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Objectives. To explore effects of coalitions (Community Engagement and Planning [CEP]) versus technical assistance (Resources for Services [RS]) for depression collaborative care and the effects of social determinants on long-term remission outcomes. Methods. We randomized 95 health care and community programs in Los Angeles County, California, to CEP or RS. In 2010, 1246 depressed (Patient Health Questionnaire [PHQ-8] ≥ 10) adults enrolled and were invited for baseline and 6-, 12-, and 36-month surveys. Of 598 3-year completers, 283 participated at 4 years (2016). We examined effects of CEP versus RS, social factors (e.g., family income, food insecurity) on time to and periods in clinical (PHQ-8 < 10) and community-defined (PHQ-8 < 10 or PHQ-2 < 3; mental health composite score [MCS-12] > 40, or mental wellness) remission during the course of 3 years, and at 4 years. Results. We found that CEP versus RS increased 4-year depression remission and, for women, community-defined remission outcomes during the course of 3 years. Social factors and clinical factors predicted remission. Conclusions. At 4 years, CEP was more effective than RS at increasing depression remission. Public Health Implications. Coalitions may improve 4-year depression remission, while addressing social and clinical factors associated with depression may hold potential to enhance remission.

In April 2015, Nepal experienced an earthquake of a magnitude of 7.6 on the Richter scale that resulted in deaths, morbidities, and infrastructure damage. In the post-earthquake period, 4 different workshops and a national "Lessons Learnt" conference were organized to assess the adequacy of the preparedness and response of the health sector. This article summarizes the main conclusions of these discussions relating to leadership, timely search and rescue, referral operations, medical relief to response activities, awareness campaigns, and support from the national and international levels, and epidemiological surveillance. The earthquake response was channeled through rapid response teams that spanned from the community level to the central level via a cluster coordination approach. Overall, the health sector's response was concluded to be largely satisfactory because it focused not only on emergency medical care, but also on the resumption of basic health services and preventive health care (eg, hygiene, risk communication) equally. Post-disaster disease outbreak did not occur because effective surveillance and outbreak monitoring was one of the priority actions. However, services related to birthing centers, neonatal services, and vaccinations were impeded in some rural areas. Some weaknesses in planning, coordination, and management were also noted. The lessons learned can provide the impetus to strengthen future preparedness and response mechanisms. (Disaster Med Public Health Preparedness. 2018;12:543-547).

Health care coalitions play an increasingly important role in both preparedness for, response to, and recovery from large scale disaster events occurring across the United States. The actions taken by the South East Texas Regional Advisory Council (SETRAC) in response to the landfall of Hurricane Harvey, and the consequential flooding that ensued, serve as an excellent example of how health care coalitions are increasingly needed to play a unifying role in response. This paper highlights a number of the strategic planning, operational planning and response, information sharing, and resource coordination and management activities that were undertaken for the response to Hurricane Harvey. The successful response to this devastating storm in the Houston, Texas area serves as an example to other regions across the country as they work to implement the 2017-2022 health care capabilities articulated by the Department of Health and Human Services Office of the Assistant Secretary for Preparedness and Response. (Disaster Med Public Health Preparedness. 2017;11:637-639).

Organizations that pursue health advocacy often tackle other issues too. How do these multi-issue organizations articulate and combine health with other issues? We examine how a Los Angeles coalition focused primarily on housing took up health in its 2008-2011 campaign against a residential development. Participant observation and archival data reveal that cultural context influenced how the coalition made claims about health, in two ways. First, advocates shared two major symbolic categories, which oriented the great bulk of their appeals regarding health. Second, advocates crafted rhetorical appeals that reflected their shared sense of social identity and obligation as spokespersons for a distinctive kind of community. These two kinds of cultural context influenced advocates' claims in public, formal settings as well more internal communication. These distinct, cultural influences on claims-making create challenges for socioeconomically diverse coalitions collaborating on health problems., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

The process for developing national emergency management strategies for both the United States and the United Kingdom has led to the formulation of differing approaches to meet similar desired outcomes. Historically, the pathways for each are the result of the enactment of legislation in response to a significant event or a series of events. The resulting laws attempt to revise practices and policies leading to more effective and efficient management in preparing, responding, and mitigating all types of natural, manmade, and technological hazards. Following the turn of the 21st century, each country has experienced significant advancements in emergency management including the formation and utilization of 2 distinct models: health care coalitions in the United States and resiliency forums in the United Kingdom. Both models have evolved from circumstances and governance unique to each country. Further in-depth study of both approaches will identify strengths, weaknesses, and existing gaps to meet continued and future challenges of our respective disaster health care systems.

