The importance of healthy communities of higher education

A framework for understanding issues that contribute to vibrant and healthy communities of higher education is presented. The focus is on how individual and community health relate to institutional missions, purposes, and goals. This framework may be applied to 2-year and 4-year colleges and universities whether they are public, private, research, teaching, sectarian, religious, residential, or computer institutions. The following questions are addressed: Why should colleges maintain healthy communities? How do we define health in colleges and universities? Why is this important for society? What are the key responsibilities in fostering healthy educational communities? Who is responsible for assuring that this happens? What added value do personal and community health yield for institutions of higher education? Readers are provided with a rationale for assessing the role and importance of individual and community health in their campus environments; engaging students, faculty, and staff in discussions about these issues; and determining whether more thorough, systematic, and intensive community health assessments or interventions are needed in their campus settings.     

Collaboration--in a variety of ways--creates health care value

This is an opportune time for physician/nurse partnerships as the health care community moves from systems that treat sickness to systems that are responsible for the health of the community. No one profession has all the answers to the problems facing health care today. Providers working collaboratively have the potential to find solutions as long as they keep in mind that the patient is the ultimate purpose for their being. Value will be added by health care professionals who allow consumers better access to information and more involvement in their care.     

Where angels fear to tread: Issues in sampling, design, and implementation of school-based mental health services research.

Research on school-based mental health systems is an important but hazardous enterprise. Current trends suggest that child mental health professionals will increasingly focus on community service systems that are family-based and school-centered. Challenges to conducting research on effectiveness of such services include underidentification of children with emotional or behavioral disorders, lack of concordance between diagnostic criteria used in school vs mental health systems, problems of comorbidity, analysis of data from multiple informants, lack of interdisciplinary or interagency collaboration, community involvement, and a variety of other factors. These issues and suggestions for addressing them are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Race differences in psychopathology and disparities in treatment seeking: Community and jail-based treatment-seeking patterns.

Whites in community samples use mental health services at a much higher rate than African Americans (Kessler et al., 2005). Is this also the case among those in jails? In this study of jail inmates (229 African American, 185 White), there were no race differences in the overall need for mental health treatment (63% of participants had significant symptoms on the Personality Assessment Inventory), but race differences in the level and types of symptoms were evident. In addition, although Whites were more likely to report preincarceration treatment, there were no differences in treatment seeking or access to mental health programs while in jail, implying that if barriers to treatment in the community were removed (cost/insurance, location/transportation, time), racial disparities in treatment utilization may be reduced. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Developing tomorrow's integrated community health systems: a leadership challenge for public health and primary care

As the nation's health system moves away from earlier models to one grounded in population health and market-based systems of care, new challenges arise for public health professionals, primary care practitioners, health plan and institutional managers, and community leaders. Among the challenges are the need to develop creative concepts of organization and accountability and to assure that dynamic, system-oriented structures support the new kind of leadership that is required. Developing tomorrow's integrated community health systems will challenge the leadership skills and integrative abilities of public health professionals, primary care practitioners, and managers. These leaders and their new organizations must, in turn, assume increased accountability for improving community health.     

Graduate nursing education: developmental disabilities and special health care needs

As children and adults with developmental disabilities and special health care needs are integrated into home, school, and community life, nurses are being required to provide leadership, advocacy, and training in community settings to a much greater extent than in the past. To assess the school and community need for formal graduate preparation for nurses who work with individuals with developmental disabilities and/or special health care needs, 25 nurses in leadership positions representing urban and rural health agencies throughout Minnesota took part in a 5-hour focus group discussion. Analysis of data summarized from this process shows five features of the recommended curriculum necessary for advanced practitioners in this specialty area: (a) discipline-specific core competencies, (b) discipline-specific specialty competencies, (c) genetic competencies not specific to nursing but necessary to function in nursing roles, (d) interdisciplinary and intradisciplinary learning experiences, and (e) clinical experiences with preceptors. The authors recommend the development of interdisciplinary graduate programs designed to prepare nurses to assume leadership roles in school health, public health, home health care, and systems management that will affect public policy and, ultimately, promote change in the systems charged with responsibility to serve this population.     

