Impact Of Community-based Intervention Research Articles

Impact of community-based interventions on out-of-hospital cardiac arrest outcomes: a systematic review and meta-analysis

Survival following out-of-hospital cardiac arrest (OHCA) remains low, typically less than 10%. Bystander cardiopulmonary resuscitation (CPR) and bystander-AED use have been shown to improve survival by up to fourfold in individual studies. Numerous community-based interventions have been implemented worldwide in an effort to enhance rates of bystander-CPR, bystander-AED use, and improve OHCA survival. This systematic review and meta-analysis aims to evaluate the effect of such interventions on OHCA outcomes. Medline and Embase were systematically searched from inception through July 2021 for studies describing the implementation and effect of one or more community-based interventions targeting OHCA outcomes. Two reviewers screened articles, extracted data, and evaluated study quality using the Newcastle–Ottawa Scale. For each outcome, data were pooled using random-effects meta-analysis. Of the 2481 studies identified, 16 met inclusion criteria. All included studies were observational. They reported a total of 1,081,040 OHCAs across 11 countries. The most common interventions included community-based CPR training (n = 12), community-based AED training (n = 9), and dispatcher-assisted CPR (n = 8). Health system interventions (hospital or paramedical services) were also described in 11 of the included studies. Evidence certainty among all outcomes was low or very low according to GRADE criteria. On meta-analysis, community-based interventions with and without health system interventions were consistently associated with improved OCHA outcomes: rates of bystander-CPR, bystander-AED use, survival, and survival with a favorable neurological outcome. Bystander CPR—14 studies showed a significant increase in post-intervention bystander-CPR rates (n = 285 752; OR 2.26 [1.74, 2.94]; I2 = 99%, and bystander AED use (n = 37 882; OR 2.08 [1.44, 3.01]; I2 = 54%) and durvival—10 studies, pooling survival to hospital discharge and survival to 30 days (n = 79 206; OR 1.59 [1.20, 2.10]; I2 = 95%. The results provide foundational support for the efficacy of community-based interventions in enhancing OHCA outcomes. These findings inform our recommendation that communities, regions, and countries should implement community-based interventions in their pre-hospital strategy for OHCA. Further research is needed to identify which specific intervention types are most effective.

Are Neighborhood Conditions Associated With Surgical Delays and Meniscus Tears in Children and Adolescents Undergoing ACL Reconstruction?

Are Neighborhood Conditions Associated With Surgical Delays and Meniscus Tears in Children and Adolescents Undergoing ACL Reconstruction?

Knowledge and Experience of STIs Among Female Sexual Workers in an African Rural Community: The Impact of Community-based Interventions

Backgrounds: Sufficient knowledge of STIs is important in the prevention and control of HIV. This study compares the knowledge and experience of STIs among female sex workers (FSW) in a rural community with and without intervention.
 Methodology: The study is a quantitative study involving FSW in Bonny Kingdom. A structured questionnaire was used to obtain the demographics, knowledge and symptoms of STI. Data were analysed using SPSS version 25.
 Results: There were 261 respondents in the pre-intervention and 186 in post-intervention surveys. Knowledge of STIs was 86.6% in the pre-intervention and 97.3% in the post-intervention surveys. Knowledge of STI symptoms in women ranged from 23.7% to 32.5% in pre-intervention and 65.3 to 93.9% in post-intervention. Knowledge of STI symptoms in men ranged from 25.6%-37.9% in pre-intervention and 62.5%-93.8% in the post-intervention. In pre-intervention, 44.7% experienced STI symptoms within 12 months and 9.3% in the last two-months as compared to 6 3.2% and 1.1% in post-intervention survey.
 Conclusion: This study showed a significant reduction of STI among FSW due to interventions. Intervention is an important tool in the prevention and control of STIs and HIV in rural communities where there are limited and poor health facilities.

