starting from the utility of a multidisciplinary and systemic approach to health. One way in which this can be achieved is by shifting adolescent health programs (AHPs) from a clinically oriented to an education-based model. In particular, AHPs need to consider a personalized and systemic approach to the well-being of adolescents in order to potentiate their strengths and improve weaknesses, enhancing self-esteem, empowerment, and resilience. This is in line with the complexity of human physiology and psychology, as well as scientific evidence showing that several factors significantly influence health status including lifestyle, social context, emotional experiences, and cognitive skills, as demonstrated by the AVATAR Project (“A new purpose for promotion and eVAluation of healTh and well-being Among healthy teenageRs”). This project—which provides a new framework for AHPs—was carried out in Italy and enrolled healthy students as subjects, and aimed to promote well-being in adolescents using a systemic and multistake-holder approach that involved creating a network composed of the different figures and environments around adolescents and moving toward a more school-based and student-centered approach to adolescent health education.展开更多
Item Response Theory (IRT) models have been extensively used in the field of education to identify link between a response to a test item and underlying latent capability of the test taker. We demonstrate the benefit ...Item Response Theory (IRT) models have been extensively used in the field of education to identify link between a response to a test item and underlying latent capability of the test taker. We demonstrate the benefit of using IRT model to analyze health data using data from M. chat program such that statisticians can use the method in lieu of traditional methods including Cronbach’s alpha, discriminant analysis and factor analysis. M. chat is a technology based health coaching program and the baseline survey from the participants in the program includes response in different but correlated domains of diet, social habits, leisure practices, mental health, substance abuse, self-sufficiency and medication adherence. We analyzed baseline data from 416 subjects using IRT models. Our results indicated that responses pertaining to alcohol and substance abuse were the most discriminating items with an average discrimination estimate of approximately 4.99 whereas the least discriminating items were the diet habits, with an average estimate of -0.476.展开更多
Agrarian occupational health is a neglected primary health-care service in India.A nurse-led health promotion program is planned based on a Conceptual Model for the Occupational Health Nurse Specialist prepared by Ms....Agrarian occupational health is a neglected primary health-care service in India.A nurse-led health promotion program is planned based on a Conceptual Model for the Occupational Health Nurse Specialist prepared by Ms.Janice Dees(1984)inspired from Orem’s self-care theory.The interventions included are range of motion exercise,progressive muscle relaxation technique,foot and palm massage,and literacy on safety practices.The wellness of field farmers is expected by following this program plan.展开更多
Background:School health program(SHP)is the most cost-effective investment a nation can make to simultaneously improve education and health conditions of her citizen.In spite of this,the adoption of SHP in developing ...Background:School health program(SHP)is the most cost-effective investment a nation can make to simultaneously improve education and health conditions of her citizen.In spite of this,the adoption of SHP in developing countries is still below set standard.Therefore,this study assesses the operations of SHP in secondary schools in Egor Local Government Area(LGA),Benin City,Nigeria.Materials and Methods:A descriptive cross-sectional survey was conducted with accidental sampling method to select 56 school health teachers from secondary schools in Egor LGA.A self-structured instrument was used to collect data based on the research objectives.Data collected were analyzed using percentages,means,and standard deviation.Results:This study showed that despite high level of the program awareness,the actualization of its objective was found to be poor,and this was found to be related with the lack of government support,lack of needed personnel and materials,lack of effective supervision of the program and inappropriate funding.Conclusion:In-service training on SHP should be provided to enhance the skills needed for implementation of SHP.The government should provide needed materials and equipment and employ competent health personnel to take charge of the school health services,and other policymakers should mobilize and strengthen SHP and education activities at the state.展开更多
In the peroid of confusion after the Korean War, there was an absolute shortage in the volume of food. The intake of energy and all other nutrients fell short of the recommended dietary intake. To solve the food short...In the peroid of confusion after the Korean War, there was an absolute shortage in the volume of food. The intake of energy and all other nutrients fell short of the recommended dietary intake. To solve the food shortage, there were many food assistant programs through the government channel. With the economic developments during past years, now, there are enough foods for everyone. Thus, food assistant program, which has been the only nutrition program in the government, is no longer needed except for low-income families.Currently, there are not enough nutrition programs in the government. In 1994, about 30 public health center start nutrition programs with the help of Korean Dietetic Association.In this study, kinds of nutrition programs, age, sex and number of participants, the content of programs are studied. The effects of nutrition programs are partially evaluated.Also, problems with current nutrition programs are discussed. Finally, future directions of nutrition programs in the public health centers are discussed展开更多
