2.50
Hdl Handle:
http://hdl.handle.net/10755/153671
Type:
Presentation
Title:
Health Promotion Outcomes in a Comprehensive Community Health Project
Abstract:
Health Promotion Outcomes in a Comprehensive Community Health Project
Conference Sponsor:Sigma Theta Tau International
Conference Year:2002
Conference Date:July, 2002
Author:Verran, Joyce
P.I. Institution Name:University of Arizona
Title:Professor
This report is of the test of a Comprehensive Multilevel Nursing Practice Model For Rural Hispanics funded by the Agency on Health Care Policy and Research for five years with an additional one-year no-cost extension. Objective: The objective was to test three components of community health nursing in four rural communities on the outcomes of health status and health impact. The components were personalized preventive nursing (PPN), organized indigenous caregivers (OIC), and community empowerment (CE). Design: Four rural communities were randomly assigned (without replacement) to the four treatments in this experimental design. Health promotion activities were one of the outcome measures. Population, Sample, Setting, Years: There were approximately 10,000 residents ages ranging from newborn to over 75 years. The sample was 50% Hispanic and 50% non-Hispanic white. All subjects were in the sample for the treatment protocols. However, the sample for outcome measures surveys was households randomly selected in each community (n=1,400). Three surveys were done over 5 years. These communities were in sparsely populated, underserved areas of Arizona. The communities were economically depressed and highly dependent upon copper mining. The study was conducted from 1990 to 1995 with an additional year for analysis, 1995-1996. Concepts and Variables: Health care availability, accessibility, acceptability and affordability were concepts on which the treatment protocols were based. This report is on routine health screening measures: mammograms, colo-rectal screening, pap tests, blood pressure, cholesterol tests, glucose tests, eye examinations, urine testing, dental examinations, vaccinations, and hearing examinations. This report focuses on similarities and differences on these measures among communities, ethnic groups, and over time. Methods: Surveys were administered to a member of the household and data were then collected by report on all members. Surveys were in English and Spanish so the subject could select the preferred language. The questions focused on a series of health promotion health screening activities. The subject was asked when they or a member of the household had last had the test or treatment. Data were then treated at the individual level and aggregated to the household level. Multi level ANOVAs were used to analyze the data. Post hoc analyses helped to determine where significant differences were located. Findings: The effect of the treatment on health promotion activities varied by activity, ethnicity, age group, and by time. This lack of uniform results is difficult to interpret. However, there were significant findings in the predicted direction particularly between time 1 and 2. Some changes were not significant at time 3. These differences can in part be explained by change in community dynamics. All changes are documented with significant findings noted for each site, ethnicity, age category, and time. Most tests improved between times 1 and 2. However, frequently time 2 and time 3 were not different. Conclusions: Accessibility, affordability, availability and acceptability were parts of the success of the treatments. Many services had not been available in these health personnel shortage areas. Although an identifiable pattern among the measures was not discerned, change at least between time 1 and 2 were found and were statistically significant. Some of these preventive measures were difficult to obtain if the grant personnel did not bring services to the community. Although permanent health services were secured for the community after the grant ended, these services focused on a clinic approach with service to individuals within the context of the family. It is critical that the community's health be considered. Thus, instead of telling the patient to go to Tucson to obtain a mammogram, the mobile service needs to be brought to the community. Implications: Community health, which traditionally has dealt with the community as the client is under fire in many parts of the country. Whole community health nursing services are being dismantled. Without that philosophy of care, broad community initiatives are lost. In this study, the change in vaccination rates for children and elderly was excellent. This type of finding warrants the cost of bringing services to rural communities. For each dollar spent on preventive activities such as vaccinations between $14 and $25 dollars are saved in treatment dollars. If the community health nurse and promotoras are not present, the notch groups of clients do not receive care. Society is not always cognizant of the interacting effects that create a community's health.

