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Fulltext Community participatory approach: an important managerial role in cancer control

Latiff KA

Asian Pac J Cancer Prev, 2008;9(2):357-59.
PMID: 18712990

Despite the mountain of information generated by researchers, the cancer problem has not significantly declined and perhaps in certain situations it is gradually increasing, affecting those who are previously at low risk. There is a tendency to believe that positive outcomes can always be expected once intervention activities, like exercise promotion, are carried out, but practical experience gives rise to serious doubt. A greater understanding of the biological mechanisms operating in the physical activity, cancer relation, complete measurement of physical activity through a subject's life, assessment of all potential confounders and association modifiers are needed to confirm a protective role of physical activity in cancer development and allow specific exercise prescriptions for community-based prevention in particular cancer sites. Furthermore, the most important impetus of any community intervention approach should be oriented in the form of 'from people to the people'. More emphasis needs to be placed on effective management and parameters for assessment of management success.

Matched MeSH terms: Community Health Services/organization & administration*
A framework for cohesive healthcare coalition formation

Cheah YN, Chong YH, Neoh SL

Stud Health Technol Inform, 2006;124:575-80.
PMID: 17108579

The mobilisation of cohesive and effective groups of healthcare human resource is important in ensuring the success of healthcare organisations. However, forming the right team or coalition in healthcare organisations is not always straightforward due to various human factors. Traditional coalition formation approaches have been perceived as 'materialistic' or focusing too much on competency or pay-off. Therefore, to put prominence on the human aspects of working together, we present a cohesiveness-focused healthcare coalition formation methodology and framework that explores the possibilities of social networks, i.e. the relationship between various healthcare human resources, and adaptive resonance theory.

Matched MeSH terms: Community Health Services/organization & administration
Fulltext Addressing non-communicable diseases in Malaysia: an integrative process of systems and community

Mustapha F, Omar Z, Mihat O, Md Noh K, Hassan N, Abu Bakar R, et al.

BMC Public Health, 2014;14 Suppl 2:S4.
PMID: 25080846 DOI: 10.1186/1471-2458-14-S2-S4

The prevalence of non-communicable diseases (NCDs) and NCD risk factors in Malaysia have risen substantially in the last two decades. The Malaysian Ministry of Health responded by implementing, "The National Strategic Plan for Non-Communicable Diseases (NSP-NCD) 2010-2014", and the "NCD Prevention 1Malaysia" (NCDP-1M) programme. This paper outlines the primary health system context in which the NCDP-1M is framed. We also discuss the role of community in facilitating the integration of this programme, and outline some of the key challenges in addressing the sustainability of the plan over the next few years. The paper thus provides an analysis of an integration of a programme that involved a multi-sectoral approach with the view to contributing to a broader discourse on the development of responsive health systems.

Matched MeSH terms: Community Health Services/organization & administration*
Fulltext Community-based blood pressure measurement by non-health workers using electronic devices: a validation study

Reidpath DD, Ling ML, Yasin S, Rajagobal K, Allotey P

Glob Health Action, 2012;5:14876.
PMID: 22761601 DOI: 10.3402/gha.v5i0.14876

INTRODUCTION: Population monitoring and screening of blood pressure is an important part of any population health strategy. Qualified health workers are expensive and often unavailable for screening. Non-health workers with electronic blood pressure monitors are increasingly used in community-based research. This approach is unvalidated. In a poor, urban community we compared blood pressure measurements taken by non-health workers using electronic devices against qualified health workers using mercury sphygmomanometers.
METHOD: Fifty-six adult volunteers participated in the research. Data were collected by five qualified health workers, and six non-health workers. Participants were randomly allocated to have their blood pressure measured on four consecutive occasions by alternating a qualified health worker with a non-health worker. Descriptive statistics and graphs, and mixed effects linear models to account for the repeated measurement were used in the analysis.
RESULTS: Blood pressure readings by non-health workers were more reliable than those taken by qualified health workers. There was no significant difference between the readings taken by qualified health workers and those taken by non-health workers for systolic blood pressure. Non-health workers were, on average, 5-7 mmHg lower in their measures of blood pressure than the qualified health workers (95%HPD: -2.9 to -10.0) for diastolic blood pressure.
CONCLUSION: The results provide empirical evidence that supports the practice of non-health workers using electronic devices for BP measurement in community-based research and screening. Non-health workers recorded blood pressures that differed from qualified health workers by no more than 10 mmHg. The approach is promising, but more research is needed to establish the generalisability of the results.
KEYWORDS: Malaysia; blood pressure; community workers; hypertension; measurement; screening
Study site: urban, low-income community, of the Klang Valley near Kuala Lumpur, Malaysia
Device: Mercury sphygmomanometers (Spirit brand, model number CK-101C), electronic, automatic blood pressure monitors (Omron brand model HEM-7203)

