'Your Heart Can't Wait'---A worksite program: Increasing the effectiveness of worksite coordinators to implement a community-wide health education program

A worksite health education program called “Your Heart Can't Wait,” was designed by the American Heart Association Gulf Coast Area (AHA). The objectives were to educate individuals about the signs and symptoms of heart attacks and the actions they should take to improve heart attack victims' chances for survival. AHA volunteers agreed to serve as mentors for this program. ^ A study was designed to determine if worksite coordinators who had the assistance of experienced AHA volunteers had higher rates of program adoption and implementation than worksite coordinators without assistance. Ninety-seven companies participated in the study. Twelve AHA volunteers were randomly assigned to work with forty-three of the worksite coordinators. Mentor/mentee contact forms were used to assess the mentoring process during the course of the study. Program adoption forms were used to measure rates of program adoption and follow-up questionnaires were used to measure rates of program implementation after the study was completed. The twelve mentors were interviewed to provide information for improving future mentoring efforts. ^ Thirty-eight companies completed program adoption forms and fifty-one companies reported using YHCW program components. For the most part, the volunteer mentors did not spend a significant amount of time contacting or working with their assigned worksite coordinators. As a result, the planned analysis comparing the implemented programs between worksite coordinators with and without assistance could not be completed. ^ Additional analyses were performed comparing the implemented programs based upon whether the companies had existing health education/health promotion programs and whether the worksite coordinators had experience using AHA Heart At Work program components. ^ Recommendations based on the mentor interviews were made to improve the success of volunteer assistance programs in the future. ^

An evaluation of the impact of Inner City Development's Cooperative Home School: An educational alternative program to increase the quality and level of education in San Antonio's West Side community

The research study was intended to evaluate the effectiveness of Inner City Development's (I.C.D.) Cooperative Home School, an educational alternative program to the Title I public schools of San Antonio's West Side community. The study investigated students', parents' and tutors' perception of parental involvement and educational resources. The study also investigated each student's academic achievement. ^ The study found that students progressed toward expected math proficiency at a faster rate than they did in reading proficiency. However, because the target population size was small and a comparison group was not used, the results of this study are only suggestive. This research also indicated that study subjects believed students' quality and level of education increased substantially since program exposure. Study subjects mainly attributed the students' strides in academic performance to the increased amount of individualized attention students received in the small twelve-student class size. Study subjects were more satisfied with the home school's educational resources than those of the Title I public schools. Study subjects also perceived that parental involvement both at home and at school increased since enrollment in the home school program because: (1) there were more opportunities for involvement in the home school; and (2) parents felt closer to the tutors than the teachers in public school. ^ This evaluation also suggested improvements to program operations. With the help of additional volunteers, I.C.D. program operators could improve collection and organization of academic records. Furthermore, as suggested by program participants, science could be added to the curriculum. Lastly, a formal tutor orientation could be implemented to familiarize and train tutors on classroom management procedures. ^

Health education intervention to reduce risk of infectious disease transmission among community health workers and their clients

Indigent and congregate-living populations have high susceptibilities for disease and pose a higher risk for disease transmission to family, friends and to persons providing services to these populations. The adoption of basic infection control, personal hygiene, safe food handling and simple engineering practices will reduce the risk of infectious disease transmission to, from and among indigent and congregate-living populations. ^ The provision of social services, health promotion activities and other support services to indigent and congregate-living populations is an important aspect of many public health-related governmental, community-based and other medical care provider agencies. ^ In the interest of protecting the health of indigent and congregate-living populations, of personnel from organizations providing services to these populations and of the general community, an educational intervention is warranted to prevent the spread of blood-borne, air-borne, food-borne and close contact-borne infectious diseases. ^ An educational presentation was provided to staff from a community-based organization specializing in providing housing, health education, foodstuffs and meals and support services to disabled, low-income, homeless and HIV-infected individuals. The educational presentation delivered general best practices and standard guidelines. A pre and post test were administered to determine and measure knowledge pertinent to controlling the spread of infectious diseases between and among homeless shelter-living clients and between clients and the organization's staff. ^ Comparing pre-test and post-test results revealed areas of knowledge currently held by staff and other areas that staff would benefit from additional educational seminars and training. ^

Better together: Addressing maternal and child health outcomes through community health worker continuing education curricula

