Montana State University

MSU Extension's Community Health Resources Program

337 Culbertson Hall
P.O. Box 172230
Bozeman, MT 59717

Tel: (406) 994-5552
Fax: (406) 994-1756
Location: Culbertson Hall

Community Health Specialist:

David Young

MSU Extension - Community Health Resources

College Department

Glossary - Terms & Acronyms

Capacity Building - The process of implementing activities critical to the long‑term viability of organizations by increasing the effectiveness of programmatic activities and organizational operations. The goal of capacity building is to increase organizational infrastructure and bolster sustainability and effectiveness, ultimately enabling the organization to serve more people more effectively.

Community - a group of people who share some common element, interest, heritage, hobby, ethnicity, culture, religion, work, recreation, defined geographic area, etc, such as, the faith community, the medical community, the American Indian community, the African American community, the rural community and a gated community. In essence, community is about ‘communing’ - living and sharing together; about relationships, interaction, caring, compassion and taking action. In the truest sense, a community is a body of connected people such that if one in the community is hurting, the whole community is hurting. A recent addition to the list of types of communities is the virtual community - a community of people sharing common interests, ideas, and feelings over the Internet or other collaborative networks like bulletin boards (BB). Virtual communities are considered by some as subgroups in cyberspace or a "global village" and offer two avenues of information sharing: (a) message posting and (b) real-time chat/two-way interaction . Another addition is Community Service Learning (CSL) - a teaching and learning method that enables students to link theory with action through guided reflection. CSL connects students to members of a community where they provide meaningful service that responds to community needs‑as defined by the community. Preparation before the service along with cycles of action and reflection provide multiple opportunities for learning skills and gaining knowledge. Theodore Roszak states in his book Where the Wasteland Ends that “Communities exist for the health and enjoyment of those who live in them, not for the convenience of those who drive through them, fly over them, or exploit their real estate for profit.”

Community-Based Organization - The term "community-based organization" means a private nonprofit organization, Indian tribe or tribally-sanctioned organization or other type of collection of individuals who work within a community for the improvement of some aspect of that community. Community-based organizations are usually engaged in activities and interventions at the community level and work with some social and/or justice issue(s). A community-based organization may refer to one or more of the following:

  1. a grassroots group/neighborhood organization not affiliated with a larger organization;
  2. a service organization that provides social services at the local level;
  3. a non-profit 501c(3) organization with or without subsidiaries
  4. a public or private nonprofit that is representative of a community or a significant segment of a community, and is engaged in meeting human, educational, environmental, or public safety community needs.‑local‑community‑based‑org.pdf

Community-Based Participatory Research (CBPR) - CBPR is defined as scientific inquiry conducted in communities and in partnership with researchers. The process of scientific inquiry is such that community members, persons affected by the health condition, disability or issue under study, or other key stakeholders in the community's health have the opportunity to be full participants in each phase of the work (from conception ‑ design ‑ conduct ‑ analysis ‑ interpretation ‑ conclusions ‑ communication of results). CBPR is characterized by substantial community input in the development of any grant applications. Community‑partnered approaches to research promise to deepen our scientific base of knowledge in the areas of health promotion, disease prevention, and health disparities. Community‑partnered research processes offer the potential to generate better‑informed hypotheses, develop more effective interventions, and enhance the translation of the research results into practice. Specifically, involving community and academic partners as research collaborators may improve the quality and impact of research by:

  • More effectively focusing the research questions on health issues of greatest relevance to the communities at highest risk;
  • Enhancing recruitment and retention efforts by increasing community buy‑in and trust;
  • Enhancing the reliability and validity of measurement instruments (particularly survey) through in‑depth and honest feedback during pre‑testing;
  • Improving data collection through increased response rates and decreased social desirability response patterns;
  • Increasing relevance of intervention approaches and thus likelihood for success;
  • Targeting interventions to the identified needs of community members
  • Developing intervention strategies that incorporate community norms and values into scientifically valid approaches;
  • Increasing accurate and culturally sensitive interpretation of findings;
  • Facilitating more effective dissemination of research findings to impact public health and policy;
  • Increasing the potential for translation of evidence‑based research into sustainable community change that can be disseminated more broadly.

In CBPR, community refers to populations that may be defined by: geography; race; ethnicity; gender; sexual orientation; disability, illness, or other health condition; or to groups that have a common interest or cause, such as health or service agencies and organizations, health care or public health practitioners or providers, policy makers, or lay public groups with public health concerns.
From NIH Guide for Grants and Contracts “Community Participation In Research (R21)”PAR 06-247

Community Coalition - a formal arrangement for cooperation and collaboration between groups or sectors of a community, in which each group retains its identity but all agree to work together toward a common goal of building a safe, healthy, and drug-free community.
Community Anti-Drug Coalitions of America (CADCA)

Community Health - a field within public health, is a discipline that concerns itself with the study and betterment of the health characteristics of communities. While the term community can be broadly defined, community health tends to focus on geographic areas rather than people with shared characteristics. Because health (broadly defined as well‑being) is influenced by a wide array of socio‑demographic characteristics, relevant variables range from the proportion of residents of a given age group to the overall life expectancy of the neighborhood. Medical interventions aimed at improving the health of a community range from improving access to medical care to public health communications campaigns. Recent research efforts have focused on how the built environment and socio‑economic status affect health.

