Health Needs Assessment Research Articles

A Framework for Assessing the Health Needs of Disabled Adult Patients with Autoimmune Disorders and Depression in Madinah, Saudi Arabia

Depression remains one of the biggest global challenges, requiring an active approach to tackle it across the different healthcare sectors. Given depression’s widespread prevalence and its association with chronic autoimmune conditions, such as diabetes mellitus, it has been predicted to be one of the significant causes of added disability worldwide and in Saudi Arabia (SA). To address this issue efficiently, organized efforts should be taken, which are proposed in this report as a corporate health needs assessment (HNA). In this study, a framework for a five-step HNA to detect depression among disabled adult patients in Madinah, SA, is proposed that can be used by health policymakers. These steps include getting started, identifying health priorities, assessing a health priority for action, planning for change, and moving on/project review. This proposal should provide a practical stepwise guideline to healthcare policymakers when planning healthcare services in Madinah.

Stray Dogs in Türkiye: A Health Needs Assessment Proposal for Rabies Elimination

This review article presents a comprehensive proposal for a Health Needs Assessment (HNA) aimed at eliminating rabies in Türkiye, with a focus on the country's growing population of stray dogs. It highlights the increasing numbers of unowned dogs in urban areas and the associated public health risks, including rabies transmission and dog attacks. The review emphasizes the importance of systematic data collection on the population, living conditions, and vaccination status of stray dogs, and the need for effective strategies to manage these animals. The proposed HNA involves collaboration with a consortium of stakeholders and utilizes frameworks and approaches such as Cavanagh and Chadwick’s 5-stage HNA framework and Stevens & Gillam’s approaches for conducting an HNA. The review outlines a detailed methodology structured into three work packages, focusing on epidemiological data production, identifying unmet health needs, and developing a national strategic rabies elimination plan. It discusses challenges such as consortium formation, data availability, stakeholder engagement, and cultural sensitivity, highlighting the impact and importance of the HNA in addressing rabies and stray dog management in Türkiye.

Complex social factors in pregnancy - a Scottish health needs assessment

Abstract Issue Health inequalities begin prior to conception. In the UK, babies born to women living in the most deprived areas are twice as likely to be stillborn compared to babies from the least deprived areas. Maternity services have a vital role in tackling health inequalities during the antenatal period but are not always equipped to optimally achieve this. Description A health needs assessment (HNA) of pregnant women experiencing complex social factors (CSFs) was undertaken in NHS Lothian. The objectives were to describe the epidemiology of CSF in pregnancy, identify the needs arising from these, map the services available, and understand the experiences of staff and pregnant women. The HNA reviewed data from >42,000 maternity records between 2016-2020, engaged with midwives through focus groups and questionnaires, and undertook focus groups with women who had recently used antenatal services. Results Between 2016-2020, socio-economic deprivation was the most common CSF at booking (17%), followed by domestic abuse (4%), living in temporary accommodation (4%) and teenage pregnancy (4%). Other CSFs included problem substance use, difficulty reading/speaking English and involvement in the justice system. Midwives highlighted that CSFs could affect anyone at anytime, were often multiple and overlapping, and required additional time and partnership working to support. Whilst excellent models of care existed, there was geographical inequity in the quantity and quality of support available. Conversations with women emphasised the importance of continuity of care and described how a single point of contact through a trusted practitioner helped them access the range of services required. Lessons The HNA made 15 recommendations on how maternity services could better support CSFs. These related to developing better data systems to understand CSFs, increasing staff support, designing flexible care models, and strengthening multi-agency working. Key messages • The HNA has raised awareness of the range of CSFs encountered by pregnant women and their links to short- and long-term health inequalities for women and their babies. • The HNA is being used by maternity services to improve CSF support by using routine health data, allocating resources in a way that is proportionate to need and strengthening multi-agency working.

