OBJECTIVES: This study developed an information and communication technology (ICT)-based comprehensive health and social-needs assessment (CHSNA) system based on the International Classification of Functioning, Disability, and Health (ICF) with the aim of enhancing person-centered community care for community residents and supporting healthcare professionals and social workers who provide healthcare and social services in the community. METHODS: Items related to a CHSNA tool were developed and mapped with ICF codes. Experts validated the CHSNA system design and process using the Delphi method, and a pilot test of the initial version of the system was conducted. RESULTS: The following three steps of CHSNA were embedded in the system, which had a user-friendly screen and images: basic health assessment, life and activity assessment, and in-depth health assessment. The assessment results for the community residents were presented with visualized health profiles, including images, graphs, and an ICF model. CONCLUSIONS: The developed CHSNA system can be used by healthcare professionals, social workers, and community residents to evaluate the reasoning underlying health and social needs, to facilitate the identification of more appropriate healthcare plans, and to guide community residents to receive the best healthcare services. A CHSNA system can improve the implementation of standardized terminology utilizing the ICF and the accuracy of needs assessments of community residents.
Classification ; Community Health Services ; Decision Support Techniques ; Delivery of Health Care ; Methods ; Needs Assessment ; Patient-Centered Care ; Social Work ; Social Workers

Treatment of schizophrenia has as its ultimate goals, the functional recovery of the patients and improvement of their quality of life. While antipsychotic medication is the fundamental method for treating schizophrenia, it has certain limitations in terms of treating the illness beyond its positive symptoms. Therefore, psychosocial intervention should be used in tandem with pharmacological methods in treating schizophrenia. The efficacy of several modes of psychosocial intervention for improving outcomes in schizophrenia is well attested. Approximately 10 modes of psychosocial intervention have been recommended based on existing evidence, including family intervention, cognitive behavioral therapy, supported employment, early intervention services, lifestyle intervention for physical health enhancement, treatment of comorbid substance abuse, assertive community treatment, cognitive remediation, social skills training, and peer support. Ideally, these interventions are offered to patients in combination with one another. Over the last decade, increased emphasis has been placed on early detection and intervention, with particular focus on long-term recovery. Early intervention with comprehensive psychosocial interventions should be enacted promptly from the initial detection of schizophrenia.
Cognitive Therapy ; Community Mental Health Services ; Early Intervention (Education) ; Employment, Supported ; Humans ; Life Style ; Methods ; Quality of Life ; Rehabilitation ; Schizophrenia* ; Social Skills ; Substance-Related Disorders

Frailty is a distinct clinical syndrome wherein the individual has low reserves and is highly vulnerable to internal and external stressors. Although it is associated with disability and multiple comorbidities, it can also be present in individuals who seem healthy. Frailty is multidimensional and its pathophysiology is complex. Early identification and intervention can potentially decrease or reverse frailty, especially in the early stages. Primary care physicians, community nurses and community social networks have important roles in the identification of pre-frail and frail elderly through the use of simple frailty screening tools and rapid geriatric assessments. Appropriate interventions that can be initiated in a primary care setting include a targeted medical review for reversible medical causes of frailty, medication appropriateness, nutritional advice and exercise prescription. With ongoing training and education, the multidisciplinary engagement and coordination of care of the elderly in the community can help to build resilience and combat frailty in our rapidly ageing society.
Aged ; Aging ; Community Health Services ; Frail Elderly ; Frailty ; Geriatric Assessment ; methods ; Geriatrics ; methods ; Humans ; Nurses ; Nursing ; Primary Health Care ; methods ; Social Support

OBJECTIVES: This article reviews an evaluation vector model driven from a participatory action research leveraging a collective inquiry system named SMILE (Stanford Mobile Inquiry-based Learning Environment). METHODS: SMILE has been implemented in a diverse set of collective inquiry generation and analysis scenarios including community health care-specific professional development sessions and community-based participatory action research projects. In each scenario, participants are given opportunities to construct inquiries around physical and emotional health-related phenomena in their own community. RESULTS: Participants formulated inquiries as well as potential clinical treatments and hypothetical scenarios to address health concerns or clarify misunderstandings or misdiagnoses often found in their community practices. From medical universities to rural village health promotion organizations, all participatory inquiries and potential solutions can be collected and analyzed. The inquiry and solution sets represent an evaluation vector which helps educators better understand community health issues at a much deeper level. CONCLUSIONS: SMILE helps collect problems that are most important and central to their community health concerns. The evaluation vector, consisting participatory and collective inquiries and potential solutions, helps the researchers assess the participants' level of understanding on issues around health concerns and practices while helping the community adequately formulate follow-up action plans. The method used in SMILE requires much further enhancement with machine learning and advanced data visualization.
Community-Based Participatory Research ; Diagnostic Errors ; Follow-Up Studies ; Health Promotion ; Health Services Research* ; Learning* ; Machine Learning ; Methods ; Public Health ; Public Health Informatics ; Social Learning ; Telemedicine

OBJECTIVETo study the efficacy of community management model of bronchial asthma in children.