Impact of Community-Based Intervention on Quality of Life, Patient Activation

Impact of Community-Based Intervention on Quality of Life, Patient Activation

Impact of a community-based intervention on Aedes aegypti and its spatial distribution in Ouagadougou, Burkina Faso

BackgroundSeveral studies highlighted the impact of community-based interventions whose purpose was to reduce the vectors’ breeding sites. These strategies are particularly interesting in low-and-middle-income countries which may find it difficult to sustainably assume the cost of insecticide-based interventions. In this case study we determine the spatial distribution of a community-based intervention for dengue vector control using different entomological indices. The objective was to evaluate locally where the intervention was most effective, using spatial analysis methods that are too often neglected in impact assessments.MethodsTwo neighbourhoods, Tampouy and Juvenat in Ouagadougou, Burkina Faso, were chosen among five after a survey was conducted, as part of an assessment related to the burden of dengue. As part of the community-based intervention conducted in Tampouy between August and early October 2016, an entomological survey was implemented in two phases. The first phase consisted of a baseline entomological characterization of potential breeding sites in the neighbourhood of Tampouy as well as in Juvenat, the control area. This phase was conducted in October 2015 at the end of the rainy season. The mosquito breeding sites were screened in randomly selected houses: 206 in Tampouy and 203 in Juvenat. A second phase took place after the intervention, in October 2016. The mosquito breeding sites were investigated in the same yards as during the baseline phase. We performed several entomological analyses to measure site productivity as well as before and after analysis using multilevel linear regression. We used Local Indicators of Spatial Association (LISAs) to analyse spatial concentrations of larvae.ResultsAfter the intervention, it is noted that LISAs at Tampouy reveal few aggregates of all types and the suppression of those existing before the intervention. The analysis therefore reveals that the intervention made it possible to reduce the number of concentration areas of high and low values of pupae.ConclusionsThe contribution of spatial methods for assessing community-based intervention are relevant for monitoring at local levels as a complement to epidemiological analyses conducted within neighbourhoods. They are useful, therefore, not only for assessment but also for establishing interventions. This study shows that spatial analyses also have their place in population health intervention research.

The impact of community-based interventions for the older population: a quasi-experimental study of a hip-fracture prevention program in Norway

BackgroundHip fractures among older adults are a major public health problem in many countries. Hip fractures are associated with expensive health care treatments, and serious adverse effects on patients’ health and quality-of-life. In this paper, we estimate the effect of a community-based hip fracture prevention program that was initiated in 16 Norwegian municipalities in 2007. Specifically, the participating municipalities implemented one or more of the following interventions: exercise programs for older adults, information and education campaigns to communicate how to effectively reduce falls to care workers and older adults, and preventive home safety assessment and modification help services.MethodsWe used a difference-in-difference design, and identified control municipalities by matching on pre-intervention trends in the outcome. The outcome measure was the incidence of hip-fractures among older adults (≥65 years).ResultsWe found no statistically significant effects of the implemented program on the incidence of hip fractures, on average, in older subgroups (≥80 years) or in municipality-specific analyses.ConclusionsIt is unclear whether the interventions managed to achieve a change in hip fracture rates at the population level.

Creating pathways to integration: The impact of community-based intervention in Gugulethu

Section 36 of the Correctional Services Act describes the purpose of imprisonment as “enabling the sentenced prisoner to lead a socially responsible and crime-free life in the future.” But interviews with 48 young ex-prisoners in Gugulethu revealed a stark discrepancy between rhetoric and reality. Analysis outlined obstacles to integration, both psycho-social and material in nature, which community-level organizations were unable to fix on their own. To construct viable pathways to integration, and satisfy its legislative mandate, the Department of Correctional Services (DCS) must initiate large-scale coordination with civil society organisations.

Beyond Assessment: Impact Evaluation of a Community-Based Education Development in Lao PDR

The study assessed the impact of community-based interventions (CBI) that the five-year Second Education Development Project in Lao PDR's poorest districts employed through a quasi-experimental design. Sampled Project village schools were compared with control groups. Control groups were determined using propensity scoring to simulate experimental schools. Treatment or interventions included community-based contracting, community grants, and teacher training. Results of these treatments showed that the CBI package led to positive and improved education outcomes such as increasing enrolment, increased promotion rates, decreased repetition rates, increased gender parity, and higher completion rates. There were significant positive changes in social capital, community development, gender participation, built capacities in village school management, better teaching-learning process and cheaper contracting costs. More significantly, CBI was not only cost-effective but ensured collective ownership as well. The evaluation concludes that effectiveness of one intervention increases in combination with others, making the CBI approach more appropriate.