Beneficiaries of Temporary Protection (BOTPs) in Mid-West, Ireland: a retrospective analysis

Abstract Since the outbreak of war in Ukraine, over 78,000 migrants have come to Ireland seeking protection. It is necessary to capture their demographics, to understand their immediate health concerns and to identify their additional service requirements to ensure that this cohort can continue to shelter healthily in Ireland. A retrospective cohort analysis was carried out on Health Needs Assessments (HNAs) undertaken for BOTPs in congregated settings. Date of entry to Ireland was captured on 1820 HNA forms returned to the Department of Public Health Mid-West Area E. Patterns in the demographics and the health service utilisation of arrivals, over the first year of conflict, were analysed. Participants were grouped by arrival date, Cohort 1 (24/02/22-20/09/22) (n = 1130) and Cohort 2 (21/09/22-03/03/23) (n = 690). The proportion of male adult arrivals increased from 32% in Cohort 1 to 36% in Cohort 2 and the proportion of older adults (>65 yrs) increased by 40% in Cohort 2. The respondents that reported being pregnant increased from 0.5% of females (aged >14) in Cohort 1 (n = 3) to 2.9% in Cohort 2 (n = 9). Cohort 2 reported lower uptake of COVID-19 vaccines, with 30% self-reporting as doubly vaccinated, compared with 44% of Cohort 1 (p < 0.01). There were no significant differences in child immunisation rates between Cohort 1 + 2. Chronic disease status in both cohorts were consistent, with some exceptions. Statistically significant differences were noted (p < 0.01) across different age groups for some chronic diseases, including heart disease and Diabetes Type 2. Differences in age and sex distributions between Cohort 1 and Cohort 2 will impact on the utilisation of health services. Higher rates of pregnancy may impact on primary care and maternity services. Low rates of child immunisation have resulted in the roll-out of a targeted catch-up vaccination programme for those aged 0-23 years. Predicting HNA trends will help to re-orient health services to meet the needs of these groups. Key messages • Differences in age and sex distributions between early (Cohort 1) and late (Cohort 2) arrivals will impact the utilisation of health services and must be accounted for when planning local services. • Predicting trends of chronic disease and health needs has enabled local health service teams to carry out targeted interventions to ameliorate health and health service access for these groups.

Tribal Perspectives on Hypertension: Results From the Center for Native American Health Native-CHART Needs Assessment.

American Indian/Alaska Native (AI/AN) hypertension contributes to cardiovascular disease, the leading cause of premature death in this population. The purpose of this article is to document strategies, concerns, and barriers related to hypertension and cardiovascular disease from Native-Controlling Hypertension and Risks through Technology (Native-CHART) symposiums facilitated by the Center for Native American Health (CNAH). The objectives of this evaluation were to combine Health Needs Assessment (HNA) data and explore barriers and strategies related to hypertension while assessing changes in participants' perspectives over time (2017-2021). CNAH followed an iterative process each year for planning the HNA, facilitating the HNA, and refining and reflecting on HNA findings over time. This involved 3 interconnected steps: (1) developing a shared understanding for the HNA, "Why are we here?," (2) facilitating the HNA during annual symposiums "What do we do?," and (3) reflecting on "What did we learn?". Data were collected using a culturally centered HNA co-created by the CNAH team and tribal partners. Qualitative data analysis utilized a culturally centered thematic approach and NVivo software version 12.0. Quantitative data analysis included summarizing frequency counts and descriptive statistics using Microsoft Excel. Over the 5-year period, 212 Native-CHART symposium participants completed HNAs. Data collected from HNAs show persistent barriers and concerns and illuminate potential strategies to address AI/AN hypertension. Future efforts must explore effective strategies that build on community strengths, culture and traditions, and existing resources. This is the path forward. CNAH's culturally centered and unique HNA approach helped assess participant perspectives over time. CNAH facilitated symposiums over multiple years, even amid a global pandemic. This demonstrates resilience and continuity of community outreach when it is needed the most. Other universities and tribal partners could benefit from this iterative approach as they work to design HNAs with tribal populations.

