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Alsbury-Nealy K, Scodras S, Munce S, Colquhoun H, Jaglal SB, Salbach NM. Models for establishing linkages between healthcare and community: A scoping review. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e3904-e3920. [PMID: 36317803 DOI: 10.1111/hsc.14096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 07/22/2022] [Accepted: 10/16/2022] [Indexed: 06/16/2023]
Abstract
Community-based programmes can support healthcare systems by delivering preventive services and health promotion. This study aimed to determine the nature, range, and extent of theoretical models that guide the development of linkages between healthcare settings and community programmes. A scoping review guided by the Joanna Briggs Institute methodology and the PRISMA-ScR was conducted. Four databases (MEDLINE, EMBASE, CINAHL and PsycINFO) were searched on August 8, 2020. Two reviewers independently screened articles by title and abstract and divided the remaining articles for full-text screening. Articles that described the development of a theoretical model to guide the establishment of linkages between healthcare settings and community programmes, were peer-reviewed, and in English, were included. Articles that solely applied linkage models were excluded. One reviewer extracted data on study and model characteristics (e.g. model purpose, model components and relationships between components from the included articles). Categorical data were summarised using frequencies and percentages. Conventional content analysis was used for variables that had lengthier descriptions and variable terminology. The search identified 8926 records. Six articles describing six unique models were included in the review. Of the four models that described intended users, three (75%) identified primary care. Healthcare settings were identified in all models, with three (50%) focusing on primary care. Models used two or more linkage strategies: (1) agreeing on sharing resources, staff, and information, (2) coordinating services and referral processes, (3) planning and evaluation, (4) leadership, policies, and funding, (5) boundary spanning and (6) brokering. All models used the linkage strategy of agreeing on sharing resources, staff, and information. Findings provide important considerations for healthcare and community programme providers planning linkages. Future research should investigate the role and characteristics of community programmes in linkages, and linkages with other types of healthcare settings.
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Affiliation(s)
- Kyla Alsbury-Nealy
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Stephanie Scodras
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Sarah Munce
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
- Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Heather Colquhoun
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Susan B Jaglal
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Nancy M Salbach
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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Yun MR, Lee SJ, Song M, Seo K, Ko HN, Choi S, Yu B. Health Service Challenges at Senior Centers in an Urban South Korean Community: A Mixed-Method Approach Focusing on Nurses' Roles. J Nurs Manag 2022; 30:3295-3303. [PMID: 35969490 DOI: 10.1111/jonm.13768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 07/18/2022] [Accepted: 08/11/2022] [Indexed: 11/30/2022]
Abstract
AIMS To identify challenges and recommendations for senior center health services focusing on nurses' roles in an urban South Korean community. BACKGROUND Senior centers can potentially provide easily accessible and cost-effective health services to older adults. It is essential to identify current challenges to improve health services. METHOD This study used an explanatory sequential mixed-methods design. Quantitative descriptive data were obtained from a survey of all nurses at senior centers in Seoul (n = 30). For the qualitative data, focus group interviews were conducted with various senior center stakeholders (n = 15). RESULTS Two main themes, discrepancy between services and needs and reform senior centers, were identified with six subthemes. CONCLUSIONS Challenges identified included insufficient availability to meet health service needs, overlapping health services, and no legal clarification of nurses' roles. Recommendations to improve the senior center health services include to focus on the centers' main goals, function as health and welfare hubs, establish legal guidelines, and provide adequate nurse staffing. IMPLICATION FOR NURSING MANAGEMENT The senior centers need to hire more nurses and define nurses' occupational roles legally for the centers to serve as a hub connecting medical care and welfare.