School-based health centers in the context of education reform

The rapid proliferation of school-based health centers is taking place at the same time that school systems are seeking to improve their educational practices. Many different school reform models are being promulgated with modest success. Absence of connections between school reorganization and the provision of human services may lead to failure. The emerging community school model integrates quality education with effective health, mental health, and social services in "one stop" school centers that become student, parent, and community hubs.     

“Predictors of preintake attrition in a rural community mental health center”: Clarification.

Reports an error in "Predictors of preintake attrition in a rural community mental health center" by Marne L. Sherman, David D. Barnum, Erik Nyberg and Adam Buhman-Wiggs (Psychological Services, 2008[Nov], Vol 5[4], 332-340). The article contains data that were obtained from archival records of the same community mental health center (serving adults, adolescents, and children), and that reflect information from initial consumer contacts made with the center during the same period of time, as that reported in “Clinical Intake of Child and Adolescent Consumers in a Rural Community Mental Health Center: Does Wait-time Predict Attendance?” by Marne L. Sherman, David D. Barnum, Adam Buhman-Wiggs, and Erik Nyberg (Community Mental Health Journal, 2009, Vol. 45, No. 1, pp. 78–84). Information is provided in this clarification about the data used in both articles. (The following abstract of the original article appeared in record 2008-16478-003.) Preintake attrition presents a challenge in outpatient mental health settings, in part due to the waste of limited clinical resources when potential consumers do not attend appointments. While understanding the phenomenon of mental health consumer attrition has received clinical and empirical attention for more than 40 years, the data remain somewhat mixed as to the key predictors of preintake attrition. Additionally, little attention has been directed at understanding missed intake appointments in community mental health centers within rural settings. This study examines predictors of attended appointments for intake in a rural community mental health center, with particular attention to the effect of intake delay or wait-time between call for appointment and scheduled appointment. Wait-time is identified as a significant predictor of appointment attendance in logistic regression analysis, even after controlling for consumer variables, such as referral source and payor source. The impact of wait-time on the likelihood of attending the intake appointment was not moderated by the case urgency. Considerations for applying these results to the organization of clinical service delivery in a rural community mental health center are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Conscientiousness, perceived risk, and risk-reduction behaviors: A preliminary study.

Participants (N?=?343) from an Oregon community completed surveys at baseline, 3 months, and 12 months to assess personality, the perceived health risk of radon in combination with smoking, and changes in smoking behavior. Conscientiousness predicted instituting a more restrictive household smoking rule (p?p?p?     

Citizens shaping policy: The Canadian Mental Health Association's framework for support project.

Fifteen plus years of work in mental health policy development from a community development perspective under the aegis of the Canadian Mental Health Association are described. The evolution of a model de-emphasizing formal mental health services and emphasizing partnerships between consumers, family members, the community at large, and mental health service providers is presented. Particular attention is paid to the value of re-investing in natural support systems both through the diversion of funds to such groups and the recognition of such systems as integral components of the cultural response to serious mental illness. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predictors of preintake attrition in a rural community mental health center.