Repository Posting Date:
26-Oct-2011
Date of Publication:
Jul-2002
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleHealth Promotion Outcomes in a Comprehensive Community Health Projecten_GB
dc.identifier.urihttp://hdl.handle.net/10755/153671-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Health Promotion Outcomes in a Comprehensive Community Health Project</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2002</td></tr><tr class="item-conference-date"><td class="label">Conference Date:</td><td class="value">July, 2002</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Verran, Joyce</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of Arizona</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Professor</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">jverran@nursing.arizona.edu</td></tr><tr><td colspan="2" class="item-abstract">This report is of the test of a Comprehensive Multilevel Nursing Practice Model For Rural Hispanics funded by the Agency on Health Care Policy and Research for five years with an additional one-year no-cost extension. Objective: The objective was to test three components of community health nursing in four rural communities on the outcomes of health status and health impact. The components were personalized preventive nursing (PPN), organized indigenous caregivers (OIC), and community empowerment (CE). Design: Four rural communities were randomly assigned (without replacement) to the four treatments in this experimental design. Health promotion activities were one of the outcome measures. Population, Sample, Setting, Years: There were approximately 10,000 residents ages ranging from newborn to over 75 years. The sample was 50% Hispanic and 50% non-Hispanic white. All subjects were in the sample for the treatment protocols. However, the sample for outcome measures surveys was households randomly selected in each community (n=1,400). Three surveys were done over 5 years. These communities were in sparsely populated, underserved areas of Arizona. The communities were economically depressed and highly dependent upon copper mining. The study was conducted from 1990 to 1995 with an additional year for analysis, 1995-1996. Concepts and Variables: Health care availability, accessibility, acceptability and affordability were concepts on which the treatment protocols were based. This report is on routine health screening measures: mammograms, colo-rectal screening, pap tests, blood pressure, cholesterol tests, glucose tests, eye examinations, urine testing, dental examinations, vaccinations, and hearing examinations. This report focuses on similarities and differences on these measures among communities, ethnic groups, and over time. Methods: Surveys were administered to a member of the household and data were then collected by report on all members. Surveys were in English and Spanish so the subject could select the preferred language. The questions focused on a series of health promotion health screening activities. The subject was asked when they or a member of the household had last had the test or treatment. Data were then treated at the individual level and aggregated to the household level. Multi level ANOVAs were used to analyze the data. Post hoc analyses helped to determine where significant differences were located. Findings: The effect of the treatment on health promotion activities varied by activity, ethnicity, age group, and by time. This lack of uniform results is difficult to interpret. However, there were significant findings in the predicted direction particularly between time 1 and 2. Some changes were not significant at time 3. These differences can in part be explained by change in community dynamics. All changes are documented with significant findings noted for each site, ethnicity, age category, and time. Most tests improved between times 1 and 2. However, frequently time 2 and time 3 were not different. Conclusions: Accessibility, affordability, availability and acceptability were parts of the success of the treatments. Many services had not been available in these health personnel shortage areas. Although an identifiable pattern among the measures was not discerned, change at least between time 1 and 2 were found and were statistically significant. Some of these preventive measures were difficult to obtain if the grant personnel did not bring services to the community. Although permanent health services were secured for the community after the grant ended, these services focused on a clinic approach with service to individuals within the context of the family. It is critical that the community's health be considered. Thus, instead of telling the patient to go to Tucson to obtain a mammogram, the mobile service needs to be brought to the community. Implications: Community health, which traditionally has dealt with the community as the client is under fire in many parts of the country. Whole community health nursing services are being dismantled. Without that philosophy of care, broad community initiatives are lost. In this study, the change in vaccination rates for children and elderly was excellent. This type of finding warrants the cost of bringing services to rural communities. For each dollar spent on preventive activities such as vaccinations between $14 and $25 dollars are saved in treatment dollars. If the community health nurse and promotoras are not present, the notch groups of clients do not receive care. Society is not always cognizant of the interacting effects that create a community's health.<br/><br/></td></tr></table>en_GB
dc.date.available2011-10-26T12:25:58Z-
dc.date.issued2002-07en_GB
dc.date.accessioned2011-10-26T12:25:58Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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