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Affiliation(s)
- Mi Ra Yun
- Red Cross College of Nursing, Chung-Ang University, Seoul, Korea
| | - Soo Jin Lee
- Department of Nursing, College of Natural Sciences, Korea National Open University, Seoul, Korea
| | - Misoon Song
- College of Nursing, Seoul National University, Seoul, Korea
| | - Kyoungsan Seo
- College of Nursing, Chungnam National University, Daejeon, Korea
| | - Ha Na Ko
- College of Nursing, Gachon University, Incheon, Korea
| | - Suyoung Choi
- College of Nursing, Jeju National University, Korea
| | - Boas Yu
- Henry P. Becton School of Nursing and Allied Health, Fairleigh Dickinson University, Teaneck, NJ, USA
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Boll AM, Ensey MR, Bennett KA, O'Leary MP, Wise-Swanson BM, Verrall AM, Vitiello MV, Cochrane BB, Phelan EA. A Feasibility Study of Primary Care Liaisons: Linking Older Adults to Community Resources. Am J Prev Med 2021; 61:e305-e312. [PMID: 34497030 DOI: 10.1016/j.amepre.2021.05.034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 05/10/2021] [Accepted: 05/12/2021] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Programs and services available through the aging services network can help community-dwelling older adults to age in place but are often not discussed in routine primary care. The primary care liaison was developed as a novel integration intervention to address this disconnect. METHODS Employed by an Area Agency on Aging, primary care liaisons performed outreach to primary care with the goal of raising awareness of community-based programs, resources, and services available to older adults and their caregivers and facilitating referrals. The evaluation of the primary care liaison model, conducted from December 2015 to February 2019, used the Reach, Effectiveness, Adoption, Implementation, Maintenance framework and assessed reach (number of clinics contacted), adoption (number of referrals to the Area Agency on Aging), implementation (number of follow-up contacts with a practice), and effectiveness (proportion of referrals reached and provided relevant resources). RESULTS The primary care liaisons contacted a median of 18.5 clinics per month (IQR=15-31). Primary care referrals averaged >100 per month, and referrals increased over time. Successful follow-up outreach visits had a median of 3 (IQR=2-10), and follow-up contacts had a median of 3 (IQR=1-7) per practice. Three quarters of caregivers for people with dementia reached by Area Agency on Aging staff were provided with information about relevant resources. CONCLUSIONS The primary care liaison model is feasible, fosters ongoing interactions between primary care and Area Agencies on Aging, and connects older adults and their caregivers to relevant programs and services. Adoption of the primary care liaison model by other Area Agencies on Aging across the U.S. may help further the vision of optimized health and well-being of older adults.
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Affiliation(s)
- Allison M Boll
- Aging and Disability Services (ADS) Seattle King-County, Seattle, Washington
| | - Melissa R Ensey
- Area Agency on Aging & Disabilities of Southwest Washington, Vancouver, Washington
| | - Katherine A Bennett
- Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Washington, Seattle, Washington
| | - Mary P O'Leary
- Aging and Disability Services (ADS) Seattle King-County, Seattle, Washington
| | | | - Aimee M Verrall
- Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Washington, Seattle, Washington.
| | - Michael V Vitiello
- Department of Psychiatry & Behavioral Sciences, University of Washington, Seattle, Washington
| | - Barbara B Cochrane
- Department of Child, Family, and Population Health Nursing, University of Washington, Seattle, Washington
| | - Elizabeth A Phelan
- Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Washington, Seattle, Washington; Department of Health Services, School of Public Health, University of Washington, Seattle, Washington
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Noël PH, Wang CP, Finley EP, Espinoza SE, Parchman ML, Bollinger MJ, Hazuda HP. Provider-Related Linkages Between Primary Care Clinics and Community-Based Senior Centers Associated With Diabetes-Related Outcomes. J Appl Gerontol 2018; 39:635-643. [PMID: 29923445 DOI: 10.1177/0733464818782853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The Institute of Medicine (IOM) suggests that linkages between primary care practices and community-based resources can improve health in lower income and minority patients, but examples of these are rare. We conducted a prospective, mixed-methods observational study to identify indicators of primary care-community linkage associated with the frequency of visits to community-based senior centers and improvements in diabetes-related outcomes among 149 new senior center members (72% Hispanic). We used semistructured interviews at baseline and 9-month follow-up, obtaining visit frequency from member software and clinical assessments including hemoglobin A1c (HbA1c) from colocated primary care clinics. Members' discussion of their activities with their primary care providers (PCPs) was associated with increased visits to the senior centers, as well as diabetes-related improvements. Direct feedback from the senior centers to their PCPs was desired by the majority of members and may help to reinforce use of community resources for self-management support.
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Affiliation(s)
- Polly Hitchcock Noël
- University of Texas Health San Antonio, USA.,South Texas Veterans Health Care System, Washington, DC, USA
| | - Chen-Pin Wang
- University of Texas Health San Antonio, USA.,South Texas Veterans Health Care System, Washington, DC, USA
| | - Erin P Finley
- University of Texas Health San Antonio, USA.,South Texas Veterans Health Care System, Washington, DC, USA
| | - Sara E Espinoza
- University of Texas Health San Antonio, USA.,South Texas Veterans Health Care System, Washington, DC, USA
| | | | - Mary J Bollinger
- Central Arkansas Veterans Healthcare System, Little Rock, USA.,University of Arkansas for Medical Sciences, Little Rock, USA
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