Proposal Protocol for Management of Health Needs among Patients Undergoing Intestinal Obstruction Surgery

Background: Intestinal obstruction surgery is a common surgical emergency due to a mechanical or functional blockage of the bowel. Obstruction frequently causes abdominal pain, nausea, vomiting, constipation and distention. Aim: The aim of this study was to propose a protocol for health needs management among patients undergoing intestinal obstruction surgery. Design: A descriptive exploratory design was utilized in carrying out this study. Setting: The study was conducted at surgical departments and outpatients' clinics at El Demerdash surgical hospital. Subjects: A Purposive sample (90) adult patients undergoing intestinal obstruction surgery. Tools: Two tools were used for data collection were: I- Patients' interviewing questionnaire it was includes socio-demographic characteristics and medical data sheet. II- health needs assessment questionnaire to assess (physical, psychological, social, educational and spiritual needs). Results: the result of the study showed that less than half of the studied patients had moderate level related to total physical needs, less than two thirds of them had moderate level related to total psychological needs and slightly less than three quarters of them had moderate level related to total social needs. Moreover, slightly less than two thirds of the studied patients had low level related to total educational needs. While, slightly more than half of them had moderate level related to total spiritual needs. Conclusion: The highest needs were social needs followed by psychological, educational, spiritual and then later physical needs. There were highly statistically significant positive correlations between total physical, psychological, social, educational and spiritual needs of the studied patients undergoing intestinal obstruction surgery. Recommendation: Continuous assessment of the needs of the patients undergoing intestinal obstruction surgery is highly recommended

Qualitative Focus Group Study Examining Perceptions of the Community's Important Health Issues, Health Care Needs and Perceived Barriers to Access Among Arabic Speaking Primary Care Clients in the State of Qatar.

ObjectiveThis study is a part of the Primary Health Care Corporation’s (PHCC) Health Needs Assessment (HNA) Initiative. It focuses on identifying perceptions of Arabic speaking primary care clients regarding community’s major health issues, their experiences in utilizing health services, and the barriers that limit their access to health care in the State of Qatar.Study Setting and DesignA total of 10 focus groups sessions were conducted at different PHCC’s health centers between October of 2019 and March of 2020. Sessions were distributed to cover all PHCC’s three geographical regions. Data were analyzed using thematic analysis.ParticipantsA total of 89 adult Arabic speaking individuals were recruited. Participants included were in the age groups (18–69), native Arabic speaker, and registered at one of the PHCC’s health centers with a valid health card at time of recruitment.ResultsAreas investigated included perceptions of the community’s health issues, needed health services, and perceived barriers to health care. Priority health issues identified were chronic non-communicable diseases, mental health, timely access to care, cultural competency of delivered services, and integration and coordination across health care settings and sectors. Participants were able to identify socioeconomic and environmental factors such as the need for health and wellness interventions at schools that affects the health of the individual and the community. The importance of raising the community’s awareness about health-related issues and availability of health services was highlighted by study participants.ConclusionCollecting qualitative data provides an opportunity to examine people’s perceptions, and motivations and engage the whole community. This process is very important for strategic planning of health services. The study attempts to fill the knowledge gap and should be linked to health policy and the development of socially and culturally appropriate health programs.

Determinants of health and health needs assessment of artisanal and small-scale gold miners in Kadoma, Zimbabwe: A mixed method approach

