A scoping review of community health needs and assets assessment: concepts, rationale, tools and uses

Use of the Delphi method as an instrument of community participation in health needs assessment

We conducted a comprehensive analysis of the usefulness of the Delphi technique for facilitating community participation in local health needs assessments within the Andalusian Local Health Action Network, Spain. We developed an ad hoc online questionnaire based on the Social Determinants of Health model and applied it to a panel of experts in two municipalities in the province of Seville (Andalusia, Spain) between May and June 2021. Our results reflected good panelist participation. The questionnaire successfully enabled the prioritization of both new and original items, some of which were incorporated into local health policies. We concluded that the Delphi method was effective for facilitating participation in local health needs assessments offering a replicable, cost-effective approach that accelerated local policy development and supported the implementation of Health in All Policies within local government.

Risk factors for child abuse and neglect: Systematic review and meta-analysis

OBJECTIVES

Child maltreatment is a major public health issue associated with adverse outcomes and societal costs, yet its risk factors lack contemporary quantitative synthesis. This review aims to identify and quantify individual, familial, community, and societal risk factors associated with different types of child maltreatment and explore patterns across maltreatment types.

STUDY DESIGN

Systematic review and meta-analysis.

METHODS

This study followed PRISMA guidelines and reviewed literature on child maltreatment from 2013 to 2023. Eligible studies focused on physical, sexual, emotional abuse, neglect, and multi-type maltreatment in children under 18. Databases used included PubMed, PsycINFO, and Web of Science. Data was extracted and analyzed using meta-analysis with fixed and random effects models. Risk of bias was assessed using the ROBINS-I tool, and sensitivity and subgroup analyses were performed. Certainty of evidence was evaluated using the GRADE approach.

RESULTS

Of 5554 identified studies, 42 met inclusion criteria. Significant results include: male children showed higher odds of physical abuse (OR:1.49). Employed families, higher family education, older parental age, and higher family income had lower odds of maltreatment (OR from 0.51 for income to 0.99 for parental age). Larger family size, parental mental health, maltreatment history, and substance use had higher odds of maltreatment (OR from 1.07 for family size to 5.21 for mental health). Urban areas had lower odds of physical abuse (OR: 0.88).

CONCLUSIONS

Findings underscore the importance of addressing identified risk factors at multiple levels, with implications for practice, policy, and future research to refine prevention strategies and promote child well-being.

Using Photovoice to Improve Engagement in Community Health Assessments Addressing Behavioral Health

Behavioral health disorders are well-known to have close links with the social determinants of health, yet little is known about how impacted communities perceive these links. Qualitative participatory methods can not only provide insight into how communities conceptualize these relationships but also empower those with lived experience to contextualize their perspectives and formulate calls to action. This study used Photovoice as a participatory method to supplement the Clark County Health Department Community Health Assessment and determine priority facilitators and barriers contributing to the behavioral health of Clark County, KY, residents. A secondary aim was to gain a greater understanding of how the Photovoice methodology impacts community engagement efforts in Community Health Assessments. Twenty-three Clark County residents participated in four Photovoice groups involving five weekly sessions, which included photograph "show and tell," critical group dialogue, participatory analysis, and planning for dissemination. Secondary analysis of Photovoice focus group discussions revealed behavioral health facilitators and barriers were most influenced by (1) public sector unresponsiveness, (2) strong partnerships formed between community and grassroots organizations, and (3) the siloed division of responsibility between agencies and across sectors. The authors also found the Photovoice method successfully enhanced engagement and empowered those with lived experience to frame their perspectives of the behavioral health landscape. This project has implications for enhancing community engagement and empowerment in behavioral health-focused public health assessments and shaping policy to promote multi-sector collaboration.

Community health needs assessment: findings from a community-university partnership strengthening program on maternal and child health in Pakistan

BACKGROUND

Pakistan has been progressing at a slow pace in enhancing maternal and child health (MCH) indicators, experiencing some of the poorest pregnancy outcomes globally. In response to the challenges faced at the community level in MCH, a community health needs assessment (CHNA) was undertaken through a community-university partnership project. The aim of this CHNA was to understand the MCH needs and associated social determinants within the specific local context of the community.

