Community ownership and program continuation following a health demonstration project

Bracht, Neil F.; Finnegan, John R.; Rissel, Chris; Weisbrod, Rita R.; Gleason, Julie E.; Corbett, Julia B.; Veblen-Mortenson, Sara

doi:10.1093/her/9.2.243

Cited by 126 publications

(69 citation statements)

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“…It has been argued that the 'incorporation' (Bracht et al, 1994) or 'integration' (Bossert, 1990) of evidence-based practice requires that it be 'institutionalised' (Steckler & Goodman, 1989), or 'routinised' within general health care (Shedic-Rizkallah & Bone, 1998). Such routinisation arguably rests on capacity building at a number of levels, from individual staff members, to teams, organisations, links between organisations, and to the community itself (Hawe et al, 1998).…”

Section: Discussionmentioning

confidence: 99%

Investigating the sustainability of outcomes in a chronic disease treatment programme

Bailie

Robinson

Kondalsamy‐Chennakesavan

et al. 2006

Social Science & Medicine

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This study examines trends in chronic disease outcomes from initiation of a specialised chronic disease treatment programme through to incorporation of programme activities into routine service delivery. We reviewed clinical records of 98 participants with confirmed renal disease or hypertension in a remote indigenous community health centre in Northern Australia. For each participant the review period spanned an initial three years while participating in a specialised cardiovascular and renal disease treatment programme and a subsequent three years following withdrawal of the treatment programme. Responsibility for care was incorporated into the comprehensive primary care service which had been recently redeveloped to implement best practice care plans. The time series analysis included at least six measures prior to handover of the specialised programme and six following handover. Main outcome measures were trends in blood pressure (BP) control, and systolic and diastolic BP. We found an improvement in BP control in the first 6-12 months of the programme, followed by a steady declining trend. There was no significant difference in this trend between the pre-compared to the post-programme withdrawal period. This finding was consistent for control at levels below 130/80 and 140/90, and for trends in mean systolic and diastolic BP. Investigation of the sustainability of programme outcomes presents major challenges for research design. Sustained success in the management of chronic disease through primary care services requires better understanding of the causal mechanisms related to clinical intervention, the basis upon which they can be 'institutionalised' in a given context, and the extent to which they require regular revitalisation to maintain their effect.

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Section: Discussionmentioning

confidence: 99%

Investigating the sustainability of outcomes in a chronic disease treatment programme

Bailie

Robinson

Kondalsamy‐Chennakesavan

et al. 2006

Social Science & Medicine

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“…2 Other identifi ed factors, however, address interaction between the programme and key stakeholders (eg, tailoring an intervention to an issue, the context, and the providers, showing achievement of goals), or planning for evolution of these interactions over time (eg, integrating a programme into established structures, strengthening institutions, and ensuring adaptability). These dynamic • Maintenance of health benefi ts [6][7][8] • Continuation of health programmes [9][10][11][12][13][14] • Institutionalisation of programmes within organisational systems 6,7,15 • Community capacity 6,9,13,16,17 • Multidimensional:…”

Section: Empirical Assessments Of Health-programme Sustainabilitymentioning

confidence: 99%

Sustainability science: an integrated approach for health-programme planning

Gruen

Elliott

Nolan³

et al. 2008

The Lancet

327

341

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Planning for programme sustainability is a key contributor to health and development, especially in low-income and middle-income countries. A consensus evidence-based operational framework would facilitate policy and research advances in understanding, measuring, and improving programme sustainability. We did a systematic review of both conceptual frameworks and empirical studies about health-programme sustainability. On the basis of the review, we propose that sustainable health programmes are regarded as complex systems that encompass programmes, health problems targeted by programmes, and programmes' drivers or key stakeholders, all of which interact dynamically within any given context. We show the usefulness of this approach with case studies drawn from the authors' experience.

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“…[34][35][36][37][38] Sustainability depends on numerous factors that impact the formation and maintenance of CBPR partnerships for which a considerable literature exists. [14][15][16]18,19,21,22,[25][26][27][28][29] However, there is little agreement on how to define and conceptualize sustainability.…”

Section: Overview Of Sustainabilitymentioning

confidence: 99%

Challenges and Facilitating Factors in Sustaining Community-Based Participatory Research Partnerships: Lessons Learned from the Detroit, New York City and Seattle Urban Research Centers

et al. 2006

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In order to address the social, physical and economic determinants of urban health, researchers, public health practitioners, and community members have turned to more comprehensive and participatory approaches to research and interventions. One such approach, community-based participatory research (CBPR) in public health, has received considerable attention over the past decade, and numerous publications have described theoretical underpinnings, values, principles and practice. Issues related to the long-term sustainability of partnerships and activities have received limited attention. The purpose of this article is to examine the experiences and lessons learned from three Urban Research Centers (URCs) in Detroit, New York City, and Seattle, which were initially established in 1995 with core support from the Centers for Disease Control and Prevention (CDC). The experience of these Centers after core funding ceased in 2003 provides a case study to identify the challenges and facilitating factors for sustaining partnerships. We examine three broad dimensions of CBPR partnerships that we consider important for sustainability: (1) sustaining relationships and commitments among the partners involved; (2) sustaining the knowledge, capacity and values generated from the partnership; and (3) sustaining funding, staff, programs, policy changes and the partnership itself. We discuss the challenges faced by the URCs in sustaining these dimensions and the strategies used to overcome these challenges. Based on these experiences, we offer recommendations for: strategies that partnerships may find useful in sustaining their CBPR efforts; ways in which a Center mechanism can be useful for promoting sustainability; and considerations for funders of CBPR to increase sustainability.Israel, Lichtenstein, and McGranaghan are with the

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Community ownership and program continuation following a health demonstration project

Cited by 126 publications

References 0 publications

Investigating the sustainability of outcomes in a chronic disease treatment programme

Investigating the sustainability of outcomes in a chronic disease treatment programme

Sustainability science: an integrated approach for health-programme planning

Challenges and Facilitating Factors in Sustaining Community-Based Participatory Research Partnerships: Lessons Learned from the Detroit, New York City and Seattle Urban Research Centers

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