Third World countries have used community health advisors (CHAs) for many years to deliver health services, health education, and linkages to isolated and underserved communities. In 1998 the National Community Health Advisor Study estimated there were at least 600 such programs in the United States using about 12,500 CHAs. Program activities and…

In 1994, the University of Denver received a grant to develop and operate the Frontier Mental Health Services Resource Network (FMHSRN). FMHSRN's principal aim was to improve delivery of mental health services in sparsely populated "frontier" areas by providing technical assistance to frontier and rural audiences. Traditional…

This paper discusses some of the factors that lead to the success of a health information library, including: (1) the mission statement; (2) practical matters such as location, equipment, furniture, and layout; (3) considerations in writing the procedure and policy manual; (4) confidentiality; (5) staff and volunteer training; (6) sources of…

This essay is based on a series of roundtables convened through the Knight Collaborative National Medical Education Roundtable. It reports that the challenges and transformations experienced in recent years by community-based medical schools and clinical campuses offer a lens to the whole higher education enterprise, and asks the fundamental…

Summarizes conference proceedings and provides an overview of the nature and key issues of cut-back management in community mental health services. Discusses leadership and management, leadership strategies and values, the management of organizational resource reduction applied to human services, the process of reorganization, and…

Although delivery of health and mental health services to American Indian communities is improved by use of community-based paraprofessionals, these workers face conflicts related to kinship obligations. Discusses the role of family networks in Coast Salish community dynamics, and consequent influences on counselor effectiveness and the access of…

Interview results provide details on condom use in youth at highest risk for AIDS. Condom use increased with time and age because of positive beliefs concerning condoms and increased awareness of HIV transmission. High-risk youths proved no more likely than lower risk youths to increase their condom use. (RJM)

Delivery of primary health care (PHC) programs is critical to rural African health care. The paper explores the school's role in PHC delivery and indicates ways that professional health personnel and teacher educators can cooperate in preparing teachers with necessary knowledge and skills to participate meaningfully in PHC delivery. (SM)

The Bureau of Primary Health Care (BPHC) was developed to increase access to comprehensive primary and preventive health care, to improve the health status of medically underserved populations, and to assist communities to identify populations at risk. The needs of women of racial and ethnic minority populations are BPHC's newest initiative;…

Preparation for rural medical practice is adequate in the areas of clinical knowledge and procedural skills, but to increase the retention of rural physicians, more curricular emphasis is needed in the areas of sensitivity to rural social issues, counseling, networking, and fostering self-confidence to function effectively in an environment with…

In the Kentucky Homeplace Project, specially trained paraprofessionals who live in medically underserved rural communities make home visits, facilitate access to health care, and provide case management and culturally appropriate prevention education for poor families. Strengths include local administration and staff and holistic and traditional…

Purpose: The psychiatric home visit is an effective intervention for elderly patients who otherwise would not receive mental health services. Home visits also have potential to be useful for training. Here, the current practice of home visits in geropsychiatry fellowship programs is examined. Design and Methods: The directors of 55 current…

The purpose of this article is to assist health educators and students to integrate theory with practice by examining four major learning theories for their implications for motivating healthy behavior change. Using a prototypical case example based on the authors' experiences with farm families through community health screenings, the learning…

Many Americans do not have access to adequate medical care. Previous research on this problem focuses primarily on individual-level determinants of access such as income and insurance coverage. The role of community-level factors in helping or hindering individuals in obtaining needed medical care, however, has not received much attention. We…

Focusing on current environmental issues and strategies for preparing for the future, this document provides the following conference papers: (1) "Preparing Environments for the 21st Century," by Bailus Walker, Jr.; (2) "Green vs. Greed: Development and Conservation," by John Ferrara; (3) "Plants and People: A Developing Relationship," by Alan…