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2.
N C Med J ; 81(4): 261-265, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32641464

RESUMO

North Carolina's providers and payers increasingly recognize the unique needs of people and their caregivers burdened from the pain, symptoms, and stress of serious illness. This article lays out five actions for expanding access to medical and social supports outside the hospital setting.


Assuntos
Serviços de Saúde Comunitária/organização & administração , Cuidados Críticos/organização & administração , Necessidades e Demandas de Serviços de Saúde/organização & administração , Serviços de Assistência Domiciliar/organização & administração , Humanos , North Carolina
3.
Prev Chronic Dis ; 17: E57, 2020 07 09.
Artigo em Inglês | MEDLINE | ID: mdl-32644921

RESUMO

"Upstream" interventions that increase access or reduce barriers to healthy foods and opportunities for physical activity - referred to as policy, systems, or environmental strategies - are central to encouraging and supporting healthy behaviors that prevent chronic disease at a population level. However, they are complex and challenging to execute, especially during coronavirus disease 2019 (COVID-19), and efforts to build practitioner capacity are warranted. In this commentary, we describe a user or human-centered design (HCD) capacity-building approach to support practitioners in accomplishing the goals of the New York State Creating Healthy Schools and Communities (CHSC) initiative. This approach has been especially helpful during COVID-19, as it enables support to be responsive to practitioners' constantly changing needs. Given that CHSC is a project specific to New York State and that the efforts of the Obesity Prevention Center for Excellence were tailored to obesity prevention, more research and evaluations should be conducted to better understand how the use of HCD could support practitioners addressing other complex public health issues in the United States.


Assuntos
Betacoronavirus , Serviços de Saúde Comunitária , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Serviços de Saúde Escolar , Comportamentos Relacionados com a Saúde , Pessoal de Saúde , Política de Saúde , Humanos , New York/epidemiologia , Pandemias
4.
Mo Med ; 117(3): 216-221, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32636553

RESUMO

Show-Me ECHO, a state-funded project, provides access to education within a community of learners in order to optimize healthcare for the citizens of Missouri. Through videoconferencing and case-based review, ECHO shifts professional development from learning about medical problems in isolation to experiential learning as part of a multidisciplinary team. The establishment of a statewide COVID-19 ECHO is allowing a rapid response to this novel, unprecedented, and unanticipated health care crisis. There are many ongoing opportunities for clinicians from across the state to join a Show-Me ECHO learning community as a means to elevate their practice and improve ability to respond amidst a constantly evolving health care environment.


Assuntos
Serviços de Saúde Comunitária/tendências , Infecções por Coronavirus/terapia , Acesso aos Serviços de Saúde/tendências , Pneumonia Viral/terapia , Infecções por Coronavirus/prevenção & controle , Humanos , Missouri , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , População Rural/estatística & dados numéricos , Comunicação por Videoconferência/tendências
5.
Medicine (Baltimore) ; 99(27): e20967, 2020 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-32629706

RESUMO

BACKGROUND: Hypertension is a silent disease of the masses with an increasing prevalence and poor control rates. This study aims to establish and test the efficacy of a nurse-led hypertension management model in the community. METHODS: A single-blind, randomized controlled trial was performed. 156 hypertensive patients with uncontrolled blood pressure were equally and randomly allocated into 2 groups. Patients in the study group received a 12-week period of hypertension management. Blood pressure, self-care behaviors, self-efficacy, and satisfaction were assessed at the start of recruitment, 12 and 16 weeks thereafter. RESULTS: After the intervention, blood pressure of patients in the study group had greater improvement in self-care behaviors and a higher level of satisfaction with the hypertensive care compared to the control group (both P < .05). CONCLUSIONS: The nurse-led hypertension management model is feasible and effective for patients with uncontrolled blood pressure in the community.


