Community Service Research Articles

Evaluation of New Frailty at the Front Door Service in a Model 3 Hospital

Abstract Background Frailty at the Front Door (FFD) is a key component of integrated care for frail older persons who attend an Emergency Department (ED). This service was established in a model 3 hospital in 2023. Variable Indicative of Placement (VIP) was used to screen patients aged ≥70 years for frailty. Interdisciplinary assessments and interventions were provided by a Senior Physiotherapist and Senior Occupational Therapist (OT). Methods All assessments by the FFD team from June 2023 to February 2024 inclusive, were included. The variables analysed were age, gender, modified Barthel Index (mBI) score, 4AT score, Clinical Frailty Scale (CFS) score, discharge status, length of stay (LOS), referral pathways and re-presentation within 28 days. Data was analysed in Excel. Results There were 490 assessments over the 9-month period, 217 (44%) male and 273 (56%) female, with a mean age of 80 (SD±7.77) years. The median CFS was 5 (range 2-8) and median mBI was 17 (range 4-20). The 4AT score was ≥4 in 44 (9%) cases (indicating possible delirium and possible cognitive impairment). One hundred and eighty-four (38%) patients were discharged home from ED. Seventy (14%) patients re-presented to ED within 28 days. Acute hospital admission was required for 306 (62%) with a mean LOS of 11 (SD±0.5) days. There were 213 referrals to community services for those patients discharged home. These included Dietetics (36%), Physiotherapy (22.5%), ALONE (18%), Delirium Clinic (9.4%), OT (6%) and others (8.1%). There were 238 referrals to acute services for admitted patients, including Physiotherapy (59%), Dietetics (18.5%), OT (17%) and Speech and Language therapy (5.5%). Conclusion This evolving FFD service is a positive step towards improving older persons’ care in ED. Recognition of frailty in ED leads to early identification of care needs and timely referral to alternative pathways in the community and acute services as appropriate.

Unmet Needs Post Stroke: Level of Unmet Need According to Discharge Destination

Abstract Background Stroke survivors often face unmet needs after leaving acute and rehabilitation services (McKevitt et al., 2011). UK and Ireland stroke guidelines (2023) advise a 6-month health and social care review for all patients, yet resource access in hospital and community settings hinder this. Targeting those with the most unmet needs could improve service delivery. Consequently, we examined unmet needs of stroke patients post-rehabilitation, comparing those who were discharged to rehabilitation (RG) to the non-rehabilitation group (NRG). Methods Participants: All patients attending a post-stroke review clinic between March 2023 and April 2024. Groups: RG included patients discharged to Early Supported Discharge or inpatient rehabilitation; NRG included patients not discharged to these services. Data: Collected demographic information and assessed unmet needs using a modified Greater Manchester Stroke Assessment Tool. Analysis: Using Microsoft Excel, group comparisons were made using chi-squared tests and t-tests, with log transformation applied to non-normally distributed data. Results 251 patients attended during the data collection period (69 patients (27%) in RG, 182 patients (73%) in NRG). The average age was 68 in both groups. The RG had a longer mean length of stay (23 days) compared to the NRG (19 days) (p=0.0007). The RG also had a higher mean score on the clinical frailty scale (RG 4, NRG 3, p=0.05). In the RG, 97% reported no follow-up after discharge, compared to 78% in the NRG. A greater proportion of RG patients reported swallow difficulties (12% vs. 3%, p=0.03), mobility difficulties (46% vs. 30%, p=0.02), and falls (41% vs. 30%, p=0.008) compared to NRG patients. Conclusion Data from this exploratory study suggests substantial unmet needs among post-stroke patients with a significantly higher level of unmet needs among patients who were discharged to post-acute rehabilitation. Despite this, the majority of these patients were not seen by community services at the time of 6-month review.