Objective: This study aimed to identify the indirect benefits of health care preparedness funding as perceived by current and former recipients of the US Department of Health and Human Services Office of the Assistant Secretary for Preparedness and Response's Hospital Preparedness Program., Methods: This was a qualitative inductive content analysis of telephone interviews conducted with regional stakeholders from several health care coalitions to identify their perceptions of the indirect benefits of preparedness funding., Results: Content analysis of interviewee responses resulted in 2 main categories of indirect benefits of federal health care preparedness funding: (1) dual-use technology and programs and (2) impact of relationships on day-to-day operations. Within the dual-use technology and programs category, 3 subcategories were identified: (1) information systems, (2) clinical technology, and (3) health care operations. Similarly, 3 subcategories relating to the indirect benefits in the impact of relationships on day-to-day operations category were identified: (1) cooperation, (2) information sharing, and (3) sense of community., Conclusion: This study identified indirect benefits of federal investment in hospital and health care preparedness in day-to-day operations. Major categories of these benefits included dual-use technology and programs and impact of relationships on day-to-day operations. Coalition members placed a high value on these benefits, even though they were not direct outcomes of grant programs. Further research is needed to quantify the economic value of these indirect benefits to more accurately measure the total return on investment from federal grant funding.

A health care emergency preparedness coalition (coalition) is a group of health care organizations, public safety agencies, and public health partners that join forces for the common cause of making their communities safer, healthier, and more resilient. Coalitions have been characterized as being focused on hospital systems instead of the health care of the community as a whole. We discuss 2 examples of coalition partners that use a more inclusive approach to planning, response, and recovery. The first is a large health care system spread across 23 states, and the other is a public safety agency in northeast Pennsylvania that took the lead to address the preparedness and response toward a large influx of burn patients and grew to encompass all aspects of community health care.

Objective: The purpose of this article was to describe how the Hospital Preparedness Program (HPP) and other health care coalitions conceptualize and measure progress or success and to identify strategies to improve coalition success and address known barriers to success., Methods: We conducted a structured literature review and interviews with key leaders from 22 HPPs and other coalitions. Interview transcripts were analyzed by using constant comparative analysis., Results: Five dimensions of coalition success were identified: strong member participation, diversity of members, positive changes in members' capacity to respond to or recover from disaster, sharing of resources among members, and being perceived as a trendsetter. Common barriers to success were also identified (eg, a lack of funding and staff). To address these barriers, coalitions suggested a range of mitigation strategies (eg, establishing formal memoranda of agreement). Both dimensions of and barriers to coalition success varied by coalition type., Conclusions: Currently, the term health care coalition is a one-size-fits-all term. In reality, this umbrella term describes a variety of different configurations, member bodies, and capabilities. The analysis offered a typology to categorize health care coalitions by primary function during a disaster response. Developing a common typology that could be used to specify capabilities or functions of coalitions may be helpful to advancing their development.

Public health HIV prevention efforts have begun to focus on addressing social and structural factors contributing to HIV risk, such as unstable housing, unemployment, and access to health care. With a limited body of evidence-based structural interventions for HIV, communities tasked with developing structural changes need a defined process to clarify their purpose and goals. This article describes the adaptations made to a coalition development model with the purpose of improving the start-up phase for a second group of coalitions. Modifications focused on preparing coalitions to more efficiently apply structural change concepts to their strategic planning activities, create more objectives that met study goals, and enhance coalition procedures such as building distributed coalition leadership to better support the mobilization process. We report on primary modifications to the process, findings for the coalitions, and recommendations for public health practitioners who are seeking to start a similar coalition.

This article addresses the recent trend of physicians being pressured to sell to hospitals in order to stay in practice. The author utilizes his experience in the healthcare industry to identify causes of this trend and ways in which physician groups can avoid finding themselves in these situations. The author uses real data from an existing medical practice to support his ideas and demonstrate how implementing change now will be beneficial for the success of this medical practice in the future. Objective practice evaluation and the execution of an efficient strategic plan are cited as the most important factors contributing to the financial solvency of medical practices in the current and future healthcare environment.

Faced with a high rate of unemployment and an increase in uninsured patients, Lee Memorial Health system in Ft. Myers, FL sponsored a community-wide effort to provide health care options for unfunded patients. Triage Center provides post-acute medical care for the homeless. Salvation Army operates 10-bed respite unit that provides skilled nursing services for homeless. Hospital operates free clinics for the uninsured.