[Correction Notice: An erratum for this article was reported in Vol 6(2) of Psychological Services (see record 2009-06563-006). The article contains data that were obtained from archival records of the same community mental health center (serving adults, adolescents, and children), and that reflect information from initial consumer contacts made with the center during the same period of time, as that reported in “Clinical Intake of Child and Adolescent Consumers in a Rural Community Mental Health Center: Does Wait-time Predict Attendance?” by Marne L. Sherman, David D. Barnum, Adam Buhman-Wiggs, and Erik Nyberg (Community Mental Health Journal, 2009, Vol. 45, No. 1, pp. 78–84). Information is provided in this clarification about the data used in both articles.] Preintake attrition presents a challenge in outpatient mental health settings, in part due to the waste of limited clinical resources when potential consumers do not attend appointments. While understanding the phenomenon of mental health consumer attrition has received clinical and empirical attention for more than 40 years, the data remain somewhat mixed as to the key predictors of preintake attrition. Additionally, little attention has been directed at understanding missed intake appointments in community mental health centers within rural settings. This study examines predictors of attended appointments for intake in a rural community mental health center, with particular attention to the effect of intake delay or wait-time between call for appointment and scheduled appointment. Wait-time is identified as a significant predictor of appointment attendance in logistic regression analysis, even after controlling for consumer variables, such as referral source and payor source. The impact of wait-time on the likelihood of attending the intake appointment was not moderated by the case urgency. Considerations for applying these results to the organization of clinical service delivery in a rural community mental health center are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Health promotion and education: a diagnosis of sanitation conditions using participatory research and community education (S?o Jo?o dos Queiróz - Quixadá/Ceará, Brazil)

This study was conducted in a rural community, S?o Jo?o dos Queiróz, a township in the county of Quixadá, Ceará, Brazil, using a combination of participatory research and community education in compliance with the health promotion reference and principles of the 1986 Ottawa Charter. The project was joined by representatives of several local government institutions and organizations from the grassroots community movement. The theme generating the research, as defined by an assembly meeting of the community association, was a diagnosis of sanitation conditions in the community. The starting point was the assessment of local conditions. Results showed adverse local conditions in sanitation, literacy, income, and employment. Suggestions for solving the problems were organized so as to be included in the planning agenda for local health policies. Evaluation was procedural and enriched with daily research activities. The problem-solving pedagogical approach developed during the educational process contributed to a critical reconstruction, appropriation, and sharing of the resulting knowledge.     

Haemorheology in diabetic foot

Have the 1990 NHS and community care reforms totally divorced the national health service from its founding principles? Is commercialism compatible with public service? In the following extracts from a paper presented at the HVA 1993 annual professional conference Reg Pyne, in a presentation of his personal views, highlights short-comings in the organisation and delivery of both health and social care since the reforms were introduced. He calls on nurses and their managers to stand by their professional principles to defend standards and equity in NHS services.     

Social support in families of children with chronic conditions: supportive and nonsupportive behaviors

We questioned parents of 182 young children with a variety of chronic health conditions concerning the amount of emotional, informational, and tangible social support they received from the family, community, and service providers. We also asked parents to describe nonsupportive or hurtful behaviors received from family or community members. Both mothers and fathers reported that family members provided the most emotional and tangible social support and service providers the most informational support. The amount of perceived support from all sources increased over time, but 78% of mothers and 60% of fathers reported at least one instance of nonsupport from these same sources, primarily from extended family members and health professionals. We encourage health professionals to show respect and to provide timely, accurate information in a sensitive manner to parents whose child has a chronic health condition and to assist parents in handling nonsupportive behaviors from family and friends.     

Public health advocacy on behalf of women in S?o Paulo: learning to participate in the planning process

In 1988, a new Constitution was adopted in Brazil in which guidelines for community participation in the development and implementation of the national health system were delineated. The health and welfare of women and children were given priority. Implementation of these guidelines presents a major challenge in a city such as S?o Paulo with a population of 15 million, of which an estimated 5.8 million are women of childbearing age. In order to determine the extent to which community organizations are actively participating in planning health services for women and children in S?o Paulo, a study was undertaken to examine the experience of community and professional organizations in public health advocacy. This paper describes a sample of these organizations, their constituents, membership, history, funding, advocacy objectives, and strategies used and results obtained. The information gathered indicates that the community organizations are involved in activities that include major efforts to improve access to health care by providing specialized courses in women's health, including the status of women's work, sexuality, discrimination, family planning, and the politics of health; publishing newsletters; producing radio programs; engaging in legal action; and using petitions, demonstrations, and public meetings to garner public support on specific issues.     