Background Examining the health outcomes of veterans who have completed the United States Veterans Health Administration’s(VHA’s)Traumatic Brain Injury(TBI)Screening and Evaluation Program may aid in the refinement ...Background Examining the health outcomes of veterans who have completed the United States Veterans Health Administration’s(VHA’s)Traumatic Brain Injury(TBI)Screening and Evaluation Program may aid in the refinement and improvement of clinical care initiatives within the VHA.This study compared self-reported physical functioning,cardiometabolic health conditions,and health care utilization patterns in Million Veteran Program enrollees with TBI Screening and Evaluation Program data(collected between 2007 and 2019),with the goal of enhancing understanding of potentially modifiable health conditions in this population.Methods In this observational cohort study,veterans(n=16,452)were grouped based on the diagnostic outcome of the TBI Screening and Evaluation Program:1)negative TBI screen(Screen^(-));2)positive TBI screen but no confirmed TBI diagnosis[Screen^(+)/Comprehensive TBI Evaluation(CTBIE)^(-)];or 3)positive TBI screen and confirmed TBI diagnosis(Screen^(+)/CTBIE^(+)).Chi-square tests and analysis of covariance were used to explore group differences in physical functioning,cardiometabolic health conditions,and health care utilization patterns,and logistic regressions were used to examine predictors of Screen^(+/-)and CTBIE^(+/-)group status.Results The results showed that veterans in the Screen^(+)/CTBIE^(-)and Screen^(+)/CTBIE^(+)groups generally reported poorer levels of physical functioning(P’s<0.001,np2=0.02 to 0.03),higher rates of cardiometabolic health conditions(P’s<0.001,φ=0.14 to 0.52),and increased health care utilization(P’s<0.001,φ=0.14 to>0.5)compared with the Screen-group;however,health outcomes were generally comparable between the Screen^(+)/CTBIE^(-)and Screen^(+)/CTBIE^(+)groups.Follow-up analyses confirmed that while physical functioning,hypertension,stroke,healthcare utilization,and prescription medication use reliably distinguished between the Screen-and Screen^(+)groups(P’s<0.02,OR’s 0.78 to 3.38),only physical functioning distinguished between the Screen^(+)/CTBIE^(-)and Screen^(+)/CTBIE^(+)groups(P<0.001,OR 0.99).Conclusions The findings suggest that veterans who screen positive for TBI,regardless of whether they are ultimately diagnosed with TBI,are at greater risk for negative health outcomes,signifying that these veterans represent a vulnerable group that may benefit from increased clinical care and prevention efforts.展开更多
Compliance with appropriate flock health program is vital for preventing introduction and minimizing impact of diseases in goat farms. Unfortunately, most goat farms in Uganda, especially in the Albertine Graben Zone ...Compliance with appropriate flock health program is vital for preventing introduction and minimizing impact of diseases in goat farms. Unfortunately, most goat farms in Uganda, especially in the Albertine Graben Zone lack flock health program. The associated frequent outbreaks slow down effort aimed at commercializing goat production. In this study, we documented flock dynamics, identified and prioritized pressing challenges experienced by goat farms during the year 2022 and generated appropriate flock health program and packaged it for dissemination to farmers. Materials and Methods: Using a cross-sectional design, semi-structured questionnaire, data were collected and analyzed with MS Excel 2013. The data included: location and socio-demographics of household, farming system, flock dynamics, housing, feeding system, health management, challenges encountered by goat farm and suggested solutions. Results: Beginning January 2022 to December 2022, the number of goats reared in all the 45 sample farms increased from 2128 to 2220 goats. Results showed that 884 kids were produced and 88 breeding goats were introduced into the farms. Three hundred ninety-nine goats died due to mainly diseases and 435 goats got withdrawn through nondeath. The average farm level and overall mortality rate were 21 goats per 1000 goatmonths and 15 goats per 1000 goatmonths respectively. The most pressing challenges encountered by sample farms were death of goats especially due to diseases, poor access to veterinary extension services, high cost of inputs and feed scarcity. Solutions suggested by sample farms were improved access to veterinary services, improved housing, enhanced vaccination of goats against diseases, and enhanced grazing land management and feed conservation, all of which were incorporated into the flock health program. Conclusion and Recommendations: An appropriate flock health program was generated based on flock dynamics and production constraints which reveal high mortality and limited access to veterinary services respectively. Actors are recommended to promote adoption and adherence to the flock health program so as to increase goat production and access to wider market.展开更多
Community health workers are equipped with the tools and resources necessary to bring about a change in the form of a rapid chain reaction.The community health workers model focuses on the practices,strategies,plans,a...Community health workers are equipped with the tools and resources necessary to bring about a change in the form of a rapid chain reaction.The community health workers model focuses on the practices,strategies,plans,and implementation techniques needed to organize a community health event based on diverse agendas:health,environment,and minorities.This model encompasses past experiences as a guide with tested strategies to assist future health interns with a ground framework and resources to showcase the importance of adopting healthy and environmentally friendly practices.The basic outline of the model is based on data collected from various community health events in Illinois(United States of America)and New Delhi(India).These