BackgroundThe role of artisanal and small-scale gold mining (ASGM) as a source of income is rapidly gaining importance in the economically difficult times in Zimbabwe. Small-scale miners are now responsible for over 50% of the Zimbabwean gold production. However, the sector is still characterised by high labour-intensity, low productivity and capital, limited mechanisation and outdated technologies. Since increasing efforts in recent years to improve miners’ health while reducing the exposure to mercury have not been effective, a more sustainable approach is needed to identify interventions targeting the health of artisanal and small-scale miners and the mining communities. ObjectiveThe main objective of this study was the accurate and extensive empirical identification of the determinants of health in ASGM and of the miners’ health needs. In tandem with these needs, topics which generate more effective, sustainable, and feasible future health interventions targeting occupational health should be identified. MethodsBased on the identification of determinants of health, a health needs assessment (HNA) was used to conduct miners’ needs by applying a mixed methods approach and triangulation. This included qualitative and quantitative interviews with individuals, group interviews, focus group discussions, observations and informal conversations. ResultsThere were 85 structured and 84 semi-structured interviews, a focus group discussion, and observations conducted. Six main themes were identified around which miners’ health needs can be aggregated as follows: living conditions, nutrition and hygiene; safe work environment and mining processes; financial support; health care services; formalisation and education. DiscussionThe following aspects were considered most important for sustainable interventions: possible health impacts, feasibility, value for miners and their willingness to adapt. Accordingly, interventions aiming at increasing education, knowledge and awareness of miners were identified as most promising in improving occupational health.

A Broad-Based Approach to Social Needs Screening in a Pediatric Primary Care Network.

In 2016, the American Academy of Pediatrics recommended universally screening patients for social needs, and in 2018, a quality measure for social needs screening was included in some Massachusetts Medicaid contracts. However, exact guidelines for screening were not provided. We describe the results and implications from a broad-based health-related social needs (HRSN or "social needs") screening program within our large, pediatric primary care network. We adapted items from The Health Leads toolkit to create our network's screening tool: The Health Needs Assessment (HNA). We trained staff to use the tool and provided staff with resources to assist families with their needs. All patients with a primary care physician in the network were eligible to complete an HNA. We calculated descriptive statistics and estimated the risk of identifying a social need using multivariable regression analyses. Between June 2018 and May 2019, 100,097 patients completed an HNA; 8% of patients identified a social need, and 33% of those patients requested assistance with the need(s). The multivariate analysis revealed an association between several patient characteristics-health insurance type, age, median household income by zip code, complex chronic conditions, race/ethnicity-and identifying a social need. Our large, pediatric primary care network successfully instituted a broad-based HRSN screening program in response to state and national screening recommendations. We observed a low prevalence of reported social needs and a propensity to forego assistance. Additional research is needed to understand the barriers around the disclosure of social needs and requests for assistance.

The Effects of Polyvictimization on Mental and Physical Health Outcomes in an LGBTQ Sample.

Lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) individuals are at elevated risk for violent victimization and often experience increased health disparities compared to their non-LGBTQ counterparts. The present study examined associations between polyvictimization and mental and physical health in an LGBTQ sample. Participants included 385 LGBTQ individuals involved in a larger health-needs assessment of LGBTQ individuals living in the southeastern United States. The sample primarily identified as gay/lesbian (63.4%), cisgender (78.7%), and White (66.5%), and the mean participant age was 34.82 years (SD = 13.45). A latent class analysis (LCA) was conducted on seven items assessing different types of violence exposure. The LCA identified a three-class model, with classes characterized by low trauma exposure (71.4%), nondiscriminatory violence (15.1%), and high trauma exposure (13.5%). Differences in demographic characteristics, perceptions of mental and physical health, and diagnoses of specific health conditions were assessed across classes. The high-trauma class reported poorer perceived physical and mental health compared to the other two classes, with mean differences in past-month poor health days ranging from 11.38 to 17.37. There were no differences between the classes regarding specific physical health conditions; however, the high-trauma and nondiscriminatory violence classes had significantly higher rates of anxiety, depression, drug abuse, and suicidality than the low-trauma class, ORs = 2.39-23.83. The present findings suggest that polyvictimization is an important risk factor for poor health among LGBTQ individuals. These results have implications for addressing health disparities among the broader LGBTQ community.

