Actualizing a Provider Alliance to Expand Health Services Access to a Low-Income Urban Community

Abstract

Social change to facilitate health care access for vulnerable populations sometimes involves model-driven innovative structures and innovative planning and implementation approaches. This paper described and analyzed the rationale, conceptual framework, program components, and implementation of the South Central Health Care Alliance (SCHCA) implemented in South Los Angeles from January 2002 to December 2004. The program development and implementation was guided by an integrated framework linking the Open Systems Theory, the Social Cognitive Theory, the Health Belief Model, and the Preventive Health Education and Medical Home Project. The performance of the SCHCA as a social system, partnership, and participatory implementation program is also presented. While the SCHCA was found to be a dynamic social system that responded well to contingencies, its performance as a partnership and participatory implementation program was wanting in many respects.

Economic Strain Deteriorates While Education Fails to Protect Black Older Adults Against Depressive Symptoms, Pain, Self-rated Health, Chronic Disease, and Sick Days

“…What education can do in economically constrained urban areas is very limited [185][186][187][188][189][190][191] . In such a context, a lack of liquid assets (i.e., cash) becomes very detrimental.…”

Developing community partnerships for primary healthcare: An integrative review on management challenges

“…We encountered this in thirty-five articles. The lack of or fragile connection between the partnership and the actual community [10][11][12][13][14][15][16][17][18] as well as the absence of participation by the community [10,19,20] were highlighted. Factors relating to the actual participants from the community were also found to hinder the development of the partnership [21].…”

“…It should have a sense of community and all of its actions should have the community as a base or focus. In turn, the partnership must also be accepted by the community itself [10,15,18,19,21,23,24,27,33,[35][36][37][38][39][40][41][42][43][44].…”

“…A history of partnerships with conflict [14,17,22,25,54], conflicting regulations [13] limited collaboration [25], little or no experience of joint working [33,53,55], or where partners are being ignored are detrimental to any partnership. In addition to these aspects, differing agendas between partners, lack of involvement and collaboration, and poor inter-professional partnerships appeared in eighteen articles [10,11,13,14,38,46,49,52,[55][56][57][58][59]. Feelings of competitiveness or perceived competition, tension, competing priorities amongst the partners [13][14][15]17,23,25,39,51,53,58] and lack of trust/confidence [11,[13][14][15]19,37,44,52,60] appeared as barriers to the development process.…”

“…Feelings of competitiveness or perceived competition, tension, competing priorities amongst the partners [13][14][15]17,23,25,39,51,53,58] and lack of trust/confidence [11,[13][14][15]19,37,44,52,60] appeared as barriers to the development process. Furthermore, absence of flexibility [19,33,39,61] and resistance to change on the part of the leaders, team members and the organization [12,15,22,26,52,54,58,62] were seen as hindrances, as was the lack of clarity and understanding about the roles [10,15,22,33,39,47,55,58,62] within the partnership. As noted above, a good understanding of the roles is fundamental in a partnership.…”