The Community Connections initiative provides an example of building collaboration and partnerships across traditional boundaries--public-private, medical home, and community-based services--to improve care transitions and support for older adults and adults with disabilities. This approach was inspired by the self-governance and community engagement model, with the knowledge, experience, and participation of community stakeholders.

Improving transitions of care has significant importance to our health care system. While care transitions has been studied and researched by many individuals over the past 20 years, more work is needed to further improve the process. Those beginning to focus on transitions need not begin from scratch, but can use information and research from national and regional collaborative models, as well as other tools and resources to enhance the quality of transitions programs.

Context: This article reviews and updates the evidence base informing four recommendations of the Robert Wood Johnson Foundation Commission to Build a Healthier America (the commission) that address the creation of healthy, vital neighborhood and community environments., Evidence Acquisition: Reviews of published research, consultation with experts in housing, community development policy, and site visits by the commission were conducted between 2006 and 2009. The literature reviews and national statistics were updated with publications appearing through the first half of 2010., Evidence Synthesis: The physical, social, and economic environments of local communities affect residents' health and exacerbate health disparities. Public and private decision makers are increasingly recognizing the importance of investing in cross-cutting strategies to reduce exposures harmful to health and to establish conditions that support healthful daily practices. Pilot and demonstration projects that engage community members in identifying priorities and implementing interventions that improve health and quality of life show promise in terms of their overall impact and effect on health disparities., Conclusions: Consistent with the broad policy directions outlined in the commission's recommendations, an effective population health improvement strategy requires enlisting new partners among public agencies including housing, transportation, recreation, community development, and planning, and joint efforts between private sector business and voluntary organizations. Evaluation research of community-based interventions is needed to generate strong evidence of impact in order to guide policy and secure future investments in such measures., (Copyright © 2011 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.)

North Carolina has worked to develop an infrastructure and identify priorities to reduce the high morbidity and mortality from injuries. Findings of the North Carolina Institute of Medicine (NCIOM) Task Force on Adolescent Health and the NCIOM Task Force on Prevention, combined with the North Carolina Division of Public Health strategic plan and the Injury and Violence Prevention State Advisory Council, have laid the path toward this goal.

Industrialized countries are confronting the challenge of providing their population with accessible, high-quality, safe and efficient healthcare. They face the growing challenge of caring for an increasing number of patients suffering from chronic and complex diseases. Chronically ill patients see multiple clinicians at different healthcare sites, which increases the risks of errors and poor coordination. These experiences together with rising healthcare costs force the different healthcare systems in the industrialized countries to introduce and test new ways to offer healthcare while taking into account the entire chain of care. Disease management programmes together with institutions and structures like medical homes which are accessible and help to coordinate care make a difference for those patients. The German way to a better coordination of and a better access to healthcare is a step in the right direction, but there is a lack of data demonstrating the increase in effectiveness and efficiency. The opportunity has been missed to conduct pilot studies in order to identify measurable, reliable, and valid outcome indicators and thus create greater transparency. The question is not "whether" but "how" new ways of offering care can be introduced to increase the performance of the whole system, to decrease coordination problems, and to stabilise healthcare spending.

Background: The objective of Alabama Racial and Ethnic Approaches to Community Health 2010 is to implement and evaluate a community action plan (CAP) developed by a diverse coalition to reduce breast and cervical cancer screening disparities between African American and White women., Methods: The CAP entailed (1) establishing a core working group (CWG) in each county, (2) training CWG members to promote screenings, and (3) providing coalition members with technical assistance to write mini-grants., Results: Overall, 241 CWG members were trained. They have conducted 2800 cancer screening surveys. A total of 8 coalition members received mini-grants., Conclusion: Community capacity building can lead to a sense of ownership and empowerment.

Arthritis and Rheumatism International (ARi), founded in 1988, is an association of national lay organizations comprising mainly people whose lives are affected by arthritis and rheumatism. ARi's charter defines the organization's aims, including to raise awareness of the needs of people with arthritis/rheumatism, to improve the quality of their lives through education and self-management programs, and to support research into causes, management, prevention, and cure of arthritis. With the aid of a grant from the Pfizer Foundation in 2002, ARi has been able to further develop into a strong organization throughout the world, with a membership of 22 countries. Successful intitiatives include the People with Arthritis and Rheumatism in Europe Manifesto, which has served as a very effective focus for developing action plans, opening dialogues, building partnerships with other organizations, lobbying governments, and gaining media attention throughout Europe. The manifesto (website: www.PAREmanifesto.org) was developed by ARi working in conjunction with The International Organisation of Youth with Rheumatism and the EULAR Social League. These are examples of initiatives that ARi aims to promote on a global scale in the next few years.