Consolidating Integrated Care: A Joint Falls Prevention Initiative between Community and Hospital Based Physiotherapy Services

Abstract Background Physiotherapists from Primary Care, Integrated Care Programme for Older Persons (ICPOP) and hospital-based Frailty Intervention Team services came together to establish a community working group with the aim of reducing the incidence of falls of those in their collective catchment area. The agreed objective being to pilot a 6 week falls prevention initiative between community and hospital-based services. Methods 7 Physiotherapists across 3 services formed a community working group. A 6-week physiotherapy led, multifaceted intervention program involving exercise, education and an opportunity for socializing was developed. The class was accessible to persons over the age of 65 years who had or were at risk of falling. Participants were recruited from the caseloads of the physiotherapists involved. Objective assessments of gait speed, grip strength and balance were carried out via hand grip dynamometry, Timed Up and Go (TUAG) and Short Physical Performance Battery (SPPB). Subjective measures of participant’s quality of life were assessed via the EQ 5D 5L, Falls Efficacy Scale (FES) and Sarc-F. On completion of the intervention participants were retested. Results 10 participants were recruited to the pilot from both community and hospital based, out-patient services. Over 80% of participants attended 4 out of 6 sessions. Participants grip strength improved by 3.4kg, TUAG by 6.43% (1.03 seconds) and SPPB by 13.3%. EQ 5D 5L scores improved by 15%, FES score improved by 17.81% and SARC-F scores improved by 6%. 40% of participants went on to engage with a follow-on exercise group delivered by the local Sports Partnership. Conclusion Overall, there was a notable improvement in participant’s physical function and quality of life and self-efficacy scores post intervention. This highlights the positive impact of multimodal group interventions, which incorporate both exercise and education to promote self-efficacy within frail older population at risk of falling.

As Fit as a Fiddle

Abstract Background The EDITH (emergency department in the home) team is an alternative pathway for older adults requiring emergency care. The team consists of an occupational therapist (OT) and a doctor who provide specialized geriatric care in patients' homes thus negating the need for an emergency department (ED) presentation. The patients' profile is typically frail older adults however this service can be accessed by any person over 65 years within the catchment. Methods Clinical frailty scales (CFS) are routinely completed as part of the OT assessment process. A review of the OT logbooks and electronic healthcare records was completed over an 18-month period. The average CFS was 6 however 11 patients with a CFS of 1 or 2 were identified. The health care records was analysed to identify similarities in this subset patient population group. Results It was found that none of these patients had formal supports, and none were living in residential care. The age range was 65 to 90 years old. None of these patients required an onwards referral to community services or provision of OT equipment. Presenting complaint breakdown: explained falls (2), DVT (2), Blood pressure issues (2), pain (2), catheter (1), covid (1), INR problems (1). At 3 months post EDITH review it was found that no patients had a re attendance to ED. Conclusion Patients with a low level of clinical frailty make up a very small sub set of the general EDITH patient population. These patients appear to be living independently within the community and do not require extensive OT input. Their presenting complaints appear to be predominately isolated medical events as opposed to chronic medical issues.

Teknik Sipil Menyenangkan: Membangun Generasi Penerus Cerdas dengan Pengenalan Teknik Sipil

This community service program aims to introduce civil engineering to students of SMK Negeri 2 Karang Baru, Aceh Tamiang, in order to build a smart and competent future generation in the field of construction. Through enjoyable and practical learning methods, students are introduced to the basics of structural design, building techniques, and the use of modern technology in construction. The program results show a significant increase in students' knowledge and skills, as well as increased interest in careers in civil engineering. This program has also succeeded in boosting students' confidence in applying civil engineering concepts. This success provides a strong foundation for further development and replication of the program in other schools. Keywords: Civil Engineering, Enjoyable Learning, Structural Design, Building Techniques, Construction Technology

Redesigning Community Dwelling Geriatric Integrated Care Program for Better Care Co-Ordination and Health Outcomes

Abstract Background Existing health services and care models need to adapt to the increasing ageing population, multimorbidity, and frailty. Thus, diverse healthcare providers and caregivers are demanded to continue living at home. An Integrated Care Program, involving a multidisciplinary team with a patient-centred focus, is being promoted as an alternative model of care. However, uncoordinated existing services put them at risk of fragmented care, leading to adverse outcomes. This study aimed to fill gaps in previous ICP research by introducing a change roadmap into the implementation phase of the program. In addition, the study proposed evaluating the effectiveness and implementation of the pilot project together with the process evaluation. Methods The study conducted a systematised literature review to examine the outcomes and different structures of the ICP. Implementation Science was utilised to define, design, and deliver the model of change. Results A systematised literature review showed that most ICPs were led by an Advanced Nurse Practitioner with positive outcomes. SWOT analysis, stakeholders’ involvement, existing community service providers, and a population survey provide an in-depth perspective of the target population and set up contextually adapted implementation strategies. An ANP-led MDT was proposed to co-ordinate the ICP. A process evaluation to assess the care model together with health outcomes was outlined. Conclusion The study showed that ANP-led MDT, person-centred, co-ordinated care provides the best ICP implementation strategy. The study will further understand the ICP implementation process among frail older people in the community.

