Dissertations / Theses on the topic 'Health workers training'

Objectives. A community health worker (CHW) is a frontline public health worker who is a trusted member of and/or has an unusually close understanding of the community served. While natural leadership may incline individuals to the CHW profession, they do not always have skills to address broad social issues. We describe evaluation of the Women’s Health Leadership Institute (WHLI), a 3-year training initiative to increase the capacity of CHWs as change agents. Methods. Pre-/postquestionnaires measured the confidence of 254 participants in mastering WHLI leadership competencies. In-depth interviews with CHW participants 6 to 9 months after the training documented application of WHLI competencies in the community. A national CHW survey measured the extent to which WHLI graduates used leadership skills that resulted in concrete changes to benefit community members. Multivariate logistic regressions controlling for covariates compared WHLI graduates’ leadership skills to the national sample. Results. Participants reported statistically significant pre-/post improvements in all competencies. nterviewees credited WHLI with increasing their capacity to listen to others, create partnerships, and initiate efforts to address community needs. Compared to a national CHW sample, WHLI participants were more likely to engage community members in attending public meetings and organizing events. These activities led to community members taking action on an issue and a concrete policy change. Conclusions. Leadership training can increase the ability of experienced CHWs to address underlying issues related to community health across different types of organizational affiliations and job responsibilities.

A Thesis submitted to The University of Arizona College of Medicine - Phoenix in partial fulfillment of the requirements for the Degree of Doctor of Medicine.<br>This systematic review focuses on improving recognition and treatment of acute medical conditions in pregnant women, infants and children in low and middle income countries by Community Health Workers (CHWs). By examining critically selected articles from different electronic databases, this review seeks to organize and present the important characteristics of a training program aimed at reducing maternal, neonatal and childhood mortality. Data in the form of peer‐reviewed and published articles were collected using three public databases – PubMed, Ovid and EMBASE – using specific search terms. Greater than 300 articles where found using the specific search terms. Those articles were then processed through a series of inclusion and exclusion criteria resulting in a cohort of papers which were then individually analyzed for content. After critical analysis of all 15 publications included in the study, it becomes clear that training programs are incredibly diverse. These four aspects of training programs appear to be the most variable between the studies: size of the training program, length of the training program, training assessment and follow‐up refresher courses. Training programs that are shorter in duration or greater in class number do not seem to be any less effective than longer programs with fewer participants. Future studies should be performed in which one training program with identical training techniques, lengths, and focuses is taught in different regions. The impact that this study has on the literature is as follows: Training programs of shorter duration seem to be as effective as their longer counterparts. Finally, there is a clear need for more robust, standardized and geographically and culturally diverse training programs to more effectively study training methods.

Includes bibliographical references<br>Introduction: There is a large treatment gap for people with mental disorders in Africa and other low resourced countries, estimated to be between 70% and 90%. The treatment gap is mainly due to the lack of trained mental health professionals and inadequate mental health service resources in Africa. There has been a growing global movement championed by the World Health Organisation (WHO) to integrate mental health into primary health care as the most effective way of reducing this treatment gap. This study aimed to investigate the impact of WHO Mental Health Gap Action Programme (mhGAP) training and supervision on primary health workers' knowledge, attitudes, confidence and detection rate of major mental disorders in the district of Mulanje, Malawi. Method: The study was a quantitative evaluation using a quasi-experimental method (single cohort pre- and post-measures) and an interrupted time-series design. Forty-three primary healthcare workers from Mulanje, Malawi completed pre- and post- training questionnaires assessing knowledge, attitudes and confidence regarding the assessment and management of major mental disorders. Rates of diagnosis of major mental disorders were obtained from clinic registers for 5 months prior to and 7 months following training. Results: The results showed a significant change on knowledge and confidence scores but not attitudes. The mean knowledge score showed a statistically significantly increase from 11.8 (standard deviation [SD]: 0.33) before training to 15.1 (SD: 0.38) immediately after training; t(42) = 7.79, p <.01. Mean knowledge score was also significantly higher six month post training (13.9, SD: 2.52) than before training; t(42) = 4.57, p < .01. Similarly, the mean confidence score increased significantly from 39.9 (SD): 7.68) before training to 49.6 (SD: 06.14) immediately after training; t(84) = 8.43, p <.01. Mean confidence score was also significantly higher six month post training (46.8, SD: 6.03) than before training; t(84) = 6.60, p <.01. There was no overall significant difference in mean CAMI scores before, immediately after and 6 months after training in all four of the CAMI components. The F-test statistic and P-value for Authoritarianism, Benevolence, Social Restrictiveness and Community Mental Health Ideology were: F2, 126, 0.05 = 2.5; p =.09, F2, 126, 0.05 = 0.1; p =.9, F2, 126, 0.05 = 0.03; p = 1.0 and F2, 126, 0.05 = 0.04; p = 1.0, respectively. In the months January to May 2014 (before training), median number of cases per month was 77 (inter quartile range [IQR]: 65-87) whereas after training (months June to December) median number of cases was 186 (IQR: 175-197) showing a significant increase in median number of cases before and after the training; p =0.001. Conclusion: The results show clear improvements in the knowledge, confidence and detection of severe mental illness in primary care in Mulanje and demonstrate the potential for narrowing the treatment gap by rolling out mhGAP training nationally in Malawi. The findings of this study add to the growing evidence for policy makers of the effectiveness of mental health training and supervision of primary care workers in a resource-constrained country. Further research is needed to evaluate factors that may lead to change in health worker attitudes, to evaluate training and supervision programmes using more robust evaluation designs, such as randomised controlled trials, and to assess the scale up of mhGAP programmes at larger population levels.

Thesis (MPhil (Industrial Psychology. Africa Centre for HIV/AIDS Management))--University of Stellenbosch, 2011.<br>ENGLISH ABSTRACT: “Treatment failure, defaulter rate, patients lost to follow up”. These are the words usually spoken by health care workers at the CCMT clinics in the country. These are words that they try at all times to come with solutions to, without much success. Much as both the health care workers and patients know the importance of taking medication, often medication is not taken as required. Adherence is defined as the degree to which a patient follows a treatment regimen which has been designed in the context of a consultative partnership between the client and the health care worker. This obligation is comprehensive as it tends to examine all factors that can affect adherence. It includes characteristics such as the treatment regimen, the provider behaviour, social and environmental factors that may hinder adherence on the patient. There are several factors that lead to non-adherence to treatment. The factors may be classified as Biomedical, Psychological and Social factors. The major tool that can be used to address such issues is adequate training of all staff members working at the CCMT clinics. The researcher explored training needs and gaps at a CCMT site that will assist to combat problems of non-adherence to treatment. Health care works at an identified site where questioned on the level of training they have received and on what they need to improve their management of patients and adherence. It was realised that some categories of staff at the clinic do not receive training as expected and that others do not receive adequate training that will assist them in adherence counselling. Recommendations made by staff members were that training should be readily available to all staff members and that it should also be rolled out to other departments and sections within the hospital so there is continuum of care of HIV positive patients. Non adherence to antiretroviral treatment is a challenge faced by health care providers as well as patients themselves. It results in treatment failure, a decrease in the quality of life of the patient and an increase in morbidity and mobility. Non-adherence means any reason where the patient is not taking recommended doses, not sticking to the recommended time or not taking it in the recommended way.<br>AFRIKAANSE OPSOMMING: Navolging word gedefinieer as die mate waarop die pasiënt die behandeling wat voorgeskryf is in samewerking tussen die pasiënt en die gesondheidsorgwerker, nakom. Hierdie vepligting is omvattend omdat dit geneig is om alle faktore wat die nakoming kan beinvloed, ondersoek. Dit sluit eienskappe in soos die behandeling regimen, die verskaffersgedrag, sosiale en omgewingsfaktore wat ‘n struikelblok kan wees vir die nakoming van die pasiënt. Daar is verskeie faktore wat kan lei tot nie-nakoming van behandeling. Die faktore kan geklassifiseer word as bio-mediese, sielkundige en sosiale faktore. Die belangrike instrument wat gebruik word om sulke sake aan te spreek, is voldoende opleiding van alle personeellede wat by CCMT klinieke werk. Die navorser ondersoek opvoedkundige behoeftes en leemtes by ‘n CCMT perseel, wat sal help om probleme van nie-nakoming van behandeling sal bestry. Gesondheidsorgwerkers by ‘n geïdentifiseerde perseel, was ondervra oor die vlak van opleiding wat hulle ontvang het en wat hulle nodig het vir beter bestuur van pasiënte en nakoming van behandeling deur pasiënte. Daar is gevind dat sommige kategorieë van personeel by die klinkiek nie die opleiding ontvang het wat nodig is nie en dat ander personeellede nie voldoende opleiding ontvang het wat hulle sal help met nakoming van berading nie. Personeellede het aanbeveel dat opleiding geredelik beskikbaar gemaak moet word aan alle personneel en dat dit na ander departemente en afdelings binne die hospitaal uitgebrei moet word om die voortsetting van sorg vir MIV/VIGS-positiewe pasiënte te verseker. Nie-nakoming van antiretrovirale behandeling is ‘n uitdaging vir beide gesondheidsorgwerkers en pasiënte. Dit lei tot die mislukking van behandeling, ‘n afname in die kwaliteit van die pasiënt se lewe en ‘n verhoging in morbiditeit en mobiliteit.

