Health Resource Centre Research Articles

A Retrospective Study of the Profiles of Outpatients Attending the State Adolescent Friendly Health Resource Center, Andhra Pradesh, South India.

Adolescents compose a significantly large age group, and attention to their health needs is lacking due to insufficient data and policy implementation globally and in India. India, having 268 million adolescents, faces the world's largest adolescent population, which highlights the importance of addressing their health requirements. The aim of this study was to describe the morbidity profiles of adolescent patients attending the State Adolescent Friendly Health Resource Centre at a tertiary-level healthcare institution in South India. A retrospective secondary data analysis was conducted at the State Adolescent Friendly Health Resource Center from 2022 to 2023. Data on adolescent health were collected from this center's OPD using a structured questionnaire, which included information on demographics, immunization status, chief complaints, and dietary intake. Diagnosis coding was done using the International Classification of Diseases, Tenth Revision (ICD-10), with estimated energy and protein intake. The study analyzed 4,000 adolescent patients, with a nearly equal gender distribution across physical OPD and telemedicine services. Adolescent females between 15 and 16 years had more visits for consultation. Most patients were within the normal BMI range, and telemedicine was popular among females with normal BMI. Obesity was more common in males, while overweight was prevalent in females. Energy and protein intake varied across BMI categories, with obese individuals having the highest intake. The morbidity profiles revealed significant gender differences in healthcare utilization and disease patterns. Gender differences in adolescent morbidity and the underutilization of telemedicine highlight the need for tailored healthcare interventions and further research based on socioeconomic factors.

Standardization of Clinic Flow to Improve Patient Experience in a Student-Run Free Clinic

The Saint Louis University Health Resource Center, a student-run free clinic, has seen a rapid expansion in both the number of services supplied by the clinic and the number of patients seen at clinic. While we are excited to serve more patients, the increase in volume has resulted in increased wait times and clinic throughput, the most frequent complaint of patients. To combat these growing concerns, we standardized the route patients take through the services the clinic provides and embedded this flow into a new statusboard that automatically logs the amount of time patients spend with each service and in the clinic overall. This information feeds directly into a process map of the clinic that better visualizes clinic processes. The utilization of a standardized statusboard resulted in a significant 12 minute and 44 second reduction in the median time patients spend in clinic and identified key decision points where bottlenecks occur in clinic flow. It also resulted in a statistically significant improvement in patent satisfaction. Our results demonstrate that standardizing clinic flow via an automated statusboard improves clinic efficiency, reduces throughput time, and can also significantly improve patient satisfaction. The resulting process map can also identify areas needing intervention and opportunities to continue expanding. As we continue to gather data on where clinic patients are spending the most time, we will continue to optimize services to provide the best experience possible for our patients.

Feasibility of Implementing a Low-Barrier Long-Acting Injectable Antiretroviral Program for HIV Treatment and Prevention for People Experiencing Homelessness.

Long-acting (LA) antiretrovirals may provide meaningful benefit to people who use drugs and people experiencing homelessness (PEH) who face disproportionate structural and psychosocial barriers in adhering to daily oral HIV antiretroviral therapy or pre-exposure prophylaxis (PrEP), but their use in these populations has not been studied. The Maria X. Martinez Health Resource Center is a low-barrier (eg, no appointment) community-based clinic serving San Francisco PEH. A multidisciplinary care model with robust monitoring and outreach support was developed to provide LA antiretroviral therapy (ART) and LA-PrEP to eligible patients experiencing difficulties adhering to oral antiretrovirals. Feasibility was assessed by evaluating the rates of HIV viremia and on-time injections among patients receiving LA antiretrovirals over the first 24 months of program implementation. Between November 2021 and November 2023, 33 patients initiated LA-ART or LA-PrEP (median age, 37 years; 27% transgender/nonbinary; 73% non-White; 27% street homeless; 52% sheltered homeless; 30% with opioid use disorder; 82% with methamphetamine use disorder). Among 18 patients with HIV, 14 initiated LA-ART injections with detectable viremia (median CD4 count, 340 cells/mm 3 ; mean log 10 viral load, 3.53; SD, 1.62), 8 had never previously been virally suppressed, and all but 1 achieved or maintained virologic suppression (mean, 9.67 months; SD, 8.30). Among 15 LA-PrEP patients, all remained HIV negative (mean, 4.73 months; SD, 2.89). Of 224 total injections administered, 8% were delayed >7 days. The implementation of LA antiretrovirals is feasible in low-barrier, highly supportive clinical settings serving vulnerable PEH. Expansion of such programs will be critical in ending the HIV epidemic.

