--- Tasha Beauchamp <[log in to unmask]> wrote:
>
I am impressed about that "HABIT" news letter you talk
about Tasha. Just looking at the summary it just goes
to confirm why possibly some interventions fail in
communities. Most of the time we as health
professionals mascarade in total "uprightness" and
"impose" on communities that we may not so completely
understand .Communties that existed for years with
culture , values , beliefs about the way life is or
should be. Indeed health promotion or the new public
health now focusses on community aspects as well as
other issues ( 5 requirements ) and it is amazing how
long it has taken us to finally appreciate the
importance of this in what we do.It is not surprising
that we shall continue to echo the appalling health
indicators in indeginous populations further showing
us how "not very succesful " current interventions are
or have been . It would be nice if Judith`s compliance
work might indeed focus on the health care providers,
may be it already does , as well ( for example
instructions to patients if any on how , when , why
they are on medication, adequate time with the doctor/
nurse, patient numbers per day , staff morale and
motivation for those handling the local population
e.t.c ) It is not uncommon for patients to be given
drugs with instructions written in a language unknown
to them and numbers stating 2 times 2 .Talk about
literacy!
Dear Judith,
>
> Actually, I just read in the "HABIT"(Health Behavior
> Information Transfer)
> e-mail newsletter, the following mini-article which
> actually relates
> specifically to your stomping grounds! Hope this
> helps.
>
> Tasha
>
>
> 1. Physician: Comply Thyself: Looking at Adherence
> in New Ways
>
> One of the most intractable problems in health care
> is helping people
> comply, or -- in the more common parlance today --
> adhere to recommended
> treatments and behavior changes to manage existing
> health problems and
> prevent new ones. Progress in improving adherence
> has been painstakingly
> slow, but hope is not lost; researchers and
> clinicians are starting to look
> at these issues in new ways.
>
> A book recently published in Australia flips the
> issue of compliance on its
> head by examining the culture of health
> professionals' work, rather than
> recipients of care, as a central influence on
> non-compliance.
>
> ěForgetting Compliance ń Aboriginal Health and
> Medical Cultureî by Kim
> Humphery and Tarun Weeramanthri, with Joseph Fritz,
> critically reviews the
> health sciences literature on patient compliance.
> The authors also analyze
> the failure of more than 20 years of targeted
> research on compliance issues
> to achieve significant improvements in treatment
> uptake.
>
> The central focus of the book, however, is the
> analysis of interviews with
> 76 health care providers working in Aboriginal
> health in the Northern
> Territory of Australia. Although the cultural
> context and geographical
> settings in which these individuals provide care are
> unique, the
> conclusions the authors draw are likely to have more
> general impact:
> ěProvision and uptake of services are two sides of
> the same coin. If we are
> to rethink compliance, we need to remake health
> services practices and
> institutional arrangements. More radically, we need
> to forget compliance as
> a ëproblem,í and see it as a natural marker of the
> differences (in values,
> in power and in resources) between professional
> systems and clients.î
>
> For information about how to order ěForgetting
> Compliance,î e-mail
> [log in to unmask]
>
> Send your ideas, comments and resources to
> [log in to unmask]
> Subscribe to HABIT by visiting
> http://www.cfah.org/habitsubscribers.htm
>
>
> >The Tiwi Health Board (an Aboriginal Community
> Controlled Health Provider)
> >are interested in examining the impact of health
> promotion strategies on
> >medication compliance, specifically medications for
> the chronic diseases
> >diabetes, hypertension, and renal impairment.
> >
> >I am interested to know if anyone has any
> experience with measuring
> >compliance to treatment regimens (specifically
> relating to medications for
> >chronic diseases) in indigenous populations, and if
> so, what measurement
> >tools were used.
> >
> >Judith Oliver
> >Consultant Pharmacist
> >Tiwi Health Board
> >Darwin, NT
> >Australia.
>
>
> + + + + + + + + + + + + + + + + + + + + + + + + + +
> + + + + + + + + + + + +
>
> Natasha Beauchamp
> Project Coordinator
> ORegon Center for Applied Science, Inc. (ORCAS)
> 1839 Garden Ave.
> Eugene, OR 97405
>
> Tel: (541) 342-7227
> Toll Free: (888) 349-5472
> Fax: (541) 342-4270
> mailto:[log in to unmask]
> Website: http://www.orcasinc.com
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