Assuntos
Serviços de Saúde Comunitária/organização & administração , Hipertensão/enfermagem , Padrões de Prática em Enfermagem/normas , Idoso , Anti-Hipertensivos/uso terapêutico , Feminino , Humanos , Hipertensão/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente , Autocuidado , Autoeficácia , Método Simples-Cego
9.
J Aging Soc Policy ; 32(4-5): 432-438, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32515297

RESUMO

Millions of older Americans depend on services provided by Area Agencies on Aging to support their nutritional, social, and health needs. Social distancing requirements and the closure of congregate activities due to COVID-19 resulted in a rapid and dramatic shift in service delivery modes. Area Agencies on Aging were able to quickly pivot due to their long-standing expertise in community needs assessment and cross-sectoral partnerships. The federal Coronavirus relief measures also infused one billion dollars into the Aging Network. As the pandemic response evolves, Area Agencies on Aging are poised to be key partners in a transformed health system.


Assuntos
Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Serviço Social/organização & administração , Idoso , Idoso de 80 Anos ou mais , Envelhecimento , Betacoronavirus , Fortalecimento Institucional/organização & administração , Serviços de Saúde Comunitária/organização & administração , Abastecimento de Alimentos , Humanos , Relações Interinstitucionais , Pessoa de Meia-Idade , Pandemias , Encaminhamento e Consulta/organização & administração , Estados Unidos/epidemiologia
10.
J Frailty Aging ; 9(3): 165-171, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32588032

RESUMO

BACKGROUND: Walking interventions improve physical function, reduce fall risk, and prevent mobility disability-even in those with compromised walking ability. However, most prior studies have been conducted in controlled research settings, with no dissemination of an evidence-based walking program for older adults who have mobility limitations and/or are socially isolated. OBJECTIVES: This study reports data on the feasibility and acceptability of a community-based walking program (Walk On!) for older adults who are functionally limited, and assesses changes in physical function among attendees. The program sessions focused on long-distance walking, and took place for one-hour, for two days/week, and for 12 weeks at a time. DESIGN: Pilot implementation study. SETTING: Local church in Winston-Salem, NC. PARTICIPANTS: 49 program participants; Measurements: Physical function battery and satisfaction survey data, as well as formative evaluation data from six attendees of a focus group, are reported. RESULTS: The majority of the participants were >75 years (71%), female (65%), and presented with low levels of physical function (usual gait speed=0.79±0.16; 30.6% used an assistive device). Satisfaction with the program was high (100% would recommend it to others) and focus group results were overwhelmingly positive. Mean attendance to scheduled sessions was 77%±21%, and 63% of participants attended at least 75% of scheduled sessions (n=8 attended 100%). On average, participants improved their 6-min walk distance by 8.9%, their SPPB score by 15.4%, their timed-up-go time by 9.0%, and their usual gait speed by 11.4%. CONCLUSION: The results of the initial evaluation of Walk On! show high feasibility and acceptability of the program, as well as efficacy for improving physical function. Further research is needed to evaluate a delivery method for wider implementation of the program and to definitively test its effectiveness for improving function and other health benefits.


Assuntos
Serviços de Saúde Comunitária/organização & administração , Promoção da Saúde/organização & administração , Limitação da Mobilidade , Desenvolvimento de Programas , Caminhada , Idoso , Estudos de Viabilidade , Feminino , Grupos Focais , Humanos , Masculino , Projetos Piloto , Avaliação de Programas e Projetos de Saúde , Caminhada/fisiologia
11.
Afr J Prim Health Care Fam Med ; 12(1): e1-e3, 2020 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-32501021

RESUMO

Corona Virus Infectious Disease 2019 (COVID-19) was first reported in Cape Town in March 2020 and the transmission was soon observed in local communities. Cape Town has many vulnerable communities because of poverty, overcrowding and comorbidities, although it has a relatively small elderly population. Amongst the unique and early responses to the pandemic in South Africa has been the strategy of community screening and testing (CST). This process has been drawn from health department's prior adoption of a community-orientated primary care (COPC) approach, which relies on teams of community health workers working in delineated communities to prevent disease and provide early interventions for those at higher risk. The COPC principles were applied in the CST programme, which involved collaboration between facility and community-based teams, linking public health and primary care approaches, careful mapping of cases in highly vulnerable communities, targeted screening around cases, testing of those that screened positive, health education and linkage to primary care. The overall aim was to slow down transmission through early identification and isolation of diagnosed cases. Key challenges involved the designing of a screening tool with appropriate sensitivity and specificity as well as the logistics of staffing, transport, consumables, data collection and capture, security, ablutions and personal protective equipment. Key opportunities included synergies between CST and evolving commitment to COPC in the health system. Key threats were the deteriorating security situation in the most vulnerable communities because of loss of income, food insecurity and CST distrust as well as increasing turn-around-times for test results.


