The little things are big: evaluation of a compassionate community approach for promoting the health of vulnerable persons.

BACKGROUND: Vulnerable persons are individuals whose life situations create or exacerbate vulnerabilities, such as low income, housing insecurity and social isolation. Vulnerable people often receive a patchwork of health and social care services that does not appropriately address their needs. The cost of health and social care services escalate when these individuals live without appropriate supports. Compassionate Communities apply a population health theory of practice wherein citizens are mobilized along with health and social care supports to holistically address the needs of persons experiencing vulnerabilities. AIM: The purpose of this study was to evaluate the implementation of a compassionate community intervention for vulnerable persons in Windsor Ontario, Canada. METHODS: This applied qualitative study was informed by the Consolidated Framework for Implementation Research. We collected and analyzed focus group and interview data from 16 program stakeholders: eight program clients, three program coordinators, two case managers from the regional health authority, one administrator from a partnering community program, and two nursing student volunteers in March through June 2018. An iterative analytic process was applied to understand what aspects of the program work where and why. RESULTS: The findings suggest that the program acts as a safety net that supports people who are falling through the cracks of the formal care system. The 'little things' often had the biggest impact on client well-being and care delivery. The big and little things were achieved through three key processes: taking time, advocating for services and resources, and empowering clients to set personal health goals and make authentic community connections. CONCLUSION: Compassionate Communities can address the holistic, personalized, and client-centred needs of people experiencing homelessness and/or low income and social isolation. Volunteers are often untapped health and social care capital that can be mobilized to promote the health of vulnerable persons. Student volunteers may benefit from experiencing and responding to the needs of a community's most vulnerable members.

Comparison of coping responses to symptoms between first-time sufferers and those with a previous history of acute myocardial infarction.

BACKGROUND AND OBJECTIVE: Little is known about how experience with a previous acute myocardial infarction (AMI) impacts individuals' reactions to symptoms of a recurrent episode. Thus, the purpose of this study was to compare the use of coping strategies during an acute cardiac event in patients experiencing a first AMI with those experiencing a recurrent AMI. SUBJECTS AND METHODS: Secondary data analyses were performed to examine differences in the use of coping strategies between individuals with and without a history of AMI. Mann-Whitney U test was performed to compare those with (n = 26) and without (n = 109) a previous AMI with respect to 15 coping strategies, each of which was measured on a 5-point Likert scale. RESULTS AND CONCLUSIONS: Patients with a history of AMI were more likely to use prescribed medications to deal with their symptoms than were patients who did not have a previous AMI (M = 1.5 and 0.20; median = 2.0 and 0.0, respectively; P < .001). However, patients who had no previous AMI were more likely to respond by taking nonprescription medications (M = 0.90 and 0.60; median = 1.0 and 0.0, respectively; P = .04). The results suggest that patients with and without a history of AMI tend to respond to their symptoms with similar coping strategies. When differences occurred, patients with and without a history of AMI differed only with respect to the type of self-medication choices they made. Implications pertaining to these findings are discussed.