Participation In Community-based Programs Research Articles

Engagement with life and psychological well-being in late adulthood: Findings from community-based programs in Portugal.

Human aging is a multidirectional, multidimensional, and multicausal process that reflects biological, psychological, and sociocultural influences, which act in distinct combinations throughout the life-span. Proactivity towards avoiding the usual aging process is needed. This study analyses the long-term effects of participation in Community-Based Programs on psychological well-being. A sample of 150 community-dwelling participants enrolled in Community-Based Programs, aged 55 to 84 years and living in three Portuguese localities were matched by age (55-64, 65-74, 75-84 years), gender, and locality with a comparison group of non-participants. We administered a multidimensional gerontological protocol which included socio-demographic information, measures of health/disease, functional ability, social network, cognitive performance and psychological well-being. Hierarchical regression models were used to test the effects of Community-Based Programs on psychological well-being adjusting for remaining variables. Overall, psychological well-being is positively associated with household income and satisfaction with health. Nevertheless, in participants, psychological well-being builds predominantly upon social network and is not associated with a moderate inability or cognitive deficits, contrasting with psychological well-being in non-participants. After adjusting for background variables, psychological well-being was positively associated with health satisfaction and social network and negatively related to moderate inability. Further, a significant interaction of participation in Community-Based Programs with age, points out higher levels of psychological well-being in participants contrasting with a downward trend in non-participants. After stratification by age, psychological well-being increases with time attending Community-Based Programs in the oldest (75-84 years) contrasting with the remainder. Participation in Community-Based Programs may improve the negative effects of the aging process on psychological well-being. This positive effect as age increases may be linked to a reinforcement of social network, valued more by participants in Community-Based Programs. Furthermore, the programs may act as a healing/maintenance strategy in persons with moderate inability and/or cognitive deficits.

The benefits of coordinated rehabilitation in the treatment of stroke patients: A literature review

The article reveals the features of coordinated rehabilitation – a process that leads to rehabilitating of people with neurological damage that limits their functionality. The purpose of the article is a literature review within the framework of GAJU 066/2022/S, funded by the grant agency of the South Bohemian University of Czech Budejovice, Czech Republic, examining the effectiveness of coordinated rehabilitation in patients recovering from strokes and the use of the standardized Functional Independence Measure (FIM) test to assess the patient’s condition. Data come from current Czech and foreign publications. The EDS multi-finder was used to search for literary sources. Document searches were from 2016-2022 in Czech and English. Search terms include post-stroke rehabilitation, FIM, rehabilitation after stroke, neurorehabilitation, and community based rehabilitation. The start of coordinated rehabilitation of stroke patients should be timely, long-term, comprehensive, and effective, involving a multidisciplinary approach and teamwork. It is essential to develop an individual approach and create a suitable individual plan that allows the use of the FIM test. This is the only way to establish long-term and mutually beneficial cooperation. As the cost of rehabilitation increases, the financial burden on the healthcare system also increases. Caring for a stroke patient also puts various burdens on the family. Successful rehabilitation can reduce the use of costly medicines and materials and decrease the need for nursing care and the term of hospital stay. The social costs of strokes are associated with long-term dependence and a low degree of resocialization. Considering the frequency of strokes and the associated disability, there is an increasing need for coordinated services within coordinated rehabilitation. Gaps in data on coordinated stroke rehabilitation should be filled by providing necessary information about long-term participation in community-based programs.

Evaluation of an Electronic Health Record Referral Process to Enhance Participation in Evidence-Based Arthritis Interventions

Purpose and ObjectivesEffective community-based programs to manage arthritis exist, but many adults with arthritis are unaware that these programs are available in their communities. An electronic health record (EHR) referral intervention was designed to strengthen health care and community-based partnerships and increase participation in these arthritis programs. The intervention was developed in response to a national effort that aimed to enhance the health, wellness, and quality of life for people with arthritis by increasing the awareness and availability of, and participation in arthritis-appropriate evidence-based interventions.Intervention ApproachThe National Recreation and Park Association recruited 4 park and recreation agencies and their health care partners to implement an EHR-based retrospective and point-of-care referral intervention. Eligible for referral were adults aged 45 or older with an arthritis condition who were seen by a physician within the past 18 months, and were living within the park and recreation service area. After health care organizations identified eligible adults, they either mailed communication packages describing the availability and benefits of the intervention and conducted phone calls to encourage arthritis-appropriate intervention participation or counseled and referred patients during an office visit.Evaluation MethodsThe pilot was assessed by using semi-structured interviews with key intervention staff members and the Consolidated Framework for Implementation Research.ResultsOur approach resulted in referrals for 3,660 people, 1,063 (29%) of whom participated in an intervention. Analysis of key informant interviews also highlighted the specific contextual factors, facilitators, and barriers that influenced the adaptation and overall implementation of the referral intervention.Implications for Public HealthOur pilot demonstrates that successful coordination between health care organizations and community-based organizations can promote awareness of and participation in community-based programs. An understanding of the contextual factors and lessons learned can be used to inform processes that can lead to more effective and sustainable health care and community-based partnerships.