events included back to school fairs,cleanliness drives,health camps,and educational events.As community health workers can help in implementing better practices in the masses through one-on-one interactions,this model of community health worker programs would outline event organization tips,predicted outcomes,targeted audience,and required material templates.The next phase of this model highlights utilizing the data and experience from these events to report to the health ministries of different countries for the incorporation of the proposed practices in their health agendas and policies.This model,if implemented unanimously,could bring about a revolution in the arena of health workers.They will be assisted at each step,will establish connections with health workers globally,and share their health and environment-based agendas to collaborate and organize important events.This model envisions a strong established network of community health workers,display of their agenda,and creation of a ripple effect throughout the society by the means of these programs.展开更多
Quality of maternal and newborn care could be improved if health care providers’ knowledge and competencies as well as system level constraints are addressed. However, due to several barriers staff nurses who form th...Quality of maternal and newborn care could be improved if health care providers’ knowledge and competencies as well as system level constraints are addressed. However, due to several barriers staff nurses who form the frontline of health care workforce have limited access to enhancing their clinical knowledge and competencies. To address this gap, a new cadre of nurse mentors (NMs) for the public health system were trained by specialists from a teaching hospital in a special 5-week training course. This included 54 hours of theory and 110 hours of practical in clinical obstetric and newborn care, apart from mentoring, quality improvement and health systems issues. The nurse mentors were assigned to support staff nurses in the primary health care centres (PHCs) in eight northern Karnataka districts. Each NM covered 6-8 PHCs monthly for 2 - 3 days and thus a total of 385 PHCs were reached. They received support in the field through supportive supervision visits done by the specialists who had trained them, as well as by refresher training and clinical postings to the district hospitals. This paper presents impact of the training program on change in immediate and long term knowledge and competency scores of nurse mentors. Their baseline knowledge scores changed from 44.3 ± 12.7 to 72.1 ± 13.8 immediately after the training in obstetric and from 18.2 ± 19.1 to 66.4 ± 14.9 in newborn (p p p > 0.05). Skills score soon after training increased from 62.2 ± 13.2 to 69.6 ± 12.5 in obstetric after a 1 year period and from 52.6 ± 9.3;63.5 ± 14.4 in newborn (p < 0.001) content areas respectively. These findings have implications for those interested in improving quality of maternal and child care through nurse-dependent health delivery systems.展开更多
基金supported by the National Research Foundation of Korea(NRF)grant funded by the Korea government(MSIT)(No.2020R1A5A2019413).
文摘Objectives:This study aimed to evaluate the clinical effectiveness,durability,and acceptability of a Korean medicine-based online mental health self-care program for mothers.Methods:This non-randomized comparative study evaluated the clinical effectiveness,durability,and acceptability of a Korean medicine-based online mental health self-care program for mothers.Group 1(regular version)included 120 participants who attended one live session per week for 5 weeks,while Group 2(shortened version)included 30 participants who completed five recorded sessions within 1 week.A total of 112 participants(93.3%)in Group 1 and all 30 participants(100%)in Group 2 completed the program and surveys.Results:Within-group analyses demonstrated significant improvements for depression(ΔCESD-10[Center for Epidemiological Studies Depression Scale-10]=−2.38±2.10,p<0.001;Cohen’s d=1.10),anxiety(ΔGAD-7[Generalized Anxiety Disorder Scale-7]=−3.82±3.20,p<0.001;d=0.93),and stress(ΔPSS[Perceived Stress Scale]=−6.44±4.50,p<0.001;d=1.12)in Group 1.Between-group analysis of covariance(ANCOVA)of postintervention scores showed significant differences favoring Group 1 in CESD-10(p<0.001)and GAD-7(p=0.025).These improvements were largely maintained through the 12-week follow-up(all p<0.001),indicating both statistical and clinical significance.The average willingness-to-pay per session was 8562.5±3609 KRW,and overall satisfaction was high.Conclusion:These findings demonstrate that the regular 5-week Korean medicine-based online program is effective,cost-effective,and capable of sustaining improvements in maternal mental health,supporting its potential use in community-based care strategies.
文摘Objective:To investigate the impact of programmed harmonious nursing combined with hierarchical management on nursing quality and satisfaction in a health management center.Methods:A total of 100 patients who received care at this health management center from January 2024 to January 2025 were selected as subjects.Using a random number table method,they were divided into an observation group(n=50)and a control group(n=50).The control group followed traditional methods,while the observation group integrated programmed harmonious nursing with hierarchical management.Comparative analysis was conducted on nursing quality scores,adverse event occurrence rates,and patient satisfaction between the two groups.Results:The observation group showed significantly improved nursing quality scores(P<0.05)and markedly reduced incidence of adverse events(P<0.05),with statistically significant differences compared to pre-treatment conditions(P<0.05).Conclusion:The combination of hierarchical management and programmed harmonious nursing demonstrates effectiveness in enhancing medical service quality,reducing adverse reactions,and improving patient satisfaction—a method worthy of promotion.