The South African National Development Plan (NDP) (National Planning Commission, 2011, p. 1) provides the road map for a reformed public health system by 2030. The proposed health system will be facilitated by, amongst others, training an appropriate balance of healthcare professional s including a cadre of community health workers (CHWs) that have a broad skills mix suited to reaching a larger number of people with first level intervention. With this in mind, a pilot group of CHWs were up-skilled as Rehabilitation Care Worker s (RCWs). The training program was a joint project between the Division of Disability Studies and the Departments of Occupational Therapy, Physiotherapy and Speech and Language Therapy at UCT. Problem: Little is known about the perspectives of RCWs on the benefits and challenges of additional training in rehabilitation and disability related skills. Rationale: To inform the curriculum for a rehabilitation care worker (RCW) training program and the Western Cape Department of Health (WCDoH) of ways in which this cadre of worker could contribute to the realization of the 2030 Healthcare Plan. Aim: To describe the outcomes of a pilot RCW training program from the perspective of the pilot group of graduates. The objectives were to identify the areas of practice where RCWs feel competent/incompetent, to identify aspects of the health services where RCWs believe they can contribute the most/the least and to identify the facilitators/barriers they experienced when deployed in the health field. Methodology: A qualitative descriptive study was conducted. Method: Focus groups were carried out with three groups of six participants. Findings: The plot that permeated the participants’ perspectives revolved around how the RCWs were pioneers in breaking new ground for the Western Cape Department of Health (WCDoH). Two themes informed the plot: "we move health services to a new level" and "we manage change in new ways". Discussion: It is argued that the pilot RCW curriculum achieved its’ objective of equipping a cadre of worker with basic rehabilitation, care and disability inclusion skills. While the envisaged role of RCWs in the health service and in making the NDP a reality is supported, it is argued that attention needs to be given to supervision structures and to training of all other health workers in order to promote inter professional practice. Conclusions: The pilot group of RCWs believe that they have acquired a new and large variety of skills that have enabled them to make a broad and positive impact in their places of work, at home and in the broader community.

The aim of this research is to inform conceptual approaches to health and safety (H&S) training for mineworkers in South Africa. The study focuses specifically on those mineworkers who have the least formal education or training, termed elementary workers (unskilled) and machinery operators and drivers (semi-skilled). It is an integrative literature review of sources drawn from mine health and safety in South Africa; self-efficacy; adult education and training (AET); education and training in mining; and relevant health promotion studies. The sources selected refer to work in the Southern African mine H&S context, or comparable situations. Compelling ideas and formulations for training are suggested in the literature of the different disciplines reviewed. A core concept considered is self-efficacy and the concept has substantial support in the literature. Both the term and concept of ‘self-efficacy’ have been used in South African and mining studies, but often without proper consideration of the sources of self-efficacy and its task- and context-specificity. The review reveals a lack of evidence of effective advocacy and training around generic mining occupational hazards, such as lung disease. H&S training is most evidently linked to operator training, which is aligned with unit-standards. However, substantial numbers of mineworkers lack adequate formal education for such training programmes, or the informal skills to be included via recognition of prior learning (RPL) processes. The proposed role of H&S representatives appears demanding, but the associated skills training outlined in public unit standards, lacks essential elements. The findings identify key considerations for an underpinning approach to H&S training for elementary mineworkers. These are: new learning required; risk perception and management; existing and associated logics; team ethos; maintaining new learning and practice; and a dialogic aspect to programmes. Additional findings suggest that the convergent effects of different policies result in the training of the least educated mineworkers being marginalised. The study concludes with six propositions that relate to the research and development of H&S training for mineworkers, public evidence of training, policy effects and the predicament of mineworkers who lack formal education.<br>Thesis (PhD)--University of Pretoria, 2011.<br>Education Management and Policy Studies<br>unrestricted

The World Health Organization (WHO) has forecast a global shortage of health workers by 2030, predominantly affecting low- and middle-income countries (LMICs). This sits in tension with the United Nations’ (UN) Sustainable Development Goal 3 (healthy lives and well-being) through universal health coverage (UHC). To address this problem, the WHO encourages task shifting, recruitment, training, and deployment of health workers. In lowand middle-income countries (LMICs), frontline health workers (FLHWs) are responsible for expanding the reach of the health system and providing crucial reproductive, maternal, newborn and child health (RMNCH) services. Adequate and appropriate training is fundamental to the success of FLHWs, particularly in contexts where their scope of work may evolve or expand over time. Digital health solutions (defined as the use of digital, mobile and wireless technologies to support the achievement of health objectives) are increasingly being used to support the training of FLHWs. Strategies may rely on use of digital tools, including mobile phones, as the primary modality for training or as tools which augment traditional face-to-face instruction. Digital health has potential for FLHW training as it allows for listening, learning and teaching through interactive health content accessible even on basic mobile phones. This dissertation explored the literature on FLHWs in LMICs, digital health in LMICs, digital health used by FLHWs, and digital health used for training of FLHWs in LMICs. The journal “ready” component is a systematic review which discusses the various aspects of digital training for FLHWs in LMICs. For the purposes of the systematic review, seven electronic databases were searched for articles published in English from 2008-2018. Combinations of medical subheadings (MeSH) that were used were: “mHealth”, “health worker”, “community health worker” and “low- and middle-income country”. From a total of 2628 identified studies, abstracts were screened with four filters to identify studies about “training”, and eventually a total of 16 studies were included. The included studies were critically appraised and coded descriptively to enable a narrative synthesis of findings. Of the sixteen studies, twelve used mobile and/or smartphones for FLHW training. A wide range of digital platforms were used to provide information (and where relevant enable interaction). Duration of training programs varied from five days to six months. Training content was relevant to the various health services and practice areas the FLHWs worked in. Training focused on continuing education through in-service training of new content or in-service refresher courses. Three training pedagogies were used: 1) didactic training techniques – in four studies information was provided passively without an interactive component; 2) interactive training techniques – six studies used platforms to provide information along with an interactive component via multi-media; and, 3) blended-learning approach – six studies delivered training via didactic and interactive approaches by combining live and distance training. Consistent with the literature review, all studies reported increased knowledge and positive perceptions of digital health for FLHW training. Interactive and blended learning approaches, especially when accessed through mHealth technologies, are feasible, effective, appropriate, cost effective and scalable in LMICs. The conclusion from the literature and systematic reviews were that long-term effects (e.g. change in behaviour, improved service provision) need to be researched further.