Creating and Implementing an Indigenous Evaluation Framework Process With Minnesota Tribes

This article is an exemplar of incorporating traditional Indigenous approaches into evaluation practice and addresses the Eastern Door—Be a Good Relative. Throughout the creation of a process for implementing an Indigenous evaluation framework, the American Indian Public Health Resource Center team came to the work rested and ready in ways that reflected traditional, cultural, and spiritual ways of knowing. Throughout the authors’ process, they respectfully listened and sought to understand first and foremost their Tribal partners and let them guide the authors’ decision-making process for taking the best pathway forward together. The authors are honoured to share their story.

Accuracy of Supervised Machine Learning in Predicting Depression, Anxiety and Stress Using Web-based Big Data: Preserving the Humanistic Intellect

Introduction: One of the most useful tool to assess the extent of depression, anxiety and stress symptoms is the validated Depression, Anxiety and Stress Scale, 21 items (DASS-21). The availability of online mental health resource centre provides big data capable of machine learning analytics for early detection of mental health issues. However, prediction accuracy of these data using machine learning method remains elusive. Methods: A cross sectional study was conducted, using secondary data of respondents who answered an online DASS-21 questionnaire from an online resource center. Depression, anxiety and stress were measured using DASS21 as either the outcome or predictor, depending on the model. The model includes sociodemographic predictors such as gender, age, race, marital status, education level and occupational status. A feed-forward artificial neural network was constructed based on multilayer perceptron machine learning procedure using IBM SPSS version 23. Results: A total of 339,781 respondents data were obtained. The observed prevalence of depression, anxiety and stress was 39.9%, 48.5% and 13.4%, respectively. This resulted in 76.4% prediction accuracy for depression, 76.3% accuracy for anxiety and 87.4% prediction accuracy for stress. Stress and anxiety were the most important factors contributing to the disease model. Conclusion: The prediction models have high accuracy to predict the true observed depression, anxiety and stress prevalence. The clinical relevance of these prediction models still needs the human intellect judgment based on Maqasid al-Shariah principles. Machine learning therefore should not be abused but to help in decision-making towards early detection and prompt treatment.

Information Streams in Health Facilities: The Case of Uganda

Abstract With the prevailing COVID-19 pandemic, the lack of digitally-recorded and connected health data poses a challenge for analysing the situation. Virus outbreaks, such as the current pandemic, allow for the optimisation and reuse of data, which can be beneficial in managing future outbreaks. However, there is a general lack of knowledge about the actual flow of information in health facilities, which is also the case in Uganda. In Uganda, where this case study was conducted, there is no comprehensive knowledge about what type of data is collected or how it is collected along the journey of a patient through a health facility. This study investigates information flows of clinical patient data in health facilities in Uganda. The study found that almost all health facilities in Uganda store patient information in paper files on shelves. Hospitals in Uganda are provided with paper tools, such as reporting forms, registers and manuals, in which district data is collected as aggregate data and submitted in the form of digital reports to the Ministry of Health Resource Center. These reporting forms are not digitised and, thus, not machine-actionable. Hence, it is not easy for health facilities, researchers, and others to find and access patient and research data. It is also not easy to reuse and connect this data with other digital health data worldwide, leading to the incorrect conclusion that there is less health data in Uganda. The a FAIR architecture has the potential to solve such problems and facilitate the transition from paper to digital records in the Uganda health system.

530-P: Complex Diabetes Management in Primary Care: Confidence and Opportunities for Specialty Support