Assuntos
Técnicas de Laboratório Clínico , Serviços de Saúde Comunitária , Infecções por Coronavirus/diagnóstico , Programas de Rastreamento , Pneumonia Viral/diagnóstico , Infecções por Coronavirus/epidemiologia , Humanos , Pandemias , Pneumonia Viral/epidemiologia , África do Sul/epidemiologia
12.
Indian J Public Health ; 64(Supplement): S91-S93, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32496232

RESUMO

Some nations in the world and some states in India have had more success in containing this pandemic. Recent efforts in strengthening the health sector have focused largely on reforms in modes of financing, but as the pandemic brings home to us, the main challenge in India remains the challenge of the organization of public services using a health systems understanding. A close to community comprehensive primary health care, quality assurance, and planned excess capacity in public health systems, a more robust disease surveillance systems that can integrate data on new outbreaks and the indigenous technological capacity to scale up innovation and manufacture of essential health commodities are some of our most important requirements for both epidemic preparedness and response.


Assuntos
Infecções por Coronavirus/epidemiologia , Planejamento em Desastres/organização & administração , Pandemias , Pneumonia Viral/epidemiologia , Betacoronavirus , Fortalecimento Institucional , Serviços de Saúde Comunitária/organização & administração , Humanos , Índia/epidemiologia , Atenção Primária à Saúde/organização & administração , Administração em Saúde Pública , Vigilância em Saúde Pública , Garantia da Qualidade dos Cuidados de Saúde/organização & administração , Determinantes Sociais da Saúde
14.
Psychol Trauma ; 12(5): 502-504, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32538659

RESUMO

Holocaust survivors in Israel and abroad appear to be especially vulnerable to COVID-19 because of their early life history, advanced age, and associated health conditions. And although some survivors may experience retraumatization because of the pandemic, others appear to be especially resilient. We encourage a strength-based approach when working with survivors to foster resilience and effective coping in this uncertain time. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Assuntos
Adaptação Psicológica , Infecções por Coronavirus , Holocausto , Controle de Infecções , Pandemias , Pneumonia Viral , Resiliência Psicológica , Isolamento Social , Sobreviventes/psicologia , Idoso , Idoso de 80 Anos ou mais , Serviços de Saúde Comunitária , Humanos , Israel
15.
Clin Immunol ; 217: 108490, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32492478
16.
BMJ Glob Health ; 5(6)2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32522738

RESUMO

INTRODUCTION: Coronavirus disease (COVID-19), affects 213 countries or territories globally. We received a request from National Health Systems Resource Centre, a public agency in India, to conduct rapid evidence synthesis (RES) on community health workers (CHWs) for COVID-19 prevention and control in 3 days. METHODS: We searched PubMed, websites of ministries (n=3), public agencies (n=6), multilateral institutions (n=3), COVID-19 resource aggregators (n=5) and preprints (n=1) (without language restrictions) for articles on CHWs in pandemics. Two reviewers screened the records independently with a third reviewer resolving disagreements. One reviewer extracted data with another reviewer cross-checking it. A framework on CHW performance in primary healthcare not specific to pandemic was used to guide data extraction and narrative analysis. RESULTS: We retrieved 211 records and finally included 36 articles. Most of the evidence was from low-and middle-income countries with well-established CHW programmes. Evidence from CHW programmes initiated during pandemics and for CHW involvement in pandemic response in high-income countries was scant. CHW roles and tasks change substantially during pandemics. Clear guidance, training for changed roles and definition of what constitutes essential activities (ie, those that must to be sustained) is required. Most common additional activities during pandemics were community awareness, engagement and sensitisation (including for countering stigma) and contact tracing. CHWs were reported to be involved in all aspects of contact tracing - this was reported to affect routine service delivery. CHWs have often been stigmatised or been socially ostracised during pandemics. Providing PPE, housing allowance, equal training opportunities, transportation allowance, improving salaries (paid on time and for a broad range of services) and awards in high-profile public events contributed to better recruitment and retention. We also created inventories of resources with guiding notes on guidelines for health workers (n=24), self-isolation in the community (n=10) and information, education and counselling materials on COVID-19 (n=16). CONCLUSIONS: CHWs play a critical role in pandemics. It is important to ensure role clarity, training, supportive supervision, as well as their work satisfaction, health and well-being. More implementation research on CHWs in pandemics is required.