METHODS

The assessment of community MCH needs was performed in two phases in Lahore, Pakistan. Initially, the semi-urban area of Shah Di Khoi, within the university's catchment area, was chosen based on an extensive review of both primary and secondary data. In the second phase, a CHNA was conducted among females of reproductive age (15-49 years) having at least one child under 5 years. Data encompassing socio-demographic characteristics, anthropometric measures, and the health needs of mothers and children were collected using a structured questionnaire. The data were analyzed employing SPSS version 21, utilizing descriptive statistics and Pearson chi-square, and binary logistic regression at a 95% confidence interval.

RESULTS

In this study, 253 reproductive-age females and 371 children under 5 were examined. Critical community issues included unmet family planning needs (29.6%), maternal anemia (18.6%), and child malnutrition (28.6%). Concerns encompassed suboptimal drinking water practices (62.0%), child non-vaccination (19.1%), widespread ghutti use (84.9%), suboptimal birth spacing (25.7%), non-exclusive breastfeeding for the first six months (88.7%), and prelacteal feeding (66.8%). Analysis identified maternal anemia (AOR = 0.38; p = 0.010), nuclear family adoption (AOR = 2.049; p = 0.033), unhealthy water practices (AOR = 0.48; p = 0.023), and ghutti provision at birth (AOR = 0.37; p = 0.030) as pivotal predictors of child nutritional status.

CONCLUSION

In order to improve the overall health status of community, it is imperative to implement collective strategies tailored to the specific factors and challenges prevalent in the community. The results underscore the importance of maintaining the community-university partnership through establishing a dedicated Maternal and Child Health Center. These findings contribute to the growing body of knowledge in MCH research and inform evidence-based policies for enhanced health outcomes in similar contexts.

Health Equity Through Black Feminist Healing: A Narrative Review on the Contributions of Black Womxn to Integrative Medicine

Background

Black women and Black femme-identifying individuals (referred to as womxn) have developed alternative health practices that support their well-being when navigating oppressive systems. Within the U.S. healthcare system, Black womxn are disproportionally impacted by inequities and discriminatory practices, leading to higher incidences of chronic conditions, limited healthcare access, and higher mortality rates. Integrative medicine has not yet adequately examined or incorporated healing modalities practiced by Black womxn and therefore has not investigated its potential to foster more inclusive care.

Objectives

This critical narrative review aims to explore the contributions of Black womxn to integrative medicine, identify components of Black feminist healing modalities, and discuss future directions for integrating these practices into integrative medicine.

Methods

A critical review was conducted using databases including PubMed, JSTOR, Taylor & Francis Online, and Sage to gather academic and praxis-focused sources. Books and films related to Black womxn healing practices were also examined. Sources were selected based on their focus on non-Western, alternative, and complementary therapies developed and practiced by Black womxn in the United States.

Results

We identified three key categories of Black feminist healing modalities: (1) Communal Care and Communication, which includes practices like storytelling, gossip, and community gathering to foster resilience; (2) Art as a Form of Cultural Strengthening, which emphasizes the use of creative expression for healing and resistance; and (3) Spirituality. These modalities provide tools for Black womxn to resist systemic oppression and promote well-being.

Conclusion

Black feminist healing modalities are crucial for creating inclusive models of care that address the specific health needs of marginalized communities. Incorporating these modalities into healthcare can contribute to health equity by offering culturally relevant and holistic approaches to health for Black womxn and other historically minoritized groups. Future research should focus on developing evidence-based practices for integrating these modalities into clinical settings.

A Community-Engaged, Mixed-Methods Approach to Prioritizing Needs in a Statewide Assessment of Community Cancer Needs

Introduction

Kentucky has the highest all-site cancer incidence and death rate in the US. In 2021, the University of Kentucky Markey Cancer Center convened a steering committee to conduct a statewide community cancer needs assessment (CNA). The goal of the final CNA phase was to gather community input on prioritizing Kentucky's cancer-related needs and ways to address them.

Methods

In 2021, we recruited 162 people to participate in online concept mapping, a participatory mixed method, to explore connections and identify priority areas. Fifty-one community members and 111 organizational partners participated in survey-based activities to prioritize 80 items representing key CNA findings and discussion groups to explore key focus areas and strategies for Kentucky communities.

Results

Concept maps display perceived similarity of the 80 items and a 6-cluster solution. High-priority focus areas included lung cancer screening, smoking, human papillomavirus (HPV) vaccination, and disparities driven by social determinants among rural, Appalachian, Black, and Hispanic residents. High-priority strategies to address needs included expanding health communication on risks, screening guidelines, and insurance benefits; patient navigation; accessible, culturally appropriate treatment information and self-efficacy in treatment decisions; access to care through financial assistance, mobile clinics, and at-home screening; and patient-provider trust and communication.