<p><!--[if gte mso 9]><xml> <o:OfficeDocumentSettings> <o:AllowPNG /> </o:OfficeDocumentSettings> </xml><![endif]--></p> <p><!--[if gte mso 9]><xml> <w:WordDocument> <w:View>Normal</w:View> <w:Zoom>0</w:Zoom> <w:TrackMoves /> <w:TrackFormatting /> <w:PunctuationKerning /> <w:ValidateAgainstSchemas /> <w:SaveIfXMLInvalid>false</w:SaveIfXMLInvalid> <w:IgnoreMixedContent>false</w:IgnoreMixedContent> <w:AlwaysShowPlaceholderText>false</w:AlwaysShowPlaceholderText> <w:DoNotPromoteQF /> <w:LidThemeOther>EN-ZA</w:LidThemeOther> <w:LidThemeAsian>X-NONE</w:LidThemeAsian> <w:LidThemeComplexScript>X-NONE</w:LidThemeComplexScript> <w:Compatibility> <w:BreakWrappedTables /> <w:SnapToGridInCell /> <w:WrapTextWithPunct /> <w:UseAsianBreakRules /> <w:DontGrowAutofit /> <w:SplitPgBreakAndParaMark /> <w:EnableOpenTypeKerning /> <w:DontFlipMirrorIndents /> <w:OverrideTableStyleHps /> </w:Compatibility> <m:mathPr> <m:mathFont m:val="Cambria Math" /> <m:brkBin m:val="before" /> <m:brkBinSub m:val="&#45<br>-" /> <m:smallFrac m:val="off" /> <m:dispDef /> <m:lMargin m:val="0" /> <m:rMargin m:val="0" /> <m:defJc m:val="centerGroup" /> <m:wrapIndent m:val="1440" /> <m:intLim m:val="subSup" /> <m:naryLim m:val="undOvr" /> </m:mathPr></w:WordDocument> </xml><![endif]--><!--[if gte mso 9]><xml> <w:LatentStyles DefLockedState="false" DefUnhideWhenUsed="true" DefSemiHidden="true" DefQFormat="false" DefPriority="99" LatentStyleCount="267"> <w:LsdException Locked="false" Priority="0" SemiHidden="false" UnhideWhenUsed="false" QFormat="true" Name="Normal" /> <w:LsdException Locked="false" Priority="9" SemiHidden="false" UnhideWhenUsed="false" QFormat="true" Name="heading 1" /> <w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 2" /> <w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 3" /> <w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 4" /> <w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 5" /> <w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 6" /> <w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 7" /> <w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 8" /> <w:LsdException Locked="false" Priority="9" QFormat="true" Name="heading 9" /> <w:LsdException Locked="false" Priority="39" Name="toc 1" /> <w:LsdException Locked="false" Priority="39" Name="toc 2" /> <w:LsdException Locked="false" Priority="39" Name="toc 3" /> <w:LsdException Locked="false" Priority="39" Name="toc 4" /> <w:LsdException Locked="false" Priority="39" Name="toc 5" /> <w:LsdException Locked="false" Priority="39" Name="toc 6" /> <w:LsdException Locked="false" Priority="39" Name="toc 7" /> <w:LsdException Locked="false" Priority="39" Name="toc 8" /> <w:LsdException Locked="false" Priority="39" Name="toc 9" /> <w:LsdException Locked="false" Priority="35" QFormat="true" Name="caption" /> <w:LsdException Locked="false" Priority="10" SemiHidden="false" UnhideWhenUsed="false" QFormat="true" Name="Title" /> <w:LsdException Locked="false" Priority="1" Name="Default Paragraph Font" /> <w:LsdException Locked="false" Priority="11" SemiHidden="false" UnhideWhenUsed="false" QFormat="true" Name="Subtitle" /> <w:LsdException Locked="false" Priority="22" SemiHidden="false" UnhideWhenUsed="false" QFormat="true" Name="Strong" /> <w:LsdException Locked="false" Priority="20" SemiHidden="false" UnhideWhenUsed="false" QFormat="true" Name="Emphasis" /> <w:LsdException Locked="false" Priority="59" SemiHidden="false" UnhideWhenUsed="false" Name="Table Grid" /> <w:LsdException Locked="false" UnhideWhenUsed="false" Name="Placeholder Text" /> <w:LsdException Locked="false" Priority="1" SemiHidden="false" UnhideWhenUsed="false" QFormat="true" Name="No Spacing" /> <w:LsdException Locked="false" Priority="60" SemiHidden="false" UnhideWhenUsed="false" Name="Light Shading" /> <w:LsdException Locked="false" Priority="61" SemiHidden="false" UnhideWhenUsed="false" Name="Light List" /> <w:LsdException Locked="false" Priority="62" SemiHidden="false" UnhideWhenUsed="false" Name="Light Grid" /> <w:LsdException Locked="false" Priority="63" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Shading 1" /> <w:LsdException Locked="false" Priority="64" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Shading 2" /> <w:LsdException Locked="false" Priority="65" SemiHidden="false" UnhideWhenUsed="false" Name="Medium List 1" /> <w:LsdException Locked="false" Priority="66" SemiHidden="false" UnhideWhenUsed="false" Name="Medium List 2" /> <w:LsdException Locked="false" Priority="67" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Grid 1" /> <w:LsdException Locked="false" Priority="68" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Grid 2" /> <w:LsdException Locked="false" Priority="69" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Grid 3" /> <w:LsdException Locked="false" Priority="70" SemiHidden="false" UnhideWhenUsed="false" Name="Dark List" /> <w:LsdException Locked="false" Priority="71" SemiHidden="false" UnhideWhenUsed="false" Name="Colorful Shading" /> <w:LsdException Locked="false" Priority="72" SemiHidden="false" UnhideWhenUsed="false" Name="Colorful List" /> <w:LsdException Locked="false" Priority="73" SemiHidden="false" UnhideWhenUsed="false" Name="Colorful Grid" /> <w:LsdException Locked="false" Priority="60" SemiHidden="false" UnhideWhenUsed="false" Name="Light Shading Accent 1" /> <w:LsdException Locked="false" Priority="61" SemiHidden="false" UnhideWhenUsed="false" Name="Light List Accent 1" /> <w:LsdException Locked="false" Priority="62" SemiHidden="false" UnhideWhenUsed="false" Name="Light Grid Accent 1" /> <w:LsdException Locked="false" Priority="63" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Shading 1 Accent 1" /> <w:LsdException Locked="false" Priority="64" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Shading 2 Accent 1" /> <w:LsdException Locked="false" Priority="65" SemiHidden="false" UnhideWhenUsed="false" Name="Medium List 1 Accent 1" /> <w:LsdException Locked="false" UnhideWhenUsed="false" Name="Revision" /> <w:LsdException Locked="false" Priority="34" SemiHidden="false" UnhideWhenUsed="false" QFormat="true" Name="List Paragraph" /> <w:LsdException Locked="false" Priority="29" SemiHidden="false" UnhideWhenUsed="false" QFormat="true" Name="Quote" /> <w:LsdException Locked="false" Priority="30" SemiHidden="false" UnhideWhenUsed="false" QFormat="true" Name="Intense Quote" /> <w:LsdException Locked="false" Priority="66" SemiHidden="false" UnhideWhenUsed="false" Name="Medium List 2 Accent 1" /> <w:LsdException Locked="false" Priority="67" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Grid 1 Accent 1" /> <w:LsdException Locked="false" Priority="68" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Grid 2 Accent 1" /> <w:LsdException Locked="false" Priority="69" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Grid 3 Accent 1" /> <w:LsdException Locked="false" Priority="70" SemiHidden="false" UnhideWhenUsed="false" Name="Dark List Accent 1" /> <w:LsdException Locked="false" Priority="71" SemiHidden="false" UnhideWhenUsed="false" Name="Colorful Shading Accent 1" /> <w:LsdException Locked="false" Priority="72" SemiHidden="false" UnhideWhenUsed="false" Name="Colorful List Accent 1" /> <w:LsdException Locked="false" Priority="73" SemiHidden="false" UnhideWhenUsed="false" Name="Colorful Grid Accent 1" /> <w:LsdException Locked="false" Priority="60" SemiHidden="false" UnhideWhenUsed="false" Name="Light Shading Accent 2" /> <w:LsdException Locked="false" Priority="61" SemiHidden="false" UnhideWhenUsed="false" Name="Light List Accent 2" /> <w:LsdException Locked="false" Priority="62" SemiHidden="false" UnhideWhenUsed="false" Name="Light Grid Accent 2" /> <w:LsdException Locked="false" Priority="63" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Shading 1 Accent 2" /> <w:LsdException Locked="false" Priority="64" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Shading 2 Accent 2" /> <w:LsdException Locked="false" Priority="65" SemiHidden="false" UnhideWhenUsed="false" Name="Medium List 1 Accent 2" /> <w:LsdException Locked="false" Priority="66" SemiHidden="false" UnhideWhenUsed="false" Name="Medium List 2 Accent 2" /> <w:LsdException Locked="false" Priority="67" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Grid 1 Accent 2" /> <w:LsdException Locked="false" Priority="68" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Grid 2 Accent 2" /> <w:LsdException Locked="false" Priority="69" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Grid 3 Accent 2" /> <w:LsdException Locked="false" Priority="70" SemiHidden="false" UnhideWhenUsed="false" Name="Dark List Accent 2" /> <w:LsdException Locked="false" Priority="71" SemiHidden="false" UnhideWhenUsed="false" Name="Colorful Shading Accent 2" /> <w:LsdException Locked="false" Priority="72" SemiHidden="false" UnhideWhenUsed="false" Name="Colorful List Accent 2" /> <w:LsdException Locked="false" Priority="73" SemiHidden="false" UnhideWhenUsed="false" Name="Colorful Grid Accent 2" /> <w:LsdException Locked="false" Priority="60" SemiHidden="false" UnhideWhenUsed="false" Name="Light Shading Accent 3" /> <w:LsdException Locked="false" Priority="61" SemiHidden="false" UnhideWhenUsed="false" Name="Light List Accent 3" /> <w:LsdException Locked="false" Priority="62" SemiHidden="false" UnhideWhenUsed="false" Name="Light Grid Accent 3" /> <w:LsdException Locked="false" Priority="63" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Shading 1 Accent 3" /> <w:LsdException Locked="false" Priority="64" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Shading 2 Accent 3" /> <w:LsdException Locked="false" Priority="65" SemiHidden="false" UnhideWhenUsed="false" Name="Medium List 1 Accent 3" /> <w:LsdException Locked="false" Priority="66" SemiHidden="false" UnhideWhenUsed="false" Name="Medium List 2 Accent 3" /> <w:LsdException Locked="false" Priority="67" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Grid 1 Accent 3" /> <w:LsdException Locked="false" Priority="68" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Grid 2 Accent 3" /> <w:LsdException Locked="false" Priority="69" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Grid 3 Accent 3" /> <w:LsdException Locked="false" Priority="70" SemiHidden="false" UnhideWhenUsed="false" Name="Dark List Accent 3" /> <w:LsdException Locked="false" Priority="71" SemiHidden="false" UnhideWhenUsed="false" Name="Colorful Shading Accent 3" /> <w:LsdException Locked="false" Priority="72" SemiHidden="false" UnhideWhenUsed="false" Name="Colorful List Accent 3" /> <w:LsdException Locked="false" Priority="73" SemiHidden="false" UnhideWhenUsed="false" Name="Colorful Grid Accent 3" /> <w:LsdException Locked="false" Priority="60" SemiHidden="false" UnhideWhenUsed="false" Name="Light Shading Accent 4" /> <w:LsdException Locked="false" Priority="61" SemiHidden="false" UnhideWhenUsed="false" Name="Light List Accent 4" /> <w:LsdException Locked="false" Priority="62" SemiHidden="false" UnhideWhenUsed="false" Name="Light Grid Accent 4" /> <w:LsdException Locked="false" Priority="63" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Shading 1 Accent 4" /> <w:LsdException Locked="false" Priority="64" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Shading 2 Accent 4" /> <w:LsdException Locked="false" Priority="65" SemiHidden="false" UnhideWhenUsed="false" Name="Medium List 1 Accent 4" /> <w:LsdException Locked="false" Priority="66" SemiHidden="false" UnhideWhenUsed="false" Name="Medium List 2 Accent 4" /> <w:LsdException Locked="false" Priority="67" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Grid 1 Accent 4" /> <w:LsdException Locked="false" Priority="68" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Grid 2 Accent 4" /> <w:LsdException Locked="false" Priority="69" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Grid 3 Accent 4" /> <w:LsdException Locked="false" Priority="70" SemiHidden="false" UnhideWhenUsed="false" Name="Dark List Accent 4" /> <w:LsdException Locked="false" Priority="71" SemiHidden="false" UnhideWhenUsed="false" Name="Colorful Shading Accent 4" /> <w:LsdException Locked="false" Priority="72" SemiHidden="false" UnhideWhenUsed="false" Name="Colorful List Accent 4" /> <w:LsdException Locked="false" Priority="73" SemiHidden="false" UnhideWhenUsed="false" Name="Colorful Grid Accent 4" /> <w:LsdException Locked="false" Priority="60" SemiHidden="false" UnhideWhenUsed="false" Name="Light Shading Accent 5" /> <w:LsdException Locked="false" Priority="61" SemiHidden="false" UnhideWhenUsed="false" Name="Light List Accent 5" /> <w:LsdException Locked="false" Priority="62" SemiHidden="false" UnhideWhenUsed="false" Name="Light Grid Accent 5" /> <w:LsdException Locked="false" Priority="63" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Shading 1 Accent 5" /> <w:LsdException Locked="false" Priority="64" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Shading 2 Accent 5" /> <w:LsdException Locked="false" Priority="65" SemiHidden="false" UnhideWhenUsed="false" Name="Medium List 1 Accent 5" /> <w:LsdException Locked="false" Priority="66" SemiHidden="false" UnhideWhenUsed="false" Name="Medium List 2 Accent 5" /> <w:LsdException Locked="false" Priority="67" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Grid 1 Accent 5" /> <w:LsdException Locked="false" Priority="68" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Grid 2 Accent 5" /> <w:LsdException Locked="false" Priority="69" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Grid 3 Accent 5" /> <w:LsdException Locked="false" Priority="70" SemiHidden="false" UnhideWhenUsed="false" Name="Dark List Accent 5" /> <w:LsdException Locked="false" Priority="71" SemiHidden="false" UnhideWhenUsed="false" Name="Colorful Shading Accent 5" /> <w:LsdException Locked="false" Priority="72" SemiHidden="false" UnhideWhenUsed="false" Name="Colorful List Accent 5" /> <w:LsdException Locked="false" Priority="73" SemiHidden="false" UnhideWhenUsed="false" Name="Colorful Grid Accent 5" /> <w:LsdException Locked="false" Priority="60" SemiHidden="false" UnhideWhenUsed="false" Name="Light Shading Accent 6" /> <w:LsdException Locked="false" Priority="61" SemiHidden="false" UnhideWhenUsed="false" Name="Light List Accent 6" /> <w:LsdException Locked="false" Priority="62" SemiHidden="false" UnhideWhenUsed="false" Name="Light Grid Accent 6" /> <w:LsdException Locked="false" Priority="63" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Shading 1 Accent 6" /> <w:LsdException Locked="false" Priority="64" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Shading 2 Accent 6" /> <w:LsdException Locked="false" Priority="65" SemiHidden="false" UnhideWhenUsed="false" Name="Medium List 1 Accent 6" /> <w:LsdException Locked="false" Priority="66" SemiHidden="false" UnhideWhenUsed="false" Name="Medium List 2 Accent 6" /> <w:LsdException Locked="false" Priority="67" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Grid 1 Accent 6" /> <w:LsdException Locked="false" Priority="68" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Grid 2 Accent 6" /> <w:LsdException Locked="false" Priority="69" SemiHidden="false" UnhideWhenUsed="false" Name="Medium Grid 3 Accent 6" /> <w:LsdException Locked="false" Priority="70" SemiHidden="false" UnhideWhenUsed="false" Name="Dark List Accent 6" /> <w:LsdException Locked="false" Priority="71" SemiHidden="false" UnhideWhenUsed="false" Name="Colorful Shading Accent 6" /> <w:LsdException Locked="false" Priority="72" SemiHidden="false" UnhideWhenUsed="false" Name="Colorful List Accent 6" /> <w:LsdException Locked="false" Priority="73" SemiHidden="false" UnhideWhenUsed="false" Name="Colorful Grid Accent 6" /> <w:LsdException Locked="false" Priority="19" SemiHidden="false" UnhideWhenUsed="false" QFormat="true" Name="Subtle Emphasis" /> <w:LsdException Locked="false" Priority="21" SemiHidden="false" UnhideWhenUsed="false" QFormat="true" Name="Intense Emphasis" /> <w:LsdException Locked="false" Priority="31" SemiHidden="false" UnhideWhenUsed="false" QFormat="true" Name="Subtle Reference" /> <w:LsdException Locked="false" Priority="32" SemiHidden="false" UnhideWhenUsed="false" QFormat="true" Name="Intense Reference" /> <w:LsdException Locked="false" Priority="33" SemiHidden="false" UnhideWhenUsed="false" QFormat="true" Name="Book Title" /> <w:LsdException Locked="false" Priority="37" Name="Bibliography" /> <w:LsdException Locked="false" Priority="39" QFormat="true" Name="TOC Heading" /> </w:LatentStyles> </xml><![endif]--><!--[if gte mso 10]> <style> /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"<br>mso-tstyle-rowband-size:0<br>mso-tstyle-colband-size:0<br>mso-style-noshow:yes<br>mso-style-priority:99<br>mso-style-parent:""<br>mso-padding-alt:0cm 5.4pt 0cm 5.4pt<br>mso-para-margin-top:0cm<br>mso-para-margin-right:0cm<br>mso-para-margin-bottom:10.0pt<br>mso-para-margin-left:0cm<br>line-height:115%<br>mso-pagination:widow-orphan<br>font-size:11.0pt<br>font-family:"Calibri","sans-serif"<br>mso-ascii-font-family:Calibri<br>mso-ascii-theme-font:minor-latin<br>mso-hansi-font-family:Calibri<br>mso-hansi-theme-font:minor-latin<br>mso-bidi-font-family:"Times New Roman"<br>mso-bidi-theme-font:minor-bidi<br>mso-fareast-language:EN-US<br>} </style> <![endif]--><span style="font-size:12.0pt<br>line-height:115%<br>font-family:&quot<br>Times New Roman&quot<br>,&quot<br>serif&quot<br>mso-fareast-font-family:&quot<br>Times New Roman&quot<br>mso-ansi-language:EN-ZA<br>mso-fareast-language:EN-ZA<br>mso-bidi-language:AR-SA">The Western Cape AIDS Training, Information and Counselling Centre (ATICC) primarily focuses on the development and provision of information and different types of training programmes on HIV/AID/STIs. The Director of the Health Service of the Cape Metropolitan Council was invited by ATICC to select seven health educators and nurses who were involved in health education and counselling in their local clinics to complete a six-month training course. The objective of this study was to evaluate the effectiveness of the ATICC training course on the counselling practice of trainees at their clinics.</span></p>

