Rolesville, North Carolina, Wake County : an action-oriented community diagnosis : findings and next steps of action

In the fall of 2003 six students from the UNC School of Public Health were requested by Wake County Human Services to work with the Rolesville community through the spring of 2004 to conduct an Action Oriented Community Diagnosis (AOCD). The team interviewed twenty-five community members and twelve service providers in the area, and then organized a committee of interested residents to plan the Rolesville Community Forum. The Forum was a venue for people to discuss the team's findings and generate ideas about action that can be taken to address the findings. Rolesville has remained small and rural since it was settled during the Revolutionary War, despite being only fourteen miles from Raleigh, the state capitol.1 However, in the last ten years, Rolesville has been undergoing rapid growth and suburbanization, and may see its population increase more than tenfold in the next twenty years.9 This unprecedented growth presents challenges to the generational families of the community, but also creates opportunities for individuals and the community as a whole. In order to effectively confront these challenges and create change, a community must have many assets, and Rolesville certainly does. Among them are: community spirit and dedication to volunteerism, its small size, the town’s emphasis on providing opportunities for youth, particularly through the Parks and Recreation programs, and its vibrant local institutions, such as the churches, EMS, and the Fire Department. Five areas in which community members expressed concern were: Community Identity and Involvement, Diversity and Change, Health and Other Services, Planning Growth, and Traffic. Several overlapping themes emerged among these five concerns, resulting in two overarching themes: rapid growth and the new diversity that growth has brought. The main action step determined at the Forum is for community members, town officials, and church leaders to increase pressure on officials at the state-level to increase funding for the U.S. 401 bypass and services for Rolesville. It was also strongly recommended that the town to diversify its communication channels to publicize town events, meetings, and planning sessions to reach long-time residents, newcomers, and Spanish-speaking residents. Another important action step is to create a public relations or welcoming committee to assist in incorporating newcomers into the community and improve communication between the town government and town residents. Finally, the AOCD team concluded that Rolesville has many resources and strengths that could be mobilized to meet the challenges being brought by exponential growth and changing demographics. With leadership from its town government and its churches, the Rolesville community can embody its motto: “Small town, bright future.”Master of Public Healt

Continuous Quality Improvement and Health Educators

Quality improvement is increasingly at the forefront of health care, creating a growing demand in clinical settings for health professionals adept at understanding and optimizing systems of health care delivery. Compared with clinicians, administrators, and health services researchers, health educators have to date played less of a role in quality improvement. However, as this article argues, the potential for health educators to contribute to such efforts is great because health education and quality improvement are more similar in their goals and approaches than is commonly recognized. Health educators bring important skills to quality improvement practice in areas such as needs assessment, participatory planning, and evaluation. To illustrate the mutual benefits that arise when these two practices intersect, the implementation of an electronic patient scheduling system led by quality improvement professionals in a large home care agency is described. </jats:p

Richard Doddridge Blackmore, the Man and His Work

Abstract not availabl

Religiosity and Death Attitudes and Engagement of Advance Care Planning Among Chronically Ill Older Adults

The aim of this study was to examine the association of religiosity and death attitudes with self-reported advance care planning (ACP) in chronically ill older adults. Survey data were collected in person for a sample of 157 chronically ill older adults drawn from primary care clinics in North Carolina. Logistic regression was used to examine associations of religiosity and death attitudes in the likelihood of engagement in three ACP outcomes: (a) ACP discussions with the doctor, (b) ACP discussions with family, and (c) the completion of a living will. Greater reported religiosity ( b = 1.67, p &lt; .01) was significantly associated with reported ACP discussions with the doctor ( R2 = .29, model significance p &lt; .01). Less fear of death was significantly associated ( b = −0.41, p &lt; .01) with self-reported completion of a living will ( R2 = .21, model significance p &lt; .01). Religiosity and fears of death should be considered in future ACP studies. </jats:p