Conclusion

Our findings indicate the utility of the concept mapping process to facilitate the prioritization of wide-ranging catchment area needs and ways to address them. Moving forward, the prioritized focus areas and strategies can inform Kentucky's new state cancer plan and future research to reduce the state's cancer burden and disparities.

Bibliometric Analysis of Comprehensive Geriatric Assessment from 2004 to 2023

Background

The global aging population necessitates specialized tools for complex geriatric health issues. Comprehensive Geriatric Assessment (CGA) provides multidimensional evaluations of elderly, integrating inputs from various professionals to create individualized care plans. This study aims to visually assess the research trends and hotspots in the field of CGA, review mainstream perspectives in this field, and provide a foundation for future research and treatment.

Methods

Original and review articles related to comprehensive geriatric assessment, published from 2004 to December 2023, were extracted from the Web of Science database. Four different software tools-CiteSpace, VOSviewer, Bibliometrix R package, and the Online Analysis Platform of Bibliometrics-were utilized for this comprehensive analysis.

Results

According to our retrieval strategy, we found a total of 4,411 related literatures. There has been a substantial increase in the research on comprehensive geriatric assessment in the past 20 years. These publications have been cited 157,366 times, with a mean of 35.68 citations per publication. The largest number of publications were from the US, and Italy ranked second (14.98%). Keyword burst and concurrence showed that "randomized trial", "adjuvant chemotherapy" and "breast cancer" were the top 3 most frequently occurring keywords.

Conclusion

Our bibliometric analysis reveals significant growth in CGA research over the past two decades, with a shift from cancer-focused studies to chronic conditions like frailty and sarcopenia. These findings highlight evolving priorities in geriatric care and underscore the need for future research to integrate technological advancements, such as AI, to enhance the precision, scalability, and cost-effectiveness of CGA in diverse settings.

Understanding one health challenges in marginalized urban settings: A patient and public involvement (PPI) approach from the CHIP consortium activities across four global cities

Background

Slum communities face health risks influenced by environmental, human, and animal health factors, particularly antimicrobial resistance (AMR). Tailored, community-driven solutions are needed to address these multifactorial health determinants. This study explores One Health challenges in urban slums using a Patient and Public Involvement (PPI) approach.

Objectives

This study aims to use qualitative methods within a PPI framework to examine the social, environmental, and animal health factors contributing to AMR and other health challenges in urban slums. Focusing on One Health, we engaged slum residents in Jaipur, Jakarta, Antofagasta, and Istanbul through participatory approaches like social mapping and transect walks to identify health risks and develop intervention strategies.

Methods

A PPI approach was employed to involve communities in the research process, ensuring culturally relevant insights. Data collection included social mapping, transect walks, and key informant interviews in the four cities, highlighting critical health determinants such as environmental contamination, healthcare access, and animal-related risks. Thematic analysis identified common challenges and intervention opportunities within the One Health framework.

Conclusion

The study underscores the importance of PPI in addressing One Health challenges in urban slums and reveals interconnected human, environmental, and animal health risks. Engaging communities fostered trust and provided locally relevant solutions to complex health issues like AMR. Future interventions should be co-designed with communities to address social determinants like sanitation and healthcare access for sustainable outcomes.

Effectiveness of a resilience-building nursing intervention on psychological well-being in Arab community-dwelling older adults

BACKGROUND

Psychological resilience plays a crucial role in the well-being of community-dwelling older adults. This study aimed to evaluate the effectiveness of a resilience-building nursing intervention on enhancing psychological well-being in this population.

METHODS

A randomized controlled trial was conducted with 84 community-dwelling older adults in Abha, Saudi Arabia. Participants were randomly assigned to either the intervention group (resilience-building nursing intervention) or the control group (standard care). Psychological resilience and quality of life were assessed using validated scales at baseline, post-intervention, and follow-up.

RESULTS

The intervention group showed significant improvements in psychological resilience (mean difference: +3.2, p = 0.001) and quality of life (mean difference: +5.4, p = 0.002) at follow-up compared to the control group. Factors influencing resilience included age, gender, socioeconomic status, health status, intervention exposure, community engagement, and living arrangements.

CONCLUSION

The resilience-building nursing intervention effectively enhanced psychological well-being among community-dwelling older adults. Integrating such interventions into routine nursing care can promote holistic well-being and enable older adults to thrive within their communities.