Background. The incidence of birth defects is a significant public health issue in the United States, adversely affecting the quality of life for parents as well as children born with these defects. Minority populations face a greater burden of birth defects and associated health problems. Prenatal practices can have a large impact on infant health outcomes. Several behaviors during pregnancy, including the intake of folic acid, can greatly influence the likelihood of a child being born with a birth defect. Community Health Workers have been shown to be effective agents at improving prenatal practices, especially when they facilitate support groups that feature pregnant women. ^ Methods. A continuing education curriculum has been created for Community Health Workers that provides content in the area of Maternal and Child Health. Content was selected after conducting a review of relevant literature and theory. Materials for conducting a training for Community Health Workers have been created in addition to materials that were designed for the population with whom the CHWs work. ^ Results. A description of each "key point" of the curriculum and a justification how it relates to the literature of the prevention of birth defects is given here. Additionally, the process of creating the curriculum using the platform delineated in the methods is described. ^ Discussion. Insights for future curriculum development are discussed along with next steps in the process of certifying the curriculum at the state level. A framework for future evaluation of the curriculum is given.^

Sudden Infant Death disparities: A systematic review on health education and policy recommendations for decreasing Sudden Infant Death in the African-American community

Objective: To perform a systematic review of the literature on SIDS and SUID deaths concentrated in the African-American community, describe health education and policy recommendations and recommend a new approach that may aid in decreasing the disparity of infant mortality in the African-American community. ^ Methods: The PubMed database was systematically searched to identify relevant articles for final review and analysis. Using the CASP 2006 system to critique literature, twelve articles were found that met inclusion and exclusion criteria. ^ Results: Evidence in the literature confirmed there was a current disparity among African Americans' infant mortality rates in comparison to other US ethnic groups. The underlying reasons for these disparities included the following maternal and infant characteristics: mothers younger than eighteen, having more than one live infant, having a high school education or less, never been married, and have infants born preterm or with low birth weight. Maternal smoking, substance abuse, and breastfeeding did not have a significant impact on infant sleep environments among African Americans. ^ Conclusion: Tailored health education programs at the community level, better access to pre-pregnancy and prenatal care, and increased maternal perception of risk that is relevant to the infants sleeping environment are all possible solutions that may decrease African American infant mortality rates.^

Health outcomes, quality improvement and cost-effectiveness of the Community Diabetes Education (CoDE) program: Results of a randomized controlled trial

The objectives of this dissertation were to evaluate health outcomes, quality improvement measures, and the long-term cost-effectiveness and impact on diabetes-related microvascular and macrovascular complications of a community health worker-led culturally tailored diabetes education and management intervention provided to uninsured Mexican Americans in an urban faith-based clinic. A prospective, randomized controlled repeated measures design was employed to compare the intervention effects between: (1) an intervention group (n=90) that participated in the Community Diabetes Education (CoDE) program along with usual medical care; and (2) a wait-listed comparison group (n=90) that received only usual medical care. Changes in hemoglobin A1c (HbA1c) and secondary outcomes (lipid status, blood pressure and body mass index) were assessed using linear mixed-models and an intention-to-treat approach. The CoDE group experienced greater reduction in HbA1c (-1.6%, p<.001) than the control group (-.9%, p<.001) over the 12 month study period. After adjusting for group-by-time interaction, antidiabetic medication use at baseline, changes made to the antidiabetic regime over the study period, duration of diabetes and baseline HbA1c, a statistically significant intervention effect on HbA1c (-.7%, p=.02) was observed for CoDE participants. Process and outcome quality measures were evaluated using multiple mixed-effects logistic regression models. Assessment of quality indicators revealed that the CoDE intervention group was significantly more likely to have received a dilated retinal examination than the control group, and 53% achieved a HbA1c below 7% compared with 38% of control group subjects. Long-term cost-effectiveness and impact on diabetes-related health outcomes were estimated through simulation modeling using the rigorously validated Archimedes Model. Over a 20 year time horizon, CoDE participants were forecasted to have less proliferative diabetic retinopathy, fewer foot ulcers, and reduced numbers of foot amputations than control group subjects who received usual medical care. An incremental cost-effectiveness ratio of $355 per quality-adjusted life-year gained was estimated for CoDE intervention participants over the same time period. The results from the three areas of program evaluation: impact on short-term health outcomes, quantification of improvement in quality of diabetes care, and projection of long-term cost-effectiveness and impact on diabetes-related health outcomes provide evidence that a community health worker can be a valuable resource to reduce diabetes disparities for uninsured Mexican Americans. This evidence supports formal integration of community health workers as members of the diabetes care team.^

