Describes cancer control activities by the Indian Health Service in North Dakota, South Dakota, Iowa, and Nebraska, including risk factor assessment and cancer screening using a modified Health Risk Appraisal; interventions to reduce smoking; community empowerment; development of health education materials; and clinical preventive services. (SV)

Investigated services received, length of treatment, and outcomes of thousands of Asian-American, African-American, Mexican-American, and White clients using outpatient community mental health services. Asian Americans and Mexican Americans underutilized services. African Americans overutilized services and exhibited less positive outcomes.…

A model for assessing the needs of the rural elderly based on the goal of empowerment is described and evaluated through a case study in Pennsylvania. Overall, the 63 community workers positively evaluated the needs assessment data derived through the model. Ways to enhance the model are discussed. (SLD)

Two studies were conducted to determine the stability of self-assessment of evaluation performance and use by 276 evaluators of community mental health centers over a 6-week period. The test-retest reliability of two instruments developed to assess internal evaluation was examined. The value of these instruments is discussed. (SLD)

Describes the economic and demographic changes experienced by rural communities over the past few years and how they have increased rural health professionals' responsibilities. Presents the Community Wellness program and four case histories illustrating how it has strengthened community infrastructure, developed human capital, and created rural…

A community service project involved nursing faculty and students in providing primary health services. One core activity had nursing students conducting vision screening for preschoolers in at-risk populations. (SK)

Describes Hawaii's Healthy Start Program (HST), its ongoing evaluation study, and evaluation findings at the end of two of a planned three years of family-program participation and follow-up. HST uses home visitors to help prevent abusive and neglectful parenting. Found significant differences in program implementation among the three…

Collaboration between a community coalition and a nursing school in Chicago resulted in a primary health care clinic, school-based health centers, family education and counseling programs, and screening services. It provides a unique opportunity to combine service delivery and academic education. (SK)

Auburn University's School of Nursing revised the curriculum based on a view of nursing as a humanistic discipline transcending institutional boundaries. Community-based nursing was defined as a philosophy of care with an individual and family focus, emphasizing partnerships with clients. (Contains 15 references.) (SK)

Articles in this special issue consider different aspects of community-level evaluation research and demonstrate the emerging sophistication and promise of this field. Process evaluation, qualitative research, and meta-analysis are promising new directions for ensuring more appropriate levels of analysis and more appropriate outcomes. (SLD)

Developments in information technology and the ongoing restructuring of health services to increase provision in community settings militate in favour of a streamlining of communications and the exchange of information about patients among health and social care providers. Yet the principles of confidentiality and privacy appear to inhibit this…

Purpose: Few international comparisons of health services are performed using microlevel data. Using such data, this paper compares the need for and receipt of assistance with activities of daily living (ADLs) in comparable samples in the United States and Sweden, a country with a universal system of community-based services. Design and Methods:…

This article examines how a research partnership between a university-based research centre and a regional health authority operated as a context for promoting and examining continuous learning in the workplace. The article identifies and explores the issues and questions that emerged in the effort to establish a stable and supportive research…

Background: Unmet need for dental care is the most prevalent unmet health care need among children with special health care needs (CSHCN), even though these children are at a greater risk for dental problems. The combination of rural residence and special health care needs may leave rural CSHCN particularly vulnerable to high levels of unmet…

Objective: This study examines the effects of clinical site assignment within a multiple-site psychiatry clerkship program on the convergent outcome of the National Board of Medical Examiners (NBME) subject examination. Method: NBME scores, controlled for baseline pre-clerkship knowledge base as measured by second year human behavior scores, were…