Evaluating a Community-Placed and Clinically Integrated Community Health Worker Program

Community health worker (CHW) programs can act as bridges between patients and health care teams, but the complexity and variability of program components and outcomes make them difficult to evaluate. This evaluation used a realist approach to identify underlying mechanisms and contextual factors associated with successful implementation of a community-placed CHW program affiliated with a primary care practice in the Midwest United States. The analysis identified mechanisms by which stakeholders built trust, self-efficacy, and empowerment to improve patient-centered outcomes and experiences.

Will Disruptive Innovation in Health Care Improve the Health of Populations?

Health care in the United States is long overdue for an upheaval. The mismatch between costs, by far the highest in the world, and health outcomes, among the worst in the high-income world, has long been glaring. Perhaps the good news is that the time for such an upheaval has come. At least 4 forces have been gathering steam, each promising to change the nature of health care and, in so doing, influence population health.

Designing a framework for primary health care research in Canada: a scoping literature review

Despite significant investments to improve primary health care (PHC) delivery in Canada, provincial health care systems remain fragmented and uncoordinated. Canada’s commitment to strengthening PHC should be driven by robust research and evaluation that reflects our health policy priorities and responds to the needs of the population. One challenge facing health services researchers is developing and sustaining meaningful research priorities and agendas in an overburdened, complex health care system with limited capacity for PHC research and support for clinician researchers.

Strategy for revitalization of the primary health care in Cuba

Despite the existence of an integrated model of health systems and services, the research conducted in the areas of management, support, health services and finances show some phenomena that weaken the capacity of responding to the population's health requirements, particularly the first care level. The range of possibilities offered by the transforming process in the health sector encourages putting forward a revitalizing strategy centered on the capacity and need of innovating and further developing the Cuban primary health care strategy. The bases supporting the proposal, the objectives and the strategic areas of development were presented, with the focus on ...

Measuring procedure for the resolute capability of basic health care teams

Introduction: the resolute capability is a quality to be taken into account to improve the performance of the integrated service networks.
Objective: to design a methodological procedure to evaluate the resolute capability of the basic health teams at the primary health care.
Methods: developmental research study of health systems and services conducted from December 2012 through February 2013. An expert working group was created in the National School of Public Health. A literature and documentary review using Big 6 model was made. Some scales were set to analyze the results to be achieved in addition to the preparation of a ...

Operationalizing mHealth to improve patient care: a qualitative implementation science evaluation of the WelTel texting intervention in Canada and Kenya

Mobile health (mHealth) applications have proliferated across the  globe with much enthusiasm, although few have reached scale and shown public health impact. In this study, they explored how different contextual factors influenced the implementation, effectiveness and potential for scale-up of welTel, an easy-to-use and evidence-based mHealth intervention. WelTel uses two-way SMS communication to improve patient adherence to medication and engagement in care, and has been developed and tested in Canada and Kenya. 

Derivation and validation of the Personal Support Algorithm: an evidence-based framework to inform allocation of personal support services in home and community care

Personal support services enable many individuals to stay in their homes, but there are no standard ways to classify need for functional support in home and community care settings. The goal of this proyect was to develop and evidence-based clinical tool to inform service planning while allowing for flexibility in care coordinator judgment in response to patient and family circumstances. 

Community Care for People with Complex Care Needs: Bridging the Gap between Health and Social Care

Introduction: A growing number of people are living with complex care needs characterized by multimorbidity, mental health challenges and social deprivation. Required is the integration of health and social care, beyond traditional health care services to address social determinants. This study investigates key care components to support complex patients and their families in the community.

Methods: Expert panel focus groups with 24 care providers, working in health and social care sectors across Toronto, Ontario, Canada were conducted. Patient vignettes illustrating significant health and social care needs were presented to participants. The vignettes prompted discussions on i) how best to meet ...

Using Information Communication Technology in Models of Integrated Community-Based Primary Health Care: Exploring ICT in the iCOACH Study

Information and communication technology (ICT) is a promising enabler to support delivery of integrated care by inter-disciplinary teams by supporting information sharing across professional and  organizational boundaries; arguably a crucial aspect of successful models of integrated care

Global collaborative healthcare: assessing the resource requirements at a leading Academic Medical Center

Academic Medical Centers ("AMCs") have served as a hub of the United States ("US") health system and represented the state-of-the art in American health care for well over century. Currently, the AMCs have engaged in global collaborative healthcare, employing different models based on services offered, global distribution, and inclination to assume risk. Engaging in these collaborations requires significant effort from across the health system, and an understanding of the resources required is paramount for effective delivery and to avoid overextension and diversion from the primary mission of these organizations.