Sheila Davis - Academia.edu (original) (raw)

Papers by Sheila Davis

International Journal of Africa Nursing Sciences, 2016

The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease, 2006

Out-patient tuberculosis (TB) clinics in Durban, South Africa. Health care provider concerns abou... more Out-patient tuberculosis (TB) clinics in Durban, South Africa. Health care provider concerns about persons with active TB defaulting on medications led to a study of adherence among persons receiving anti-tuberculosis therapy and, specifically, the relationships between meaning in life, life goals, sense of coherence, social support, symptom presence and intensity, and adherence in individuals diagnosed with TB. A cross-sectional, descriptive design was used to gather self-reported data from TB-infected individuals who were enrolled in out-patient clinics. Data were collected from 159 Zulu and/or English-speaking persons who agreed to participate in the study. A significant relationship was found between higher life goals and adherence to TB treatment (P = 0.027). Analysis of variance revealed that higher meaning in life ratings were significantly associated with older age (P = 0.007). Having children and children living in the same household were significantly associated with low m...

Springer eBooks, Apr 1, 2018

Moral Distress in the Health Professions, 2018

This final chapter captures the voices of several leaders in health care and bioethics who respon... more This final chapter captures the voices of several leaders in health care and bioethics who responded to one or both of the following questions: 1. What do you think is the most significant or important reason that healthcare professionals might feel trapped and unable to do what they think is right (and hence experience moral distress)? 2. What does moral success look like to you? Can you give an example of moral success from your perspective with regard to healthcare?

Health Services Research and Managerial Epidemiology, 2015

Objectives: Community Health Workers (CHWs) serve as a means of improving outcomes for underserve... more Objectives: Community Health Workers (CHWs) serve as a means of improving outcomes for underserved populations. However, their relationship within health care teams is not well studied. The purpose of this integrative review was to examine published research reports that demonstrated positive health outcomes as a result of CHW intervention to identify interprofessional teamwork and collaboration between CHWs and health care teams. Methods: A total of 47 studies spanning 33 years were reviewed using an integrative literature review methodology for evidence to support the following assumptions of effective interprofessional teamwork between CHWs and health care teams: (1) shared understanding of roles, norms, values, and goals of the team; (2) egalitarianism; (3) cooperation; (4) interdependence; and(5) synergy. Results: Of the 47 studies, 12 reported at least one assumption of effective interprofessional teamwork. Four studies demonstrated all 5 assumptions of interprofessional teamw...

BackgroundThe COVID-19 pandemic has had disproportionate impacts across race, social class, and g... more BackgroundThe COVID-19 pandemic has had disproportionate impacts across race, social class, and geography. Insufficient attention has been paid to addressing the massive inequities worsened by COVID-19. In July 2020, Partners In Health (PIH) and the University of Global Health Equity (UGHE) designed a four-module short course, “An Equity Approach to Pandemic Preparedness and Response: Emerging Insights from COVID-19 Global Response Leaders.” We describe the design and use of a case-based, short-course education model to transfer knowledge and skills in equity approaches to pandemic preparedness and response.MethodsThis course used case studies of Massachusetts and Navajo Nation in the U.S, and Rwanda to highlight examples of equity-centered pandemic response. A post-session assessment survey was completed by course participants after each of the four modules. A mixed-method analysis was conducted to understand knowledge acquisition on key topics and assess participants’ experience a...

International Journal of Health Policy and Management, 2021

The rapid development of coronavirus disease 2019 (COVID-19) vaccines has not been met with the a... more The rapid development of coronavirus disease 2019 (COVID-19) vaccines has not been met with the assurance of an effective and equitable global distribution mechanism. Low-income countries are especially at-risk, with the price of the vaccines and supply shortages limiting their ability to procure and distribute the vaccines. While the COVAX initiative is one of the solutions to these challenges, vaccine nationalism has resulted in the hoarding of vaccines and the signing of parallel bilateral deals, undermining this formerly promising initiative. Moreover, inequity in local distribution also remains a problem, with clear discrimination of minorities and lack of logistical preparation in some countries. As we continue to distribute the COVID-19 vaccines, pharmaceutical companies should share their technology to increase supply and reduce prices, governments should prioritize equitable distribution to the most at-risk in all nations and low-income countries should bolster their logist...

