Disparate Views of Community in Primary Health Care: Understanding How Perceptions Influence Success

Wayland, Coral; Crowder, Jerome W.

doi:10.1525/maq.2002.16.2.230

Cited by 37 publications

(32 citation statements)

References 24 publications

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“…Yet, an organizational expertise in clinical care did not necessarily translate to optimal outreach [28,29]. The reluctance of one county hospital to adopt new outreach plans to increase access to mammography among uninsured women may have reflected downstream financial concerns with uninsured patients who may rely on the hospital for services other than for reimbursable breast cancer screening services [30,31].…”

Section: Discussionmentioning

confidence: 99%

County-level outcomes of a rural breast cancer screening outreach strategy: a decentralized hub-and-spoke model (BSPAN2)

Lee

Higashi

Inrig

et al. 2016

Behav. Med. Pract. Policy Res.

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Rural mammography screening remains suboptimal despite reimbursement programs for uninsured women. Networks linking non-clinical community organizations and clinical providers may overcome limited delivery infrastructure in rural areas. Little is known about how networks expand their service area. To evaluate a hub-andspoke model to expand mammography services to 17 rural counties by assessing county-level delivery and local stakeholder conduct of outreach activities. We conducted a mixed-method evaluation using EMR data, systematic site visits (73 interviews, 51 organizations), 92 patient surveys, and 30 patient interviews. A two-sample t test compared the weighted monthly average of women served between hub-and spoke-led counties; nonparametric trend test evaluated time trend over the study period; Pearson chi-square compared sociodemographic data between hub-and spoke-led counties. From 2013 to 2014, the program screened 4603 underinsured women. Counties where local Bspoke^organizations led outreach activities achieved comparable screening rates to hub-led counties (9.2 and 8.7, respectively, p = 0.984) and did not vary over time (p = 0.866). Qualitative analyses revealed influence of program champions, participant language preference, and stakeholders' concerns about uncompensated care. A program that leverages local organizations' ability to identify and reach rural underserved populations is a feasible approach for expanding preventive services delivery. KeywordsRural, Breast cancer, Healthdisparities, Health services delivery, Mixed methods, Program implementation BACKGROUND Despite the Affordable Care Act's emphasis on preventive services, many rural communities face significant challenges in linking women to the full continuum of breast cancer screening services (e.g., screening and diagnostic mammography, breast biopsy, and referral to cancer treatment) [1]. Rural populations, when adjusted for age, are more likely than their urban counterparts to lack health insurance [2], such that women are significantly less likely to meet

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Section: Discussionmentioning

confidence: 99%

County-level outcomes of a rural breast cancer screening outreach strategy: a decentralized hub-and-spoke model (BSPAN2)

Lee

Higashi

Inrig

et al. 2016

Behav. Med. Pract. Policy Res.

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“…As Wayland and Crowder's (2002) study demonstrated about the lack of sufficient community health workers in urban Bolivia, the pharmacy may be worth exploring as a venue to reach groups who, like vendors may not spend much time in their home neighborhoods or communities.…”

Section: Discussionmentioning

confidence: 99%

“…Wayland and Crowder (2002) looked at an urban community located in the Andes in Bolivia and the attitudes people in the community had towards community health workers. The growth of the city prevented health workers from being able to make as many visits to communities as normally done.…”

Section: Pharmacies Pharmaceuticals and Friendshipsmentioning

confidence: 99%

Staying Well on the Margins of the Formal Economy: Exploring Occupational Health and Treatment among Peruvian Vendors in the Urban Marketplace

Blaisdell

2012

SSRN Journal

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With a growing percentage of the world's population living in urban areas, many people in cities are increasingly participating in economic activities on the margins of the formal economy. Many such workers generate income by vending goods on a small-scale level in and around traditional open-aired marketplaces. As a setting for health, marketplaces have been studied largely in the interest of consumer safety but less in terms of occupational health. This study explores the health of market vendors with a health promotion lens. It assumes health to be a holistic concept that considers the physical and psychosocial affects that vendors experience as a result of their work. Situated in the Andes, I describe how traditional concepts of health and well-being related to social reciprocity and ritual payments to the natural surroundings inform vendors' everyday health practices in a market located in the city of Arequipa, in the southern Andes of Peru. Data interpreted through socio-economic frameworks describes how one's social status, inside and outside the market, as well as social networks, affect health and rationale of treatment choices, largely in terms of biomedical and traditional methods. It was found that the nature of vendor's work represents a challenge to maintaining health in relation to both biomedical and traditional health practices. Findings suggest that treatment decisions may be motivated by demands of work, but also made as a means to re-enforce social relationships that go on to support one's economic well-being.

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“…However, community-based approaches to treatment and surveillance have attracted their own criticisms. Anthropologists Coral Wayland and Jerome Crowder (Wayland & Crowder, 2002) argued that WHO's current definition of community 'ultimately homogenizes what may be heterogeneous groups' by assuming that an aggregate of individuals in a given location will automatically share a 'form of social organization and cohesion…as well as interests and aspirations, including health ' (pp. 232-233).…”

Section: Surveillance and Supervisionmentioning

confidence: 99%

Social, Historical and Cultural Dimensions of Tuberculosis

et al. 2015

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SummaryTuberculosis (TB) researchers and clinicians, by virtue of the social disease they study, are drawn into an engagement with ways of understanding illness that extend beyond the strictly biomedical model. Primers on social science concepts directly relevant to TB, however, are lacking. The particularities of TB disease mean that certain social science concepts are more relevant than others. Concepts such as structural violence can seem complicated and off-putting. Other concepts, such as gender, can seem so familiar that they are left relatively unexplored. An intimate familiarity with the social dimensions of disease is valuable, particularly for infectious diseases, because the social model is an important complement to the biomedical model. This review article offers an important introduction to a selection of concepts directly relevant to TB from health sociology, medical anthropology and social cognitive theory. The article has pedagogical utility and also serves as a useful refresher for those researchers already engaged in this genre of work. The conceptual tools of health sociology, medical anthropology and social cognitive theory offer insightful ways to examine the social, historical and cultural dimensions of public health. By recognizing cultural experience as a central force shaping human interactions with the world, TB researchers and clinicians develop a more nuanced consideration of how health, illness and medical treatment are understood, interpreted and confronted.

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Disparate Views of Community in Primary Health Care: Understanding How Perceptions Influence Success

Cited by 37 publications

References 24 publications

County-level outcomes of a rural breast cancer screening outreach strategy: a decentralized hub-and-spoke model (BSPAN2)

County-level outcomes of a rural breast cancer screening outreach strategy: a decentralized hub-and-spoke model (BSPAN2)

Staying Well on the Margins of the Formal Economy: Exploring Occupational Health and Treatment among Peruvian Vendors in the Urban Marketplace

Social, Historical and Cultural Dimensions of Tuberculosis

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