RESUMO
OBJECTIVES: To examine the leadership attributes and collaborative connections of local actors from the health sector and those outside the health sector in a major place-based health initiative. METHODS: We used survey data from 340 individuals in 4 Healthy Places North Carolina counties from 2014 to assess the leadership attributes (awareness, attitudes, and capacity) and network connections of local actors by their organizational sector. RESULTS: Respondents' leadership attributes-scored on 5-point Likert scales-were similar across Healthy Places North Carolina counties. Although local actors reported high levels of awareness and collaboration around community health improvement, we found lower levels of capacity for connecting diversity, identifying barriers, and using resources in new ways to improve community health. Actors outside the health sector had generally lower levels of capacity than actors in the health sector. Those in the health sector exhibited the majority of network ties in their community; however, they were also the most segregated from actors in other sectors. CONCLUSIONS: More capacity building around strategic action-particularly in nonhealth sectors-is needed to support efforts in making widespread changes to community health.
Assuntos
Planejamento em Saúde Comunitária/organização & administração , Serviços de Saúde Comunitária/organização & administração , Coalizão em Cuidados de Saúde/organização & administração , Melhoria de Qualidade , Fortalecimento Institucional , Comportamento Cooperativo , Tomada de Decisões Gerenciais , Política de Saúde , Prioridades em Saúde , Pesquisa sobre Serviços de Saúde , Humanos , Liderança , North Carolina , Objetivos Organizacionais , Inquéritos e Questionários , Populações VulneráveisAssuntos
Assistência Ambulatorial/economia , Assistência Ambulatorial/organização & administração , Prestação Integrada de Cuidados de Saúde/economia , Prestação Integrada de Cuidados de Saúde/organização & administração , Organização do Financiamento , Assistência Centrada no Paciente/organização & administração , Transtornos Relacionados ao Uso de Substâncias/terapia , Ensaios Clínicos como Assunto , Humanos , North CarolinaAssuntos
Enfermagem em Saúde Comunitária/economia , Enfermagem Baseada em Evidências , Reforma dos Serviços de Saúde/economia , Serviços de Assistência Domiciliar/economia , Centros de Saúde Materno-Infantil/economia , Enfermagem em Saúde Comunitária/legislação & jurisprudência , Feminino , Financiamento Governamental , Reforma dos Serviços de Saúde/legislação & jurisprudência , Humanos , Lactente , Recém-Nascido , Centros de Saúde Materno-Infantil/legislação & jurisprudência , North Carolina , GravidezRESUMO
PURPOSE: Efforts to provide medication assistance to the rural poor in central Louisiana are described. SUMMARY: The Central Louisiana Medication Access Program (CMAP) began functioning in 2001 with the objective of providing medication assistance and medication education to the rural poor in the community. The program serves individuals who use the outpatient clinic at the state-run public hospital in central Louisiana. Patients receive prescription drugs for a variety of chronic conditions, paying only a processing fee of dollar 3 per prescription, with a maximum outlay of dollar 15 per visit. A pharmacist counsels the patients about their medications. The medications are funded both through the program and through assistance programs run by pharmaceutical companies. A total of 5307 patients were enrolled in the CMAP between May 2001 and March 2003, and they received over 140,000 prescriptions at a cost saving to them in excess of dollar 2.5 million. CONCLUSION: The CMAP has been able to provide prescription medications and medication counseling to needy patients in a rural environment at little cost to them.