Nursing Outlook, 2021

The purpose of this consensus paper was to convene leaders and scholars from eight Expert Panels ... more The purpose of this consensus paper was to convene leaders and scholars from eight Expert Panels of the American Academy of Nursing and provide recommendations to advance nursing's roles and responsibility to ensure universal access to palliative care. Part I of this consensus paper herein provides the rationale and background to support the policy, education, research, and clinical practice recommendations put forward in Part II. On behalf of the Academy, the evidence-based recommendations will guide nurses, policy makers, government representatives, professional associations, and interdisciplinary and community partners to integrate palliative nursing services across health and social care settings. The consensus paper's 43 authors represent eight countries (Australia, Canada, England, Kenya, Lebanon, Liberia, South Africa, United States of America) and extensive international health experience, thus providing a global context for the subject matter. The authors recommend greater investments in palliative nursing education and nurse-led research, nurse engagement in policy making, enhanced intersectoral partnerships with nursing, and an increased profile and visibility of palliative nurses worldwide. By enacting these recommendations, nurses working in all settings can assume leading roles in delivering high-quality palliative care globally, particularly for minoritized, marginalized, and other at-risk populations.

Nursing Outlook, 2021

The purpose of this consensus paper was to convene leaders and scholars from eight Expert Panels ... more The purpose of this consensus paper was to convene leaders and scholars from eight Expert Panels of the American Academy of Nursing and provide recommendations to advance nursing's roles and responsibility to ensure universal access to palliative care. On behalf of the Academy, these evidence-based recommendations will guide nurses, policy makers, government representatives, professional associations, and interdisciplinary and community partners to integrate palliative nursing services across health and social care settings. Through improved palliative nursing education, nurse-led research, nurse engagement in policy making, enhanced intersectoral partnerships with nursing, and an increased profile and visibility of palliative care nurses worldwide, nurses can assume leading roles in delivering high-quality palliative care globally, particularly for minoritized, marginalized, and other at-risk populations. Part II herein provides a summary of international responses and policy options that have sought to enhance universal palliative care and palliative nursing access to date. Additionally, we provide ten policy, education, research, and clinical practice recommendations based on the rationale and background information found in Part I. The consensus paper's 43 authors represent eight countries (Australia, Canada, England, Kenya, Lebanon, Liberia, South Africa, United States of America) and extensive international health experience, thus providing a global context for the subject matter.

The Lancet Global Health, 2021

Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on ... more Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre-including this research content-immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

The Lancet Global Health, 2020

AIDS Care, 2007

Peripheral neuropathy is the most common neurological complication in HIV and is often associated... more Peripheral neuropathy is the most common neurological complication in HIV and is often associated with antiretroviral therapy. As part of a larger study on self-care for symptoms in HIV disease, this study analyzed the prevalence and characteristics of peripheral neuropathy in HIV disease, sociodemographic and disease-related correlates and self-care strategies. A convenience sample of 1,217 respondents was recruited from data collection sites in several US cities, Puerto Rico, Colombia and Taiwan. Results of the study indicated that respondents with peripheral neuropathy (n=450) identified 20 self-care behaviors including complementary therapies, use of medications, exercise and rest and/or elevation of extremities. Ratings of frequency and effectiveness were also included. An activities checklist summarized into five categories of self-care behaviors including activities/thoughts, exercise, medications, complementary therapies and substance was used to determine self-care behaviors. Taking a hot bath was the most frequent strategy used by those with peripheral neuropathy (n=292) and received the highest overall rating of effectiveness of any self-management strategies included in this study at 8.1 (scale 1-10). Other self-care strategies to manage this symptom included: staying off the feet (n=258), rubbing the feet with cream (n=177), elevating the feet (n=236), walking (n=262), prescribed anti-epileptic agent (n=80), prescribed analgesics (n=84), over-the-counter medications (n=123), vitamin B (n=122), calcium supplements (n=72), magnesium (n=48), massage (n=156), acupuncture (n=43), reflexology (n=23) and meditation (n=80). Several behaviors that are often deemed unhealthy were included among the strategies reported to alleviate peripheral neuropathy including use of marijuana (n=67), cigarette smoking (n=139), drinking alcohol (n=81) and street drugs (n=30).