Matched MeSH terms: Community Health Services/organization & administration*
A model for community participation in breast cancer prevention in Iran

Ahmadian M, Samah AA

Asian Pac J Cancer Prev, 2012;13(5):2419-23.
PMID: 22901232

CONTEXT: Genuine community participation does not denote taking part in an action planned by health care professionals in a medical or top-down approach. Further, community participation and health education on breast cancer prevention are not similar to other activities incorporated in primary health care services in Iran.
OBJECTIVE: To propose a model that provides a methodological tool to increase women's participation in the decision making process towards breast cancer prevention. To address this, an evaluation framework was developed that includes a typology of community participation approaches (models) in health, as well as five levels of participation in health programs proposed by Rifkin (1985 and 1991).
METHOD: This model explains the community participation approaches in breast cancer prevention in Iran. In a 'medical approach', participation occurs in the form of women's adherence to mammography recommendations. As a 'health services approach', women get the benefits of a health project or participate in the available program activities related to breast cancer prevention. The model provides the five levels of participation in health programs along with the 'health services approach' and explains how to implement those levels for women's participation in available breast cancer prevention programs at the local level.
CONCLUSION: It is hoped that a focus on the 'medical approach' (top-down) and the 'health services approach' (top-down) will bring sustainable changes in breast cancer prevention and will consequently produce the 'community development approach' (bottom-up). This could be achieved using a comprehensive approach to breast cancer prevention by combining the individual and community strategies in designing an intervention program for breast cancer prevention.

Matched MeSH terms: Community Health Services/organization & administration*
Fulltext Profiles of men-who-have-sex-with-men seeking anonymous voluntary HIV counseling and testing at a community-based centre in Malaysia

Koh KC, Kamarulzaman A

Med J Malaysia, 2011 Dec;66(5):491-4.
PMID: 22390108 MyJurnal

Community-based HIV voluntary counseling and testing (VCT) services is an effective alternative for mapping the local demographics of at-risk populations for HIV as well as provide an acceptable and reliable means of early detection of HIV. We describe the profiles of men-who-have-sex-with-men (MSM) who sought VCT services in a community based centre in Kuala Lumpur.

Matched MeSH terms: Community Health Services/organization & administration*
Emerging patterns of disability distribution in developing countries

Mitchell RA, Zhuo DH, Watts GH

Int Disabil Stud, 1989 10 1;11(4):145-8.
PMID: 2534963

A study based on the WHO model of community-based rehabilitation in Guangzhou City, China, is described. Preliminary epidemiological data are reported, and compared with analogous data from Korea, Vietnam, Malaysia, Mexico, Indonesia, and Pakistan. Confidence levels for estimates of the prevalence of limb dysfunction, visual dysfunction, hearing and/or speech dysfunction, and mental retardation are also reported.

Matched MeSH terms: Community Health Services/organization & administration
Organization of a blood transfusion service in tropical areas

Lopez CG

Southeast Asian J. Trop. Med. Public Health, 1979 Jun;10(2):177-83.
PMID: 524138
Matched MeSH terms: Community Health Services/organization & administration*
Fulltext Perceptions of medical students regarding community-based teaching experiences: an observation from Bangladesh

Ahmed SMM, Hasan MN, Kabir R, Arafat SMY, Rahman S, Haque M, et al.