Since its creation, the Association française des Polyarthrites is doing everything possible to come to the aid of people with polyarthritic diseases and to help medical research make advances against this illness. Each year, with the help of sponsors, we organize a national information campaign with first-hand accounts and presentations by sufferers on radio and television stations, so that polyarthritis should be better understood by the general public. Last year, together with other associations, we asked the Minister of Health about the barriers to receiving innovative treatment for polyarthritis because of the cost. Because of this action, the Minister has made additional funds available so that more sufferers can benefit from new treatment. Recently, several associations dealing with chronic and serious inflammatory rheumatic illnesses who came together as an action group presented a text to the Minister of Health about the urgent need to make these illnesses a public health priority. Working sessions between the Minister, patient associations, and rheumatologists to consider how to implement a public health plan are in progress.

Musculoskeletal conditions (MSC) are among the most frequent in adults in France, with over 20% of the population experiencing bone, joint, and muscle disorders. MSC are an increasing health concern in France, growing in importance on the public health agenda. Some of the present governmental plans are connected with MSC (Pain, the Disabled, Nutrition, Geriatrics). An overview of the present situation in France is provided, regarding the burden, the present situation, and steps forward. Scientific societies and patient groups are actively involved in campaigning in several fields; 2 examples are described: osteoporosis and rheumatoid arthritis and spondyloarthropathies. The Bone and Joint Decade initiative, officially endorsed by the French Government on June 20, 2000, provides the opportunity to develop more coordinated actions through the national network and international partnership as well (including the European League Against Rheumatism) to finally improve the health-related quality of life for people with MSC.

Objectives: To review the evolution of formal and informal coalitions and their involvement in cancer politics and policy., Data Sources: Organizational and political experience., Conclusions: Cancer has gone through several stages of growth, from single institutions seeking specific favorable treatment, to competitive coalitions. With more than 850 cancer organizations and associations representing the various cancer constituencies, the practicalities of politics demand some consensus and cooperation remains a significant challenge., Implications for Nursing Practice: Oncology nurses must be aware of the various cancer coalitions and have an understanding of how many organizations work together for the improvement of cancer care.

Community coalitions, as they are currently applied, are unique organizations whose ability to promote community change is different from other types of community organizations. This article explores those differences and elaborates how community coalitions can use those differences to transform conflict into greater capacity, equity, and justice. Concerns are also raised in this article about how community coalitions can intentionally and unintentionally protect the status quo and contain the empowerment of grassroots leadership and those of marginalized groups. There is a need for more theory, research, and discourse on how community coalitions can transform conflict into social change and how they can increase the power of grassroots and other citizen-lead organizations.

The future holds great promise for community coalitions as powerful interventions for community change. Community change is envisioned as: working with whole communities; increasing grassroots and civic engagement; promoting diversity, collaboration and, advocacy; increasing roles for professional technical assistance and evaluation; future changes in the role of government; and the building of healthy communities. Examples of these dimensions follow, as contributed by activists from a wide range of fields.

The many audiences for information about the quality of health care have different and sometimes conflicting interests and priorities. This is reflected in the diversity of current efforts to use health care data to identify, measure, and demonstrate quality. The author surveys three of these approaches in depth: (1) the professional approach, which relies on the actions of private-sector accreditation groups, trade associations and health plans, hospitals, and other providers to assure quality; (2) the market-driven approach, which relies on the use of quality data by health care purchasers and consumers in choosing plans and providers; and (3) the public-sector approach, which relies on the regulatory, oversight, and purchasing actions of government at the federal, state, and local levels to assure quality. The author concludes that efforts to measure and report the quality of health care invariably confront a variety of technical and political issues. Several observers maintain that it is more important for participants in quality issues to reach consensus on the issues than to reach technical perfection in the way the data are handled. Important obstacles in the technical realm include inadequate investment in sufficiently sophisticated and compatible information systems and the fact that where such systems are in place, they generally cannot be linked. But efforts, both technical and legal, are under way to overcome these obstacles. Even so, some of the issues of health care quality will remain moving targets because of constant changes in the health care environment and in technology. The author closes with the hope that the various actors within the health care industry may coordinate their efforts in dealing with these issues.