Continuity of care for patients with schizophrenia and related disorders: a comparative south-Verona and Groningen case-register study

BACKGROUND: It is widely believed that for the severely mentally ill continuity of care is essential to ensure a better outcome and prevent long-term hospitalization. However, not much progress has been made in the operationalization and measurement of this concept. We used two indicators to compare continuity of care of schizophrenic patients in two kinds of mental health systems. One is a community mental health system without the back-up of a mental hospital (South-Verona, Italy). The other is an institution-based system in which mental hospitals are still predominant (Groningen, The Netherlands). METHODS: The first indicator of continuity of care, readiness of aftercare, is the time from discharge from hospital to the first day- or out-patient contact. Survival analysis was applied to correct for censored observations. The second indicator, flexibility of care, is the use of combinations of in-, day- and out-patient care during 2-year follow-up. RESULTS: More patients in South-Verona received community care within 2 weeks after discharge (71.5%), than in the Groningen register area (54.6%). The survival functions differed significantly. Cox regression analysis revealed that in both systems a contact before admission, the time between this contact and admission and the duration of the admission are predictors for aftercare. A higher percentage of patients made multiple service use (combinations of in-, day- and out-patient care) in South-Verona than in Groningen (62 v. 45%). CONCLUSIONS: Both indicators showed a higher continuity of care in the South-Verona system.     

Using psychology to promote human welfare: A conceptual analysis of the role of community psychology.

Analyzed according to a conceptually developed matrix the approaches by which psychology can be used to enhance human welfare. The approaches include clinical psychology, community mental health, community psychology, and public policy psychology. Each approach is examined in terms of the intended target, the content of the intervention, the process involved in the intervention approach, and the knowledge base necessary for attempting such interventions. The differences between community psychology and community mental health are emphasized, and it is concluded that community psychology should disengage itself from the community mental health movement to fulfill its most important functions of interfacing with the social systems of deviance control and of socialization and support. (51 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The influence of governmental policy on community health partnerships and community care networks: an analysis of three cases

This is a comparative analysis of hospitals' efforts in three communities to pursue collaborative ventures to advance community health. The events occurred over a two-year period characterized by increasing market competition and national debate about comprehensive health care financing reform. The study objectives are to better understand factors that contributed to the initiation of the collaborative efforts, and factors that sustained, hindered, or thwarted these efforts. The study explores how the collaborative ventures in these three communities fared in the face of multiple and conflicting policies and the simultaneous creation of larger, competing health systems. A number of concluding generalizations address the impact of interorganizational dynamics and public policy initiatives on community health partnerships.     

Reaching out, reaching in: Two examples of public education.

Thirty-five years after former American Psychological Association (APA) President George A. Miller (1969) exhorted psychologists to "give psychology away," then-current APA President Ronald F. Levant (2005) encouraged us to "make psychology a household word"--but how do we go about accomplishing this goal? To highlight the value, issues, and challenges of providing such services, 2 case examples of public outreach are described: The Mental Health Tune Up, a 2-day community outreach event, involves multiple mental health organizations in seminars, a resource fair, mental health self-screenings, and workshops; the Toronto Marathon Psyching Team offers mental skills, support, and mental and emotional triage to runners before, during, and after a major international marathon. Event organization, volunteer training and support, interdisciplinary collaboration, corporate community support, systems integration, publicity, and program evaluation are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sustaining interventions in community systems: on the relationship between researchers and communities

Important goals of research-based community interventions include the long-term maintenance of effects and fostering of collaboration between researchers and community leaders. This article reviews the challenges associated with transferring innovations to community systems, changing program delivery from an experimental context controlled by researchers to program delivery controlled by community organizations, and sustaining long-term effects of interventions. It is suggested that researchers who develop and implement community interventions in diverse health areas need to confront several issues: (a) fostering effective long-term relationships between researchers and the communities they study and in which they intervene and (b) designing and implementing interventions that are useful to community systems after the formal phase of research ends.