Rural Remote Health, 2019 08;19(3):4614.
PMID: 31400766 DOI: 10.22605/RRH4614

INTRODUCTION: Community orientation in medical education, which prepares medical students to become more effective practitioners, is now a global movement. Many medical schools around the world have adopted the concept as the main curricular framework in order to align learning programs with the needs of the community and the learner. Despite many changes over the past few decades, many improvements are still needed in medical education in Bangladesh. This study investigated medical students' perceptions of the community-based learning experiences incorporated into the Bachelor of Medicine, Bachelor of Surgery (MBBS) degree at Uttara Adhunik Medical College, Dhaka (UAMC), Bangladesh.
METHODS: A total of 135 students from three undergraduate year levels of the MBBS degree at UAMC, Dhaka, Bangladesh, undertook study tours (community-based teaching, CBT) as a part of a community medicine course and visited a medical college, two rural health centres and a meteorology centre in the Cox's Bazar district, 400 km from Dhaka city. A questionnaire was used to assess the perceptions of students regarding the administration, organisation and learning experiences of the study tours. Students were required to write reports, present their findings and answer questions in their examinations related to the study tours and CBT.
RESULTS: The majority of the students agreed or strongly agreed that the tour was a worthwhile (93%) and enjoyable (95%) learning experience that helped them to understand rural health issues (91%). More than half of the students reported that the study tours increased their awareness about common rural health problems (54%) and provided a wider exposure to medicine (61%). Only 41% of students reported that the study tour increased their interest in undertake training in a rural area. A substantial number of students also expressed their concerns about the planning, length, resources, finance and organisation of the study tours.
CONCLUSIONS: Overall, the study tours had a positive effect, enhancing students' awareness and understanding of common rural health problems. As study tours failed to increase the motivation of the students (approximately 60%) to work in rural areas, CBT in the medical curriculum should be reviewed and implemented using effective and evidence-based models to promote interest among medical students to work in rural and underserved or unserved areas.

Matched MeSH terms: Community Health Services/organization & administration*
A phone-counseling smoking-cessation intervention for male Chinese restaurant workers

Burton D, Zeng XX, Chiu CH, Sun J, Sze NL, Chen Y, et al.

J Community Health, 2010 Dec;35(6):579-85.
PMID: 20186474 DOI: 10.1007/s10900-010-9244-7

We sought to develop a smoking-cessation intervention for male Chinese restaurant workers in New York City that required no seeking out by participants; provided support over a relatively long period of time; and was responsive to participants' cultural backgrounds and daily lives. The resulting intervention consisted of a minimum of 9 proactive phone counseling sessions within a 6-month period for each participant recruited at his worksite. All activities were conducted in Chinese languages. The efficacy of this proactive phone-counseling intervention was assessed in a pretest/posttest design comparing baseline smoking with smoking 6 months after the intervention ended. Of 137 male employees recruited at their restaurants, 101 (median age 40.5) participated in the phone-counseling intervention in 2007-2008, with 75 completing the program with at least 9 counseling calls. We found a linear increase in smoking cessation from 0% at Call 1 to 50.7% at Call 9 for 75 men who completed the program, and we found for all 101 participants a 32.7% intent-to-treat cessation rate for 6 months post-end of program, adjusted to 30.8% by saliva cotinine assessments. The results indicate that combining field outreach with phone counseling over an extended period of time can facilitate smoking cessation for population groups whose environments do not support efforts to quit smoking.

Matched MeSH terms: Community Health Services/organization & administration*
Fulltext The influence of psycho-social factors on participation levels in community-based breast cancer prevention programs in Tehran, Iran

Ahmadian M, Samah AA, Redzuan M, Emby Z

Glob J Health Sci, 2012 Jan 01;4(1):42-56.
PMID: 22980116 DOI: 10.5539/gjhs.v4n1p42

BACKGROUND: Although significant consideration has been devoted to women participation in breast cancer prevention programs, our understanding about the psychosocial factors which influence participation remains incomplete.
METHOD: The study applied a quantitative approach based on the cross-sectional survey design and multistage cluster random sampling. A total of 400 women aged 35-69 years, were surveyed at 4 obstetric and gynecologic clinics affiliated to Tehran University of Medical Sciences in Tehran: the participation levels of 86 women who have had a mammogram were analyzed based on their self-efficacy, belief, social influence, and barriers concerning mammography utilization.
RESULTS: Consistent with the study framework, in bivariate analysis, the higher level of women's participation in breast cancer prevention programs was significantly related to more positive belief about mammography (p< .05), greater social influence on mammography (p< .01) and fewer barriers to mammography (p< .01). Self efficacy (p= .114) was not significantly related to the higher level of participation.
CONCLUSION: Results suggest that women's participation levels in breast cancer prevention programs might be associated with the specific psychosocial factors on breast cancer preventive behavior such as mammography screening.

Matched MeSH terms: Community Health Services/organization & administration*