Assuntos
Agentes Comunitários de Saúde , Infecções por Coronavirus , Saúde do Trabalhador , Pandemias , Pneumonia Viral , Papel Profissional , Betacoronavirus , Serviços de Saúde Comunitária , Agentes Comunitários de Saúde/organização & administração , Agentes Comunitários de Saúde/normas , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/terapia , Infecções por Coronavirus/transmissão , Tomada de Decisões , Humanos , Índia , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pneumonia Viral/terapia , Pneumonia Viral/transmissão
18.
Prev Chronic Dis ; 17: E49, 2020 06 25.
Artigo em Inglês | MEDLINE | ID: mdl-32584753

RESUMO

Publicly available data on racial and ethnic disparities related to coronavirus disease 2019 (COVID-19) are now surfacing, and these data suggest that the novel virus has disproportionately sickened Hispanic communities in the United States. We discuss why Hispanic communities are highly vulnerable to COVID-19 and how adaptations were made to existing infrastructure for Penn State Project ECHO (Extension for Community Healthcare Outcomes) and Better Together REACH (a community-academic coalition using grant funds from Racial and Ethnic Approaches to Community Health) to address these needs. We also describe programming to support COVID-19 efforts for Hispanic communities by using chronic disease prevention programs and opportunities for replication across the country.


Assuntos
Betacoronavirus , Doença Crônica/epidemiologia , Doença Crônica/prevenção & controle , Serviços de Saúde Comunitária , Infecções por Coronavirus/etnologia , Infecções por Coronavirus/prevenção & controle , Hispano-Americanos , Pandemias/prevenção & controle , Pneumonia Viral/etnologia , Pneumonia Viral/prevenção & controle , Infecções por Coronavirus/epidemiologia , Acesso aos Serviços de Saúde , Disparidades nos Níveis de Saúde , Disparidades em Assistência à Saúde , Humanos , Pneumonia Viral/epidemiologia , Estados Unidos/epidemiologia
20.
J Public Health Manag Pract ; 26(4): 334-344, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32433388

RESUMO

CONTEXT: COVID-19 was characterized as a pandemic by the World Health Organization on March 11, 2020. This research aims to analyze the public health strategies to prevent and control COVID-19 in Shanghai, China, and provide recommendations for public health policy and interventions in the United States. PROGRAM: Based on the Social-Ecological Model, this research collected information for public health strategies from the Shanghai Municipal Health Commission and various Chinese websites. EVALUATION: The daily confirmed new cases of COVID-19 decreased from 27 to 0 in 53 days since the first case of COVID-19 was confirmed in Shanghai on January 20, 2020. DISCUSSION: The pattern of daily confirmed new cases suggests the effectiveness of public health strategies. This research also provides recommendations on the development and improvements of public health strategies in the U.S. by acknowledging the differences in political and social systems between the two countries.


Assuntos
Controle de Doenças Transmissíveis/organização & administração , Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Betacoronavirus , China/epidemiologia , Serviços de Saúde Comunitária/organização & administração , Educação em Saúde/organização & administração , Recursos em Saúde/organização & administração , Humanos , Meios de Comunicação de Massa , Saúde Pública , Vigilância em Saúde Pública/métodos , Quarentena/organização & administração , Estados Unidos
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