PENGUATAN KEMANDIRIAN ANAK BERBASIS SCAFFOLDING MELALUI MENDONGENG

Children's independence will be difficult to develop if there is no habituation, education, and supportive environment. This community service aims to strengthen children's independence through the scaffolding method implemented in storytelling activities. Scaffolding is a learning approach that allows children to develop abilities gradually with the help and guidance of a companion. The implementation of the community service was carried out at the Lab School Early Childhood Education which involved all students, parents, and teachers. The methods used include material development and direct practice with storytelling. Community service activities were carried out in several stages starting from teacher and parent training on storytelling techniques based on the principle of scaffolding, children were involved in storytelling sessions designed to develop independence, reflection and discussion activities were used to measure progress and provide feedback on children's independence. Data were collected through interviews, and content analysis from aspects of children's independence. The results of the study showed that children's independence has great potential to become a habit through scaffolding where children's independence in thinking and acting, improving communication skills, and strengthening relationships between children, teachers, and parents are more memorable to children when using the storytelling method. Active activities during storytelling that use music, movement, and positive narratives in educating children's independence so as to create a fun learning experience for children. The continuation of this community service activity will develop scaffolding content in the form of ebooks.

Effort to Optimize Learning Physics at Integrated Islamic High School via a Physics based Ethnoscience Approach

The aim of community service program is to enhance the educational experience at the integrated Islamic high school (SMA IT Khairu Ummah) Rejang Lebong district by employing an ethnoscience approach. The service program is implemented in SMA IT Khairu Ummah to address challenges posed by inadequate learning facilities and infrastructure, particularly in physics education, which may impede the teaching and learning process. The implementation of community service initiatives in 2024 comprises four phases. The first phase encompasses observational efforts within schools to acquire a comprehensive picture of the educational environment. The second phase involves the socialization of service activities and coordination with school principal and educators, particularly those teaching physics. The third phase entailed instructing educators on the development of ethnoscience-focused educational resources. The last phase entails regular assessment and guidance involving two Mahasiswa Kampus Merdeka Belajar program and five physics lecturers to guarantee that the community service program positively influences the learning process. The findings indicate that the training positively enhances teacher competencies by implementing ethnoscience education that leverages the local community's cultural and traditional diversity, even amidst constraints of limited facilities and infrastructure. Physics teacher and students of SMA IT Khairu Ummah SMA IT have implemented an ethnoscience-based physics approach that is effective in enhancing students' comprehension of scientific processes and their acquisition of related skills.

Older adults’ decisions regarding mobility to age in place in medium- and high-rise multi-storey residential buildings in urban settings: A case study of South East Queensland, Australia

Population ageing and urbanisation requires a more thorough understanding and monitoring of older adult residential mobility trends. Many older adults move to urban areas and previous studies have been carried out on ageing in place in traditional low-rise residential buildings. However, there is little in the literature about the important push and pull factors influencing older adult moves to medium- and high-rise multi-storey residential buildings in urban areas as they age. This case study research considered the housing migration model of push and pull factors used in elderly residential mobility and investigated the older adults' decision-making regarding mobility to age in place in medium- and high-rise multi-storey residential buildings in South East Queensland, Australia. The study revealed how the older adults expressed a desire to age in place in multi-storey residential buildings in urban areas and identified it as an important element of quality of life. Many older adults chose to move house to high density urban areas from low density urban areas between the ages of 65 and 84. The ‘pull’ factor to significantly influence the decisions of movers was a low maintenance property and lifestyle change from a large suburban home whereas the ‘push’ factor was upkeep difficulties of the house related to old age. This study makes empirical contributions to knowledge in ageing residential mobility trends in urban areas and concludes by providing policy recommendations for developing more effective housing, public spaces, transportation, and community activities and services for older adults, including highlighting a number of recommendations for future research.