Access to specialized diabetes care is limited due to shortage of endocrinologists and distance to specialty clinics. In addition, referrals to out-of-network providers frequently results in suboptimal care coordination. Tele-mentoring models such as ECHO (Extension for Community Healthcare Outcomes) extends specialty knowledge to primary care providers. Prior to the implementation of a series of ECHO sessions, we assessed provider confidence in managing type 2 diabetes (T2D) . Methods: Prescribing providers (PP) from three VA Health Care Systems in Florida (North Florida/South Georgia) , Texas (Valley Coastal Bend) and Wisconsin (Milwaukee) were invited to participate. We asked questions about practice patterns, prescription habits, and confidence level treating T2D. Results: A total of 49 PP completed the assessment. Mean age was 42.5 years and 74% were females. They were clinical pharmacists (63%) , physicians (22%) , ARNP (8%) , and the rest were trainees. Clinical experience < 5 year was present in 14.2%, whereas 67% had > years. Half of the providers felt very or extremely confident managing a complicated case (A1c>8% on two oral agents) , whereas only 14% of providers felt either “not at all” or somewhat confident. Most of the providers felt very or extremely confident obtaining a diabetes-focused history (63%) , educating patients about complications (69%) , or changing insulin regimens (61%) . Although most of the providers prescribed a glucose meter very often or always (81%) , only 6% of them prescribed a continuous glucose monitor frequently. When sending a referral, 32% mentioned either lack of local endocrinologists or long waiting time as main barriers. Providers felt that patients prefer to stay with their local VA PCP for diabetes care instead of seeing a specialist (65%) Conclusions: A third of providers perceive significant barriers to access specialized diabetes care. There are opportunities to improve provider confidence and skills managing diabetes. Disclosure C.E.Mendez: Advisory Panel; Monarch Medical Technologies . K.Hazen: None. L.M.Semeah: None. J.A.Leey: None. E.A.Mattox: None. S.Kadiyala: None. M.Xhikola: None. K.Yantsides: None. A.D.Oien: None. I.O'shaughnessy: None. A.E.Hansen: None. J.Lucas: None. Funding Veterans Rural Health Resource Center - 00RH

Incorporation of Standard Operating Procedures for Leadership and Volunteer Transitions in a Student-Run Free Clinic

At the Saint Louis University Health Resource Center, all student leadership roles transition yearly, requiring a robust method to maintain institutional knowledge. Standard operating procedures (SOPs) are written documents containing detailed instructions for the completion of functions within a greater organization. SOPs are utilized in clinical settings and may be useful for student-run free clinics (SRFCs). This project sought to formally establish clinic procedures into centralized documents and assess the utility of these documents. We created SOPs for all leader and volunteer positions which were then assembled into Leadership and Volunteer Handbooks for increased accessibility. Two surveys, one for leaders and one for volunteers, were distributed after the 2020-2021 leadership transition period to investigate the utility of the SOPs. Although the response rates were insufficient, results suggest that leader and volunteer respondents found confidence in utilizing the SOPs during the transition period and beyond. SOPs allow our volunteers and leaders to enhance the performance of their roles despite frequent turnover of positions. Per constructive feedback from survey respondents, we plan to improve awareness of SOPs and increase the frequency of updating SOPs to reflect current clinic operations. Future research should evaluate the utility and efficacy of SOPs in other SRFCs through multiple transition cycles of active leaders and volunteers.

In the Shadow of Tragedy: Jeanne M. Stellman and the Work of the Women’s Occupational Health Resource Center

In the Shadow of Tragedy: Jeanne M. Stellman and the Work of the Women’s Occupational Health Resource Center

University of N.H. to develop children's BH resource center

The New Hampshire Executive Council has approved a $4.3 million contract over three years to the University of New Hampshire's Institute on Disability (IOD) to develop a new Children's Behavioral Health Resource Center (CBHRC), according to a Nov. 30 news release. Working in collaboration with other institutions, family groups, providers, and youth and families, the CBHRC will strengthen the network of behavioral health supports for children across the state. The new center is designed to help address the current shortage of resources by improving the capacity of providers, educators and agencies to deliver high‐quality, research‐based practices across the state. The CBHRC will focus on providing evidence‐based training, technical assistance, easy‐to‐access information about strengths‐based and youth‐centered practices, and approaches to best address the behavioral health needs of children up to the age of 21. The CBHRC is a collaboration between the IOD and UNH's Institute for Health Policy and Practice, the Behavioral Health Improvement Institute at Keene State College and the Geisel School of Medicine at Dartmouth College.

