Community Care in Catalonia and Spain AT A GLANCE Josep Vidal-Alaball Primary Care & Public Health physician

What is Community Care? Community Care interventions in Catalonia and in Spain Final considerations

Community Care Definition Can be defined as the health of the individuals and the groups in a particular community(1). This is determined by the interaction of personal, family, cultural and physical factors and the socio-economic environment (determinants of health). (1) Gofin J, Gofin R. Essentials of global community health. Sudbury, MA: Jones & Barlett Learning; 2010: 269

A community health intervention is a strategy aimed to improve the health of a defined community 4

Community Care interventions in Catalonia Working Group in Community Oriented Primary Care (APOC) - 1987 Community Oriented Primary Care (COPC) is a practice in which the elements of community, family and individual care are given together (reflecting the spirit of the International Conference on Primary Health Care held in Alma-Ata in 1978). In Catalonia; first working shop in 1987 organized by the Catalan Society of PC  Working group COPC part of FM training curriculum since 1990

COPC methodology integrates the individual (clinical) and the community (public) approach. Consists in a cyclic process of planning based on the population needs. 6

Conducted 30 workshops for more than 1,000 professionals Group. 20 members: PC nurses and doctors, public health practitioners, social workers Conducted 30 workshops for more than 1,000 professionals Helped implement COPC model in several health centres http://www.apoc-copc.org/eng/linksE.htm 7

Acting Together for Health network (AUPA) Network of several health institutions (primary care and public health) and professional bodies and societies. To promote Community Care projects in Primary Care: Annual grants for funding community projects Provide training to professionals and PC trainees Publish research and educational material Methodological advice to centres Promote collaborative research projects http://www.gencat.cat/salut/ies-aupa/html/ca/Du63/index.html 8

From may 2003  96 Centres 9

Community Health Workers project (ASACO) Based on health assets and Salutogenesis Public Health + Primary Care Teams First phase: Identify representative community agents Train agents on social determinants, salutogenesis and assets for health. Same training! Blog (training sessions, resources…) Video http://youtu.be/NzPSCx9BS6g 10

Groups in 3 areas created Second phase: Groups in 3 areas created Identification health assets. Methodology: ABCD (Asset based community development) What gives you health? Video Boxes Identification problems (COPC methodology) 12

http://projecteasaco.wordpress.com 13

Health in Neighbourhoods – Urban Renewal Plan 2004: Neighbourhoods law includes plan to improve health in the most disadvantaged neighbourhoods in Catalonia. Objective: To introduce health as a major element for the improvement of the living conditions and welfare of the neighbourhood. Analysis and detection needs with the community, prioritization of actions and implementation. 14

Evaluation of health equity effects http://www.sophie-project.eu/index.htm 15

http://jech.bmj.com/content/68/9/811.abstract 16

Roquetes Community development Plan Emanates from a COPC group, uses the Health in Neighbourhoods programme. After conducting a community analysis and diagnosis, prioritize 3 problems: Musculoskeletal disorders Lack of healthy habits Lack of self-care skills 17

Carmel Community Development Plan Since 2001 Amalgam of individual neighbours, neighbourhood associations, health professionals and public administrations To promote processes of participation among the community to improve the neighbourhood Several Community Projects: Support group for women who are going through a time of significant change in their life http://www.carmelamunt.org/bloc/quequicom/ 18

Community Care interventions in Spain Programme of Community Activities in Primary Care (PACAP) Program Spanish Society of PC to stimulate Community Activities in PC – 1995 Produce a journal: Comunidad Promote Community Activities Networks Community Activities Search engine http://www.pacap.net/pacap/

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Health Observatory of Asturias Since 2010 Space of knowledge about health information in Asturias. Generate periodic reports. Link information on health indicators to various community health projects developed in Asturias http://www.obsaludasturias.com 22

Training to community health agents (75h) Health Assets. Mapping Projecte RIU Facilitate access to health services for vulnerable population in Alzira Training to community health agents (75h) Health Assets. Mapping http://on.fb.me/1pc7hFJ 23

Final Considerations Future challenges Aging population. Chronic diseases Training. Particularly non-health workers Economic climate: ? Opportunity Research – Evidence Involve non-health related agents  Inter-ministerial Public Health Plan (Health in all policies)

Thank You! http://www.slideshare.net/jvalaball Josep Vidal-Alaball josep.vidal@gmail.com Twitter: @jvalaball http://www.slideshare.net/jvalaball