基金a grant from the National Natural Science Foundation (No.30271140, 2002)
文摘Objective To investigate the social mental state of drug addicts in a compulsive drug abuse treatment center; evaluate the effectiveness of integrated program for the prevention of abuse relapse and improvement of drug addicts＇ psychological health. Methods The study subjects were addicts from the Wuhan Compulsive Drug Abuse Treatment Center between October 2003 and June 2004, who satisfied the inclusion criteria. A non-randomized control-intervention study design was adopted. Volunteers willing to take part in intervention were put into the intervention group with their full awareness and willingness to prevent drug abuse relapse. The control group was composed of the addicts who were willing to prevent relapse and to be followed up after their discharge. Results The effectiveness of the integrated intervention program in promoting addicts＇ psychological health： before the intervention, the scores of Self-Rating Anxiety Scale （SAS）, the positive and negative dimensionalities of Simple Coping Style Questionnaire （SCSQ） and Chinese Perceived Stress Scales （CPSS） had no significant differences between the intervention group and the control group. After the intervention, except that the SCSQ＇s positive dimensionality in the intervention group was significantly higher than that in the control group, other indices in the intervention group were lower. Before and after the intervention, the psychological health level in both the groups was lower than that in the normal population; there were significant differences between addicts and normal subjects in regards with all of the indices above. Conclusion Drug abuse was associated closely with addicts＇ social mental factors. The integrated intervention program can alleviate anxiety and stress, reduce co-morbid mental disorders and effectively improve their coping style. In conclusion, the program can promote addicts＇ psychological health significantly.
文摘Successful health promotion programs are characterized in part, by the willingness of audiences to engage, participate, and adopt healthier behaviors. But presentation of messages that reach and resonate with the intended audience remains challenging. This is due in part to the variety of mindsets—viewpoints, attitudes, and beliefs—within a population. These mindsets play an essential role in understanding and predicting behaviors and lifestyle factors associated with health or chronic diseases. The purpose of this study is to demonstrate how a specific survey-based method of mindset segmentation can distinguish predominant mindsets and then be used to create, adapt, and/or market health programs to appeal to these mindsets. Steps in survey construction, distribution, and analysis are described. Interpretation of the results, yielding three primary mindsets, is the critical outcome of this segmentation method. The applications of this interpretation to community health education programs are suggested. This approach has potential to inform, enhance, or customize programs, tailoring activities, methods, and messages to the preferences of the community.
基金supported by the Natural Science Foundation of Hubei Province(No.2021CFB348).
文摘ObjectiveTo evaluate the impact of Antimicrobial Stewardship Programs(ASPs)on antibiotic use and drug resistance.MethodsThis was a retrospective,multicenter,management intervention study.The data from 85 maternity hospitals(maternal and child health care hospitals)in Hubei province from 2012 to 2019 were collected.The indicators related to antimicrobial drug use included the utilization rate of different grades of antimicrobial drugs,the intensity of antimicrobial agent use,the rational use of prophylactic antimicrobial agents before class I surgical incision,and pathogenic detection and consultation rates before antimicrobial drug use.ResultsSince the implementation,the purchase of antimicrobial agents in hospitals has been maintained within the prescribed range,and the defined daily dose system(DDDs)of antimicrobial agents has been reduced,prophylactic use and accurate treatment of antimicrobial agents related to class I surgical incision have been more reasonable.With the implementation of ASPs,the detection rate of imipenem-resistant Acinetobacter baumannii,cefotaxime-resistant Escherichia coli,and methicillin-resistant Staphylococcus aureus has been decreased in China from national bacterial resistance surveillance data.ConclusionASPs have positive effects on antibiotic use and drug resistance in 85 maternity hospitals(maternal and child health care hospitals).
文摘Previous main body of research on end-life-care in South Korea has focused on developing services quality in hospital settings or service payment system in National Health Insurance Program. The delivery system of hospice and palliative care services has evolved in diverse ways but there is little research on reviewing the past history of development and whole picture of them so far. So, the aim of this study is to review the old hospice and palliative care system and also to introduce the current one supported by the National Health Insurance Program in South Korea. The palliative care or hospice services in South Korea have been available in diverse settings and provided by different organizations (i.e. catholic hospitals or charity organizations). Finally, it was set up in 2004 that the hospice team or official Palliative Care Units (PCUs) was established in hospitals, in order to meet the end-of-life care for the patients with terminal cancer under the Cancer Control Act. The current hospice and palliative care services such as pain management, bereavement services, and counselling can be reimbursed by National Health Insurance program since 2008. Nevertheless hospice and palliative care services are available to dying patients, yet the utilization rate of hospice and palliative care services or the length of stay in the palliative care unit (PCU) is still relatively short compared to other country systems. South Korea is undergoing several efforts to expand the services in PCU along with the development of quality indicators for PCU. Hospice and palliative care services are still new in the health care system and unfamiliar to the public so it requires raising awareness for medical professionals and the public as well as further research.