AIDS Care, 2007

The prevalence of peripheral neuropathy is frequent in HIV disease and is often associated with a... more The prevalence of peripheral neuropathy is frequent in HIV disease and is often associated with antiretroviral therapy. Unhealthy behaviours, particularly substance-use behaviours, are utilized by many HIV-positive individuals to manage neuropathic symptoms. As part of a larger study on self-care for symptoms in HIV disease, this study analyzed the prevalence and characteristics of unhealthy behaviours to self-manage peripheral neuropathy in HIV disease. Sociodemographic and disease-related correlates and unhealthy behaviours were examined in a convenience sample of 1,217 respondents who were recruited from data collection sites in several US cities, Puerto Rico, Colombia, and Taiwan. Results of the study indicated that respondents with peripheral neuropathy (n=450) identified a variety of unhealthy self-care behaviours including injection drug use, oral drug use, smoking cigarettes and alcohol ingestion. Specific unhealthy behaviours that participants reported to alleviate peripheral neuropathy included use of marijuana (n=67), smoking cigarettes (n=139), drinking alcohol (n=81) and street drugs (n=30). A subset of those individuals (n=160), who identified high levels of neuropathy (greater than five on a scale of 1-10), indicated significantly higher use of amphetamines and injection drug use in addition to alcohol use and cigarette smoking. For participants from Norway, substance use (using alcohol: 56%) was one of the most frequent self-management strategies. Implications for clinical practice include assessment and education of persons with HIV for self-care management of the complex symptom of peripheral neuropathy.

DNP Education, Practice, and Policy, 2018

The Journal of infectious diseases, Oct 28, 2016

An epidemic of Ebola virus disease (EVD) beginning in 2013 has claimed an estimated 11 310 lives ... more An epidemic of Ebola virus disease (EVD) beginning in 2013 has claimed an estimated 11 310 lives in West Africa. As the EVD epidemic subsides, it is important for all who participated in the emergency Ebola response to reflect on strengths and weaknesses of the response. Such reflections should take into account perspectives not usually included in peer-reviewed publications and after-action reports, including those from the public sector, nongovernmental organizations (NGOs), survivors of Ebola, and Ebola-affected households and communities. In this article, we first describe how the international NGO Partners In Health (PIH) partnered with the Government of Sierra Leone and Wellbody Alliance (a local NGO) to respond to the EVD epidemic in 4 of the country's most Ebola-affected districts. We then describe how, in the aftermath of the epidemic, PIH is partnering with the public sector to strengthen the health system and resume delivery of regular health services. PIH's exper...

Clinical Scholars Review, 2014

ABSTRACT Over the past 25 yearsand particularly since the 2010 earthquakeZanmi Lasante/Partners I... more ABSTRACT Over the past 25 yearsand particularly since the 2010 earthquakeZanmi Lasante/Partners In Health has found a high prevalence and incidence of depression in its patients. However, given the high stigma surrounding depression in local communities, lack of a skilled mental health care workforce to address this need, a formalized structure, system, and locally defined science to find, assess, refer, and treat mental health issues, and a lack of financial resources to support such initiatives, these needs were unable to be effectively addressed by the existing health care system. However, long term strategic investments into mental health care from various avenues provided the resources to build the local Haitian capacity to address mental health issues that is based on a community based model of care. This presentation will focus on the first year of this three year initiative, which focuses on building the service delivery, clinical supervision, management, monitoring and evaluation, and capacity building of local community health workers, psychologists, social workers, nurses, and physicians to address the burden of depression in ZL/PIH's catchment area of 1.2 million people. The findings will provide a step by step road map on how to build mental health services into a government run health care system. Additionally, I will demonstrate not only that the most effective means to address mental health illness burden in low resource settings requires a community based approach whose core lies in partnership with and investment in local partners to ensure long term sustainability, but that this can be successful.

Resources References Bibliography 2 4 5 10 15 25 29 33 37 40 43 46 4

Background: Health system leaders are often unaware of the potential value realized when includin... more Background: Health system leaders are often unaware of the potential value realized when including community health workers (CHWs) in healthcare delivery models. A group of RWJF Executive Nurse Fellows, recognizing this knowledge gap, developed a resource guide to facilitate implementation of polyvalent CHW programs in health systems and to achieve the “Triple Aim” of improved individual care, improved population health, and decreased healthcare costs. Description: The purposes of this presentation are to discuss changes in the healthcare delivery environment, to identify opportunities for partnerships between advanced public health nurses and nursing leaders in healthcare systems, and to describe the usefulness of the CHW resource guide. Lessons Learned: Strategies including intra- and inter-professional collaboration can address the skepticism that may exist about CHWs, their roles and competencies; how to integrate them into healthcare systems; and how to attain smooth transition...