PENDAMPINGAN PEMBUATAN PUPUK DAN PESTISIDA ORGANIK GUNA MENDUKUNG USAHA BUDIDAYA STROBERI PADA KELOMPOK TANI SIDA URIP DESA SERANG KEC. KARANGREJA PURBALINGGA

Strawberries have various benefits for human health so they are widely loved by the public. Serang Village, Karangreja District, Purbalingga. This village is located on the slopes of Mount Slamet with an altitude of about 650 - 1,600 m dp is one of the centers of strawberry cultivation in Central Java, but since 2016 it has experienced a decline in production due to poor quality seeds, high fertilizer prices, declining soil fertility and the existence of pests and plant diseases. The purpose of this research-based community service activity is to implement the results of the research to solve the problems that exist in the Sida Urip farmer group, provide training in making organic fertilizers and pesticides, assist in the practice of making organic fertilizers and pesticides, improve skills in maintaining strawberry plants, so that it can increase strawberry production The method used in this activity is Rural Appraisal Participation, which is the active involvement of all elements of the target audience, the stages of the activity include: Survey, socialization of activities, training, practice, demonstration plot making and evaluation. The results of the activity showed that there was an increase in the knowledge and skills of farmer groups in making compost and biological agents to support environmentally friendly strawberry cultivation. The eco-friendly strawberry demonstration plot produces 38.69 kg/bed of strawberries and conventional strawberry cultivation land produces 37.45 kg/bed. The assistance carried out by the service team also increased enthusiasm and cohesiveness among members of the Sida Urip farmer group.

TRANSFORMASI USAHA SAMPAN PADA KELOMPOK MASYARAKAT SUNGAI MELALUI OTOMATISASI DAN STRATEGI PEMASARAN INOVATIF

Area-based development emphasizes the optimal management of local resources to achieve community welfare. Kampung Beting, Pontianak, has great potential in transportation and river tourism but is hindered by a negative stigma as a center for drug trafficking. Through community service programs, business transformation is applied to the boat mining group with automation, installing waterproof canopies, using solar cell lights, and rebranding. The results show increased operational efficiency, revenue, and a regional image change. Innovative marketing strategies that capitalize on historical and cultural potential have successfully enhanced tourist attraction and local community welfare.

PEMBENTUKAN KOMUNITAS PERMAINAN TRADISIONAL DALAM MENINGKATKAN KECERDASAN INTERPERSONAL ANAK USIA SEKOLAH

The excessive use of smartphones for playing online games has a negative impact on school-age children, necessitating an alternative to divert their attention. One effective solution is introducing traditional games, which significantly benefit children's interpersonal intelligence, such as teamwork, expressing opinions, supporting each other, and decision-making. To address this issue, the team conducted a community service program in Kampung Kandungmangu, RT09/RW 03, Cisauk. This program involved 15 school-age children and included presentations, mentoring, implementation, and evaluation. The results of the program showed that participants gained a deeper understanding of traditional games and their benefits. Even after the program ended, the children continued to play traditional games to apply the knowledge and skills they acquired during the program. This indicates that traditional games not only successfully divert attention from online games but also positively contribute to the development of children's interpersonal intelligence.

PRODUK OLAHAN IKAN (PROKAN) UPAYA MENINGKATKAN INOVASI PRODUK PERIKANAN DI DESA SISARAHILI TELUK SIABANG, KECAMATAN SAWO, KABUPATEN NIAS UTARA

Sisarahili Village is one of the underdeveloped villages that has a lot of potential in the fisheries sector. Based on survey information in the village, the income and economy of the people of Sisarahili Teluk Siabang Village have decreased since the Covid-19 pandemic in 2020. The problem faced by the community in Sisarahili Teluk Siabang Village is the lack of knowledge and skills possessed by the community to process fishery products into processed fish products that are highly nutritious and have high selling value. In order to solve this problem, this service activity aims to provide knowledge and skills to the community in Sisarahili Teluk Siabang Village about the technology of processing fishery products into processed fish products (PROKAN) which are highly nutritious and can increase the income and economy of the community. The implementation method used to achieve the target of service activities is by conducting counseling, training on the technology of processing fishery products into Processed Fish Products (PROKAN): nuggets and meatballs and mentoring. The community group that is the special target of this service activity is fisherwomen. Through the Student Organization Capacity Strengthening Program (PPK ORMAWA), it becomes a student movement in providing knowledge about the technology of processing fishery products into Processed Fish Products (PROKAN). This community service activity was welcomed enthusiastically by the community by attending the counseling and training of Processed Fish Products (PROKAN). The community stated that they got additional insights and skills in processing fish into various products, namely nuggets and meatballs.