文摘This proposal focuses on the prevalence of teenage pregnancy issue in NJ and illustrates the benefits of school-based health clinics and educational programs which should be implemented for teenage pregnancy and childbearing.Without the early intervention of educational programs and preventive medical services which should be implemented in school areas,teen pregnancy and childbearing can have physical and emotional health influences on teen mothers,their babies and other family members,and the worst consequence should be abortion.What’s more,teenage pregnancy and childbearing have substantial economic consequence for state.The annual estimated cost associated with teen childbearing (teens 19 and younger) in NJ to taxpayers is at least $167 million in 2004 (24% federal costs and 76% state and local costs).Studies demonstrated that a much larger amount of money is spent on the consequences of teenage pregnancy than on prevention.NJ has an opportunity to invest in prevention and reduce not only the monetary but also the societal costs to our youth burdened by the often overwhelming responsibilities of teenage pregnancy and parenting.According to the 15 years follow-up research and data analyzing,two models of success which specifically implemented in South Carolina high schools and Chicago public schools have been proved to effectively reduce incidence of repeat pregnancy and emergency room visits,reduce incidence of teen mothers smoking during pregnancy,improve emotional outcomes among teen mothers,decrease incidence of teen mothers drug impairment,arrest,conviction,or jail time and reduce use of food stamps and other public assistances,which can consequently increase the state public health costs.In order to support teen mothers’ academic,physical,emotional and social needs in a stable and consistent school environment,the plan which titled "Physical and Mental Health Promotion for NJ Teen Mothers" is effective and practical enough to arouse the attention of some relevant departments.It’s worth patron to fund the plan because supporting teenage pregnancy at early stage can subsequently benefit the national and state economy and teen mothers.
文摘Objectives: The aim of this study was to implement a health education program for education of preconception care (PCC) for female workers of reproductive age through a seminar and to evaluate the program based on PCC knowledge and awareness and behaviors before the seminar and at 3 and 6 months after the seminar. Methods: A small group health education seminar was implemented using leaflets for 84 female workers of reproductive age, age 20 to 35 years old, and an intervention by group discussion and feedback was provided. Of these participants, 60 (71%) who provided valid survey responses were included in the analysis. The primary outcome indicators were PCC knowledge, PCC awareness and behaviors, and a food frequency questionnaire, and the secondary outcome indicators were self-efficacy and the health awareness and stress management subscales of the Health-Promotion Lifestyle Profile scale. The survey was conducted three times, before the seminar and at 3 and 6 months after the seminar, and the results were compared. Results: The percentage of individuals with PCC knowledge was significantly increased at 3 months after the seminar as compared with before the seminar, and it remained at this level even at 6 months after the seminar. The percentage of individuals with PCC awareness and behaviors was significantly increased for the items actively eat foods containing folic acid, prevent sexually transmitted diseases, and conduct self-examinations for breast cancer at 3 months after the seminar and for the items eat well-balanced meals, make the mind active, prevent sexually transmitted diseases, and conduct self-examinations for breast cancer at 6 months after the seminar. Furthermore, the score for the health awareness subscale of the Health-Promotion Lifestyle Profile scale was significantly increased at 6 months after the seminar. Conclusion: The health education program established PCC knowledge at 6 months after the seminar and improved some PCC awareness and behaviors. Therefore, it was suggested that the program would be effective for education of PCC for female workers of reproductive age.
基金This study was funded by National Research Council of Thailand(NRCT106/2562)Mae Fah Luang University.The funders had no role in study design,data collection and analysis,decision to publish,or preparation of the manuscript.