International Journal of Africa Nursing Sciences, 2016

The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease, 2006

Out-patient tuberculosis (TB) clinics in Durban, South Africa. Health care provider concerns abou... more Out-patient tuberculosis (TB) clinics in Durban, South Africa. Health care provider concerns about persons with active TB defaulting on medications led to a study of adherence among persons receiving anti-tuberculosis therapy and, specifically, the relationships between meaning in life, life goals, sense of coherence, social support, symptom presence and intensity, and adherence in individuals diagnosed with TB. A cross-sectional, descriptive design was used to gather self-reported data from TB-infected individuals who were enrolled in out-patient clinics. Data were collected from 159 Zulu and/or English-speaking persons who agreed to participate in the study. A significant relationship was found between higher life goals and adherence to TB treatment (P = 0.027). Analysis of variance revealed that higher meaning in life ratings were significantly associated with older age (P = 0.007). Having children and children living in the same household were significantly associated with low m...

Springer eBooks, Apr 1, 2018

Moral Distress in the Health Professions, 2018

This final chapter captures the voices of several leaders in health care and bioethics who respon... more This final chapter captures the voices of several leaders in health care and bioethics who responded to one or both of the following questions: 1. What do you think is the most significant or important reason that healthcare professionals might feel trapped and unable to do what they think is right (and hence experience moral distress)? 2. What does moral success look like to you? Can you give an example of moral success from your perspective with regard to healthcare?

Health Services Research and Managerial Epidemiology, 2015

Objectives: Community Health Workers (CHWs) serve as a means of improving outcomes for underserve... more Objectives: Community Health Workers (CHWs) serve as a means of improving outcomes for underserved populations. However, their relationship within health care teams is not well studied. The purpose of this integrative review was to examine published research reports that demonstrated positive health outcomes as a result of CHW intervention to identify interprofessional teamwork and collaboration between CHWs and health care teams. Methods: A total of 47 studies spanning 33 years were reviewed using an integrative literature review methodology for evidence to support the following assumptions of effective interprofessional teamwork between CHWs and health care teams: (1) shared understanding of roles, norms, values, and goals of the team; (2) egalitarianism; (3) cooperation; (4) interdependence; and(5) synergy. Results: Of the 47 studies, 12 reported at least one assumption of effective interprofessional teamwork. Four studies demonstrated all 5 assumptions of interprofessional teamw...

BackgroundThe COVID-19 pandemic has had disproportionate impacts across race, social class, and g... more BackgroundThe COVID-19 pandemic has had disproportionate impacts across race, social class, and geography. Insufficient attention has been paid to addressing the massive inequities worsened by COVID-19. In July 2020, Partners In Health (PIH) and the University of Global Health Equity (UGHE) designed a four-module short course, “An Equity Approach to Pandemic Preparedness and Response: Emerging Insights from COVID-19 Global Response Leaders.” We describe the design and use of a case-based, short-course education model to transfer knowledge and skills in equity approaches to pandemic preparedness and response.MethodsThis course used case studies of Massachusetts and Navajo Nation in the U.S, and Rwanda to highlight examples of equity-centered pandemic response. A post-session assessment survey was completed by course participants after each of the four modules. A mixed-method analysis was conducted to understand knowledge acquisition on key topics and assess participants’ experience a...

International Journal of Health Policy and Management, 2021

The rapid development of coronavirus disease 2019 (COVID-19) vaccines has not been met with the a... more The rapid development of coronavirus disease 2019 (COVID-19) vaccines has not been met with the assurance of an effective and equitable global distribution mechanism. Low-income countries are especially at-risk, with the price of the vaccines and supply shortages limiting their ability to procure and distribute the vaccines. While the COVAX initiative is one of the solutions to these challenges, vaccine nationalism has resulted in the hoarding of vaccines and the signing of parallel bilateral deals, undermining this formerly promising initiative. Moreover, inequity in local distribution also remains a problem, with clear discrimination of minorities and lack of logistical preparation in some countries. As we continue to distribute the COVID-19 vaccines, pharmaceutical companies should share their technology to increase supply and reduce prices, governments should prioritize equitable distribution to the most at-risk in all nations and low-income countries should bolster their logist...