Supporting Telemental Health for Rural Disabled Veterans: Bringing Rehabilitation Expertise to Rural Mental Health Providers

<h3>Research Objectives</h3> To explore the unique challenges of using video telehealth for mental health care for rural veterans with complex disabilities for the purpose of developing resources for mental health providers serving rural veterans with complex disabilities. <h3>Design</h3> This is a sub-project of an ongoing study aiming to improve access to mental healthcare for veterans with disabilities. We collected insights from mental health providers during an online educational seminar, using discussion questions and chat transcripts to gather information on their experiences using telehealth. Thematic and content analysis were used to analyze responses. <h3>Setting</h3> Mental health service lines within VA Community-Based Outpatient Clinics (CBOC). <h3>Participants</h3> The online seminar consisted of mental health providers working in CBOCs, was held twice, and had 48 unique respondents across these sessions. <h3>Interventions</h3> Not applicable. <h3>Main Outcome Measures</h3> Participants discussed 1) considerations when recommending telehealth, 2) challenges encountered, and 3) resources needed to support initiating telehealth with a disabled veteran. <h3>Results</h3> Main themes that emerged include: Travel burden (e.g. high service utilization, travel distance, and transportation challenges) and access to tech (high-speed internet and video capable device) were most common considerations when recommending telehealth. Challenges reported included privacy concerns, limited familiarity with technology, and limited experience working with Veterans with complex disabilities. Desired resources included tailored training, educational materials, and systematic early intervention when a veteran becomes disabled. <h3>Conclusions</h3> Rural Veterans with disabilities face unique challenges to accessing mental health care. Video telehealth can bridge the gap, but Veterans with complex disabilities sometimes require more support in getting started. Because decisions to use telehealth are frequently provider driven, non-rehabilitation providers benefit from training and resources to facilitate working with Veterans who have complex disabilities. Further work is needed to address this topic. <h3>Author(s) Disclosures</h3> This work was supported by The Office of Rural Health and the Veterans Rural Health Resource Center in Salt Lake City.

PRACTITIONER APPLICATION: Characteristics of Successful Health Alliance Strategies: Evidence from Rural Healthcare Experiences

In the article, the author discusses the characteristics and benefits of successful health alliance strategies by presenting evidence from rural healthcare in the U S Also cited are how the COVID-19 pandemic provided opportunities to improve access to healthcare and promote strategic alliances, and the report by the National Rural Health Resource Center showing the trends and disruptors in rural healthcare environment

Diagnostic accuracy of screening tools for chronic obstructive pulmonary disease in primary health care: Rapid evidence synthesis.

Background:Chronic obstructive pulmonary disease (COPD) contributed significantly to burden of diseases in India, with missed, incorrect, and delayed diagnosis in primary care. We conducted a rapid evidence synthesis, to summarize the evidence on accuracy of the screening tests for COPD in primary health care on request form State Health Resource Centre, Chhattisgarh.Methods:Considering the rapid nature of decision making, our approach was to first search for existing systematic reviews. We identified one existing systematic review on the topic with the search conducted until 2014. We updated the review by searching in two major databases screened, title/abstracts, and full texts of studies as per eligibility criteria and extracted relevant data. A narrative synthesis was conducted.Results:We retrieved 7,007 and included five new studies, to add to 10 studies of the existing systematic review. Overall, 13 studies assessed diagnostic accuracy of screening questionnaires [e.g., COPD Diagnostic Questionnaire (CDQ)], five assessed handheld flow meters (COPD6 and PICO-6), and four assessed the combination of both the tests. The CDQ questionnaire using a score threshold ≥16.5 or >17 demonstrated comparatively a higher sensitivity both in pooled result for ever-smokers [87.5% (95% CI 83.1--90.9%)] and among the adults >35 years [73.8--93% (95% CI 69--98%)] when compared to a different score threshold of CDQ and other questionnaires. Handheld flow meters reported a pooled high sensitivity of 79.9% (95% CI 74.2--84.7%) in ever-smokers and 87.9% in adults with age >35 years.Conclusions:The need for better diagnosis of COPD in primary healthcare can be addressed by using of COPD Diagnostic Questionnaire alone or in combination with hand-held flow meters. There is scope for more implementation research on the domain.

Pharmacists' experiences with the Bloom Program application process.

The Bloom Program, which began as a demonstration project, is an ongoing community pharmacy-based mental illness and addictions program funded by the government of Nova Scotia. To be eligible to offer the Bloom Program, interested pharmacists were required to complete a 9-part application on behalf of their pharmacies. A process evaluation was conducted to inform future program implementation changes of program components, including the application process. Qualitative interviews from 24 pharmacists were inductively analyzed to determine the challenges and opportunities in the program's application process. Key and impactful components of the application process included training, providing a mental health and addictions resource centre within the pharmacy and completing outreach activities with local mental health and addictions services and support organizations. The training content and format for the program was highly valued. Community outreach to local mental health and addictions resources, and other health care resources in the community, was particularly valuable in supporting patient navigation of the health care system and extending the pharmacists' networks. Components of the application process were challenging for many pharmacists but were beneficial personally and professionally. Dedicated resources (e.g., time and staffing) are required for the efficient completion of the application process. Pharmacists viewed the Bloom Program application process as intensive yet necessary and relevant for preparing to deliver the Program. The demonstration project process evaluation was essential for elucidating the strengths of the application process and, importantly, identifying areas for improvement. Can Pharm J (Ott) 2021;154:xx-xx.