文摘Objectives This study aimed to investigate the effect of a peer-training program for village health volunteers(VHVs)to improve chronic disease management among older adults in rural Thailand.Methods The study was guided by community-based participatory research(CBPR).The peer-training program was developed by engaging diverse stakeholders,including community organizations,healthcare services,VHVs,older adults with chronic illnesses,and folk scholars in remote communities with high healthcare needs.The peer-training program comprised a three-day training workshop that convened once a week for three weeks with the following six sessions:knowledge sharing,peer support and empowerment,health literacy and health behavior,the general caring procedure for older adults with chronic illnesses,information sharing and communication,and home visit.From January to April 2021,a total of 28 VHVs completed the peer training program in a rural area in Chiang Rai province,Thailand.The Health Literacy and Health Behavior-3E2S(HLHB-3E2S),the Management of Non-Communicable Diseases Questionnaire(MNCDQ),and a self-confidence questionnaire were used to survey pre(week 1)and post-intervention(week 12),respectively.Then VHVs were interviewed to collect attitudes,and opinions about the intervention.Results After the intervention,the HLHB-3E2S scores(49.39±5.54 vs.52.35±4.26,P=0.001),the MNCDQ scores(44.10±6.27 vs.50.60±4.84,P<0.001),and the self-confidence questionnaire scores(22.28±2.46 vs.23.21±1.81,P=0.01)of VHVs significantly increased.VHVS also reported that the peer-training program enhanced their healthcare services,including health education,chronic disease management,leadership skills,and improving their relationship with healthcare providers.Conclusion Peer training programs are a practical strategy to improve VHVs’capacities.Healthcare professionals should provide a continuous training program for VHVs with their peers to increase capacities,confidence,and satisfaction in caring for the older adults with chronic diseases in the community.
文摘Objective: The pilot study was intended to test the feasibility of a multiple-component lifestyle intervention targeting African American adults in a weight control and cardiometabolic risk reduction program on diet, activity, and stress, using community-engagement principles. Methods: Applying mixed qualitative and quantitative measures, the intervention had a two-part sequential study design consisting of 12 weekly small group sessions that provided individual and group counseling in nutrition, exercise, and mindfulness, while incorporating focus group and interactive techniques to learn about barriers and acceptable practices for this population. The program was implemented at an African-American church in Nashville, Tennessee. Results: Thirty-four participants (aged 56.1 ± 11 years, body mass index (BMI) 36.7 ± 6.6 kg/m2) completed the intervention. Lifestyle changes after the 12 weekly sessions showed some positive trends including reduced sodium intake (from 2725.3 ± 326.5 to 2132 ± 330, mg/day, P = 0.008), increased walking steps (from 4392.1 ± 497.2 to 4895.3 ± 497.9, steps/day, not significant), and slightly decreased Perceived Stress Scale (PSS) scores (from 13.7 ± 1.4 to 12.4 ± 1.5, not significant). Body fat % among male participants decreased significantly (from 33.8 ± 2.6 to 28 ± 2.6, %, P = 0.043). Among cardiometabolic risk biomarkers, hemoglobin A1c (HbA1c) decreased significantly (from 6.6 ± 0.2 to 6.1 ± 0.2, %, P β = 2.4, P = 0.006). Twenty-one participants took part in focus groups during the program to identify barriers to healthy lifestyle changes. Primary barriers reported were price, time for preparing healthy meals, unfamiliarity with mindfulness activities, their health condition, and daily schedule available for physical activities. Conclusions: This church-based pilot intervention was proven feasible by showing modest progress in reducing adiposity and decreasing HbA1c levels. The focus group and interactive methods facilitated program direction. Future full-scale studies are warranted to identify key strategies that provide more personalized approaches and supportive environments to sustain a healthy lifestyle among these at risk minorities with limited resources.
文摘Adolescence represents a sensitive time period during an individual’s development during which physical, psychological, and social risk factors for non-communicable diseases are established. As such, there is a necessity to engage adolescents in planning and decision-making processes that will affect their future health. This paper describes the need for more innovative and transversal actions, starting from the utility of a multidisciplinary and systemic approach to health. One way in which this can be achieved is by shifting adolescent health programs (AHPs) from a clinically oriented to an education-based model. In particular, AHPs need to consider a personalized and systemic approach to the well-being of adolescents in order to potentiate their strengths and improve weaknesses, enhancing self-esteem, empowerment, and resilience. This is in line with the complexity of human physiology and psychology, as well as scientific evidence showing that several factors significantly influence health status including lifestyle, social context, emotional experiences, and cognitive skills, as demonstrated by the AVATAR Project (“A new purpose for promotion and eVAluation of healTh and well-being Among healthy teenageRs”). This project—which provides a new framework for AHPs—was carried out in Italy and enrolled healthy students as subjects, and aimed to promote well-being in adolescents using a systemic and multistake-holder approach that involved creating a network composed of the different figures and environments around adolescents and moving toward a more school-based and student-centered approach to adolescent health education.
文摘Item Response Theory (IRT) models have been extensively used in the field of education to identify link between a response to a test item and underlying latent capability of the test taker. We demonstrate the benefit of using IRT model to analyze health data using data from M. chat program such that statisticians can use the method in lieu of traditional methods including Cronbach’s alpha, discriminant analysis and factor analysis. M. chat is a technology based health coaching program and the baseline survey from the participants in the program includes response in different but correlated domains of diet, social habits, leisure practices, mental health, substance abuse, self-sufficiency and medication adherence. We analyzed baseline data from 416 subjects using IRT models. Our results indicated that responses pertaining to alcohol and substance abuse were the most discriminating items with an average discrimination estimate of approximately 4.99 whereas the least discriminating items were the diet habits, with an average estimate of -0.476.