Nursing Outlook, 2021

The purpose of this consensus paper was to convene leaders and scholars from eight Expert Panels ... more The purpose of this consensus paper was to convene leaders and scholars from eight Expert Panels of the American Academy of Nursing and provide recommendations to advance nursing's roles and responsibility to ensure universal access to palliative care. Part I of this consensus paper herein provides the rationale and background to support the policy, education, research, and clinical practice recommendations put forward in Part II. On behalf of the Academy, the evidence-based recommendations will guide nurses, policy makers, government representatives, professional associations, and interdisciplinary and community partners to integrate palliative nursing services across health and social care settings. The consensus paper's 43 authors represent eight countries (Australia, Canada, England, Kenya, Lebanon, Liberia, South Africa, United States of America) and extensive international health experience, thus providing a global context for the subject matter. The authors recommend greater investments in palliative nursing education and nurse-led research, nurse engagement in policy making, enhanced intersectoral partnerships with nursing, and an increased profile and visibility of palliative nurses worldwide. By enacting these recommendations, nurses working in all settings can assume leading roles in delivering high-quality palliative care globally, particularly for minoritized, marginalized, and other at-risk populations.

Nursing Outlook, 2021

The purpose of this consensus paper was to convene leaders and scholars from eight Expert Panels ... more The purpose of this consensus paper was to convene leaders and scholars from eight Expert Panels of the American Academy of Nursing and provide recommendations to advance nursing's roles and responsibility to ensure universal access to palliative care. On behalf of the Academy, these evidence-based recommendations will guide nurses, policy makers, government representatives, professional associations, and interdisciplinary and community partners to integrate palliative nursing services across health and social care settings. Through improved palliative nursing education, nurse-led research, nurse engagement in policy making, enhanced intersectoral partnerships with nursing, and an increased profile and visibility of palliative care nurses worldwide, nurses can assume leading roles in delivering high-quality palliative care globally, particularly for minoritized, marginalized, and other at-risk populations. Part II herein provides a summary of international responses and policy options that have sought to enhance universal palliative care and palliative nursing access to date. Additionally, we provide ten policy, education, research, and clinical practice recommendations based on the rationale and background information found in Part I. The consensus paper's 43 authors represent eight countries (Australia, Canada, England, Kenya, Lebanon, Liberia, South Africa, United States of America) and extensive international health experience, thus providing a global context for the subject matter.

The Lancet Global Health, 2021

Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on ... more Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre-including this research content-immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

The Lancet Global Health, 2020

AIDS Care, 2007

Peripheral neuropathy is the most common neurological complication in HIV and is often associated... more Peripheral neuropathy is the most common neurological complication in HIV and is often associated with antiretroviral therapy. As part of a larger study on self-care for symptoms in HIV disease, this study analyzed the prevalence and characteristics of peripheral neuropathy in HIV disease, sociodemographic and disease-related correlates and self-care strategies. A convenience sample of 1,217 respondents was recruited from data collection sites in several US cities, Puerto Rico, Colombia and Taiwan. Results of the study indicated that respondents with peripheral neuropathy (n=450) identified 20 self-care behaviors including complementary therapies, use of medications, exercise and rest and/or elevation of extremities. Ratings of frequency and effectiveness were also included. An activities checklist summarized into five categories of self-care behaviors including activities/thoughts, exercise, medications, complementary therapies and substance was used to determine self-care behaviors. Taking a hot bath was the most frequent strategy used by those with peripheral neuropathy (n=292) and received the highest overall rating of effectiveness of any self-management strategies included in this study at 8.1 (scale 1-10). Other self-care strategies to manage this symptom included: staying off the feet (n=258), rubbing the feet with cream (n=177), elevating the feet (n=236), walking (n=262), prescribed anti-epileptic agent (n=80), prescribed analgesics (n=84), over-the-counter medications (n=123), vitamin B (n=122), calcium supplements (n=72), magnesium (n=48), massage (n=156), acupuncture (n=43), reflexology (n=23) and meditation (n=80). Several behaviors that are often deemed unhealthy were included among the strategies reported to alleviate peripheral neuropathy including use of marijuana (n=67), cigarette smoking (n=139), drinking alcohol (n=81) and street drugs (n=30).