PENGEMBANGAN PROFESIONALISME GURU ERA DIGITAL MELALUI PELATIHAN PEMBUATAN VIDEO KREATIF PEMBELAJARAN

This community service activity is based on the fact that many teachers feel confused when trying to create educational videos, even though creating educational videos is a prerequisite for teacher certification in today's professional landscape. The community service activity began with an observation, followed by a discussion forum to map out the issues found, which then served as the basis for determining the material to be delivered. The next phase involved training for the teachers, which was concluded with an evaluation. This training was held on December 16, 2023, in the computer lab at MTs Nurul Huda. The training was attended by 20 teachers from MTs Nurul Huda. The results indicated that teachers' competencies have improved, as evidenced by 10 out of 20 participants being able to independently create educational videos related to their subjects at MTs Nurul Huda.

PELATIHAN PENYUSUNAN LAPORAN KEUANGAN DIGITAL BERBASIS SYARIAH YANG BERKESINAMBUNGAN GUNA MENINGKATKAN KINERJA KEUANGAN UMKM BINAAN PONDOK PESANTREN AL MUBAAROK CARINGIN DI KOTA BANDUNG

Financial competency through training in preparing sharia-based digital financial reports is the main factor in improving financial performance and one of the assessments for the success of a company's financial performance. The preparation of sharia-based digital financial reports is carried out through a sharia-based digital accounting process. Sharia-based digital financial reports are carried out through the process of recording, classifying and summarizing all transactions at MSMEs assisted by the Al Mubarook Caringin Islamic Boarding School in Bandung City, in order to produce sharia-based digital financial reports that can be used for decision making for stakeholders. This training in preparing sharia-based digital financial reports is a Community Service activity carried out at the Al Mubaarok Caringin Islamic Boarding School in Bandung City. Sharia-based digital financial reporting competency is really needed by MSMEs in various cities/regencies in West Java. Financial reports will provide various benefits for the continuity of MSME businesses, especially the Al Mubarook Caringin Islamic Boarding School in Bandung City and generally in various cities/regencies in West Java. The benefits of sharia-based digital financial reports include, MSMEs can assess their company's financial performance, MSMEs have access to banking, MSMEs can, MSMEs can plan and control their financial budgets, West MSMEs can calculate their taxes, and MSMEs have sharia-based digital financial reports that can be applied in various Islamic boarding schools in West Java.

Optimalisasi Sumber Daya Lokal melalui Literasi Ekonomi: Kunci Peningkatan Kesejahteraan di Desa Perkebunan Maryke

The optimization of local resources is a key strategy in improving community welfare, particularly in rural in Perkebunan Maryke Village. Through economic literacy, communities can be empowered to understand, manage, and effectively and sustainably utilize the potential resources around them. This article discusses the role of economic literacy in strengthening the community's capacity to manage local resources to achieve better economic welfare. It also explores how empowerment programs, such as the Community Service Program (KKN), can act as catalysts in expanding the community's understanding of economics, particularly in managing local assets such as agriculture, fisheries, and handicrafts. The study results show that good economic literacy enables communities to make more informed decisions regarding investment, production, and marketing of local products, which ultimately contributes to increased income and social welfare. Therefore, strengthening economic literacy is a strategic step in empowering communities to become more economically independent through the utilization of their local resources.

PEMBERDAYAAN MASYARAKAT MELALUI DIGITALISASI PENGOLAHAN DATA NASABAH di BANK SAMPAH KEMUNING, JATI MELATI, KOTA BEKASI

Household waste in RW 12, Jati Melati, Pondok Melati, Bekasi City if not managed properly will result in piles of garbage that pile up and cause unpleasant odor pollution. This problem can be overcome by the presence of the Kemuning Waste Bank in the local environment. The impact of the waste bank, household waste can be reduced because some of the waste is deposited into the waste bank and provides economic value for the depositor. However, there is a problem faced by the Kemuning Waste Bank, namely in terms of recording customer data which is still done manually because it does not have technological devices that support digital recording. This makes it difficult for officers to recapitulate customer data reports, present information on the amount of waste obtained based on the category and type of waste, and calculate customer savings payments when due. This activity uses the method of designing a data input system, socialization, training and mentoring. The results of Community Service Activities show that officers have the competence to input, process and present data on the same day as the day of deposit and weighing customer waste.