Thesis (M.C.P.)--Massachusetts Institute of Technology, Dept. of Urban Studies and Planning, 2002.<br>Includes bibliographical references (leaves 69-72).<br>This thesis explores the barriers to participation in the 1199 Home Care Industry Bill Michelson Education Fund (Home Care Education Fund). The Home Care Education Fund is structured as a Taft-Hartley, joint labor-management training fund to provide skills upgrading opportunities to unionized home care workers. It is the only such fun in the United States devoted exclusively to home care workers. Home care is a growing sector of the health care industry, and home attendants and home health aides are projected to be among the fastest-growing occupations in the following decade, according to the Bureau of Labor Statistics. Home care workers are also some of the most economically disadvantaged workers in the health care sector, earning poverty-level wages and, with the exception of 1199/SEIU members, lacking health insurance and pension benefits. Three sets of stakeholder groups were interviewed for this thesis: home care workers, who participated in a series of focus group meetings and personal interviews; home care agency employers; and Home Care Education Fund and ETJSP staff members. A written survey instrument was implemented to home care agency employers regarding their staffing levels and training benefits to supplement personal interviews. Each group articulated a coherent set of barriers facing home care workers, with unique challenges facing the agency employers and Education Fund staff in meeting the workers' needs. It is argued that shared interests bind these groups together and that a considerable overlap exists between the provision of quality medical care, welfare and job training policies. Further, there is an urgent need to support a frontline, marginalized workforce that is caring for thousands of disabled and elderly clients on a daily basis. The ultimate goal of this thesis is to identify those key barriers that prevent participation in the Home Care Education Fund so that staff and trustees may work together to tailor their services to meet their unique needs. It concludes with supporting recommendations for workforce development policy.<br>by Hilary Sharpless Chapman.<br>M.C.P.

This study was designed to investigate the effectiveness of the California Brief Multicultural Competence Scale (CBMCS) and training as a tool to increase cultural competency skills. The interest of this was to determine if the training brought about a change in empathy or effectively increased knowledge about the importance of culture.

Thesis (PhD)--University of Stellenbosch, 2006<br>ENGLISH ABSTRACT: Zambia is reported to have high levels of maternal morbidity and mortality due to low contraceptive prevalence rates, over 50% of births not being attended to by skilled persons, and teenage pregnancies. A number of organisations (stakeholders) have invested in the training of adolescent reproductive health peer educators with the aim of empowering them to be role models to their peers in reproductive health, but Zambia does not have a generic and locally developed training programme for peer educators. The purpose of this study was to develop a training programme that would produce competent and more effective peer educators for Zambia. The objectives were to determine the characteristics of the ideal peer educator. Further objectives were to ascertain the factors that contribute to or impair the development of the ideal peer educator, and to determine whether training programmes that were being used were producing ideal peer educators and enhancing healthy lifestyle behaviours. Key stakeholders participated in group interviews were they presented and critiqued their training programmes. Emerging out of this process was a draft training programme, developed by the stakeholders. Focus Group Discussions (FGDs) were held with adolescent peer educators from Lusaka, Kafue, Livingstone and Maheba refugee camp. Data were analysed by triangulating the outcomes of the group interviews (with the stakeholders) with the outcomes of the FGDs and reviewed literature. The FGDs highlighted the characteristics of an ideal peer educator as well as factors that contribute towards his/her competence development. Numerous factors were reported that had a negative impact on the development of an ideal peer educator. The peer educators reported that their training had had a positive effect on their lifestyle behaviours. While they had gained more knowledge on HIV and AIDS, they recommended more training on other health issues. The study found that at community level, peer educators were not being given adequate respect because the concept of voluntary work was not readily accepted and they were regarded as failures in life. Major demotivating factors were the lack of payment of incentives and the fact that peer educators were not certified. Peer educators did not receive sufficient support from programme managers/coordinators to enable them to become more effective at community level. Weaknesses in the way the training programmes were conducted were also discerned. Based on the findings of this study, it is recommended that more life skills’ development be promoted for peer educators. Training should be contextualised for the communities in which the peer educators work. The developed training programme, which should be used as a guide, should be repackaged to suit the profiles (e.g. values) of the different communities. Adolescents and various social sectors (inclusive of indicated stakeholders) ought to be involved in diagnosing community needs so as to influence both peers and communities in a way that would promote adolescent reproductive health. This study also recommends a more informal way of practising peer education, which would produce trainees who would be peer educators and role models in any given setting.<br>AFRIKAANSE OPSOMMING: Na berig word is die hoë siekte- en sterftesyfers onder moeders in Zambië daaraan te wyte dat voorbehoedmiddels nie algemeen gebruik word nie, dat meer as 50% van geboortes plaasvind sonder die bystand van bekwame persone, en dat daar ‘n hoë voorkoms van tienerswangerskappe is. ‘n Aantal organisasies (belanghebbers) het in die opleiding van adolessent- portuurgroep-opvoeders in reproduktiewe gesondheid belê ten einde hierdie portuurgroep-opvoeders te bemagtig om as rolmodelle in reproduktiewe gesondheid op te tree. Zambië het egter nie ‘n eie generiese, plaaslik-ontwikkelde opleidingsprogram vir portuurgroep-opvoeders nie. Die doel van hierdie studie was om ‘n opleidingsmodel en opleidingsprogram te ontwikkel wat bekwame en meer effektiewe portuurgroep-opvoeders vir Zambië sou kon oplewer. Die doelstellings was om die kenmerke van ‘n ideale portuurgroep-opvoeder te bepaal en om die faktore te identifiseer wat óf tot die ontwikkeling van ‘n ideale portuurgroep-opvoeder bydra óf sy/haar ontwikkeling strem. Daar moes ook vasgestel word of bestaande opleidingsprogramme ideale portuurgroep-opvoeders oplewer en gevolglik gesonde leefstylgedrag bevorder. Die navorser het groeponderhoude gebruik en betekenisvolle belanghebbers genooi om hulle opleidingsprogramme aan te bied, te beoordeel en krities te bespreek. ‘n Konsepopleidingsprogram wat deur die belanghebbers ontwikkel is, het uit hierdie proses ontstaan. Fokusgroepbesprekings (Engels: Focus Group Discussions of FGDs) is met adolessente portuurgroep-opvoeders van Lusaka, Kafue, Livingstone en die Maheba-vlugtelingekamp gehou. Data is ontleed deur die uitkomste van die groeponderhoude (met die deelhebbers) met die uitkomste van die fokusgroepbesprekings en die bespreekte literatuur te trianguleer. Die fokusgroepbesprekings het die soeklig op die kenmerke van die ideale portuurgroepopvoeder asook op die faktore wat tot sy/haar bekwaamheidsontwikkeling bydra, laat val. Talle faktore wat ‘n negatiewe uitwerking op die ontwikkeling van ‘n ideale portuurgroep-opvoeder het, is ook vasgestel. Die portuurgroep-opvoeders het bevestig dat hul opleiding ‘n positiewe invloed op hul lewenstylgedrag gehad het. Terwyl hulle genoem het dat hulle meer kennis oor MIV en VIGS opgedoen het, het hulle aanbeveel dat daar ook meer klem op ander gesondheidskwessies behoort te wees. In hierdie studie is daar bevind dat portuurgroepopvoeders op gemeenskapsvlak nie met voldoende respek behandel word nie. Die begrip van vrywillige werk word nie geredelik aanvaar nie, en die opvoeders word as mislukkings beskou. Faktore wat besonder ontmoedigend inwerk is die gebrek aan ‘n aansporingsloon en die feit dat portuurgroep-opvoeders nie sertifikate ontvang nie. Portuurgroep-opvoeders het ook nie voldoende ondersteuning van programbestuurders/- koördineerders ontvang om hulle in staat te stel om meer effektief op gemeenskapsvlak op te tree nie. Daar is voorts swakhede opgemerk in die wyse waarop die opleidingsprogramme uitgevoer is. Gegrond op die bevindinge van hierdie studie, word daar aanbeveel dat die ontwikkeling van lewensvaardighede tot ‘n groter mate bevorder word. Opleiding behoort gekontekstualiseer te word vir die gemeenskappe waarbinne die opvoeders werk. Die bestaande opleidingsprogram, wat as ‘n riglyn gebruik behoort te word, behoort herstruktureer te word om by die profiele (bv. die waardes) van die verskillende gemeenskappe in te pas. Adolessente en verskillende sosiale sektore (insluitend die aangeduide belanghebbers) behoort betrokke te wees by die bepaling van die gemeenskap se behoeftes ten einde beide portuurgroepe en gemeenskappe so te beïnvloed dat adolessente- reproduktiewe gesondheid bevoordeel sal word. Hierdie studie beveel ook aan dat portuurgroep-opvoeding op ‘n informeler grondslag beoefen behoort te word sodat die kwekelinge uiteindelik in enige gegewe omgewing suksesvolle portuurgroepopvoeders en rolmodelle sal kan wees.