METHODThrough community outreach and clinic, 120 cases of children with asthma were enrolled from the 11 000 children aged 0 to 14 in Zhanlanlu area, and a community management model of asthma was established according to the Global Initiative for Asthma requirements combined with the actual situation of the community, both physicians and patients participated in case identification, file creation, and long-term standardized management. Through repeated medical education, the telephone hotline and interactive network of asthma among physicians, children and parents, a physician-patient relationship was established. The data of standardized medication, scheduled re-visit to the hospital, frequency of asthma attacks, antibiotic use, medical expenses, the loss of parents work hours etc. before and after the implementation of community management model were analyzed and compared.

RESULTAfter implementation of community management model, the use of systemic corticosteroids (19.4%), oral medication (31.6%) was significantly lower than those before implementation (68.3% and 90.0%) (χ(2) = 51.9, 41.1, P < 0.01), use of inhaled corticosteroids (76.5%) and oral leukotriene receptor antagonist (79.6%) was significantly higher compared with control and before management level (10.0%), χ(2) = 106.0, P < 0.01. The days of attacks of asthma (4.6 ± 2.3), the use of antibiotics (16.2 ± 6.1), (5.7 ± 2.9) and the cost of treatment significantly decreased. In 16 cases (13.3%) two-way referral was applied. In this study, the dropout rate was 18.3%, by telephone and network supervision of lost cases, re-education, made some children return to management, eventually the dropout rate was 9.2%.

CONCLUSIONEnrollment of children with bronchial asthma into community management model made the children adhere to the management regularly and a standardized management was achieved.

Adolescent ; Adrenal Cortex Hormones ; administration & dosage ; therapeutic use ; Anti-Asthmatic Agents ; administration & dosage ; therapeutic use ; Asthma ; drug therapy ; therapy ; Child ; Child Health Services ; methods ; organization & administration ; Child, Preschool ; Community Health Services ; methods ; organization & administration ; Community Networks ; Disease Management ; Drug Administration Schedule ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Patient Compliance ; Patient Education as Topic ; organization & administration ; Self Care

BACKGROUNDThe community medical center is the first barrier for lipid control. We aimed to survey the residents' cholesterol condition in the community, and pursue the reasons for the upsetting results from various aspects.

METHODSResidents and physicians were recruited from four community centers. Residents completed questionnaires and a physical examination as well as biochemical analysis. Physicians were also asked to complete a questionnaire, some of which were about basic knowledge of lipids.

RESULTSAbout 37.0% male and 48.1% female had elevated cholesterol levels. Residents' blood pressure (BP), fasting glucose (FG), body mass index (BMI), and waist circumference (WC) were positively associated with their low-density lipoprotein cholesterol (LDL-C) and total cholesterol (TC). Framingham risk scoring (FRS) was strongly related to cholesterol (P < 0.001 for LDL-C and TC). Residents' higher education grade was positively related to a normal cholesterol condition (P < 0.001), while personal income was negatively related to it. Rural residents had higher percent of population with normal cholesterol level (normal cholesterol rate) than their city counterpart (P < 0.001). Although physicians with college education had a much higher lipid knowledge level themselves, the physicians' factors had almost no relationship with the residents' cholesterol levels.

CONCLUSIONSManagement of hypercholesterolemia should be an important component of health strategy in Beijing. Education is imperative for residents as well as for physicians.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; China ; Cholesterol ; blood ; Community Health Services ; Educational Status ; Female ; Humans ; Hypercholesterolemia ; prevention & control ; Male ; Middle Aged ; Patient Education as Topic ; methods ; Physicians ; Surveys and Questionnaires

This article describes a design of physiological signal storage format and transfer protocol for the tele-medical system between home and community. The protocol is based on ASCII character, with frames as its basic structure. There are two kinds of frames: control frames and data frames. Control frames can start and stop data transfer, confirm the order, and ask for start. There are seven kinds of data frames, according to the different data types. Data is transferred in data frames. The protocol described in this article is simple and extensible. The design target has been accomplished in real system.
Community Health Services ; methods ; Medical Informatics Applications ; Software Design ; Telemedicine ; instrumentation ; methods