Engaging Church Leaders in a Health Needs Assessment Process to Design a Multilevel Health Promotion Intervention in Low-resource Rural Jamaican Faith Communities

Diabetes and cardiovascular diseases (CVD) are major Jamaican public health issues. Churches may be untapped settings to extend reach and impact of diabetes and CVD prevention programs, particularly in low-resourced, rural Jamaican areas. We engaged the Jamaican Lifestyles Health Ministry Association Community Action Board in designing and conducting a health needs assessment (HNA) process to identify health conditions, priority health concerns, and potentially relevant intervention strategies to address concerns with their church-community members in rural areas. Findings from the HNA process (survey and community forum) were used by faith leaders to guide the design of a culturally-religiously tailored, multilevel diabetes/CVD risk reduction intervention, Project Faith Influencing Transformation (FIT)-Jamaica (JA). Use of HNA and collaborative intervention design processes were key to successfully completing the design of a faith-based health promotion intervention in JA churches in a timely manner.

Understanding community health needs and forging an academic global health partnership in Puebla, Mexico: a mixed methods study

BackgroundAcademic global health partnerships can help address population health needs, particularly in low-resource settings. To be effective, they must start with a detailed understanding of community health needs, and involve the voice of the community. In Puebla, Mexico, a team from the Benemerita Universidad Autonoma de Puebla (BUAP) and the University of Texas at Austin (UT), undertook a comprehensive community health needs assessment of four low-income communities. MethodsAn interdisciplinary team was formed from staff and students at UT and BUAP, along with local community organisers from the Fundacion Communitaria de Puebla (FCP) in Mexico. We selected one urban community and three rural agrarian communities from the region surrounding the town of Atlixco in Puebla, Mexico. We designed a comprehensive health needs assessment with the following objectives: to understand the perceptions and priorities of the health needs of families; to characterise health behaviours, risk factors, resource use patterns, and access issues; and to describe the intersection between the built environment and health through an exploration of housing, water, and air quality. To achieve these objectives, we implemented a comprehensive, pragmatic, and responsive mixed-methods approach including semi-quantitative household surveys, key informant qualitative interviews, focus group discussions, intensive case studies of dwelling units, and technical air and water quality sampling of each household surveyed. FindingsWe included data from 242 household surveys, four key-informant interviews, six focus group discussions, and five case studies of dwelling units collected between June 3 and July 26, 2019. Mean household size was four people and mean focus group discussion size was ten participants. We noted common, and unique, issues and patterns emerging across each community. These included misinformation on the causes and treatment of diabetes; mental health trauma after the 2017 Puebla earthquake; housing conditions, agricultural practices, and indoor air pollution that jeopardise the health of families; and socioeconomic barriers affecting access to care, particularly in the rural agrarian communities. Furthermore, this project helped forge the working relationships between UT, BUAP, FCP, local community leaders, and the Ministry of Health in developing an academic global health partnership that can further explore and respond to these findings. InterpretationEngagement with communities to develop a deep understanding of their needs and priorities is of great importance. Addressing these needs will require a combination of further research, education, clinical care, public health interventions, and new policy proposals. This community health-needs assessment galvanised the start of an academic global health partnership between UT and BUAP that will adapt the Academic Model Providing Access to Healthcare (AMPATH) paradigm to work with communities and public-sector health-care delivery systems to improve population health outcomes. FundingThe President's Award for Global Learning, The University of Texas at Austin

Supporting Child Wellbeing

The Hamilton Children’s Team received its first referral in 2015, with dedicated lead professionals appointed for each child referred. The role of these lead professionals is to assess need, develop a plan for each child, and coordinate a cross-sector Child Action Network to improve care and wellbeing. Challenges were identified in Hamilton for the assessment, identification and coordination of health need within the Children’s Team, particularly for lead professionals from outside the health sector. Therefore, a health assessment package was developed in partnership with the Hamilton Children’s Team, the Waikato District Health Board and other relevant agencies. The use of a standardised and systematic approach, with training and relationship development, resources and referral pathways, resulted in identification of significant unmet need. A number of referrals to the health sector resulted from this assessment and there are implications that such a process can support ongoing attendance at health appointments, monitoring of outcomes from the Children’s Team process, and improvements to physical, emotional and mental wellbeing for families. This approach was well received by lead professionals and families, and future use is likely to enhance the Children’s Team programme and service delivery, and improve wellbeing outcomes.