Community voices in health literacy: a qualitative exploration into perceptions of a health literacy mediator

Health literacy is a vital asset needed to empower individuals to take control of their health. An individual's health literacy is the ability to find, use and apply health information and services to manage their health. They interact with the health services and members of their community who can offer additional support. Creating the role of a health literacy mediator (HLM) may help to improve health literacy outcomes for all. For this role to be accepted by individuals within a community, the community itself should be involved in the development of the roles and associated responsibilities. The aim of this study was to engage with community members to acquire their perspectives on the potential of this role. Qualitative semi-structured online interviews were used to engage in discussions with local community members. This study implemented a constructivist epistemology with qualitative research design. Data were thematically analysed to identify evolving themes that were important to the HLM role. The analysis identified three main themes that need to be considered when adopting an HLM role: (i) health empowerment of individuals, organizations and communities, (ii) meeting the needs of the community and (iii) addressing the existing barriers in navigating and accessing the healthcare system. Those working in the health promotion space must adopt novel and innovative ways to improve HL on both a local and an international scale. This study concluded that for the role of a HLM to be accepted, it would need to encompass these attributes.

A framework and process for community-engaged, mixed-methods cancer needs assessments

PURPOSE

Community health needs assessments are required for most state and local public health agencies and non-profit hospitals. Typically based on community health improvement planning models, these assessments encompass overall community health and multiple diseases to inform program planning. National Cancer Institute (NCI)-designated Cancer Centers and community-based cancer-focused programs share the goal of reducing cancer burden in the catchment areas they serve. However, to date, no published models exist to guide cancer-specific needs assessments for a determined geographic area that can inform both public health and research initiatives. The purpose of this article is to outline a cancer needs assessment (CNA) framework and community-engaged, mixed-methods process, along with a case study of how we applied it in Kentucky.

METHODS

We convened a steering committee of key organizational partners to provide input throughout the process. We developed a conceptual framework of multi-level determinants affecting cancer-related outcomes. We incorporated both quantitative and qualitative data gathered through a variety of means, including a novel application of group concept mapping to guide definition of priorities.

RESULTS

The resulting CNA has helped guide strategic planning and priorities for Kentucky's Cancer Action Plan, Markey Cancer Center, state agencies, and community-based organizations.

CONCLUSION

This framework and process can be used collaboratively by cancer center Community Outreach and Engagement offices, public health agencies, oncology programs, and community partners to plan impactful cancer control programs and research in their catchment areas. Universities can also use them to inform the planning of community engagement and health equity research efforts.

The impact of core curriculum revisions on Japanese medical schools: Navigating curriculum evolution

PURPOSE

This study examines the impact of the 2010 and 2016 Model Core Curriculum (MCC) revisions on medical education across all 82 medical schools in Japan.

METHODS

A cross-sectional survey was conducted in 2021, focusing on the response to the MCC revisions, curriculum changes, and factors influencing these changes. The survey included questions on approaches to implementing the MCC revisions, timing of curriculum updates, factors triggering these revisions, changes in student performance and career paths, and the introduction of new subjects.

RESULTS

The response rate was 100%. Most universities rapidly implemented changes following the 2016 MCC revision, demonstrating agility in adapting to national standards. Key factors influencing curriculum revisions included external evaluations and the MCC revisions themselves. Despite no significant changes in student performance or career paths from faculties' perspective, an increase in scholarly activities was noted. The introduction of new subjects post-2016 reflects a shift toward holistic perspectives such as behavioral science, general medicine/community medicine, and professionalism.

CONCLUSIONS

The findings highlight a commitment to maintaining educational quality in Japanese medical education. The responsiveness to MCC revisions suggests a growing interest in medical education among faculties and an alignment with global medical education trends to meet evolving healthcare needs.

Effects of Community Assets on Major Health Conditions in England: A Data Analytic Approach

INTRODUCTION

The broader determinants of health including a wide range of community assets are extremely important in relation to public health outcomes. Multiple health conditions, multimorbidity, is a growing problem in many populations worldwide.

METHODS

This paper quantified the effect of community assets on major health conditions for the population of England over six years, at a fine spatial scale using a data analytic approach. Community assets, which included indices of the health system, green space, pollution, poverty, urban environment, safety, and sport and leisure facilities, were quantified in relation to major health conditions. The health conditions examined included high blood pressure, obesity, dementia, diabetes, mental health, cardiovascular conditions, musculoskeletal conditions, respiratory conditions, kidney and liver disease, and cancer. Cluster analysis and dendrograms were calculated for the community assets and major health conditions. For each health condition, a statistical model with all community assets was fitted, and model selection was performed. The number of significant community assets for each health condition was recorded. The unique variance, explained by each significant community asset per health condition, was quantified using hierarchical variance partitioning within an analysis of variance model.