AIDS Care, 2007

The prevalence of peripheral neuropathy is frequent in HIV disease and is often associated with a... more The prevalence of peripheral neuropathy is frequent in HIV disease and is often associated with antiretroviral therapy. Unhealthy behaviours, particularly substance-use behaviours, are utilized by many HIV-positive individuals to manage neuropathic symptoms. As part of a larger study on self-care for symptoms in HIV disease, this study analyzed the prevalence and characteristics of unhealthy behaviours to self-manage peripheral neuropathy in HIV disease. Sociodemographic and disease-related correlates and unhealthy behaviours were examined in a convenience sample of 1,217 respondents who were recruited from data collection sites in several US cities, Puerto Rico, Colombia, and Taiwan. Results of the study indicated that respondents with peripheral neuropathy (n=450) identified a variety of unhealthy self-care behaviours including injection drug use, oral drug use, smoking cigarettes and alcohol ingestion. Specific unhealthy behaviours that participants reported to alleviate peripheral neuropathy included use of marijuana (n=67), smoking cigarettes (n=139), drinking alcohol (n=81) and street drugs (n=30). A subset of those individuals (n=160), who identified high levels of neuropathy (greater than five on a scale of 1-10), indicated significantly higher use of amphetamines and injection drug use in addition to alcohol use and cigarette smoking. For participants from Norway, substance use (using alcohol: 56%) was one of the most frequent self-management strategies. Implications for clinical practice include assessment and education of persons with HIV for self-care management of the complex symptom of peripheral neuropathy.

DNP Education, Practice, and Policy, 2018

The Journal of infectious diseases, Oct 28, 2016

An epidemic of Ebola virus disease (EVD) beginning in 2013 has claimed an estimated 11 310 lives ... more An epidemic of Ebola virus disease (EVD) beginning in 2013 has claimed an estimated 11 310 lives in West Africa. As the EVD epidemic subsides, it is important for all who participated in the emergency Ebola response to reflect on strengths and weaknesses of the response. Such reflections should take into account perspectives not usually included in peer-reviewed publications and after-action reports, including those from the public sector, nongovernmental organizations (NGOs), survivors of Ebola, and Ebola-affected households and communities. In this article, we first describe how the international NGO Partners In Health (PIH) partnered with the Government of Sierra Leone and Wellbody Alliance (a local NGO) to respond to the EVD epidemic in 4 of the country's most Ebola-affected districts. We then describe how, in the aftermath of the epidemic, PIH is partnering with the public sector to strengthen the health system and resume delivery of regular health services. PIH's exper...

Clinical Scholars Review, 2014

ABSTRACT Over the past 25 yearsand particularly since the 2010 earthquakeZanmi Lasante/Partners I... more ABSTRACT Over the past 25 yearsand particularly since the 2010 earthquakeZanmi Lasante/Partners In Health has found a high prevalence and incidence of depression in its patients. However, given the high stigma surrounding depression in local communities, lack of a skilled mental health care workforce to address this need, a formalized structure, system, and locally defined science to find, assess, refer, and treat mental health issues, and a lack of financial resources to support such initiatives, these needs were unable to be effectively addressed by the existing health care system. However, long term strategic investments into mental health care from various avenues provided the resources to build the local Haitian capacity to address mental health issues that is based on a community based model of care. This presentation will focus on the first year of this three year initiative, which focuses on building the service delivery, clinical supervision, management, monitoring and evaluation, and capacity building of local community health workers, psychologists, social workers, nurses, and physicians to address the burden of depression in ZL/PIH's catchment area of 1.2 million people. The findings will provide a step by step road map on how to build mental health services into a government run health care system. Additionally, I will demonstrate not only that the most effective means to address mental health illness burden in low resource settings requires a community based approach whose core lies in partnership with and investment in local partners to ensure long term sustainability, but that this can be successful.

Resources References Bibliography 2 4 5 10 15 25 29 33 37 40 43 46 4

Background: Health system leaders are often unaware of the potential value realized when includin... more Background: Health system leaders are often unaware of the potential value realized when including community health workers (CHWs) in healthcare delivery models. A group of RWJF Executive Nurse Fellows, recognizing this knowledge gap, developed a resource guide to facilitate implementation of polyvalent CHW programs in health systems and to achieve the “Triple Aim” of improved individual care, improved population health, and decreased healthcare costs. Description: The purposes of this presentation are to discuss changes in the healthcare delivery environment, to identify opportunities for partnerships between advanced public health nurses and nursing leaders in healthcare systems, and to describe the usefulness of the CHW resource guide. Lessons Learned: Strategies including intra- and inter-professional collaboration can address the skepticism that may exist about CHWs, their roles and competencies; how to integrate them into healthcare systems; and how to attain smooth transition...