Piecing together the crazy quilt of prenatal care.
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The failure to provide adequate prenatal care for low-income pregnant women in the United States and the effects of this failure on infant mortality are well known. Many studies have identified institutional barriers against access to care as a major cause. To overcome these barriers, Public Health District V, South Central Idaho, has created a comprehensive prenatal health care model that has almost tripled participation in its program during the first year of implementation and increased it again significantly during the second year. This decentralized pregnancy program has succeeded in getting all of the physicians offering obstetrical care in the district to serve low-income pregnant clients on a rotating basis. The new program provides pregnancy testing as well as financial screening services. Also, it has combined support services into one-stop-shopping clinics that include an innovative expansion of the Women, Infants and Children (WIC) Program of the U. S. Department of Agriculture. WIC food vouchers help attract clients into the prenatal care system and keep them coming. Enrichment of the duties of the public health nurse provides case coordination that pulls together the patchwork of medical and support services for the pregnant client. (+info)
Are comparisons of consumer satisfaction with providers biased by nonresponse or case-mix differences?
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Virtual grand rounds: a new educational approach in social work that benefits long-term care providers and patients in rural Idaho.
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INTRODUCTION: Nationwide, rural USA is experiencing a shortage of social workers. In rural Idaho, three state-wide non-profit organizations worked together to develop Virtual Grand Rounds (VGRs), a new approach to delivering continuing education to social workers and residential care coordinators, in order to promote their retention in the workforce. This study examined participant satisfaction and the potential for the delivery system to be replicated in other states. METHODS: Between July 2002 and December 2006, 740 person-hours (359 attendees x 2.06 hours) of continuing education were delivered to resident care coordinators and social workers in 9 sessions of VGRs. In total, 287 evaluation forms (79% return rate) were collected on the quality of the presentation, the presenter's expertise and delivery, the relevance and value of the presentation to the attendee, and the quality of the technology. The questionnaire consisted of 10 questions that aimed to measure participant satisfaction level, using a five-point Likert scale with a comments section. RESULTS: Programs and presenters received positive scores. Participants approved of the delivery method and the overall satisfaction rating was 4.1. As to whether the information presented would lead to changes in practice, participants responded positively with a score of 3.25. CONCLUSION: The Telehealth Idaho program contributed to a thorough training for new healthcare employees and for those in rural Idaho unable to attend the annual conference for essential training. Initial successes led to an expansion of the program to include other facility staff, and other topics which provided a new training system and infrastructure. This represents one unique contribution to addressing the rural social workers shortage. (+info)
Molecular analysis of antimicrobial-susceptible and -resistant Escherichia coli from retail meats and human stool and clinical specimens in a rural community setting.
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