文摘Agrarian occupational health is a neglected primary health-care service in India.A nurse-led health promotion program is planned based on a Conceptual Model for the Occupational Health Nurse Specialist prepared by Ms.Janice Dees(1984)inspired from Orem’s self-care theory.The interventions included are range of motion exercise,progressive muscle relaxation technique,foot and palm massage,and literacy on safety practices.The wellness of field farmers is expected by following this program plan.
文摘Background:School health program(SHP)is the most cost-effective investment a nation can make to simultaneously improve education and health conditions of her citizen.In spite of this,the adoption of SHP in developing countries is still below set standard.Therefore,this study assesses the operations of SHP in secondary schools in Egor Local Government Area(LGA),Benin City,Nigeria.Materials and Methods:A descriptive cross-sectional survey was conducted with accidental sampling method to select 56 school health teachers from secondary schools in Egor LGA.A self-structured instrument was used to collect data based on the research objectives.Data collected were analyzed using percentages,means,and standard deviation.Results:This study showed that despite high level of the program awareness,the actualization of its objective was found to be poor,and this was found to be related with the lack of government support,lack of needed personnel and materials,lack of effective supervision of the program and inappropriate funding.Conclusion:In-service training on SHP should be provided to enhance the skills needed for implementation of SHP.The government should provide needed materials and equipment and employ competent health personnel to take charge of the school health services,and other policymakers should mobilize and strengthen SHP and education activities at the state.
文摘In the peroid of confusion after the Korean War, there was an absolute shortage in the volume of food. The intake of energy and all other nutrients fell short of the recommended dietary intake. To solve the food shortage, there were many food assistant programs through the government channel. With the economic developments during past years, now, there are enough foods for everyone. Thus, food assistant program, which has been the only nutrition program in the government, is no longer needed except for low-income families.Currently, there are not enough nutrition programs in the government. In 1994, about 30 public health center start nutrition programs with the help of Korean Dietetic Association.In this study, kinds of nutrition programs, age, sex and number of participants, the content of programs are studied. The effects of nutrition programs are partially evaluated.Also, problems with current nutrition programs are discussed. Finally, future directions of nutrition programs in the public health centers are discussed
基金supported by a Career Development Award awarded to Dr. Merritt from the VA Clinical Science Research&Development Service (IK2 CX001952)Dr. Clark received start-up funds from the University of Texas at Austin that further supported this work。
文摘Background Examining the health outcomes of veterans who have completed the United States Veterans Health Administration’s(VHA’s)Traumatic Brain Injury(TBI)Screening and Evaluation Program may aid in the refinement and improvement of clinical care initiatives within the VHA.This study compared self-reported physical functioning,cardiometabolic health conditions,and health care utilization patterns in Million Veteran Program enrollees with TBI Screening and Evaluation Program data(collected between 2007 and 2019),with the goal of enhancing understanding of potentially modifiable health conditions in this population.Methods In this observational cohort study,veterans(n=16,452)were grouped based on the diagnostic outcome of the TBI Screening and Evaluation Program:1)negative TBI screen(Screen^(-));2)positive TBI screen but no confirmed TBI diagnosis[Screen^(+)/Comprehensive TBI Evaluation(CTBIE)^(-)];or 3)positive TBI screen and confirmed TBI diagnosis(Screen^(+)/CTBIE^(+)).Chi-square tests and analysis of covariance were used to explore group differences in physical functioning,cardiometabolic health conditions,and health care utilization patterns,and logistic regressions were used to examine predictors of Screen^(+/-)and CTBIE^(+/-)group status.Results The results showed that veterans in the Screen^(+)/CTBIE^(-)and Screen^(+)/CTBIE^(+)groups generally reported poorer levels of physical functioning(P’s<0.001,np2=0.02 to 0.03),higher rates of cardiometabolic health conditions(P’s<0.001,φ=0.14 to 0.52),and increased health care utilization(P’s<0.001,φ=0.14 to>0.5)compared with the Screen-group;however,health outcomes were generally comparable between the Screen^(+)/CTBIE^(-)and Screen^(+)/CTBIE^(+)groups.Follow-up analyses confirmed that while physical functioning,hypertension,stroke,healthcare utilization,and prescription medication use reliably distinguished between the Screen-and Screen^(+)groups(P’s<0.02,OR’s 0.78 to 3.38),only physical functioning distinguished between the Screen^(+)/CTBIE^(-)and Screen^(+)/CTBIE^(+)groups(P<0.001,OR 0.99).Conclusions The findings suggest that veterans who screen positive for TBI,regardless of whether they are ultimately diagnosed with TBI,are at greater risk for negative health outcomes,signifying that these veterans represent a vulnerable group that may benefit from increased clinical care and prevention efforts.