RESULTS

The resulting data indicate major health conditions are often clustered, as are community assets. The results suggest that diversity and richness of community assets are key to major health condition outcomes. Primary care service waiting times and distance to public parks were significant predictors of all health conditions examined. Primary care waiting times explained the vast majority of the variances across health conditions, with the exception of obesity, which was better explained by absolute poverty.

CONCLUSIONS

The implications of the combined findings of the health condition clusters and explanatory power of community assets are discussed. The vast majority of determinants of health could be accounted for by healthcare system performance and distance to public green space, with important covariate socioeconomic factors. Emphases on community approaches, significant relationships, and asset strengths and deficits are needed alongside targeted interventions. Whilst the performance of the public health system remains of key importance, community assets and local infrastructure remain paramount to the broader determinants of health.

Building an implementation strategy for community-based rehabilitation for mental health in Colombia

INTRODUCTION

Scientific evidence indicates that the community-based rehabilitation (CBR) model is recommended for recovery from mental disorders. However, this approach encounters barriers and often lacks implementation strategies.

AIM

The aim of this study was to create a strategy for the implementation of CBR for mental health in Colombia through the identification of barriers and facilitators, together with the expected outcomes, from the perspective of mental health decision-makers in Colombia.

METHODS

This study adopts a qualitative descriptive approach, using focus group data collection methods and thematic analysis to code and analyze the data.

RESULTS

A total of 208 individuals participated in the study, including mental health decision-makers and health care professionals. Intersectoral collaboration, contextualization, financial resources, and community commitment and autonomy were identified as barriers and facilitators. The element that was considered a priority for successful implementation was the contextualization of strategies.

CONCLUSIONS

CBR needs to be strengthened through implementation science if these strategies are to be successfully developed and implemented in various contexts.

SPANISH ABSTRACT

http://links.lww.com/IJEBH/A210.

Characteristics, enablers, and barriers to the community health and well-being assessment component of the health promotion practice cycle: a scoping review protocol

OBJECTIVE

The proposed review will describe the characteristics, enablers, and barriers to the community health and well-being assessment (CHWA) component of the health promotion practice cycle.

INTRODUCTION

CHWA guides health promotion action in communities and populations. A "critical" approach to CHWA can be adopted, which addresses the social, political, cultural, economic, commercial, and environmental determinants of health and well-being to enhance health equity for priority communities and populations. Although tools exist to guide such a critical approach, little is known about the extent to which these tools are being used or the barriers and enablers to applying best practice CHWA. Such evidence is needed to inform future health promotion CHWA and research.

INCLUSION CRITERIA

This review will consider literature that describes CHWA conducted in health promotion practice, focusing on an organizational, social, or geographical community or population. Literature that focuses on clinical practice or a specific health condition will be excluded.

METHODS

Scopus, PubMed, Web of Science, and CINAHL (EBSCOhost) will be searched to identify peer-reviewed articles. Google Scholar and Google, as well as Public Health, Health and Medical, and Nursing and Allied Health (ProQuest) databases will be searched for gray literature. Articles will be screened and data extracted by 2 or more independent reviewers. The data extraction tool will be developed by the reviewers based on the JBI template and a critical health promotion approach to CHWA. Data will be analyzed and presented as frequency tables and narrative summaries of the characteristics, enablers, and barriers to CHWA.

REVIEW REGISTRATION

Open Science Framework osf.io/jq8th/.

Scaling-Out Digitally Enabled Integrated Care in Europe Through Good Practices Transfer: The JADECARE Study

Introduction

The absence of a coordinated approach to health and social care compromises the ability of health systems to provide universal, equitable, high-quality, and financially sustainable care. Transferring evidence-based practices focused on digitally-enabled integrated care to new contexts can overcome this challenge if implementation is satisfactory. This paper presents the scaling-out methodology that JADECARE has designed to spread effective innovative practices across Europe.

Methodology

The scaling-out methodology pretends to guide the Next Adopters in the transfer and adoption of practices, whereas increasing their implementation capacity and providing an evaluation framework to assess impact and success.

