Pediatrician-led community child health initiatives: case summaries from the evaluation of the community access to child health program.

摘要

OBJECTIVES: Case study investigations of projects identified with the Community Access to Child Health (CATCH) Program were conducted to illustrate the range of achievements of CATCH and to identify those elements related to successful or unsuccessful implementation. METHODS: We developed a purposive sample of 12 projects, selected based on time of initiation (1989-1995), level of intensity of involvement in CATCH, project locus (statewide or local), nature of program service(s), project setting, and target population(s). Two investigators spent approximately 1.5 days at each site using a preestablished case study guide that included document review and multiple in-person interviews. A total of 171 interviews were conducted with project leadership and staff, community and institutional partners, and public health officials. In seven communities, we also met with individuals receiving project services (consumers). RESULTS AND CONCLUSIONS: The premise of CATCH that with information, support, and tools, pediatricians can be agents of change in their communities was confirmed. The CATCH pediatricians with whom we met capitalize on their status in the community as physicians, their expertise, and their programmatic and political connections to create opportunities to expand and improve health and social services for children. The specific leadership of these pediatricians is often key in overcoming political and cultural barriers to implement system changes. CATCH was and continues to be an effective program strategy for stimulating and enhancing community-based child health initiatives.