Health in Environmental Impact Assessment (EIA): Gaining strength from the ‘Family of health assessments’ approach

Abstract Background For connecting health-related “scientific knowledge” and “policy-making” with each other, there is a range of approaches, including health reporting, health needs / impact / technology / systems performance assessment as well as evaluative activities. The improved understanding of their communalities and differences provides opportunities for mutual learning and synergetic practice. Goal and method The goal is to strengthen the coverage of health within EIAs. We apply the “Family of health assessments” approach, as worked out by the EUPHA “health assessments” working group (EJPH 2017, pp.609-16), for connecting EIA to other approaches used to support decision-making. Results Applying this “family” approach leads to various insights, including the following: (i) Existing local health (or environmental) reports provide baseline information, as required in impact assessments. (ii) An existing Health Needs Assessment (HNA) can point to vulnerable populations, Health Systems Performance Assessment (HSPA) to specific weaknesses of local health care, potentially relevant for expected impacts. (iii) Where other impact assessments beyond EIA, e.g. Social Impact Assessment (SIA), are conducted, assessors need to be aware of potential overlap or even contradictions which could irritate decision-makers and the public. (iv) Ex-post evaluations of similar projects can inform prospective EIA. (v) The competencies required for assessing human health in EIA overlap with those required for other types of health assessments, e.g., health reporting or evaluation. Therefore, teaching modules might jointly be developed. Lessons The “family” perspective helps to make best use of existing (local) knowledge (which is often embedded in diverse forms of health assessments); and to assure consistent practice across assessments. The inter-relationship of health assessments is a reason to reconsider training courses and to develop more integrated approaches.

Health Needs Assessment in Disasters by Emergency Medical Teams in the ASEAN Region

Introduction:Japan International Cooperation Agency has started the project for strengthening the ASEAN regional capacity on disaster health management (ARCH Project) since 2016. This project conducted the start-up regional collaboration drill in ASEAN. All participants from ASEAN countries realized the need for a standardized assessment tool. Several UN agencies and international organizations launched assessment tools, but there is no standard assessment tool.Aim:To develop an integrated rapid health needs assessment (HNA) tool in the ASEAN region. This paper reports the development process of the HNA tool.Methods:The project established the project working group (PWG) to developing some tools. PWG consisted of the expert team, project team, Japanese Advisory group and twenty delegates from ten ASEAN member states. PWG established the cycle of the developing process of the HNA tool.Results:We created a health needs assessment form and a summary form. The assessment form consists of (1) Informant information, (2) Site information, (3) Overall situation of the site, (4) Public health, (5) Health facility damage. The summary form consists of (1) Informant information, (2) Site information, (3) Critical areas for support, (4) Situation of the site.Discussion:Frequently, the public health emergency operation center in an affected country is not able to obtain the critical information of an affected area in the acute phase of disasters. This HNA tool would be used in the acute phase by the Emergency Medical Teams (EMTs) because the EMT has mobility and workforce for assisting the affected country. We have agreed on the usage of the assessment form as a kind of an “interview guide”. The purpose of this assessment form is to assess a disaster situation. The next step will be to provide more opportunities for the ASEAN member states to use and learn more about this HNA form.

Health needs assessment of workers in Kaveh industrial city.