Impact of community-based interventions on HIV: the next steps.

Community based interventions increase knowledge scores and also have an impact of sexual behaviours with regard to HIV. However the problem remains as to how best to scale up these interventions and how best to overcome real or perceived barriers to their uptake. Community based interventions have multiple components and some will be more difficult to widen out than others. Those that involve face to face or one to one sessions will be most expensive and so most difficult to scale up. If some interventions can be implemented by means of custom computerized risk reduction programmes, then roll out on a large scale should be less problematic.

Impact of community-based interventions on HIV knowledge, attitudes, and transmission.

In 2012, an estimated 35.3 million people lived with HIV, while approximately two million new HIV infections were reported. Community-based interventions (CBIs) for the prevention and control of HIV allow increased access and ease availability of medical care to population at risk, or already infected with, HIV. This paper evaluates the impact of CBIs on HIV knowledge, attitudes, and transmission. We included 39 studies on educational activities, counseling sessions, home visits, mentoring, women’s groups, peer leadership, and street outreach activities in community settings that aimed to increase awareness on HIV/AIDS risk factors and ensure treatment adherence. Our review findings suggest that CBIs to increase HIV awareness and risk reduction are effective in improving knowledge, attitudes, and practice outcomes as evidenced by the increased knowledge scores for HIV/AIDS (SMD: 0.66, 95% CI: 0.25, 1.07), protected sexual encounters (RR: 1.19, 95% CI: 1.13, 1.25), condom use (SMD: 0.96, 95% CI: 0.03, 1.58), and decreased frequency of sexual intercourse (RR: 0.76, 95% CI: 0.61, 0.96). Analysis shows that CBIs did not have any significant impact on scores for self-efficacy and communication. We found very limited evidence on community-based management for HIV infected population and prevention of mother- to-child transmission (MTCT) for HIV-infected pregnant women. Qualitative synthesis suggests that establishment of community support at the onset of HIV prevention programs leads to community acceptance and engagement. School-based delivery of HIV prevention education and contraceptive distribution have also been advocated as potential strategies to target high-risk youth group. Future studies should focus on evaluating the effectiveness of community delivery platforms for prevention of MTCT, and various emerging models of care to improve morbidity and mortality outcomes.

The Healthy Start Partnership

This article investigates the impact of community-based interventions developed by the Healthy Start Partnership (HSP) to promote healthy body weights in families. Intercept surveys were conducted to monitor community exposure. A nonconcurrent, no treatment control design was used to assess population-level weight outcomes. Control (n = 219) and intervention (n = 276) cohorts of pregnant women were recruited and followed until 6 months postpartum. Data were collected through 2 self-administered questionnaires and medical record audits. Results indicate community residents were exposed to interventions. However, little evidence of positive effects of interventions on weight outcomes was found for mothers or infants.

Right From the Start: Promotion of Health-Related Physical Activity in Preschoolers

A growing body of literature has confirmed the health benefits of regular physical activity in school-aged youth. However, less systematic attention has been directed toward establishing activity profiles and evaluating the impact of community-based interventions designed to increase physical activity and reduce sedentary behavior in preschool children. In this paper, current findings are reviewed to determine whether preschoolers are achieving sufficient levels of structured and unstructured physical activity and to identify potential correlates of activity and sedentary behavior in the young child. In addition, promotion of physical activity among preschool-aged children in selected community settings is discussed and future research initiatives are highlighted. Given current trends in the overweight and obesity status of children aged two to five years, efforts aimed at increasing physical activity levels and documenting gains in health-related fitness and movement skillfulness in this pediatric population should be accelerated.

Impact of community-based interventions on condom use in the Tłįcho region of Northwest Territories, Canada.

