934 resultados para Challenges for Community Participation


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Background: Methodological challenges such as recruitment problems and participant burden make clinical trials in palliative care difficult. In 2001-2004, two community-based randomized controlled trials (RCTs) of case conferences in palliative care settings were independently conducted in Australia-the Queensland Case Conferences trial (QCC) and the Palliative Care Trial (PCT). Design: A structured comparative study of the QCC and PCT was conducted, organized by known practical and organizational barriers to clinical trials in palliative care. Results: Differences in funding dictated study designs and recruitment success; PCT had 6 times the budget of QCC. Sample size attainment. Only PCT achieved the sample size goal. QCC focused on reducing attrition through gatekeeping while PCT maximized participation through detailed recruitment strategies and planned for significant attrition. Testing sustainable interventions. QCC achieved a higher percentage of planned case conferences; the QCC strategy required minimal extra work for clinicians while PCT superimposed conferences on normal work schedules. Minimizing participant burden. Differing strategies of data collection were implemented to reduce participant burden. QCC had short survey instruments. PCT incorporated all data collection into normal clinical nursing encounters. Other. Both studies had acceptable withdrawal rates. Intention-to-treat analyses are planned. Both studies included substudies to validate new outcome measures. Conclusions: Health service interventions in palliative care can be studied using RCTs. Detailed comparative information of strategies, successes and challenges can inform the design of future trials. Key lessons include adequate funding, recruitment focus, sustainable interventions, and mechanisms to minimize participant burden.

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New communication technologies (websites and email) are believed to hold promise for delivering population health interventions. However, studies on internet-delivered physical activity (PA) programs have encountered difficulties in engaging and retaining participants. Recent PA research has focused on peoples’ perceptions of the local environment and how this relates to PA participation. This study investigated the potential of: 1) reaching people living in a regional community via a locally-based Internet Service Provider (ISP), and 2) using data on the local environment to design a PA intervention relevant to the individual. An online survey was conducted via the ISP’s website over 12 days. ISP clients (approximately 9,000) were invited to participate in the survey via electronic newsletter and direct email. Data on motivational readiness and environmental correlates of PA were collected. 820 surveys were completed, of which 797 were valid (response rate = 9%). Participants had a mean BMI 27.6±8.3, were 55% male, 56% aged >45 years, 57% worked fulltime, and 36% were in the early stages of motivational readiness for PA. Most reported positive perceptions of the local environment in terms of aesthetics, convenience, access, traffic and safety. However, over half did not know about or use local PA facilities. Over 70% were somewhat to extremely interested in having access to a PA promotion website. These data suggest that promoting PA via a locally based ISP is feasible and appealing to some people living in a regional community, but also highlight some of the challenges of using this technology to deliver population health interventions.

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This dissertation identifies, examines, and assesses the relative influence of identified empirically and conceptually relevant variables on incarcerated substance abusers' expectations of postrelease adjustment. A purposive sampling procedure was used to recruit 101 male and female substance-abusing offenders participating in prison- and jail-based drug treatment programs in south Florida. A 92-item survey questionnaire was used to collect basic demographic data; measure inmate preincarceration characteristics, social support, and rehabilitation program participation; and record archival data. Regression equations were developed utilizing ten different measures of the participants' expectations of their postrelease adjustment. Two equations yielded statistically significant F ratios; maintaining a stable living and maintaining abstinence. Twenty-two percent of the variance in respondents' expectations of maintaining a stable living was explained by preincarceration characteristics, social support, and rehabilitation program participation (F = 1.89; df = 13,87; p $<$.05). The only significant predictor variable was perception of social support (b = $-$.05; t = $-$3.6; p $<$.001). Twenty-three percent of the variance in respondents' expectations of maintaining abstinence from substances was explained by preincarceration characteristics, social support, and rehabilitation program participation (F = 2; df = 13,87; p $<$.05). Once again, the only significant predictor variable was perception of social support. The results of the analyses indicate that social support was the only important variable for understanding these respondents' efficacy expectations of postrelease abstinence and stable living. The results of this investigation demonstrate the complexity of the social support variable for prisoners, and identify social support as a potential rehabilitative resource for substance-abusing inmates. The results of this investigation underscore the importance of continued, detailed empirical study in order to understand and clarify how social support, efficacy expectations, and actual postrelease performance interrelate for this population of offenders.

