Knowledge Of Local Services Research Articles

Evaluation of an educational program for people with dementia and their caregivers.

This study evaluated the impact of a 5-week educational and supportive program for people newly diagnosed with dementia and their caregivers. The study involved a pretest-posttest survey followed by interviews. Wilcoxon signed-rank test was conducted to determine postprogram changes. Kruskal-Wallis tests measured variation in responses between the people with dementia and their caregivers. Interviews were analysed using the NVivo software identifying themes against the program objectives of improving knowledge on dementia, coping strategies, communication and support services for people with dementia and their caregivers. Fifty-three dyads (n=106) completed the survey. There were significant improvements in participants' level of understanding of dementia (z=-8.04, p < 0.001), knowledge of local services (z=-8.11, p < 0.001) and coping with life with dementia (z=-6.93, p < 0.001). These findings were consistent with interview data from 16 dyads. The increasing number of people with dementia and their caregivers living in the community present health challenges. Programs that assist this group to function well in the community are important. Evaluation of this program indicated improved outcomes in relation to adjusting to life with dementia, enhancing knowledge, fostering communication and reducing feelings of isolation. Areas of improvement included lengthening the program with ongoing contact sessions with program facilitators and other participants. Given the positive effects of the program on this vulnerable group of people, it maybe useful for health-care agencies involved in dementia care to conduct this type of program as a matter of routine treatment and care for people newly diagnosed with dementia.

Toledo Naloxone Outreach Program: Patient and Health Care Professional Student Education

Background: In 2016, Ohio was home to 2 of the top 10 cities with opioid overdoses in the United States. Dayton ranked first, and Toledo held the tenth slot. In response to the opioid epidemic, the Toledo Naloxone Outreach Program (TNOP) was developed to provide naloxone to underserved patients at a student-run free clinic.Methods: The TNOP takes place weekly at 2 locations in the greater Toledo area. Patients are asked to fill out an anonymous survey and given a brief training session by a health care professional student. Patients are then sent home with a free naloxone kit. Additionally, health care professional students were surveyed on their confidence of acquiring a substance use history and knowledge of local services for patients and family members of those experiencing addiction during the "train the trainer" event. The health care professional student survey utilized a 1-5 Likert scale and was analyzed using paired student t tests.Results: Survey results from patients indicate that a majority had not received nalox one prior to the training, indicating the service was expanding access to an otherwise underserved population. Results from the survey administered before and after health care professional student training sessions reflect a significant increase in confidence eliciting a substance abuse history and providing patients and/or family members with addiction resources in the community.Conclusion: The TNOP has provided the community of Toledo with 2 additional outreach locations for receiving free naloxone kits with proper education. Currently, TNOP is in the process of expanding the outreach program to additional student-run free clinics in Ohio.

A cross-sectional study of the barriers for seeking mental health care among medical undergraduates

Aims and Objectives: The aim and objective of this study are to study the major barriers to seeking mental health care among medical undergraduates and to understand the correlation between barriers and demographic factors. Materials and Methods: This was a cross-sectional study that was conducted with a sample that consists of 100 participants in Mamata Medical College, Khammam and Pratima Medical college, Telangana, India, during the period of 6 months (2019). A semi-structured pro forma was used to collect the sociodemographic details, and the Barriers to Access to Care Evaluation Scale was used to assess the reasons for not seeking mental health services. Results: This study found that 26% of the participants did not seek any kind of mental health care despite needing it. The analysis revealed that stigmatizing beliefs, difficulty in sharing one's concerns, preference for self-reliance, and difficulty in accessing help were the prominent barrier themes among responders. Conclusions: This study highlights the vast discrepancy in the number of individuals in need of mental health care and the actual number of people seeking it. The present findings indicate that interventions are required to improve mental health literacy and knowledge of local services.

Personal and community factors as predictors of different types of community engagement.

Citizen participation is an important element of local democracy because it increases residents' influence over local community issues. Using a sample of 494 Israeli participants, this paper examines, for the first time, the unique and combined contribution of personal factors (self-esteem and mastery) and community factors (years of activity, knowledge of local services, trust in leaders, community commitment, and community belonging) to the explanation of the variance in each of two types of community engagement: development and planning, and activism and advocacy. Data analysis included hierarchical regression that examined all variables and possible interactions among them. The results indicate that mastery and the community variables, except for years of activity, predict both types of engagement. Interestingly, knowledge of services negatively predicts both, while trust in leaders also predicts both types of engagement, but in opposite directions. In conclusion, the paper considers how these findings might inform community work interventions.

A before and after study of integrated training sessions for children's health and care services.

Recent UK policy drivers such as the National Collaboration for Integrated Care and Support and Making Every Contact Count prioritise integrated care, an approach that seeks to provide more coordinated and seamless health and social care. In children's services, despite many partners, there are challenges around integrating care. A deprived borough of London ran short training and networking sessions for services supporting children and young people. This study examined whether intersectoral training would improve participants' knowledge of local services and joint working (including communication, navigation and confidence in collaboration). As part of a service evaluation, the study utilised a pre-post Likert scale survey design for each training session, a 1-month follow-up survey, and telephone interviews with a subsample of participants. The educational intervention was three sets of 1.5hr educational workshops from December 2016 to February 2017. There were 302 attendances from 202 individuals from the health (n=99), education (n=145), social care (n=39) and voluntary (n=19) sectors. The pre and post surveys found significant increases in self-assessed knowledge of health/education/social care/voluntary services and in some elements of joint working. However, these increases were not sustained in any domain after 1month of follow-up. There was also no difference in self-assessments amongst those who attended three sessions compared to those who attended one or two. Telephone interviewees highlighted networking as being helpful and suggested that informative tasks and diverse attendance would be beneficial in future. To conclude, this study suggests that although short-learning sessions may seem to improve immediate knowledge and some elements of joint working in the short term, any gains are not sustained in the long term. The cost effectiveness of such schemes is in doubt but may be improved by a more targeted delivery of content.