Characteristics of behavior of students of medical pre-university in relation to their own health

High school students are in a special period of their life, associated with increased preparation for University admission, which affects the lifestyle and well-being, which are risk factors for the health of students. The purpose of the study was to study the behavior of students in relation to their own health Resource center «Medical Sechenov Preuniversary» by means of a questionnaire. 152 surveyed students aged 15–17 years were found to have a violation of the multiplicity and regularity of nutrition, a deficit in the consumption of protein, vegetables and fruits in the diet. A significant part of them showed a lack of motor activity. At the same time, students have complaints of a vegetative nature: they experience anxiety, cephalgia and frequent irritability, and frequent back pain is noted. The lack of personal time was diagnosed in one fourth of the student.

Local solutions by slum communities to deal with summer water scarcity: Learning from Indore, India

Abstract Issue Government of India's, NITI Aayog reports that 600 million people in India face extreme water stress. Slums and similarly vulnerable urban populations face huge challenges in accessing water for basic needs, increasing in summers. Indore is an extreme water stressed city in India. Methods During Urban Health Resource Centre's (UHRC) program work in slums, including women's groups UHRC forms and trains in 2018 we learnt of acute water scarcity in summers. Women in 16 slums were motivated to evolve and implement possible solutions. Most slum dwellers provide services on low wages to the city. With public bore-wells drying-up, in Feb.- May 2019 UHRC helped women's groups' submit community requests, reminders to elected ward representatives and Municipal offices for free water tankers. UHRC motivated slum families to collectively negotiate with private providers to reduce cost, systematise water supply for more families. In 4 peri-urban slums we strengthened water access relationship between farmers and slum dwellers. Results During Feb.-May 2019 10 of the 16 slums received free water tankers from Municipal Corporation. More population of 4 peri-urban slums accessed water from farmer's tube-well. Slum families evolved coping mechanisms of storing more general use water in underground tanks or many cans. Families with larger storage shared water with needy families demonstrating social cooperation. Lessons Trained and mentored slum women's groups gently negotiating with elected ward-level politicians and municipal officials helps in provision of free water tankers in summers. This strategy to get govt. water supply in slums is adaptable in fast growing Indian cities. Owing to geographical proximity, rural-urban cooperation can help slums in city's fringes obtain water from farmer tube-wells used for irrigation. Fostering community cooperation helps more needy families get water. Key messages Slum communities develop local mechanisms to access and store water which need to be understood by civil society organisations and Government to improve solutions for water supply in summer months. Slum women emerge as dynamic actors to improve the lives of both women and men (Sen, 2000). In this case women help negotiate for and foster community cooperation for water, store more water.