Mental illness in the United States is a major public health problem. According to the Substance Abuse and Mental Health Services Administration, in 2017, 18.9% of adults in the United States had a mental illness. The purpose of this study was to gain insight into the perceptions held by community health workers (CHWs) regarding their integration into the behavioral health care system in Maryland. Using a social constructivism paradigm and phenomenological approach, a purposive sample of 11 CHWs who supported patients with behavioral health conditions in 17 counties in the state were interviewed. Howlett, McConnell, and Perl'€™s five stream confluence policy process theory and Lipsky's street level bureaucracy theory provided the foundation to explore the perceptions of the CHWs about their integration into the behavioral health care system; the problems, policies, processes, and programs that impacted their ability to be integrated into the behavioral health team; and their function as a street level bureaucrat to facilitate their integration. A deductive iterative coding approach was used, culminating in the identification of the following 6 themes: health system utilization of CHW behavioral health integration, official policy recognition of the CHW profession, accountability for CHW integration, CHW practice support, integrated health care team management of physical and mental health and behavior, and building the CHW profession. The social change implications of this study are that CHWs'€™ integration into the broadly defined, integrated, physical and mental behavioral health team can support having a more cost-effective way toward having healthy people and communities because they link the community to health and social services and advocate for quality care.

Occupational ill-health statistics have consistently placed construction as a high risk industry. Younger workers (aged 15-24) constituting 24% of the UK construction workforce are a high risk group for occupational illnesses from more exposure to physical work factors including noise, vibrations and the handling of dangerous substances. The provision of effective training to young people entering the workforce is crucial in preventing occupational illnesses and improving the industry s occupational health (OH) performance. However, whilst the delivery of training in industries such as healthcare and aviation has rapidly been shifting from pedagogical/instructional theoretical frameworks towards more learner-focused andragogical approaches rich in hands-on/experiential learning, training in the construction industry has not taken full advantage of new training approaches. This thesis aims to examine OH training methods for UK construction apprentices and evaluate the role and effectiveness of a simulation-based training strategy, in order to enhance the OH training for construction apprentices. It presents and adopts innovative wearable, hands on simulations that were designed and developed at Loughborough University, called LUSKInS (Loughborough University Sensory and Kinaesthetic Interactive Simulations), to assess their value and utility in the training of construction apprentices. In order to address the research aim and provide comprehensive answers to the research questions, the research adopted an inductive, multimethods approach, in which the collection and analysis of data combined quantitative and qualitative research methods. First, reviews of theories of learning and existing research utilising simulation learning tools in various educational settings were carried out, to gather insights into how people learn, the theoretical underpinning to the use of simulations as well as the efficacy of simulation-based training. This analysis indicated that use of simulations that is based on the review and application of relevant learning theories has significant potential in enhancing the learning of construction apprentices. Furthermore, the analysis identified a need to move from traditional direct instructional training methods towards more experiential and learner-centred methods in construction education and training. Accordingly, the subsequent use of wearable simulations in the study was guided by experiential and constructivist learning principles, meaning that the research participants were provided with interactive and engaging contextual experiences, which allowed them to actively construct their own understanding, as opposed to them passively acquiring OH information from external sources. Second, fieldwork data was gathered through survey questionnaires, participant observations, semi-structured interviews and photo-elicitation. This involved construction apprentices and instructors from three colleges located in London, Midlands and Norfolk. Together, the quantitative and qualitative data confirmed that a traditional instructor-centred approach, which places emphasis on the passive transmission of information and the use of standardised presentations, texts and workbooks dominates the delivery of OH training for construction apprentices, despite many of the trainees in the study expressing a preference for highly engaging, active or hands-on methods of learning to passive, information-based approaches. It was clear from the findings that by failing to take into consideration the diversity in learning preferences among the trainees and the crucial role of interaction and learner participation in the learning process, the existing instructional strategies do not effectively support the learning of construction apprentices. Notably, the findings revealed that the prevailing views of training amongst instructors and their leaders, which endorse direct instructional strategies and uniformity, create barriers for opportunities to create and utilise more progressive learner-centred training strategies for construction apprentices. The findings related to the impact of the wearable simulations indicated that the use of hands-on simulations can be beneficial to the learning of construction apprentices. The simulations were found to be effective in developing the apprentices understanding of OH illnesses, as well as in changing some of their attitudes, particularly towards prioritising their health at work and adopting correct work practices, for example, wearing appropriate protective clothing when carrying out their work. In addition, the findings also showed that the simulations were largely perceived to be enjoyable, engaging and easier to understand compared to traditional training methods. However, challenges associated with the use of simulations were also identified, including the relatively high costs in terms of both time and money required in their development and implementation as well as challenges associated with trainer competence and adapting curricula to the newer training approach. Based on the empirical evidence and the related theoretical explanations, the study develops a set of propositions which not only challenge the current training paradigm, but more importantly identify the factors that can optimise the OH training of construction apprentices and overcome some of the barriers that were identified. In addition, a conceptual framework and typology of trainees learning styles are developed, in order to provide some practical guidance on how appropriate training strategies can be selected, as well as assist the wider application and integration of simulation learning tools.

Objective: To determine the value of a program instituted by an academic medical library to train public library workers across the State of Tennessee, US to deliver quality health information to patrons. Methods: Qualitative analysis including focus groups. Results: The East Tennessee State University (ETSU) Medical Library used four three-hour classes developed by the US National Library of Medicine to train public library workers across the State of Tennessee over the last five years. All four classes were offered multiple times in the nine regions of the state public library system. Approximately 250 library workers received the Consumer Health Information Specialization designation from the US Medical Library Association for participating in 12 hours of training. The motivation behind this effort was reports that the first place people with a new diagnosis go for information is the public library. Conclusion: We wanted to look for evidence to see if there was value in this project in order to know whether to repeat it in the future or whether to promote it as a model to other geographical areas. A qualitative analysis of the results of the project will be presented at the conference.

Philosophiae Doctor - PhD<br>Non-communicable diseases (NCD) continue to be a public health concern globally and contribute to the burden of disease. The formal health system in developing countries lacks the capacity to deal with these NCD as it is overburdened by communicable diseases. Thus, community health workers (CHWs) have been suggested as a solution for alleviating the burden for primary health facilities, by extending NCD care to the community. This thesis aims to develop an integrated model of care for CHWs working with patients with non-communicable diseases by describing and exploring current CHW roles, knowledge and practices in relation to community-based NCD care. The specific objectives for this study included 1) the exploration of the NCD roles of generalist CHWs in the context of a limited resource urban setting; 2) determining the NCD-related knowledge of CHWs, and factors influencing this in a limited resource urban setting and 3) a comparison of actual and envisaged roles in the management and prevention of NCD using the integrated chronic diseases management model (ICDM) as a benchmark, and propose key competencies and systems support for NCD functions of CHWs in South Africa Mixed methods were used to achieve the objectives of this study. First, a qualitative enquiry was conducted using observations to respond to the first objective. A quantitative cross-sectional design was then used to achieve the second objective, and a questionnaire was used to interview CHWs. A comparison of findings from both the quantitative and qualitative studies with policy guidelines was undertaken to address the third objective.