Discussion

JADECARE scaling-out effort is based on guiding principles found in the literature such as the balance between fidelity to the original practice and the degree of adaptation required to fit the new context, the need for capacity building in implementation to bridge the gap between research and routine practice and the focus on explaining why, for whom and in what circumstances an intervention works.

Conclusion

The JADECARE scaling-out methodology is theory-driven and pragmatic and aims to facilitate the transfer of complex interventions across different contexts.

Mental Health, Drug Use, and Programming: Applying a Needs Assessment Framework in Arkansas' Largest Jail

Jail programming is rarely informed by site-specific health needs, diagnostic-specific screening tools that are validated, or the input of incarcerated individuals. Using the community needs assessment (CNA) framework, we aimed to fill these gaps among people incarcerated in the Pulaski County Regional Detention Facility (PCRDF), Arkansas' largest jail. Participants were 179 adults at the PCRDF who completed surveys and open-ended questions focused on (a) their mental and behavioral health and (b) programming needs at the facility. Using a concurrent transformative mixed-methods design, we descriptively analyzed surveys and conducted content analysis of the open-ended questions. Over half of participants reported clinically significant anxiety (62.6%), post-traumatic stress disorder (53.1%), and/or depression (50.3%) symptoms; positive substance use disorder screening was especially common (91.7%). Nearly all (97%) individuals queried desired more programming, with the most desired being mental health and substance use programs. Other desired programs included physical health, education, community reintegration, family support, recreation, nutrition, religious/spiritual services, and meditation. Our CNA ensured the input of those directly impacted during program-focused decision making and identified strategies to effectively implement and sustain jail-based programs. Such assessments can be a potential mechanism for addressing the burden of mental and behavioral health problems in jail populations.

Findings of a Community Health Needs Assessment Survey in Al Najaf Governorate Iraq: A Snapshot of Al Marashda's Health Status

BACKGROUND

Community health assessment (CHA) is a well-known method for identifying and analyzing community health needs. This CHA survey aimed to identify and analyze community health needs and assets to prioritize these needs and to plan and act upon significant unmet community health needs.

METHODS

The CHA was planned based on the suggested standard of the North Carolina Guide including eight phases from July to December 2023. The CHA survey was performed among Al-Marashda region residents in the Al-Manathera district. The sample size of our study was 184 interviews of 12536 population. The primary data, which included demographic information, quality of life statements, and community improvement, were collected from the community using a questionnaire through opinion surveys and focus groups, while the secondary data which included the social, health, and economic status of Al-Marashda region residents were obtained from district and governorate sources. Analysis of whole data sources allowed 10 areas of community concern to be identified.

RESULTS

Findings from the CHA survey showed that diabetes and high blood pressure, poverty and unemployment, and air pollution were the most common public health problems as priorities.

CONCLUSIONS

The high-priority problems of Al-Marashda are in common with the noncommunicable diseases (NCDs) priority in Al Najaf. However, poverty and air pollution are specific to the Al-Marashda region. Public health authorities and the city governorate are advised to consider, support, and develop community diagnosis documents to implement appropriate interventions.

Mobilizing community-driven health promotion through community granting programs: a rapid systematic review

BACKGROUND

Effective health promotion responds to the unique needs of communities. Community granting programs that fund community-driven health promotion initiatives are a potential mechanism to meet those unique needs. While numerous community health-focused programs are available, the various strategies used by granting programs to foster engagement, administer grants and support awardees have not been systematically evaluated. This rapid systematic review explores the administration of community granting programs and how various program components impact process and population health outcomes.

METHODS

A systematic search was conducted across three databases: Medline, SocINDEX, and Political Science Database. Single reviewers completed screening, consistent with a rapid review protocol. Studies describing or evaluating community granting programs for health or public health initiatives were included. Data regarding program characteristics were extracted and studies were evaluated for quality. A convergent integrated approach was used to analyze quantitative and qualitative findings.

RESULTS

Thirty-five community granting programs, described in 36 studies, were included. Most were descriptive reports or qualitative studies conducted in the USA. Program support for grant awardees included technical assistance, workshops and training, program websites, and networking facilitation. While most programs reported on process outcomes, few reported on community or health outcomes; such outcomes were positive when reported. Programs reported that many funded projects were likely sustainable beyond program funding, due to the development of awardee skills, new partnerships, and securing additional funding. From the perspectives of program staff and awardees, facilitators included the technical assistance and workshops provided by the programs, networking amongst awardees, and the involvement of community members. Barriers included short timelines to develop proposals and allocate funds.