Pengembangan Website Company Profile untuk Meningkatkan Promosi Digital PT Multi Global

In the face of digital era promotional challenges, developing a company profile website has become a crucial need for PT Multi Global. Despite operating for over two decades, the company has lacked a formal promotional platform capable of reaching a broader market. Previous promotional efforts relied solely on word-of-mouth, which is limited in expanding the company’s visibility in today’s digital landscape. Through a Community Service (PkM) initiative, this study aims to design and develop an informative and responsive company profile website using WordPress CMS and the Elementor plugin. The development process follows the System Development Life Cycle (SDLC) method with a waterfall approach, encompassing requirements analysis, design, implementation, testing, and maintenance phases. The final outcome of this project is a website that provides comprehensive information about the company, its products, and services, while also enhancing brand awareness and facilitating easier access to information for customers. This website development is expected to serve as an effective solution in supporting PT Multi Global's business growth and boosting the company’s competitiveness in an increasingly competitive market.

Integrating early child development into an existing health and nutrition program: evidence from a cluster-randomized controlled trial

IntroductionIn low-resource settings, introducing child health programs into community services may compete for caregiver time. We analyzed the impact of a new early childhood development (ECD) program in rural Madagascar on family attendance at other health services and of adding at-home play materials on program attendance.MethodsWe randomized 75 communities where community health workers (CHWs) implement an existing child health and nutrition program (Projet d’Amélioration des Résultats Nutritionnels or PARN), the status quo. We offered two 6-month cycles of 12 ECD sessions to eligible caregiver-child dyads (6–30 months) in 25 sites [T]; we added take-home play materials in Cycle 2 to 25 sites [T+]. We used differences-in-differences with administrative data to analyze the effect of offering ECD sessions on monthly PARN attendance (T+/T vs. C) among age-eligible children and the impact of toy boxes/libraries on monthly ECD session attendance (T + vs. T). We used random intercept models to analyze characteristics associated with program registration.ResultsWe analyzed data for 9,408 dyads; 30% and 32% registered for the program in Cycle 1 and 2 (respectively). On average, CHWs delivered 11.4 sessions (SD: 1.5). Children from wealthier households who already attended PARN sessions were more likely to register, and we found no effect of T or T + on PARN attendance. Adding play materials did not affect monthly ECD session attendance. Children from more populated sites were less likely to participate in both ECD and PARN sessions.ConclusionsIntegrating new services for ECD into the health system was feasible and did not reduce dyad participation in existing services. Investment in health services in more populated areas is needed to provide coverage to all eligible children. Novel strategies should be explored to engage the most vulnerable children in new and existing health services.Trial registrationAEA Social Science Registry (AEARCTR-0004704) on November 15, 2019 (prospective registration) and ClinicalTrials.gov (NCT05129696) on November 22, 2021 (retrospective registration).

An inpatient mental health placement for paramedic undergraduate students: a pilot study

BackgroundThe prevalence of mental and behavioural illnesses in the Australian community is increasing. Paramedics are frequently the first health responders to a mental health crisis, and their workload associated with mental health presentations is also increasing. The present study explored the experience and perspectives of undergraduate paramedic students who participated in a pilot mental health placement.MethodsA pilot workplace learning opportunity was established in which students completed a portion of their community service hours in an inpatient mental health setting at Port Macquarie Base Hospital. Eight students attended and completed the placement and were administered the Clinical Placement Evaluation Questionnaire.ResultsStudent responses to this placement experience were overwhelmingly positive. The data showed that all the students responded “Strongly Agree” or “Agree” to each of the survey items. Thematic analysis of the qualitative data yielded four central themes related to benefits, additional training and education, nursing staff, and improvements.ConclusionsThis pilot study suggests that mental health placements for paramedics have meaningful educational value and can impact student learning. Since this pilot study, mental health placements have been permanently included as part of the undergraduate curriculum in our institution.