Background: There is an increasing amount of blood sample rejection at primary health care facilities (PHCFs) impacting negatively on the staff, facility, patient and laboratory costs. Aim: The primary objective was to determine the rejection rate and reasons for blood sample rejection at four PHCFs pre and post phlebotomy training. The secondary objective was to determine whether phlebotomy training improved knowledge amongst primary health care providers (HCPs) and to develop a tool for blood sample acceptability. Study Setting: Two Community Health Centres (CHCs) and two Community Day Centres (CDCs) in Cape Town. Methods: A quasi-experimental study design. Results: The sample rejection rate was 0.79% (n= 60) at CHC A, 1.13% (n= 45) at CHC B, 1.64% (n= 38) at CDC C and 1.36% (n= 8) at CDC D pre training. The rejection rates remained approximately the same post training (p>0.05). The same phlebotomy questionnaire was administered pre and post training to HCPs. The average score increased from 6 3% (95% CI 6.97 - 17.03) to 96% (95% CI 16.91 - 20.09) at CHC A (p 0.039), 58% (95% CI 9.09 – 14.91) to 93% (95% CI 17.64 – 18.76) at CHC B (p 0.006), 60% (95% CI 8.84 – 13.13) to 97% (95% CI 16.14 – 19.29) at CDC C (p 0.001) and 63% (95% CI 9.81 – 13.33) to 97% (95% CI 18.08 – 19.07) at CDC D (p 0.001). Conclusion: There is no statistically significant improvement in the rejection rate of blood samples (p>0.05) post training despite knowledge improving in all HCPs (p <0.05).

<p>This study investigated the challenges facing a category of community health workers (Health Surveillance Assistants) in rural Malawi district of Nkhatabay following the expansion of their programme funding from the Global Funding to fight AIDS, Tuberculosis and Malaria (GFATM). The study has noted that HSAs are facing serious accommodation problems due to the lack of involvement of communities in their selection and that many HSAs are recruited from outside their catchment areas. The study has put forward some recommendations to the Ministry of Health and other stakeholders like United Nations Children&rsquo<br>s Fund (UNICEF) and the World Health Organization (WHO) to consider in making the HSAs programme in Nkhatabay district effective. Some of the recommendations made are that supervision of the HSAs by the EHOs and the ECHNs should be intensified and that infrastructure support should be provided to the HSAs for them to be able to deliver the EHP. Infrastructure like buildings and equipment like refrigerators and bicycles should be provided to HSAs and ensure that there is a plan for their maintenance.</p>

p. 1-81<br>Submitted by Santiago Fabio (fabio.ssantiago@hotmail.com) on 2013-04-29T19:47:33Z No. of bitstreams: 1 22222222222222.pdf: 519224 bytes, checksum: aae481060043c99c59c363ced77fc1d7 (MD5)<br>Approved for entry into archive by Maria Creuza Silva(mariakreuza@yahoo.com.br) on 2013-05-04T17:33:33Z (GMT) No. of bitstreams: 1 22222222222222.pdf: 519224 bytes, checksum: aae481060043c99c59c363ced77fc1d7 (MD5)<br>Made available in DSpace on 2013-05-04T17:33:33Z (GMT). No. of bitstreams: 1 22222222222222.pdf: 519224 bytes, checksum: aae481060043c99c59c363ced77fc1d7 (MD5) Previous issue date: 2008<br>A Formação Profissional em Saúde do Trabalhador, objeto deste estudo, constitui-se hoje como um tema relevante de estudo e como uma das principais estratégias de consolidação da Rede Nacional de Atenção Integral a Saúde dos Trabalhadores -RENAST no SUS. Esta rede, apesar do contexto de implantação recente e de crise na saúde, necessita de profissionais formados com base em um conhecimento crítico sobre a relação saúde trabalho e o processo saúde-doença, de modo a contribuir com práticas inovadoras voltadas para uma perspectiva da integralidade, vigilância e humanização da atenção, no âmbito do Sistema Único de Saúde. Objetiva-se nesta pesquisa analisar os Cursos de Especialização em Saúde do Trabalhador no Brasil, no período de 1986 a 2006, quanto ao marco explicativo predominante da relação saúde e trabalho e o objetivo implícito da formação profissional. A revisão de literatura indica a inexistência de produções científicas no campo da formação profissional em Saúde do Trabalhador, o que justifica este estudo e o torna novo e original. Trata-se de um estudo qualitativo, do tipo exploratório. Os resultados apontam que apesar das fragilidades conceituais encontradas em alguns cursos, na maioria estes estão formando na perspectiva da Saúde do Trabalhador, voltados para o atendimento das necessidades de saúde dos trabalhadores e para a construção da RENAST no SUS.<br>Salvador

The dangerous work environment in the construction industry and the inherent high risks associated with construction work make it the focus of safety training and regulations. Highway construction and maintenance has unique hazards but seemingly less directly applicable safety standards, regulations, and programs. Department of Transportation (DOT) employees working in highway maintenance are exposed to a variety of unique hazards specifically associated with their work and not relating to the adjacent traffic. Yet, highway construction and maintenance work has not received sufficient attention in terms of safety research and programs. The lack of safety training and education in highway construction and maintenance work leaves a significant portion of DOT employees prone to different work-related hazards that can be avoided with additional safety awareness. As part of the efforts of the Kentucky Transportation Cabinet (KYTC) to improve safety of their employees, the study describes the design, implementation, and evaluation of a pre-task safety briefing toolbox. By analyzing recordable incidents of KYTC maintenance employees and identifying frequent hazards present within their typical work operations and the causes behind the frequent incidents, the final product of design phase is a toolbox that is relatable and relevant to KYTC maintenance crews. The toolbox presents these hazards along with incidents causes and the appropriate safety practices to avoid or mitigate the associated risk. The goal of this safety toolbox is to improve safety awareness of KYTC maintenance crews. The second part of the study is a comprehensive systematic evaluation of the effectiveness of the toolbox. Three evaluation phases including reaction and knowledge evaluation, implementation evaluation, and behavior change evaluation were carried out to assess the effectiveness of the toolbox. With 22% improvement in workers safety knowledge, 23% improvement in workers hazards identification skills, and 33.24% increase in the likelihood of safe behavior, the results showed that pre-task safety toolbox talks can increase highway workers’ safety awareness, improve their hazards identification skills, and increase their safe behavior. In addition to serving an underserved audience of the construction workforce, this study contributes to the body of knowledge in different ways. First, it sheds the light on a significant underserved portion of construction workers and the unique hazards present in their work environment. Second, it presents the design, implementation, and evaluation of a data driven safety intervention that addresses the most frequent safety issues in highway maintenance operations. Finally, it presents an empirical trial to evaluate the effectiveness of a common practice used in the construction industry in a unique sector of the industry that has not received sufficient research efforts.

Aims The purpose of this study is to explore the possibilities for video-based learning of computer systems in the field of medical education in rural sub-Saharan Africa. Background Low-income countries are forced to perform healthcare services with resources already spread too thin. The use of electronic medical records can increase the cost-effectiveness of delivering healthcare services, but the low computer literacy in sub-Saharan Africa is an obstacle necessary to overcome. E-learning and video-based learning has the potential to partially solve this problem. Methods User observations were conducted on five healthcare workers in rural Uganda. The users watched an instruction video, after which they performed an assessment test of an electronic medical record system. Results Some effectiveness was perceived – but it was slight, and varied greatly between the test subjects. Computer experience is an important prerequisite for the success of e-learning initiatives. Effectiveness was higher for more simple tasks. Conclusion This paper does not propose video-based learning as the only source of training for the target group. However, there is a possibility to envision video-based learning as a building block in a blended-learning strategy – utilising video-based learning for easier tasks and knowledge retention for users who are already familiar with the system.

Submitted by Micheli Abreu (mabreu@fiocruz.br) on 2016-02-25T17:02:49Z No. of bitstreams: 1 Gustavo_Dantas_EPSJC_Mestrado_2015.pdf: 1635389 bytes, checksum: 88bec30d05b400c61849619bdc1e3030 (MD5)<br>Approved for entry into archive by Renata Azeredo (renataazeredo@fiocruz.br) on 2016-02-29T16:09:43Z (GMT) No. of bitstreams: 1 Gustavo_Dantas_EPSJC_Mestrado_2015.pdf: 1635389 bytes, checksum: 88bec30d05b400c61849619bdc1e3030 (MD5)<br>Made available in DSpace on 2016-02-29T16:09:43Z (GMT). No. of bitstreams: 1 Gustavo_Dantas_EPSJC_Mestrado_2015.pdf: 1635389 bytes, checksum: 88bec30d05b400c61849619bdc1e3030 (MD5) Previous issue date: 2015<br>Fundação Oswaldo Cruz. Escola Politécnica de Saúde Joaquim Venâncio. Programa de Pós-Graduação em Educação Profissional em Saúde.<br>Este estudo se debruçou sobre o cenário, as contradições, e as intencionalidades políticas que permeiam a Política de Formação dos Agentes Comunitários de Saúde (ACS), institucionalizada a partir do ano de 2004. O objetivo foi analisar os processos e relações que levaram o município de Recife a realizar a 2ª e 3ª etapas da formação técnica dos ACS nos anos de 2011 e 2012 para cerca de 1.500 trabalhadores. Trata-se de um estudo qualitativo, com referencial metodológico crítico, histórico e dialético, realizado por meio de análises de documentos e entrevistas com perguntas semiestruturadas, junto à sujeitos chaves na estruturação do da 2ª e 3ª etapas do curso Técnico de ACS nessa localidade, utilizando para análise dos dados a técnica de análise de conteúdo a partir do referencial de Bardin. Visou-se, através das informações colhidas, mapear as forças políticas envolvidas neste processo e que protagonizaram disputas neste cenário, utilizando o conceito de Hegemonia trazido por Antônio Gramsci como aporte teórico à essa compreensão. Os resultados expressaram a existência de quatro forças políticas disputando o processo formativo, alinhadas à concepções de políticas de Saúde que incidiram historicamente na formulação deste trabalhador. Os movimentos das alianças realizadas entre essas forças políticas foram decisivos na materialização da conclusão do curso. Espera-se, que este trabalho possa fomentar discussões sobre os rumos da política de Formação desta categoria, na perspectiva de contribuir para a construção de ações concretas para sua materialização enquanto Política Pública.<br>This study set out to investigate the setting, the contradictions, and the political intentions that have pervaded the Training Policies for Community Health Workers (CHW), which came into force from 2004. Our aim was to analyze the processes and relationships that led the city of Recife to implement the 2nd and 3rd stages of the technical training course for CHWs in 2011 and 2012 for around 1,500 workers. This was a qualitative study with a critical, historical and dialectical methodological framework, conducted through document reviews and semi-structured interviews with the key personnel involved in structuring of the 2nd and 3rd stages of the technical course for CHWs. Data was analyzed using Bardin’s technique. Through the information gathered, we set out to chart the political forces involved in this process, who had staged disputes within this scenario, using the concept of hegemony as developed by Antonio Gramsci as a theoretical contribution towards a greater understanding. The results we obtained conveyed the existence of four political forces vying for the training process, aligned with the concepts of health policies, which have rendered an historical influence over the formulation of this worker. The activities undertaken by the alliances formed between these political forces were decisive in ensuring the conclusion of the course. It is hoped that this work may foster discussions on the course of training policies within this field, in order to contribute to the construction of concrete actions for its materialization as Public Policy.

