This progressive resource brings the innovative power of narrative medicine to the forefront of community public health care. Chapters describe community involvement across a continuum of control, from health consultants describing problems and suggesting solutions to health committees designing programs and evaluating results. Narrative strategies to this end, including authentic dialogue and community mapping, are examined in the context of public health and fleshed out with examples of different levels of participation by community members. From the respectful collaboration modeled here, the principles of community public health care can potentially expand beyond the immediate community into other social domains on a greater scale. Included in the coverage: · Narratives, local knowledge, and world entry. · Community and narratives. · What is dialogue? · Storylines, causes, and locus of interventions. · Community mapping tells a story. · The politics of storytelling. Narrative Medicine and Community-Based Health Care and Planning gives health psychologists, sociologists, social workers, and public health administrators realistic practical insights for tapping into the unique resources communities and clients have to offer. This is the next step in the evolution of public health, toward large-scale improvements in care delivery, access to and relevance of services, and patient and community outcomes.

The Principles and Practice of Narrative Medicine articulates the ideas, methods, and practices of narrative medicine. Written by the originators of the field, this book provides the authoritative starting place for any clinicians or scholars committed to learning of and eventually teaching or practicing narrative medicine.

Edited by two leading general practitioners and with contributions from over 20 authors, this book covers a wide range of topics to do with narrative in medicine. It includes a wealth of real examples of patients narratives and addresses theoretical and practical issues including the use of narrative as a therapeutic tool, teaching narrative to students, philosophical issues, narrative in legal and ethical decisions, narrative in nursing, and the narrative medical record.

Storytelling is an essential tool for reporting and illuminating the cultural contexts of health: the practices and behavior that groups of people share and that are defined by customs, language, and geography. This report reviews the literature on narrative research, offers some quality criteria for appraising it, and gives three detailed case examples: diet and nutrition, well-being, and mental health in refugees and asylum seekers. Storytelling and story interpretation belong to the humanistic disciplines and are not a pure science, although established techniques of social science can be applied to ensure rigor in sampling and data analysis. The case studies illustrate how narrative research can convey the individual experience of illness and well-being, thereby complementing and sometimes challenging epidemiological and public health evidence.

In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.

This book takes up the challenge of the failure of most initiatives in community-based service delivery to address the significant philosophical shift that is necessary to create, implement, and evaluate appropriately these sorts of projects. Challenging the tendency to focus entirely on practicalities, the authors emphasize the centrality of philosophy to any successful community-based undertaking. While fully acknowledging the importance of local knowledge and the guidance of projects by local people, this volume shows that these principles are often at odds with the ‘Cartesian’ mindset that underpins much project planning, with its emphasis on objectivity in science and knowledge. Since all knowledge is mediated by human activity and embedded in language and other modes of expression, this dualist approach must be reconsidered. A thorough rethinking of traditional service delivery, which takes into account issues of data, methodology, and bias together with questions of generalizability, community, power, and communication, this book will appeal to scholars of sociology, social policy, and social work with interests in community-based service delivery.

Community-Based Health Interventions in an Institutional Context examines challenges of "institutionalizing" community-based health care. While the community-based or localized model is growing in popularity and importance in the United States, in practice it must often be brought in to larger institutions in order to grow to scale. The typical goals of an institution—standardization, formalization, and control—may be seen as antithetical to those of a community-based healthcare provider, such as spontaneity, customization, and flexibility. The contributions to this work raise questions about how the community-based model can be scaled up through institutions, and how "institutionalization" can be rethought from a bottom-up approach. They provide not only an overview of community-based organizations, but also delve into practical topics such as establishing budgets, training workers, incorporating technology, as well as more theoretical topics like goal-setting, policy effects (like the ACA), and relationships between patient and community. This work will be of interest for researchers interested in exploring the community-based health care model, as well as practitioners in health care and health policy.

Healthcare decision makers in search of reliable information that compares health interventions increasingly turn to systematic reviews for the best summary of the evidence. Systematic reviews identify, select, assess, and synthesize the findings of similar but separate studies, and can help clarify what is known and not known about the potential benefits and harms of drugs, devices, and other healthcare services. Systematic reviews can be helpful for clinicians who want to integrate research findings into their daily practices, for patients to make well-informed choices about their own care, for professional medical societies and other organizations that develop clinical practice guidelines. Too often systematic reviews are of uncertain or poor quality. There are no universally accepted standards for developing systematic reviews leading to variability in how conflicts of interest and biases are handled, how evidence is appraised, and the overall scientific rigor of the process. In Finding What Works in Health Care the Institute of Medicine (IOM) recommends 21 standards for developing high-quality systematic reviews of comparative effectiveness research. The standards address the entire systematic review process from the initial steps of formulating the topic and building the review team to producing a detailed final report that synthesizes what the evidence shows and where knowledge gaps remain. Finding What Works in Health Care also proposes a framework for improving the quality of the science underpinning systematic reviews. This book will serve as a vital resource for both sponsors and producers of systematic reviews of comparative effectiveness research.

This salient reference grounds readers in the theoretical basis and day-to-day practice of community-based health care programs, and their potential as a transformative force in public health. Centering around concepts of self-determination, empowerment, and inclusiveness, the book details the roles of physicians, research, and residents in the transition to self-directed initiatives and greater community control. Community-focused interventions and methods, starting with genuine dialogue between practitioners and residents, are discussed as keys to understanding local voice and worldview, and recognizing residents as active participants and not simply targets of service delivery. And coverage pays careful attention to training issues, including how clinicians can become involved in community-based care without neglecting individual patient needs. Among the topics covered are: Narrative medicine in the context of community-based practice. Qualitative and participatory action research. Health committees as a community-based strategy. Dialogue, world entry, and community-based intervention. Politics of knowledge in community-based work. Training physicians with communities. Dimensions of Community-Based Projects in Health Care challenges sociologists, social workers, and public health administrators to look beyond traditional biomedical concepts of care and naturalistic methods of research, and toward more democratic programs, planning, and policy. The partnerships described in these pages reflect a deep commitment to patients’ lives, and to the future of public health.p>

Offers an innovative plan to eliminate inequalities in American health care and save the lives they endanger Over 84,000 black and brown lives are needlessly lost each year due to health disparities: the unfair, unjust, and avoidable differences between the quality and quantity of health care provided to Americans who are members of racial and ethnic minorities and care provided to whites. Health disparities have remained stubbornly entrenched in the American health care system—and in Just Medicine Dayna Bowen Matthew finds that they principally arise from unconscious racial and ethnic biases held by physicians, institutional providers, and their patients. Implicit bias is the single most important determinant of health and health care disparities. Because we have missed this fact, the money we spend on training providers to become culturally competent, expanding wellness education programs and community health centers, and even expanding access to health insurance will have only a modest effect on reducing health disparities. We will continue to utterly fail in the effort to eradicate health disparities unless we enact strong, evidence-based legal remedies that accurately address implicit and unintentional forms of discrimination, to replace the weak, tepid, and largely irrelevant legal remedies currently available. Our continued failure to fashion an effective response that purges the effects of implicit bias from American health care, Matthew argues, is unjust and morally untenable. In this book, she unites medical, neuroscience, psychology, and sociology research on implicit bias and health disparities with her own expertise in civil rights and constitutional law. In a time when the health of the entire nation is at risk, it is essential to confront the issues keeping the health care system from providing equal treatment to all.