Primary Care Professionals’ Feedback on Smiles for Life Curriculum

To assess the value of Smiles for Life: A National Oral Health Curriculum (SFL) in influencing oral health practices of primary care professionals (PCPs).The National Maternal and Child Oral Health Resource Center’s Partnership for Integrating Oral Health Care into Primary Care (PIOHCPC) project is working with five project teams in Georgia, Illinois, Maryland, Michigan, and Rhode Island that are integrating interprofessional oral health core clinical competencies into primary care practice. The competencies were developed to facilitate change in the clinical practice of PCPs working with vulnerable or underserved populations that lack or have limited access to oral health care.An initial PIOHCPC project requirement was for PCPs (physicians, nurse practitioners, nurse midwives, nurses) to complete at least two SFL courses based on their project population of focus (eg, pregnant women, children, adolescents). The curriculum consists of the following courses: Course 1: Relationship of Oral and Systemic Health; Course 2: Child Oral Health; Course 3: Adult Oral Health; Course 4: Acute Dental Problems; Course 5: Oral Health for Women: Pregnancy and Across the Lifespan; Course 6: Caries Risk Assessment, Fluoride Varnish, and Counseling; Course 7: The Oral Exam; and Course 8: Geriatric Oral Health. Three months after completion of the SFL courses, a 10‐question feedback form was sent to PCPs.PCPs working in primary care settings (community health centers, local health department, medical center women’s health clinic) serving pregnant women, children, and adolescents who completed at least two SFL courses as part of the PIOHCPC project.Thirteen PCPs (three physicians, three nurse practitioners, three nurse midwives, four nurses) completed the feedback form. One hundred percent of respondents strongly agreed/agreed that SFL courses (1) reinforced the importance of oral health to a patient’s overall health and well‐being, (2) increased their awareness of and familiarity with oral health issues in their patients, and (3) increased their confidence in integrating oral health care into primary care. Seventy‐seven percent of respondents strongly agreed/agreed that SFL courses helped reduce barriers to incorporating oral health care into primary care. Sixty‐two percent of respondents strongly agreed/agreed that integrating oral health care into primary care improved their patients’ oral health outcomes. The majority (ranging from 85 to 100 percent) of PCPs strongly agreed/agreed that SFL courses helped them integrate the interprofessional oral health core clinical competencies into primary care.Three months after completing SFL courses, PCPs indicated that the curriculum had a positive influence on oral health practices in the primary care setting. These findings are consistent with a 2017 study that examined SFL influence on clinical practice and found that the curriculum positively influenced oral health practices in the primary care setting. Additional feedback could be gathered 1 year post‐training to assess retention of PCPs’ practices related to integrating oral health care into primary care.Oral health training is essential for enhancing PCPs’ knowledge and practices related to integrating oral health care into primary care. To respond to the need to integrate oral health care into primary care, SFL should be considered as a training for PCPs.Health Resources and Services Administration.

“In these streets”: the saliency of place in an alternative black mental health resource centre

Purpose The purpose of this paper is to explore experiences of survivors of the mental health system regularly attending a mental health resource centre predominantly but not exclusively focussed on needs of the BAME community. Design/methodology/approach In total, 25 participants took part in a qualitative research study regarding their experiences of mental health and racism, alternative mental health support and struggles in the local black community. Findings Issues of race, place and space were central to the experiences of BAME mental health survivors. Participants emphasised the importance of place-based support in their everyday life, with the service provided engendering a sense of belonging conducive to coping with various struggles. Race and racism were also central to these daily struggles and the place of Liverpool 8 was at the core of notions of identity and belonging. The space within the centre provided a sanctuary from the combined discriminations and exclusions attendant on being BAME survivors of the mental health system. Practical implications Attention to matters of place and space appears crucial to the articulation of appropriate support. Social implications Place is salient to understanding the intersecting identities/experience of racism and mental health discrimination, constituting the basis for a concept of placism; associated with exclusions from feeling safe and included in everyday public places (including within the black community) with the exception of the welcoming and unconditionally accepting space of the centre. Originality/value This paper is the first to inquire into place-based experiences of alternative black mental health support. Placism is a novel construct that merits further inquiry and theoretical development.

Integrating Mental Health Interventions with Primary Health Care: An Experience from an Urban Slum of Delhi, India

Background: Mental disorders are common throughout the world. Mental disorders usually not recognized at PHC level lead to unnecessary investigations and treatment, putting a financial burden on patients. This paper describes integration of community mental health services with other services provided at a primary health center (PHC) in an urban slum of Delhi. Objectives: 1) Develop Mental Health Resource Centers with training facilities. 2) Awareness generation, advocacy and stigma reduction. 3) Develop a model of universal mental health program. Methods: This study is a community-based study, carried out over a period of one year from September 2014 to August 2015 at field practice area of the community health department of a tertiary care hospital in Delhi. A mental health resource center was established, under which people of various categories were trained. Awareness generation, advocacy and stigma reduction was done by performing a number of community meetings. A dedicated psychiatric OPD, including psychological counseling, was held biweekly. Community mental health workers (CMHWs) played an important role in fulfilling our objectives. Results: Training of 425 participants was planned and 468 people actually attended the training about common mental ailments. Road shows (4), door-to-door campaign (2), Jan Sabhas (45), mental health advocacy seminars (3), etc., were used to generate awareness about mental illnesses. Total of 867 persons attended our psychiatric OPD. 605 (69.7%) were females and 262 (30.25%) were males. Most common mental illness which was encountered was depression (18.45%). Conclusion: Integration of mental health with other dimensions of health is achievable and effective at the Primary Health Care level.

Virginia Children’s Center Represents New Wave in Facility Design

Virginia Children’s Center Represents New Wave in Facility Design