Background: HIV/AIDS pandemic really become danger to mankind on the earth. Objectives: Description epidemiological characteristics of HIV/AIDS patients. Studying clinical expression, learning aboutdemands of infected patients and community care for infected patients. Subjects and method: 71 HIV/AIDS people in Thua Thien Hue were studied in 2006. Using descriptive method to give epidemiological characteristics and behaviour of HIV/AIDS people. People were determined HIV/AIDS infection based on the criteria of Ministry of Health. The information were collected by target study. Results: HIV/AIDS people mainly from the age of 20 to 39 (83,10%), males were 52,10% and in various levels of education and all kinds of occupation. The rate of sexually transmitted infection was 84,5% and infection transmission was 15,5%. The rate of sexually transmitted infection within the last 12 months was 57,7%. 63,4% of infected people used condom while having sex with their spouses or partners. 1,4% of infected people using drug infection within the last month. 38% of the infected people had manifestations of AIDS, 77,8% of HIV/AIDS were treated with antiviral drugs. Families and communities had positive attitudes and behaviors to the HIV/AIDS people. Infected people being remoted from the society was 12,7%, 88,7% of them receiving supports from their communities such as disease treatment, spirit and material supports and job opportunities. Conclusion: Strengthen communication activities to change behavior of HIV/AIDS people and in communitiy to reduce alienation, discrimination for infected people. Execute socialization in care and support for HIV/AIDS people.
HIV/ immunology ; isolation & ; purification ; pathogenicity ; Community Health Services/ organization & ; administration ; Epidemiologic Methods ;

OBJECTIVETo explore factors associated with retention in a community-based methadone maintenance treatment (MMT) among heroin addicts in Xichang of Sichuan province.

METHODSAll 206 heroin addicts were first admitted to MMT community-based program between March to September 2004. Baseline data of patients characteristics, social function, drug using behaviors, sexual behaviors, dose of methadone and retention were collected.

RESULTSUp to Oct, 2005, all 206 patients contributed 8.98 +/- 5.74 person-months of following-up. The retention rates were 58.7% after 6 months and 34.6% after 12 months respectively. Cox proportional hazard regression model indicated that the employed (HR, 0.60; 95% CI, 0.39 - 0.92), helping family to do housework in past 30 days more than once a day (HR, 0.59; 95% CI, 0.42 - 0.82) and previous self-detoxification > or = 3 times (HR, 0.65; 95% CI, 0.47 - 0.91) were independently associated with retention.

CONCLUSIONWe should give individual counseling to help heroin addicts increasing compliance.

Adult ; Cohort Studies ; Community Health Services ; methods ; Female ; Heroin Dependence ; epidemiology ; rehabilitation ; Humans ; Male ; Methadone ; therapeutic use ; Middle Aged ; Prospective Studies ; Regression Analysis ; Treatment Outcome

INTRODUCTIONAssertive Community Treatment (ACT) provides community-based treatment to patients with severe and persistent psychiatric illnesses, so that they may continue to live and function in the community as they receive psychiatric care. This study aimed to examine the effects of ACT on the outcome of patients over a 1-year period in an Asian population.

MATERIALS AND METHODSThis naturalistic and retrospective cohort study examined the effects of ACT on 100 patients who had completed 1 year of ACT. Parameters used to measure primary outcome were i) number of admissions (NOA) and ii) total length of stay (LOS) in days. Secondary outcome compared the employment status of patients before and after ACT. Paired sample analyses were performed using SPSS.

RESULTS AND DISCUSSIONThe mean reduction in NOA 1 year post-ACT was 57.1%. The mean reduction in LOS 1 year post-ACT was 61.9%. The median reduction for NOA and LOS were both statistically significant (P <0.01). Thirty-seven patients were employed compared to 6 before the programme, a statistically significant effect on employment (odds ratio 9.69, P <0.01).

CONCLUSIONSACT appears effective in reducing the frequency and duration of admissions for patients in Singapore. The employment status of patients also showed improvement over the course of study.

Adult ; Cohort Studies ; Community Mental Health Services ; methods ; standards ; Community Psychiatry ; standards ; Female ; Follow-Up Studies ; Humans ; Male ; Mental Disorders ; therapy ; Middle Aged ; Outcome Assessment (Health Care) ; methods ; Retrospective Studies ; Severity of Illness Index ; Singapore ; Social Adjustment