BackgroundSince 2005, the Tłįchǫ Community Services Agency (TCSA) in Canada's Northwest Territories (NT) has addressed rising rates of sexually transmitted infections (STI). In 2009, STI rates in the NT were ten times higher than the national rate and Tłįchǫ regional rates were nearly four times that of the NT – 91 cases per 1000 people. We describe a social audit process that assessed the impact of an evidence-based community-led intervention.MethodsA baseline survey of sexual health knowledge, attitudes and behaviours in 2006/07 provided evidence for a Community Action Research Team (CART) to develop and to put in place culturally appropriate interventions in the Tłįchǫ region. A follow-up study in 2010 sought to assess the impact of CART activities on condom use and underlying conscious knowledge, attitudes, subjective norms, intention to change, sense of agency and discussions related to condom use and STI risks. We report the contrasts using Odds Ratios (OR) and 95% confidence intervals (CI).ResultsOne in every three follow-up respondents (315/808) participated in at least one CART activity. Participation in highly ranked interventions was associated with increased condom use during the last sexual encounter (OR 1.45, 95%CI 1.07-1.98). Those exposed to three or more activities were more likely to talk openly about condoms (OR 2.08, 95%CI 1.41-3.28), but were also less likely to be monogamous (OR 0.49, 95%CI 0.29-0.90).ConclusionsThe measurable impact on condom use indicates a strong beginning for the Tłįchǫ community intervention programmes. The interventions also seem to generate increased discussion, often a precursor to action. The Tłįchǫ can use the evidence to improve and refocus their programming, increase knowledge and continue to improve safe condom use practices.

Impact of community-based interventions on maternal and neonatal health indicators: Results from a community randomized trial in rural Balochistan, Pakistan

BackgroundPakistan has high maternal mortality, particularly in the rural areas. The delay in decision making to seek medical care during obstetric emergencies remains a significant factor in maternal mortality.MethodsWe present results from an experimental study in rural Pakistan. Village clusters were randomly assigned to intervention and control arms (16 clusters each). In the intervention clusters, women were provided information on safe motherhood through pictorial booklets and audiocassettes; traditional birth attendants were trained in clean delivery and recognition of obstetric and newborn complications; and emergency transportation systems were set up. In eight of the 16 intervention clusters, husbands also received specially designed education materials on safe motherhood and family planning. Pre- and post-intervention surveys on selected maternal and neonatal health indicators were conducted in all 32 clusters. A district-wide survey was conducted two years after project completion to measure any residual impact of the interventions.ResultsPregnant women in intervention clusters received prenatal care and prophylactic iron therapy more frequently than pregnant women in control clusters. Providing safe motherhood education to husbands resulted in further improvement of some indicators. There was a small but significant increase in percent of hospital deliveries but no impact on the use of skilled birth attendants. Perinatal mortality reduced significantly in clusters where only wives received information and education in safe motherhood. The survey to assess residual impact showed similar results.ConclusionsWe conclude that providing safe motherhood education increased the probability of pregnant women having prenatal care and utilization of health services for obstetric complications.

Evaluating the impact of community-based interventions on schooling outcomes among orphans and vulnerable children in Lusaka, Zambia

In sub-Saharan Africa, an estimated 12 million children under the age of 18 have lost a parent to acquired immune deficiency syndrome. Despite this situation, the evidence regarding effectiveness of interventions targeting these children remains scant. This article contributes to the literature by evaluating the impact of a community-based program implemented by a Zambian non-governmental organization on educational outcomes among orphans and vulnerable children (OVC) in Lusaka, Zambia. These outcomes included school enrollment and being at the correct age-for-grade. Our study design included two rounds of post-intervention data collection in 2003 and 2006; 2302 children aged 6–19 years were interviewed in 2003, and 3105 children aged 8–22 years were interviewed in 2006. We used a subsample of 2922 OVC aged 8–19 years. The effectiveness of Bwafwano was evaluated first using the individual cross-sectional samples and then using a difference-in-differences model on the pooled sample. Both cross-sectional analyses found positive and statistically significant effects of the intervention on school enrollment, with marginal effects of 0.104 and 0.168, respectively. The difference-in-differences estimates for school enrollment were positive, but small and not statistically significant. For the estimations of the effects of Bwafwano on the outcome of appropriate age-for-grade, only the difference-in-differences models showed positive program effect, with participation in the program being associated with a 15.7% increase in appropriate age-for-grade for intervention children relative to control children. This study suggests that the Bwafwano program is a promising approach to improving educational outcomes among OVC in urban Zambia.