From school to work : Muslim youths' education and employment strategies in a community in Uttar Pradesh, India

India's Muslim community, which accounts for 14.4 percent of India’s vast population and is thus the largest of all religious minorities, has been the subject of considerable development discourse as Muslims have the lowest level of educational attainment and standard of living among socio-religious groups in the country. This study addresses the meaning of education and career opportunities for Muslim youths in relation to their educational credentials and social position in the hierarchy of Muslim class and caste groups, with particular reference to a community in Uttar Pradesh. The author contends that the career opportunities, possibilities, and strategies of Muslim youths in Indian society depend on multiple factors: social hierarchy, opportunities to utilize economic resources, social networks, cultural capital, and the wider structural disparities within which the Muslims are situated and wherein they question the value of higher education in gaining them admission to socially recognized and established employment sectors.

Resilience through Adversity: A narrative case study of students' experiences of expulsion from school

Expulsion from school is life changing. This single event can alter the trajectory of a student's life--for better or for worse. How life changes is unique for each individual student. Risk and protective factors that impact an individual student's resilience determine the level of positive or negative outcomes experienced as a result of expulsion. Educators have the opportunity to take advantage of this disruption in students' education to improve the trajectory of students' lives. However, without thoughtful intervention from caring educators, this interruption in students' education may have an irreparable destructive impact on students' future. The purpose of this study was to understand the expulsion experience from the point of view of the student in order to represent this critical stakeholder group in future policy and program development, implementation, and decision-making. Students' narratives are a means for members of the educational community to access students' experiences and perceptions in order to understand the impact of expulsion on students' lives. Students' perspectives are presented through thick description in this narrative case study. The experience of these eight students is evidence that expulsion can change students' lives in a positive way. Knowing this, responsible educators must develop interventions for expelled students that channel the positive life-changing potential of this experience. Educators must develop interventions focused on bringing forth protective factors that are documented to increase resilience and to make students less susceptible to the risks inherent in removing them from school. Recommendations for educators and policy-makers are presented to assist educators in preventing expulsion and improving educational and socio-emotional outcomes for expelled students.

Towards the Consideration of the U.S. Community College Model to Address the Need for Higher Education Reforms in Ghana

ABSTRACT The higher education systems throughout the continent of Africa are undergoing unprecedented challenges and are considered in crisis. African countries, including Ghana, all have in common ties to their colonial legacy whereby they are confronted with weak policies put in place by their colonizers. Having gained their independence, Africans should now take responsibility for the task of reforming their higher education system. To date, nothing substantial has been accomplished, with serious implications for weakening and damaging the structures of the foundation of their educational systems. This qualitative, single case study utilized a postcolonial theory-critical pedagogy framework, providing guidance for coming to grips with the mindset posed by Ghana's colonial heritage in the postcolonial era, especially in terms of its damaging effects on Ghana's higher education system. The study explores alternative pathways for secondary school students to transition to tertiary education--a problematic transition that currently hinders open access to all and equality in educational opportunity, resulting in a tremendous pool of discontinued students. This transitional problem is directly related to Ghana's crisis in higher education with far reaching consequences. The alternative pathway considered in this study is an adaptation of the U.S. community college model or an integration of its applicable aspects into the current structures of the higher education system already in place. In-depth interviews were conducted with 5 Ghanaian professors teaching at community colleges in the United States, 5 Ghanaian professors teaching at universities in Ghana, and 2 educational consultants from the Ghanaian Ministry of Education. Based on their perspectives of the current state of Ghanaian higher education, analyzed in terms of pedagogy, structure/infrastructure, and curriculum, the participants provided their perceptions of salient aspects of the U.S. community college model that would be applicable to Ghana's situation, along with other recommendations. Access to all, including equality of educational opportunity, was considered essential, followed by adaptability, affordability, practicality, and quality of curriculum content and delivery. Canada's successful adaptation of the U.S. model was also discussed. Findings can help guide consideration of alternative pathways to higher education in Ghana and Africa as a whole.