Background: Health needs assessment (HNA) is essential for allocation of limited resources to the most prioritized problems. HNA in work places has gained increasing importance. Kaveh industrial city is the largest and oldest industrial city in Iran, with a wide range of different industries, making it an exemplary industrial city in Iran. This study was done to conduct health needs assessment of workers in Kaveh industrial city. Methods: In this study, intensive HNA approach and qualitative method were used. In-depth interviews and Focus Group Discussions (FGDs) were conducted to collect information related to health risk factors, and Delphi method was used to prioritize these risk factors. A total of 74 key informants participated in this study, which constituted more than 80% of the total related experts of Kaveh industrial city. Results: The main identified health challenge was inefficiency of the existing Health, Safety and Environment (HSE) control and monitoring system. The most important physical health risk factors were smoking and obesity and the most prioritized psychosocial risk factors were stress and lack of appropriate management and organizational culture. Ergonomic issues and noise pollution were the prioritized work environmental factors and inappropriate placement of pollutant industries in the industrial city was the most prioritized bioenvironmental risk factor. Unsafe road to industrial zone and poor safety devices used by workers were the most prioritized occupational injuries risk factors. Conclusion: Addressing the identified health needs of workers in Kaveh industrial city is of high importance. Also, redefining the HSE control and monitoring system should be prioritized

Lessons for commissioning and health outcomes from Her Majesty’s Prison Birmingham

Purpose This study of HMP Birmingham was part of a much larger investigation of health needs assessment (HNA), in the context of a new “HNA Toolkit” developed by Public Health England for use in the prison service. The paper aims to discuss this issue. Design/methodology/approach In 2015, details of prison healthcare in HMP Birmingham had figured in the authors’ analysis of documents. In 2018, a crisis in Birmingham typified problems developing more widely in England and Wales. Was the crisis predictable from the initial HNA? Findings Recommendations embodied in the 2015 HNA were not acted upon; the eventual problems that combined to overwhelm the running of HMP Birmingham were predictable. Originality/value Lessons from this case study could inform more coherent commissioning of prison health services. This in turn could promote timely developments for improved health and morale in the prison, amongst prisoners and staff. Longer term, this might help to avoid future crises.