ABSTRACT This study was conducted to assess mental health knowledge, attitude and practices among health care workers in Belize before and immediately after a competency based training program in mental health. A baseline Knowledge, Attitudes and Practices (KAP) survey was given to health personnel, mainly nurses, working primary and secondary care. The intervention was a 13-week face-to-face training course for health care professionals with the objective of increasing their competency in mental health and reducing stigma. After the training a post intervention KAP survey was conducted among the original respondents. 88 health care workers completed the baseline survey and 61 of those respondents completed the post-intervention questionnaire. The results showed that the level of knowledge of the participants had improved by the training intervention and that in general, the intervention was effective in correcting some misconceptions about mental illness and reducing stigmatizing attitudes among the participants.

There has been a rapid growth in the number of programs awarding undergraduate degrees in public health and the number of students receiving such degrees (1). There has not, however, been a significant discussion of the purpose of such degree programs. What, if anything, are the recipients of these degrees being trained to do? What careers, if any, are they being prepared to enter? Is the degree designed primarily to prepare students to enter graduate training in public health or some other graduate or health professional programs? Alternatively, does the degree exist because “an understanding of public health is a critical component of good citizenship and a prerequisite for taking responsibility for building healthy societies”? (2).

Objectives: The study examines how Loansome Doc services are implemented and used by libraries in the Southeast Region and describe end users' experiences with and attitudes toward Loansome Doc. Methods: 251 active DOCLINE libraries and 867 Loansome Doc users were surveyed. Results: Roughly one half of the libraries offered Loansome Doc services. Of those that did not, most indicated no plans to offer it in the future. The majority had a small number of end users and experienced minimal increases in interlibrary loan activity. Problems were relatively rare. Satisfaction with Loansome Doc was high among all types of libraries. End users were usually physicians or other health care professionals who requested articles for research and patient care. Most learned about Loansome Doc through PubMed or Internet Grateful Med. End users appeared to be largely self-taught or received informal instruction in Loansome Doc. Loansome Doc filled document requests in a timely manner, and end users reported being satisfied with the service. Conclusions: Greater promotion of what Loansome Doc is and how it can benefit libraries can increase the number of participating libraries. While satisfaction of Loansome Doc end users is high, satisfaction could be increased with more help on the PubMed screen, more library training, and faster delivery methods.

Frequently, educational approaches are considered as a dichotomy – liberal versus professional. However, perpetuating this dichotomy may not best serve students or the workforce. We are at the forefront of an educational movement and it is critical that we think intentionally about who we are training our students to be and how do we best do it. Baccalaureate public health education is occurring in a range of locations including community colleges, traditional liberal arts schools, and schools of public health. Faculty and staff have a diverse range of training and experience in educational frameworks, In addition, this educational movement is occurring at a time when the disciplinary boundaries of public health are expanding and becoming less defined.

Submitted by Maria Creuza Silva (mariakreuza@yahoo.com.br) on 2014-10-06T17:02:05Z No. of bitstreams: 1 DISSERTAÇÃO ANA LECIA COSTA. 2014.pdf: 579239 bytes, checksum: 5e92e1e55c37b019b7638854f4501f80 (MD5)<br>Approved for entry into archive by Maria Creuza Silva (mariakreuza@yahoo.com.br) on 2014-10-07T14:14:23Z (GMT) No. of bitstreams: 1 DISSERTAÇÃO ANA LECIA COSTA. 2014.pdf: 579239 bytes, checksum: 5e92e1e55c37b019b7638854f4501f80 (MD5)<br>Made available in DSpace on 2014-10-07T14:14:23Z (GMT). No. of bitstreams: 1 DISSERTAÇÃO ANA LECIA COSTA. 2014.pdf: 579239 bytes, checksum: 5e92e1e55c37b019b7638854f4501f80 (MD5)<br>A questão dos recursos humanos tem sido considerada bastante complexa, na medida em que envolve problemas relativos à formação e à disponibilidade das diversas categorias de trabalhadores que podem realizar as ações de Vigilância Sanitária nas diversas regiões, estados e municípios. Este estudo teve como objetivo geral descrever e analisar o perfil do trabalhador de Vigilância Sanitária na esfera estadual da Bahia em relação às necessidades do processo de trabalho. E como objetivos específicos, identificar as necessidades do processo de trabalho em VISA no que tange ao perfil profissional, identificar as lacunas existentes e demandas de formação na VISA e identificar os cursos nos quais os trabalhadores da VISA participaram e as suas respectivas áreas temáticas. Trata-se de um estudo descritivo e exploratório. Os dados do estudo foram oriundos da análise de documentos e de entrevistas com informantes-chave. Os documentos analisados foram o Relatório de Gestão da Secretaria de Saúde do Estado da Bahia SESAB/RAG-2010, o Plano Estadual de Saúde - PES 2008/2011, os Relatórios de Gestão da Diretoria de Vigilância Sanitária – DIVISA e da Superintendência de Vigilância à Saúde – SUVISA, os dois últimos editais dos concursos públicos da SESAB e o Plano de Cargos, Carreira e Vencimentos – PCCV/SESAB. O estudo constatou que o número de trabalhadores de VISA lotados na SESAB é insuficiente para atender à demanda de trabalho, principalmente no que diz respeito à ausência de determinadas categorias profissionais que não aquelas consideradas “grupo ocupacional serviços públicos de saúde” a exemplo de arquiteto e físico. Identificou-se também a ausência de um modelo organizacional similar para a DIVISA (nível central) e para as DIRES (nível regional), além da coerência entre os processos de formação/atualização promovida pela DIVISA/SESAB e as necessidades do serviço.<br>The issue of human resources has been considered quite complex , in that it involves issues concerning training and the availability of different categories of employees who can perform the actions of Sanitary Surveillance in the various regions , states and municipalities. This study had as main objective to describe and analyze the profile of the Health Surveillance worker at state of Bahia to the needs of the labor process. And how specific goals, identify the needs of the labor process VISA regarding the professional profile, identify gaps and training demands on VISA and identify the courses in which workers participated VISA and their respective subject areas. This is a descriptive, exploratory study. Data for the study came from the analysis of documents and interviews with key informants. The documents analyzed were the Management Report of the Secretary of Health of the State of Bahia SESAB/RAG-2010, the State Health Plan - PES 2008/2011 , the Management Report of the Board of Health Surveillance - MOTTO and the Superintendency of Surveillance health - SUVISA, the last two notices of public tenders SESAB and Career Plan , Career and Salaries - PCCV / SESAB . The study found that the number of workers in crowded VISA SESAB is insufficient to meet the demand for labor , especially with regard to the absence of specific professions than those considered " occupational group public health services " example of the architect and physical . Also identified the absence of a similar to MOTTO (central level) and for DIRES ( regional level ) organizational model , beyond the coherence between the processes of formation / update sponsored by MOTTO / SESAB and service needs.

Introduction: Work-related stress is one of the most challenging issues on workplaces. Reduced ability to relax and recover has been proposed as a key factor behind the increase of stress-related illness among workers. Massage and mental training are two commonly used techniques which may have positive effects on the ability to recover. One technique to help workers recover is a “recovery chair” which include both mechanical massage and mental training programs. However, it has not been scientifically evaluated yet whether using the techniques included in the “recovery chair”, both separately and in combination, as a health promotion tool. Aim: The overall aim of this thesis was to explore the psychological and physiological effects of the mechanical massage and mental training programs included in the “recovery chair”, both separately and in combination, as a health promotion tool for Swedish workers. Methods: In this study workers were randomly assigned to one of the following groups: i) Mechanical massage combined with mental training (n=19), ii) Mechanical massage (n=19), iii) Mental training (n=19), iv), Pause (15 min break in the armchair, n=19), v) and a Control group (n=17). Psychological effects were measured by the ”Swedish Scale of Personality” (SSP) and physiological effects were measured by heart rate, blood pressure and fingertip temperature, immediately before the randomization, after four weeks and after eight weeks (end-of-study). Results: Psychological effects: The results showed that receiving mechanical massage was associated with a significant decrease in “Somatic Trait Anxiety”. The participants in the mental training group showed a tendency to decrease in “Somatic Trait Anxiety”. The participants who received both mechanical massage and mental training showed a significant decrease in “Stress Susceptibility” between four and eight weeks. The results also showed a significant decrease in “Somatic Trait Anxiety” and a significant increase in “Detachment” for the paus group. Physiological effects: As compared to pre-intervention assessments, participants in the massage group condition showed significantly reductions in their resting heart rate, systolic and diastolic blood pressure and an increase in their fingertip temperature directly after the intervention (post-intervention). The mechanical massage and mental training group showed a significant increase in diastolic blood pressure during the last four weeks of the study. The participants in the mental training group showed a significant decrease in their heart rate, when compared the start of the study to week four. The pause group tended to have lower systolic blood pressure at post-intervention assessment when compared to the pre-intervention assessment. The participants in the control group showed significantly decrease in heart rate and their systolic blood pressure. Conclusion: The workers’ who used the “recovery chair” with mechanical massage or mental training programs, either separately or in combination, for eight weeks during working hours reported a positive impact on their levels of anxiety and stress sensitivity. The results also showed positive effects on the workers' blood pressure, pulse and fingertip temperature. The effect was particularly strong for workers' who received only mechanical massage. This indicate that stress management interventions as work place health promotion activities clearly have a potential to provide significant benefit for health and wellbeing for workers.

