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Community Care and Catalonia and Spain at a Glance
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Josep Vidal-Alaball Primary Care & Public Health physician
Community Care in Catalonia and Spain
What is Community Care?
Community Care interventions in Catalonia and in Spain
Final considerations
Can be defined as the health of the individuals and the groups in a particular community(1). This is determined by the interaction of personal, family, cultural and physical factors and the socio-economic environment (determinants of health).
Definition
(1) Gofin J, Gofin R. Essentials of global community health. Sudbury, MA: Jones & Barlett Learning; 2010: 269
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A community health intervention is a strategy aimed to improve the health of a defined community
Community Oriented Primary Care (COPC) is a practice in which the elements of community, family and individual care are given together (reflecting the spirit of the International Conference on Primary Health Care held in Alma-Ata in 1978).
In Catalonia; first working shop in 1987 organized by the Catalan Society of PC Working group
COPC part of FM training curriculum since 1990
Working Group in Community Oriented Primary Care (APOC) - 1987
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COPC methodology integrates the individual (clinical) and the community (public) approach. Consists in a cyclic process of planning based on the population needs.
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Group. 20 members: PC nurses and doctors, public health practitioners, social workers
Conducted 30 workshops for more than 1,000 professionals
Helped implement COPC model in several health centres
http://www.apoc-copc.org/eng/linksE.htm
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Acting Together for Health network (AUPA)
Network of several health institutions (primary care and public health) and professional bodies and societies.
To promote Community Care projects in Primary Care:
•Annual grants for funding community projects
•Provide training to professionals and PC trainees
•Publish research and educational material
•Methodological advice to centres
•Promote collaborative research projects
http://www.gencat.cat/salut/ies-aupa/html/ca/Du63/index.html
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From may 2003 96 Centres
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Community Health Workers project (ASACO)
Based on health assets and Salutogenesis
Public Health + Primary Care Teams
First phase:
• Identify representative community agents• Train agents on social determinants, salutogenesis
and assets for health. Same training! •Blog (training sessions, resources…)•Video http://youtu.be/NzPSCx9BS6g
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Second phase:
•Groups in 3 areas created
•Identification health assets. Methodology: ABCD (Asset based community development)
•What gives you health?
• Video
• Boxes
•Identification problems (COPC methodology)
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http://projecteasaco.wordpress.com
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Health in Neighbourhoods – Urban Renewal Plan
2004: Neighbourhoods law includes plan to improve health in the most disadvantaged neighbourhoods in Catalonia.
Objective: To introduce health as a major element for the improvement of the living conditions and welfare of the neighbourhood.
Analysis and detection needs with the community, prioritization of actions and implementation.
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Evaluation of health equity effectshttp://www.sophie-project.eu/index.htm
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http://jech.bmj.com/content/68/9/811.abstract
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Roquetes Community development Plan
Emanates from a COPC group, uses the Health in Neighbourhoods programme.
After conducting a community analysis and diagnosis, prioritize 3 problems:
1.Musculoskeletal disorders
2.Lack of healthy habits
3.Lack of self-care skills
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Carmel Community Development Plan
Since 2001
Amalgam of individual neighbours, neighbourhood associations, health professionals and public administrations
To promote processes of participation among the community to improve the neighbourhood
Several Community Projects:
•Support group for women who are going through a time of significant change in their life
http://www.carmelamunt.org/bloc/quequicom/
Program Spanish Society of PC to stimulate Community Activities in PC – 1995
Produce a journal: Comunidad
Promote Community Activities Networks
Community Activities Search engine
Programme of Community Activities in Primary Care (PACAP)
http://www.pacap.net/pacap/
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Health Observatory of Asturias
http://www.obsaludasturias.com
Since 2010
Space of knowledge about health information in Asturias. Generate periodic reports.
Link information on health indicators to various community health projects developed in Asturias
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Projecte RIU
Facilitate access to health services for vulnerable population in Alzira
Training to community health agents (75h)
Health Assets. Mapping http://on.fb.me/1pc7hFJ
Aging population. Chronic diseases
Training. Particularly non-health workers
Economic climate: ? Opportunity
Research – Evidence
Involve non-health related agents Inter-ministerial Public Health Plan (Health in all policies)
Future challenges