2316 The extra-territorial translational team: Advances in multi-faceted community engagement

OBJECTIVES: We developed the concept of the extra-territorial translational team (ETTT) in 2014 as a more inclusive revision and extension of the team science concept. Translational thinking is largely marked by the perception of the team as a thing-like structure at the center of the scientific activity. Collaboration accordingly involves bringing external others (e.g., scientists, community members, and clinicians) into the team through limited or dependent participation. The ETTT is intended to frame the team as an idea: a schema for assembling and managing relationships among otherwise disparate individuals with vested interests in the problem at hand. Thus, the ETTT can be seen as a process as well as an object. Our initial focus was on the very successful SCI Café program (where Science and Communities Interact) conducted through the Institute for Translational Sciences and the Center for Translational Sciences Award at UTMB. We found that by looking beyond the taken-for-granted features of translational research teams, we are free to discover new ways of organizing research and community engagement that are innovative yet productive. The major area of growth, however, has been the Research, Education, And Community Health Coalition (REACH). The purpose of the current study is to outline strategies for inventorying and evaluating the emerging programs that are the major components of REACH and the SCI Café and to suggest implications for the extra-territorial translational team concept. METHODS/STUDY POPULATION: The assessment of the extraterritorial team concept in REACH and SCI Café is primary a process of qualitative content analysis. We use semi-structured interviews with project leadership, observations of the actual performance of the REACH teams, and the review of REACH and SCI Café documents, for example, Quantitatively, we have conducted a Community Health Needs Assessment (CHNA) to better understand community health and resource needs. RESULTS: Both the SCI Café program and the REACH initiative follow the principles of the ETTT concept for assembling and managing research and community outreach. The following are several key principles shared by both programs: (1) The importance of creative, applicable, and inclusive mission statements: (a) REACH seeks to facilitate communication, collaborative research, and service efforts between UTMB and Institute for Translational Sciences investigators and Galveston County community leaders; (b) The SCI Café hosts interactive dialogs that serve as a medium for priming, organizing, communicating and strategizing among the individuals involved in team science via community-based research projects. (2) Increasing scientific and health literacy: (a) REACH seeks to increase literacy through both short-term and long-term interactions; (b) The SCI Café focuses on short-term yet intensive interaction through conversations among researchers, clinicians, and the public. (3) Sharing timely scientific public health information with the community: (a) REACH seeks information from community leaders on relevant topics; (b) The SCI Café can mobilize quickly to respond to timely topics by direct communication with a wide range of stakeholders, academic as well as community based. (4) Sharing leadership with the community: (a) REACH establishes formal relationships with 23 UTMB units and 39 broad-based, high impact Galveston County organizations. (b) The SCI Café works primarily with “grass roots” community-level groups and organizations. (5) Creating resources and strategies for expansion: (a) REACH is working to expand its activities to other counties in the Gulf Coast area of Texas (e.g., Brazoria and Matagorda Counties); (b) The SCI Café is expanding its program to comfortable locations accessible to local residents (e.g., schools and libraries). (6) The value of regular and systematic scientific and evaluation: (a) REACH is conducting a Community Health Needs Assessment (CHNA) that has already discovered major issues of relevance to community leaders including mental health, vaccination rates, food security, disaster preparedness, and caregiving. (b) The SCI Café conducts an evaluation survey at the conclusion of every event to stay current with participants interests and needs. DISCUSSION/SIGNIFICANCE OF IMPACT: (1) In order to maintain the ability to operate extra-territorially (i.e., beyond the safe organizational confines of the University), the 2 programs discussed here must maintain a fluid team structure. Different projects require different types of leadership, grass roots participation, university resources, communications/public relations, etc. (2) The strategy of accumulating and disseminating best practices appears to be one of the most valuable products of the extra-territorial team. (a) REACH’s “Offer and Ask” practice by which information of university and community resources (skills and expertise) are shared makes cooperation and shared leadership explicit. (b) The SCI Café’s interactional strategies for encouraging and enabling café participants to join the discussion/conversation are wonderful ways to convert an otherwise unidirectional lecture into a vibrant conversation. (3) Although the scope of these 2 programs is quite different, the message from both is that the principles of extra-territorial translational teams are application to all such endeavors to improve scientific and health literacy.

The use of anti-psychotic and other psychotropic medication in a specialist community service for adults with learning disabilities

PurposeThe purpose of this paper is to examine the extent to which, in the five integrated community teams for adults with learning disabilities (CTLDs) in an English county-wide service, the use of psychotropic medication for service users was based on the presence of an appropriate mental health condition or epilepsy.Design/methodology/approachAdult participants were recruited following referral to one of the CTLDs for assessment, treatment and/or support of a possible mental health and/or behavioural need. Data were collected about participant characteristics and psychotropic medication 12 months after recruitment.FindingsWhile a total of 42 (78 per cent) of the 54 participants were apparently prescribed regular or PRN (as required) psychotropic medication, only 24 (57 per cent) of these individuals had a recorded past or current mental health condition or epilepsy for which such medicine could be appropriate.Research limitations/implicationsThere were several limitations: the sample size was small and its representativeness was uncertain; and data collection was compromised by barriers to explicit knowledge exchange within and across the learning disability service.Practical implicationsWhile recent guidance about the use of psychotropic medication is welcome, minimising inappropriate use requires more comprehensive person-centred interventions (including crisis management plans), underpinned by imaginative, but feasible, data collection methods and integrated formulations. Investment is needed in developments that support multi-disciplinary and inter-agency working to promote “good practice” by CTLDs in responding to referrals for possible mental health and/or behavioural needs.Originality/valueComplementing recent large studies of primary care (General Practitioner) records, this is the first examination of the use of psychotropic medication by service users in English CTLDs.

Identifying health conditions, priorities, and relevant multilevel health promotion intervention strategies in African American churches: A faith community health needs assessment

Identifying health conditions, priorities, and relevant multilevel health promotion intervention strategies in African American churches: A faith community health needs assessment