Impact of COVID-19 'Stay Home, Stay Healthy' Orders on Function among Older Adults Participating in a Community-Based, Behavioral Intervention Study.

Background: Early mitigation orders for COVID-19 halted participation in community-based programs. We examined the early impact of “Stay Home, Stay Healthy” orders on functioning in older adults participating in a behavioral intervention study involving community-based exercise. Methods: A quasi-natural experiment, using mixed methods (n = 39). Participants completed interviews and questionnaires after 3–4 weeks of the Stay Home, Stay Healthy directive. PROMIS-29 outcomes were compared to pre-COVID-19 responses. Results: Participants had a mean age of 74.1 (6.5) years, 79.5% were women, and 20.5% were racial/ethnic minorities. Compared to pre-COVID-19, there was a significant increase in anxiety and decrease in fatigue and social participation. Thematic analysis revealed five main themes related to disruption of daily life, the emotional and physical impact of stay-at-home orders, unexpected positive outcomes, and perspectives on messaging surrounding the pandemic. Conclusions: Efforts to curb the spread of COVID-19 have substantially impacted the lives of older adults participating in community-based exercise.

Factors affecting community participation in the CDTI program in Morogoro, Tanzania.

Up to 4 million people in Tanzania are at risk for the parasitic disease onchocerciasis. A treatment program, Community-Directed Treatment with Ivermectin (CDTI), has made significant gains in prevention and treatment. Understanding factors affecting participation could help boost treatment coverage and sustain gains made in controlling onchocerciasis in endemic areas. To explore community-perceived factors related to participation in and sustainability of the CDTI program in southwest Tanzania. Multilevel triangulation design using surveys, focus group discussions (FGDs), and semistructured interviews to collect data in two villages in the Morogoro Rural District of Tanzania. In total, 456 villagers participated in the survey and 42 in FDGs. Five community-directed distributors (CDDs) and three community health workers were interviewed. High levels of awareness of onchocerciasis (90%) and methods of prevention and treatment (95%) were reported. Over 75% of participants knew how ivermectin was distributed and 74% have taken the drug. Over 90% of villagers knew that distribution of the drug was for treatment and prevention. Only 43% knew the cause of onchocerciasis. Through FGDs, villagers reported barriers to participation, including lack of comprehensive understanding of the disease, fears of medication, distrust of the method determining dose, lack of health education materials, insufficient CDD-resident communication, and inflexible drug distribution mechanisms. Sustaining programs without supporting growth of CDDs and reinforcing education of communities could lead to a decrease in treatment and an increase in the public health threat. This research uncovered a need for more effective community education and sensitization. Understanding barriers to participation in community-based programs can assist public health and community health nurses and key stakeholders including Ministries of Health and local and regional health systems in the development of education and support materials to enhance health literacy and encourage program participation.

Assessing Participation in Community-Based Physical Activity Programs in Brazil

This study aimed to develop and validate a risk prediction model to examine the characteristics that are associated with participation in community-based physical activity programs in Brazil. We used pooled data from three surveys conducted from 2007 to 2009 in state capitals of Brazil with 6166 adults. A risk prediction model was built considering program participation as an outcome. The predictive accuracy of the model was quantified through discrimination (C statistic) and calibration (Brier score) properties. Bootstrapping methods were used to validate the predictive accuracy of the final model. The final model showed sex (women: odds ratio [OR] = 3.18, 95% confidence interval [CI] = 2.14-4.71), having less than high school degree (OR = 1.71, 95% CI = 1.16-2.53), reporting a good health (OR = 1.58, 95% CI = 1.02-2.24) or very good/excellent health (OR = 1.62, 95% CI = 1.05-2.51), having any comorbidity (OR = 1.74, 95% CI = 1.26-2.39), and perceiving the environment as safe to walk at night (OR = 1.59, 95% CI = 1.18-2.15) as predictors of participation in physical activity programs. Accuracy indices were adequate (C index = 0.778, Brier score = 0.031) and similar to those obtained from bootstrapping (C index = 0.792, Brier score = 0.030). Sociodemographic and health characteristics as well as perceptions of the environment are strong predictors of participation in community-based programs in selected cities of Brazil.