Esta tese consiste na identificação de contribuições político-pedagógicas dos movimentos sociais populares nas experiências e práticas culturais, integrativas, tradicionais de cuidado e de educação popular em saúde, especialmente do Movimento de Mulheres Camponesas, que poderão compor a caixa de ferramentas pedagógicas dos processos de formação de profissionais/trabalhadores (as) da saúde para sua atuação no Sistema Único de Saúde (SUS) em comunidades do campo, da floresta e das águas. A pesquisa foi realizada junto ao Movimento de Mulheres Camponesas através de análise de observações, registros, documentos, histórias de vida, oficinas e círculos de cultura feitos com mulheres que participam dessa organização, como também as redes de interação com a educação popular e permanente em saúde. A pesquisa articula essas experiências e seus saberes no contexto de produção de vida, saúde e adoecimento das populações que vivem nesses territórios e os desafios para o cuidado integral e a educação em saúde. Territórios marcados pelos interesses do capital transnacional e seus impactos sobre os camponeses (as), onde os determinantes sociais e as desigualdades compõe a complexidade da situação de saúde dessas populações. Traz a ação das mulheres camponesas na produção de cuidado da vida e da saúde na sua trajetória histórica, os eixos estruturantes articulados às relações sociais de gênero, raça/etnia, classe e orientação sexual, ao feminismo e ao projeto popular de agricultura camponesa. Pelo caminho percorrido, foi possível perceber que as políticas públicas de saúde no Brasil, especialmente nos territórios de atuação dessas mulheres camponesas, são recentes e frágeis na garantia do acesso e na atenção integral à saúde. O MMC surge como espaço de luta e valorização das mulheres camponesas na conquista de direitos e a saúde emergem como uma das lutas importantes do movimento. Nele as mulheres se ressignificam, tem o cuidado com vida e a saúde como base central do seu agir e fazem experiências de libertação e emancipação, enquanto sentido profundo de sua práxis portadora de uma dinâmica educativo-terapêutica e uma mística libertadora. Dessa forma, constroem novos significados à integralidade da saúde, fortalecem o sentimento de pertença das mulheres para com o movimento, ao mesmo tempo em que fazem o enfrentamento ao agronegócio, ao neoliberalismo, à cultura machista e às formas de opressão, de exploração, de discriminação e de violência. Das experiências de organização, de cuidado, de luta e de formação que o movimento desenvolve, bem como a interação com os movimentos e práticas de educação popular em saúde e de educação permanente em saúde emergem as contribuições politico-pedagógicas que ajudam a repensar o modo de cuidar a vida e a saúde, bem como as políticas públicas de educação da saúde, tanto para o meio acadêmico, como para os processos de trabalho e educação na saúde junto ao Sistema Único de Saúde e seus atores, principalmente para a atuação no campo, nas florestas e nas águas.<br>This thesis consists in the identification of the social movements political-pedagogical contributions in the cultural, integrative, traditional experiences and practices of care and the popular education in health, especially in the Rural Women Movement, that would compose the pedagogical toolbox of the workers and health professional formation process to their actuation in the Single Health System in the field, forest and water communities. The search was realized along with the Rural Women Movement, through analysis of observations, records, documents, life stories, workshops and cultural circles made with women that make part of this organization, as well the interaction network with the popular and permanent health education. The search articulate these experiences and its knowledge in the life, health and illness production contest of the population that live in these territories, and the challenges for the comprehensive care and the health education. Territories marked by transnational capital interests and its impacts on farmers, were the social determinants and the inequalities make the complexity of these people health situation. It brings the rural women action in the life and health care in this historical trajectory, the structural axis articulated to social relation of gender, race/ethnicity, class and sexual orientation to the feminism and to the popular design of peasant agriculture. By the path taken, it was possible realize that the public health politics in Brazil, especially on the action territory of these rural women, are recent and frail in the ensuring access and in the comprehensive health care. The Rural Women Movement arises as a fight and valorization space of the rural women in the rights conquers and the health emerges as one of the most important movement fights. In it, women reframe there selves, have care with life, and have the health as a central bases of their action, and make liberation and emancipation experiences, as a deep sense of their praxis carried of a educative-therapeutic dynamics and a liberating mystic. Thereby, they construct new meanings to the health integrality, strengthen the women sense of belonging to the movement, at the same time that make the confronting agribusiness, neoliberalism, machist culture, and the forms of oppression, exploitation, discrimination and violence. From the organization, care, fight and formation experiences that the movement develops, as well as the interaction with the movements and health popular education practices and permanent health education emerges the political-pedagogical contributions that helps to rethink the way of care life and health, as well the health education public policy, both for academic as for the work processes and health education in the Single Health System and its actors, mainly to the field, forests and water action.<br>Esta tesis es la identificación de las contribuciones políticas y pedagógicas de los movimientos sociales populares en las experiencias y las prácticas culturales, de integración, de cuidado tradicional y un programa de educación para la salud, especialmente el Movimiento de Mujeres Campesinas, que podrán componer la caja de herramientas pedagógicas de procesos de formación de los trabajadores (as) y profesionales de la salud para actuación en el Sistema Único de Salud (SUS ) en comunidades del campo, de los bosques y de las aguas. La encuesta fue realizada junto al Movimiento de Mujeres Rurales a través del análisis de las observaciones, registros, documentos, historias de vida, talleres y círculos culturales realizados con mujeres que participan de esta organización, así como las redes de interacción con la educación popular y permanente en salud. La investigación articula estas experiencias y su sabiduría en el contexto de la producción de vida, salud y enfermedad de las poblaciones que viven en estos territorios y los desafíos para el cuidado integral y la educación en salud. Territorios marcados por los intereses del capital transnacional y su impacto sobre los campesinos (as), donde los determinantes sociales y las desigualdades constituyen la complejidad de la situación de salud de estas poblaciones. Trae la acción de la mujer rural en la producción del cuidado de la vida y la salud en su trayectoria histórica, los ejes estructurales articulados a las relaciones sociales de género, raza/etnia, clase y orientación sexual, al feminismo y proyecto popular de la agricultura campesina En el camino recorrido, se reveló que las políticas de salud pública en Brasil, sobre todo en los territorios de acción de estas mujeres agricultoras, son recientes y frágiles para garantizar el acceso y la atención integral de la salud. El MMC aparece como un espacio de lucha y valoración de las mujeres rurales en la conquista de los derechos y la salud surge como una de las importantes luchas del movimiento. En ella las mujeres se resignifican, tienen el cuidado con la vida y la salud como base central de su actuar y hacen experiencias de liberación y emancipación, mientras sentido profundo de su praxis portadora de una dinámica educativa-terapéutica y una mística liberadora. Por lo tanto, construyen nuevos significados a la integralidad de la salud, fortalecen el sentimiento de pertenencia de las mujeres al movimiento, mientras hacen el enfrentamiento a la agroindustria, al neoliberalismo, la cultura machista e las formas de opresión, de explotación, de discriminación y de violencia. De las experiencias de organización, de cuidado, de lucha y de formación que el movimiento desarrolla, así como la interacción con los movimientos y prácticas de la educación popular e continua en salud emergen las contribuciones políticas y pedagógicas que ayudan a repensar la forma de cuidar la vida y la salud, así como las políticas públicas de educación para la salud, tanto para la comunidad académica como de los procesos de trabajo y educación en la salud por el Sistema Nacional de Salud y sus actores, principalmente para actuar en el campo, bosques y aguas.

Although the Ministry of Health, Indonesia, has achieved some successful occupational health interventions, published literature on such interventions in Indonesia remains scarce. This study utilized mixed methods of qualitative and quantitative research for the years 2010 and 2011. The qualitative study covered respondents in West, Central, and East Java Provinces to gather stakeholders' perspectives on the impact, effectiveness, adoption, implementation, maintenance, and barriers of occupational health services for informal sectors in Indonesia. The quantitative portion measured the impact of occupational health training for community health officers using Reach, Efficacy, Adoption, Implementation and Maintenance (RE-AIM) dimensions. West Java, as a province with a center for occupational health referral services (Balai Kesehatan Kerja Masyarakat/BKKM), was compared to Central Java as a province without BKKM. The qualitative study showed that interventions improved knowledge of and engagement in occupational health among workers and health officers. Among other improvements, occupational health training resulted in some owners of food processing home industries switching from non-food to food-based coloring. The advocacy program improved local governments' political commitment to funding the occupational health program. The BKKM played important roles in delivering occupational health in West Java Province. The quantitative study showed the efficacy variable to have the lowest p-value (p:<.0001). Meanwhile, the reach variable showed on the second lowest p-value among RE-AIM components (p: <.0190). Moreover, education (p-value: 0.0001), job type (p-value: 0.0015), and job duration (p-value: 0.0289) were considered individual variables that could have contributed to the differences in RE-AIM scores between Central and West Java. The qualitative study confirmed that occupational health interventions in Indonesia resulted in some positive impacts related to safe and healthy work-related behaviors. The quantitative study found that West Java, a province with BKKM, had a better RE-AIM score as compared to Central Java, a province without BKKM. Some individual variables such as education, job type, and job duration could have contributed to the differences in RE-AIM scores between Central and West Java. The future direction of the occupational health-training program should consider the participants' diversity in their education, job type, and job duration.

The leadership of several health districts in the rural Appalachian region of northeast Tennessee and southwest Virginia has expressed interest in addressing the educational needs of their employees. The majority of these workers have not completed an undergraduate degree, but they desire to further their education. The College of Public Health at East Tennessee State University has begun preliminary discussions with these leaders to identify potential approaches to address these needs. There appear to be four approaches that should be explored by regions facing similar challenges: on-line or on-line/on-site degree completion programs; course clusters provided for academic credit; partnerships with community colleges; and training programs offered for nonacademic credit.