文摘Compliance with appropriate flock health program is vital for preventing introduction and minimizing impact of diseases in goat farms. Unfortunately, most goat farms in Uganda, especially in the Albertine Graben Zone lack flock health program. The associated frequent outbreaks slow down effort aimed at commercializing goat production. In this study, we documented flock dynamics, identified and prioritized pressing challenges experienced by goat farms during the year 2022 and generated appropriate flock health program and packaged it for dissemination to farmers. Materials and Methods: Using a cross-sectional design, semi-structured questionnaire, data were collected and analyzed with MS Excel 2013. The data included: location and socio-demographics of household, farming system, flock dynamics, housing, feeding system, health management, challenges encountered by goat farm and suggested solutions. Results: Beginning January 2022 to December 2022, the number of goats reared in all the 45 sample farms increased from 2128 to 2220 goats. Results showed that 884 kids were produced and 88 breeding goats were introduced into the farms. Three hundred ninety-nine goats died due to mainly diseases and 435 goats got withdrawn through nondeath. The average farm level and overall mortality rate were 21 goats per 1000 goatmonths and 15 goats per 1000 goatmonths respectively. The most pressing challenges encountered by sample farms were death of goats especially due to diseases, poor access to veterinary extension services, high cost of inputs and feed scarcity. Solutions suggested by sample farms were improved access to veterinary services, improved housing, enhanced vaccination of goats against diseases, and enhanced grazing land management and feed conservation, all of which were incorporated into the flock health program. Conclusion and Recommendations: An appropriate flock health program was generated based on flock dynamics and production constraints which reveal high mortality and limited access to veterinary services respectively. Actors are recommended to promote adoption and adherence to the flock health program so as to increase goat production and access to wider market.
文摘Community health workers are equipped with the tools and resources necessary to bring about a change in the form of a rapid chain reaction.The community health workers model focuses on the practices,strategies,plans,and implementation techniques needed to organize a community health event based on diverse agendas:health,environment,and minorities.This model encompasses past experiences as a guide with tested strategies to assist future health interns with a ground framework and resources to showcase the importance of adopting healthy and environmentally friendly practices.The basic outline of the model is based on data collected from various community health events in Illinois(United States of America)and New Delhi(India).These events included back to school fairs,cleanliness drives,health camps,and educational events.As community health workers can help in implementing better practices in the masses through one-on-one interactions,this model of community health worker programs would outline event organization tips,predicted outcomes,targeted audience,and required material templates.The next phase of this model highlights utilizing the data and experience from these events to report to the health ministries of different countries for the incorporation of the proposed practices in their health agendas and policies.This model,if implemented unanimously,could bring about a revolution in the arena of health workers.They will be assisted at each step,will establish connections with health workers globally,and share their health and environment-based agendas to collaborate and organize important events.This model envisions a strong established network of community health workers,display of their agenda,and creation of a ripple effect throughout the society by the means of these programs.
文摘Quality of maternal and newborn care could be improved if health care providers’ knowledge and competencies as well as system level constraints are addressed. However, due to several barriers staff nurses who form the frontline of health care workforce have limited access to enhancing their clinical knowledge and competencies. To address this gap, a new cadre of nurse mentors (NMs) for the public health system were trained by specialists from a teaching hospital in a special 5-week training course. This included 54 hours of theory and 110 hours of practical in clinical obstetric and newborn care, apart from mentoring, quality improvement and health systems issues. The nurse mentors were assigned to support staff nurses in the primary health care centres (PHCs) in eight northern Karnataka districts. Each NM covered 6-8 PHCs monthly for 2 - 3 days and thus a total of 385 PHCs were reached. They received support in the field through supportive supervision visits done by the specialists who had trained them, as well as by refresher training and clinical postings to the district hospitals. This paper presents impact of the training program on change in immediate and long term knowledge and competency scores of nurse mentors. Their baseline knowledge scores changed from 44.3 ± 12.7 to 72.1 ± 13.8 immediately after the training in obstetric and from 18.2 ± 19.1 to 66.4 ± 14.9 in newborn (p p p > 0.05). Skills score soon after training increased from 62.2 ± 13.2 to 69.6 ± 12.5 in obstetric after a 1 year period and from 52.6 ± 9.3;63.5 ± 14.4 in newborn (p < 0.001) content areas respectively. These findings have implications for those interested in improving quality of maternal and child care through nurse-dependent health delivery systems.