The Effect of Volunteering for Community Activity on the Social Resources of Low-SES Residents: Differences Between Volunteer Community Activists and Other Residents

Community interventions seek to increase volunteer activists’ social resources in order to further the establishment of social networks and better enable volunteers to promote the development of their community and answer its social needs, while also enhancing their own well-being. The current study investigated whether this goal is indeed achieved. Two hundred residents of low-SES (socioeconomic status) communities who volunteer to take an active part in community interventions (volunteer activists) and 200 other residents of these communities completed questionnaires measuring the levels of five social resources (community belonging, community commitment, knowledge of local services, social competence, community leadership). Variance analyses (MANCOVA) revealed significantly higher levels of almost all resources among the volunteer activists. Furthermore, regression analyses found significant effect of the activists’ years of involvement in community activity and the centrality of the role they perform on their social resources, suggesting that their resources are indeed strengthened by their community work. The implications for researchers and professionals are discussed, and practical recommendations are offered.

Identifying acceptable components for home-based health promotion services for older people with mild frailty: A qualitative study.

Mild frailty is common in later life, increasing the risk of hospitalisation, loss of independence and premature death. Targeted health promotion services may reduce adverse outcomes and increase quality of life; however, effective, well-developed theory-based interventions are lacking. We aimed to explore perceptions of health promotion behaviours undertaken by older people with mild frailty, barriers and facilitators to engagement, and identify potential components for new home-based health promotion services. We carried out 17 semi-structured qualitative interviews and six focus groups with 53 stakeholders, including 14 mildly frail older people, 12 family carers, 19 community health and social care professionals, and 8 homecare workers, in one urban and one semi-rural area of England. Transcripts were thematically analysed. Older people with mild frailty reported engaging in a variety of lifestyle behaviours to promote health and well-being. Key barriers or facilitators to engaging in these included transport, knowledge of local services, social support and acceptance of personal limitations. Older people, carers and professionals agreed that any new service should address social networks and mobility and tailor other content to each individual. Services should aim to increase motivation through focussing on independence and facilitate older people to continue carrying out behaviours that improve their well-being, as well as provide information, motivation, psychological support and practical support. Stakeholders agreed services should be delivered over a sustained period by trained non-specialist workers. New services including these components are likely to be acceptable to older people with mild frailty.

South Asian older adults with memory impairment: improving assessment and access to dementia care.

With increasing international migration, mental health care of migrants and ethnic minorities is a public health priority. South Asian older adults experience difficulties in accessing services for memory impairment, dementia and mental illness. This review examines barriers and facilitators in the pathway to culturally appropriate mental health care. Web of Knowledge, Pubmed and Ovid databases were searched for literature on South Asian older adults or their family carers, their understandings of mental illness and dementia and their pattern of service use. Dates were from 1984 to 2012. Abstracts were assessed for relevance, followed by detailed reading of salient papers. Three researchers rated the quality of each included study. A narrative synthesis was undertaken of extracted and charted data. Eighteen studies met the eligibility criteria for the review. South Asians and health professionals highlighted several difficulties which deterred help seeking and access to care: a lack of knowledge of dementia and mental illness, and of local services; stigma; culturally preferred coping strategies; and linguistic and cultural barriers in communication and decision making. To improve access for these groups, service users and providers need to be better informed; services need to be more culturally tailored, sometimes employing staff with similar cultural backgrounds; and health professionals can benefit from dementia education and knowledge of local services. These factors are key to the delivery of the National Dementia Strategy in England.

Community attitudes to the sexual behaviour of young people in an urban area with high rates of sexual ill-health

ContextAdults in any community are a potentially important source of sexual health information for young people. Open discussion of sexual health issues is associated with low rates of sexual ill-health....

The general practice perspective on cancer services in Lothian.

The aim of the present study was to obtain views from general practices about current and potential improvements to services for patients with suspected lung, large bowel, non-melanoma skin and breast cancer. A questionnaire study was carried out of 134 general practices within the Lothian Health Board boundary. Information was sought about referral choices, communication, quality of care, liaison between community and hospital, health promotion, treatment outcomes and palliative care. Main outcome measures were determinants of primary care referral behaviour and clinical investigation strategies, and perception of quality in secondary care and health promotion services. Seventy-nine general practices (59%) returned completed questionnaires. One-fifth of practices maintained a cancer register, and 85% provide patient information about cancer prevention. Initial management was disease dependent. Most cases of suspected lung cancer, about half of suspected colorectal cancer cases and very few cases of suspected breast cancer were investigated in primary care before referral to hospital. Hospital referral depended on knowledge of local services. A minority of practices wanted referral guidelines. It was estimated that 92% of lung and breast cancer cases, 68% of colorectal cancers and 35% of skin cancers are seen within 4 weeks. Breast cancer care was rated more highly than that for other cancers. One-third ranked community nursing support as 'excellent' and 10-15% described it as 'fair' or 'poor'; 77% describe palliative care as 'excellent' or 'good'. Fifty-one percent believe that communication with hospital is 'excellent' or 'good'. Practices were sometimes unaware of the hospital's post-diagnosis management plan; communication was often too slow and practices often received 'poor' advice about symptom control. Eighty percent thought that hospital follow-up for breast, colorectal and lung cancer should be routine; 20% thought that it was indicated for non-melanomatous skin cancer. Communication problems between primary and secondary sectors need to be tackled innovatively and the perceived quality variation in services addressed-perhaps by developing local guidelines. Practices would welcome further education about health promotion resources and cancer epidemiology.