CONCLUSIONS

This review provides a comprehensive overview of health-related community granting programs. Grant awardees benefit from technical assistance, workshops, and networking with other awardees. Project sustainability is enhanced by the development of new community partnerships and grant-writing training for awardees. Community granting programs can be a valuable strategy to drive community health, with several key elements that enhance community mobilization.

REGISTRATION

PROSPERO #CRD42023399364.

Engaging Communities in Cancer Prevention and Control Activity Prioritization through a Statewide Needs Assessment: A Case Study from Nebraska

Community outreach and engagement (COE) activities are important in identifying catchment area needs, communicating these needs, and facilitating activities relevant to the population. The National Cancer Institute-designated cancer centers are required to conduct catchment-wide cancer needs assessments as part of their COE activities. The University of Nebraska Medical Center Buffett Cancer Center undertook a three-year-long process to conduct a needs assessment, identify priorities, and develop workgroups to implement cancer prevention and control activities. Activities were conducted through collaborations with internal and external partners. The needs assessment focused on prevention, early detection, and treatment of cancer and involved secondary data analysis and focus groups with identified underrepresented priority populations (rural, African American, Hispanic, Native American, and LGBTQ+ populations). Results were tailored and disseminated to specific audiences via internal and external reports, infographics, and presentations. Several workgroups were developed through meetings with the internal and external partners to address identified priorities. COE-specific initiatives and metrics have been incorporated into University of Nebraska Medical Center and Buffett Cancer Center strategic plans. True community engagement takes a focused effort and significant resources. A systemic and long-term approach is needed to develop trusted relationships between the COE team and its local communities.

Vision Need Profiles for the City of Richmond, Virginia: A Pilot Application of Calibration Methods to Vision Surveillance

Purpose

People with vision problems (VPs) have different needs based on their age, economic resources, housing type, neighborhood, and other disabilities. We used calibration methods to create synthetic data to estimate census tract-level community need profiles (CNPs) for the city of Richmond, Virginia.

Design

Cross-sectional secondary data analysis.

Subjects

Anonymized respondents to the 2015 to 2019 American Community Survey (ACS).

Methods

We used calibration methods to transform the ACS 5-year tabular (2015-2019) and Public Use Microdata estimates into a synthetic data set of person-level records in each census tract, and subset the data to persons who answered yes to the question "Are you blind or do you have serious difficulty seeing even when wearing glasses?" To identify individual need profiles (INPs), we applied divisive clustering to 17 variables measuring individual demographics, nonvision disability status, socioeconomic status (SES), housing, and access and independence. We labeled tracts with CNP names based on their predominant INPs and performed sensitivity analyses. We mapped the CNPs and overlayed information on the number of people with VP, the National Walkability Index, and an uncertainty measure based on our sensitivity analysis.

Main Outcome Measures

Individual need profiles and CNPs.

Results

Compared with people without VP, people with VP exhibited higher rates of disabilities, having low incomes, living alone, and lacking access to the internet or private home vehicles. Among people with VP, we identified 7 INP clusters which we mapped into 6 CNPs: (1) seniors (≥ age 65); (2) low SES younger; (3) low SES older; (4) mixed SES; (5) higher SES; and (6) adults and children in group quarters. Three CNPs had lower-than-average walkability. Community need profile assignments were somewhat sensitive to calibration variables, with 18 tracts changing assignments in 1 sensitivity analysis, and 4 tracts changing assignments in ≥ 2 sensitivity analyses.

Conclusions

This pilot project illustrates the feasibility of using ACS data to better understand the support and service needs of people with VP at the census tract level. However, a subset of categorical CNP assignments were sensitive to variable selection leading to uncertainty in CNP assignment in certain tracts.

Financial Disclosures

The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Enhancing quality healthcare in Nigeria through medical laboratory services: A review

This article explores the pivotal role of medical laboratory services in enhancing the quality of healthcare in Nigeria. Medical laboratory science is a comprehensive field that involves a diverse array of diagnostic and analytical procedures. These procedures are of utmost importance in the provision of patient care, the early diagnosis of diseases, and the promotion of public health. The article elucidates the progression of medical laboratory services in Nigeria, tracing the transformation from the role of laboratory assistants to that of medical laboratory scientists. It underscores the significance of these services in informing healthcare decision-making. The essay also discusses the diverse obstacles encountered by the medical laboratory profession in Nigeria. The issues encompass insufficiencies in infrastructure, obsolescence of equipment, absence of a coherent policy framework, slow workforce expansion, persistent labor strikes, and a scarcity of trained specialists. The aforementioned issues not only impede the effectiveness of laboratory services, but also have extensive ramifications for healthcare provision throughout the nation. In order to address these difficulties and improve the standard of healthcare, the essay presents practical solutions and a thorough strategy. Furthermore, it underscores the significance of augmenting financial resources, mitigating corruption, and tackling wage inequalities in order to effectively retain medical laboratory specialists. The action plan is structured into distinct phases, each delineated by specified dates and delineating the duties of various stakeholders, such as government entities, healthcare establishments, professional associations, and diagnostic enterprises.