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The purpose of this study was to develop a series of workshops designed to raise the environmental literacy of a community college faculty and facilitate infusion of an environmental perspective into the courses they teach. Data was gathered on the effect of the workshops on the level of environmental literacy of the participants as well as the persistence of any observed effect. How faculty infused an environmental perspective into their courses was also explored.^ The workshop model was developed by reviewing adult learning and change theories, case studies of workshops at other colleges, environmental education research, and results of a pilot study. Content, organization, and delivery methods from these sources were selected and integrated to create the 14 components of the model employed by the workshops in this study.^ Forty-two faculty from the North Campus of Broward Community College participated in the study. The 20 workshop participants from seven academic departments attended seven two hour workshops during the fall term of 1996, and implemented projects to infuse environmental topics into their courses the following term. A quasi-experimental pretest-posttest-delayed posttest nonequivalent control group design was employed in which the 22 members of the control group who did not attend the workshops were administered the Wisconsin Environmental Survey at the same time as the workshop participants (immediately before the first workshop, immediately following the last workshop, and four months following the completion of the workshop series). This instrument, an adaption of the Wisconsin High School Student Environmental Survey, yielded three measures of environmental literacy: Affective, Behavior, and Cognitive Subscale scores.^ The repeated measures MANOVA performed using the scores of the two groups on the three administrations of WES revealed a significant interaction for group by time, so repeated measures ANOVA were performed for each of the three subscales to investigate the interaction. Tukey-HSD post hoc comparisons indicated that for all three subscale scores, the two groups were not significantly different on the pretest, but on the posttest and the delayed posttest, the workshop participants demonstrated significantly higher levels of environmental literacy. All statistical tests were performed at $\alpha$ =.05. ^

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This mixed method case study explored the capacity challenges of neighbourhood based community centres related to the areas of governance and leadership, program delivery, financial management and human resources. The study involved the examination of three community centres with multi-mandates (i.e., provide programs and services to individuals from pre-school to seniors in the areas of social, educational, recreational and health) and utilized three phases of data collection: 1) surveys with board members; 2) focus groups with all boards and staff; and 3) document review which examined pertinent organizational policies and procedures. Questions were aimed at gaining an understanding of some of the challenges faced by staff and administrators of neighbourhood based community centres, as there a gap in the research in this particular area. Research findings identified a number of related challenges facing non-profit organizations specifically in the areas of funding and staffing and how these challenges impact both day to day operations and longer term sustainability. More research is needed with nonprofit organizations that have these broader mandates and diverse operational challenges, hence greater capacity building challenges.

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Practice-oriented film education aimed at children has been hailed for various reasons: at a personal level, as a means of providing tools for self-expression, for developing creativity and communication skills. And at a social level, it is argued that children must now become competent producers, in addition to critical consumers, of audiovisual content so they can take part in the global public sphere that is arguably emerging. This chapter discusses how the challenges posed by introducing children to filmmaking (i.e. digital video) are being met at three civil associations in Mexico: La Matatena AC, which seeks to enrich the children’s lives by means of the aesthetic experience filmmaking can bring them. Comunicaciòn Comunitaria, concerned with the impact filmmaking can have on the community, preserving cultural memory and enabling participation. And Juguemos a Grabar, with a focus on urban regeneration through the cultural industries.

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The tropical afro-montane forest of the Northwest region is unique and under direct threat from the high population density of the region. Community-based forestry management is an opportunity to sustainably manage the remaining forest fragments. Community forestry was introduced to Cameroon with the legislation of the 1994 Forestry Law. Over two decades later little research has been conducted in the Northwest region of Cameroon. Twenty-four semi-structured interviews were conducted, and samples of forestry records were analyzed as exploratory research that would act as a base for further research. This research found that the tenure of the community over the community forest needed to be strengthened, marginalized populations needed to be empowered to participate, and governance needed to be improved both nationally, and locally. Further research will strengthen these conclusions and help Cameroon, and community forests around the world, be effectively established and managed.

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Suicide is a serious international health problem and is more likely to occur in vulnerable populations such as offenders. There is an abundance of research into suicides of prisoners, but few studies have been carried out on suicides of offenders serving community sentences. This article identifies and evaluates the limited research that is available. Recommendations for future research are made, including how in-depth interviews can provide important information about near lethal incidents from the service users’ perspective, and how international comparisons could be helpful in understanding this problem further.