Understanding Family Motivations and Barriers to Participation in Community-Based Programs for Overweight Youth

Successful obesity intervention efforts depend on effective recruitment and retention, an ongoing challenge for community-based programs. We sought to provide insights into the most salient factors affecting family enrollment and retention in community-based programs for overweight youth and their families. We especially sought to understand potentially modifiable program factors affecting participation. : We conducted semistructured, in-depth, face-to-face interviews with parents of overweight children within 1 year of referral to a public health grant-funded community-based healthy lifestyle promotion program. Purposeful sampling was used to select participants across program sites, by level of program completion, and child age and sex. Transcribed interviews were coded independently by 2 staff with a structured codebook and then analyzed by themes through an iterative process using Atlas.ti. The Integrative Model of Behavior served as an orienting theoretical framework. Community-based child obesity intervention program in King County, Washington. Twenty-three parents from diverse socioeconomic backgrounds were interviewed, of which 10 completed the program, 9 did not complete, and 4 did not enroll. Parent-reported factors related to enrollment and retention. Key parent reasons for program enrollment included: (a) addressing both eating and activity, (b) concern about child's weight, (c) seeking help outside the family, and (d) structured parent-child time. Parents perceived a lack of child motivation to enroll; some youth initially opposed attending, which was overcome through positive program experience. All families described barriers to attending, and some identified specific strategies or skills they used to overcome barriers. No single program design emerged to address every family's needs. Instead, using the themes of accessibility and accountability, we present parent- recommended design options. To meet different families' needs, public health and health care agencies offering youth health promotion programs should consider providing program options that vary intensity level and weight loss emphasis.

Real-world assignments for restorative justice education

Academic coursework on restorative justice is rapidly emerging in professional schools. As members of applied disciplines entrusted to serve the public good, students must be readily able to transfer classroom-based learning into real world application. This paper describes a weekend intensive, multidisciplinary graduate school course and how three ‘real world’ assignments are used to integrate restorative justice values, principles, and practices. The assignments include interviews with criminal justice representatives, group projects that propose restorative justice practices for addressing social issues and legal cases, and participation in community-based programs. The assignments use processes grounded in experiential learning theory to underscore various dimensions of restorative justice. They also convey and deepen the understanding of restorative justice principles and practices while at the same time develop a sense of moral agency in students.

Using Imagery and Storytelling to Educate Outpatients about 12-Step Programs and Improve Their Participation in Community-based Programs

The longer a patient remains engaged in recovery activities the greater the success of long-term abstinence. Self-help community programs that use the 12-steps such as Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) are known in the addictions field to contribute to sustained abstinence. Connecting patients to 12-step programs in early stages of recovery increases the chance of prolonged involvement. A nurse working in an outpatient substance abuse clinic developed a unique method to inform and educate patients about the 12-step process. A story and image metaphorically describe this journey. The cleaning of a vessel and subsequent discovery of tools along the way provide an uncomplicated look at the 12-steps. Nurses can use the image and story to develop the necessary tools of honesty, open-mindedness, and willingness for patients to embrace the 12-step journey.

Challenges to participating in a lifestyle intervention program: the Native American Diabetes Project.

This paper describes the factors that American Indian teachers in the Native American Diabetes Project (NADP) reported affected participation in the NADP lifestyle education sessions. A postsession exit interview was conducted with each of the 7 mentors (teachers) of the NADP sessions. Interview questions addressed general perceptions of the sessions, factors that kept participants from coming to the sessions, and attitudes toward diabetes and persons with diabetes. Interviews were transcribed and responses reflecting factors related to participation were marked and organized into topic areas. Mentors reported a range of factors that affected participation in the sessions, such as conflicts with community activities and beliefs/attitudes about diabetes. The latter factor includes program knowledge, recruitment methods, attitudes toward the program, and beliefs about diabetes. Asking community members what factors they believe affect participation is an important component of increasing participation in community-based programs. Community members can provide a valuable personal perspective of actual and potential conflicts in the community.