Diabetes and current Indian scenario: A narrative review

Health needs assessment plays a critical role in identifying priorities and allocating resources to enhance health outcomes and reduce disparities. This write-up focuses on the health priority of diabetic care in India and highlights the challenges faced in its management. The prevalence of diabetes in India is alarmingly high and is projected to increase in the future, making it a significant concern. Key challenges include lack of awareness among the population, poor diagnosis, limited access to quality care, medication adherence issues, and physicians’ limited time and knowledge. Insufficient awareness hampers prevention efforts and understanding of associated complications. Diagnosis and access to quality care remain major challenges, particularly in rural areas, due to various factors such as treatment costs and underdeveloped healthcare infrastructure. Medication adherence is a significant issue influenced by high costs, complex treatment regimens, and limited transportation options. Healthcare professionals face knowledge gaps and time constraints, affecting the optimal management of diabetes. The scarcity of trained professionals exacerbates the situation. The write-up also discusses current policies and programs in India for diabetes care, including the CARRS diabetes care delivery model, the Diabetes Tele Management System, and doctor training programs. While these initiatives aim to improve care, their effectiveness is not extensively evaluated. The conclusion emphasizes the need for increased awareness, improved diagnosis and access to care, medication affordability, enhanced healthcare professional training, and effective policy implementation to address the challenges in diabetic care in India.

Priority healthcare needs amongst people experiencing homelessness in Dublin, Ireland: A qualitative evaluation of community expert experiences and opinions

In light of evidence that housing-related disparities in mortality are worsening over time, this study aimed to explore the perspectives of experts working in homeless health and addiction services on priority healthcare needs amongst people experiencing homelessness in Dublin, Ireland, a city facing problematic increases in homelessness. As part of a larger qualitative study, a series of semi-structured interviews were carried out with 19 community experts followed by inductive thematic framework analysis to identify emergent themes and sub-themes relating to priority healthcare needs. At the societal level, community experts identified a need to promote a culture that values health equity. At the policy level, accelerating action in addressing health inequalities was recommended with an emphasis on strategic planning, Housing First, social support options, interagency collaboration, improved data linkage and sharing, and auditing. At the health services level, removing barriers to access will require the provision of more and safer mental health, addiction, women-centred, and general practice services; resolved care pathways in relation to crisis points and multi-morbidity; expanded trauma-informed education and training and hospital-led Inclusion Health programmes; and outreach programmes and peer support for chronic disease management. The voices of people experiencing homelessness, including representatives from specific homeless groups such as migrants, youth, and the elderly, must be thoroughly embedded into health and social service design and delivery to facilitate impactful change.

Implementation of community physiotherapy in primary care: one-year results of an on-call physiotherapy service

BACKGROUND

Primary health care systems have a key role in meeting health needs of community, including function. The aim of this paper is to describe the population involved in the Community Physiotherapist project and their health outcomes over a one-year period.

METHODS

The Community Physiotherapist is an on-call service which requires a request by general practitioners or medical specialists. Reason for prescription, waiting time for service delivery, diagnostic categories, provided intervention, number of interventions and outcomes were recorded for everyone included in the project. Possible differences in characteristics between individuals referred by medical specialists and general practitioners were also investigated.

RESULTS

From January to December 2022, 409 individuals were referred to the Community Physiotherapist pathway. Functional goals were achieved in 79.5% of interventions, without reported adverse events. In most cases physiotherapists provided counselling or caregiver training and 3.3% of individuals needed a full rehabilitation program. The groups of individuals referred by the two types of prescribers showed no significant differences, apart, as expected, from their median age.

CONCLUSIONS

The introduction of the Community Physiotherapist model within the primary care setting allows to provide appropriate, effective and safe interventions. Sharing the project among all the health professionals helped to support its appropriateness and effectiveness. Results also indicate that a new organizational model, such as the Community Physiotherapist, will take a long time to be implemented.