Community of Practice (CoP) - a concept first used in 1991, refers to “the process of social learning that occurs when people who have a common interest in some subject or problem collaborate over an extended period to share ideas, find solutions, and build innovations.” CoPs have become associated with knowledge management including ways of developing social capital, nurturing new knowledge, stimulating innovation and creativity within an organization and/or special interest groups. Over the past decade, CoPs have become an integral part of organizational development.

Compassion Capital Fund Demonstration Program (CCF) - the goal of the CCF is to provide experienced intermediary organizations with funds to deliver technical assistance to small faith-based and community organizations in support of their efforts: (1) to improve program effectiveness and organizational management; (2) to expand the types and reach of social service programs in their communities; and (3) to develop promising collaborations among organizations dedicated to social service delivery. Experienced intermediary organizations are those who have established relationships with grass-roots faith-based and community organizations, as well as a proven track record in providing technical assistance to such groups. Specifically, the goal of CCF is to assist faith-based and community organizations in: (1) increasing their effectiveness; (2) enhancing their ability to provide social services; (3) expanding their organizations; (4) diversifying their funding sources; and (5) creating collaborations to better serve those most in need. Intermediary organizations provide sub-awards that focus on organizations that: (1) historically have not received grants from the Federal government, and (2) are implementing programs that address priority social service needs. These sub-awards are to be used: (1) for capacity-building activities that further the sustainability of sub-awardees’ social service efforts; (2) to assist organizations in differing stages of development; (3) for promising organizations to expand the reach of existing programs, to move to a higher level of service, to upgrade case management or informational technology capabilities, or support a new social service; and (4) to improve the sub-awardee’s overall efficiency and capacity. The CCF Demonstration Program was announced in the Federal Register, June 2, 2002 and the first CCF grants were awarded in September of 2002. Since its inception and through September 2004, the CCF Demonstration Program has awarded $99.5 million to 1,906 organizations.

Complementary and Alternative Medicine - There are many terms used to describe approaches to health care that are outside the realm of conventional medicine as practiced in the United States. The National Center for Complementary and Alternative Medicine (NCCAM), a component of the National Institutes of Health, defines complementary and alternative medicine, as a group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine. While some scientific evidence exists regarding some CAM therapies, for most there are key questions that are yet to be answered through well‑designed scientific studies‑‑questions such as whether these therapies are safe and whether they work for the diseases or medical conditions for which they are used. The list of what is considered to be CAM changes continually, as those therapies that are proven to be safe and effective become adopted into conventional health care and as new approaches to health care emerge. Complementary and alternative therapies are different. Complementary medicine is used together with conventional medicine. An example of a complementary therapy is using aromatherapy to help lessen a patient's discomfort following surgery. Alternative medicine is used in place of conventional medicine. An example of an alternative therapy is using a special diet to treat cancer instead of undergoing surgery, radiation, or chemotherapy that has been recommended by a conventional doctor. Integrative medicine, on the other hand, combines mainstream medical therapies and CAM therapies for which there is some high‑quality scientific evidence of safety and effectiveness.
National Center for Complementary and Alternative Medicine, NIH,

Cooperatives - are an organized response to a need or an opportunity perceived by at least several people who are willing to commit themselves to an autonomous association. Cooperatives are usually voluntary business ventures that are owned and controlled by the people who use specific products, supplies or services. Cooperatives are formed to meet the specific needs and desires of members and are structured to adapt to member’s changing needs. Cooperatives are based on the values of self-help, social responsibility, democracy, honesty, integrity, equity and solidarity. Cooperatives are useful for promoting the interests of less powerful members of society. Farmers, ranchers, producers, workers and consumers have found that they can accomplish more collectively through the mechanism of a cooperative than they can individually. Approximately 47,000 cooperatives involving over 100 million members are in operation today across the U.S. enabling consumers to secure a wide variety of goods and services such as health care, insurance, housing, food, heating fuel, hardware, credit unions, child care and utility service.

Core values - are the operating philosophies or principles that guide an organization's internal conduct as well as its relationship with the external world. Core values are usually summarized in the mission statement or in the statement of core values.

Cure - (1) restoration to health of a person afflicted with a disease or other disorder; (2) the favorable outcome of the treatment of a disease or other disorder; (3) a course of therapy, a medication, a therapeutic measure, or another remedy used in treatment of a medical problem, as faith healing, fasting, rest cure or work cure.
Mosby’s Pocket Dictionary of Medicine, Nursing, & Allied Health, 2nd Edition, 1994

Direct Services ‑ are those services provided directly to needy individuals/families, including such tangible items as cash/checks/money orders, commodities, food, clothing, shelter, day care, and etc. Additionally, direct services includes any form of direct health care delivery (physical, mental, dental). Funds distributed under the Compassion Capital Fund Demonstration Program are not to be used for direct services but rather for building and expanding an organization’s ability to deliver needed social services. For example, an organization that distributes food to the poor should not receive a sub‑award funding simply to purchase additional food. Nor should an organization that provides substance abuse treatment services receive additional funds simply to enable it to provide exactly the same services to more people. Use of funds in this manner does not serve to improve an organizations' sustainability, efficiency or capacity. Rather, the organizations would simply use additional funds in the same way they used existing funds, without fundamentally changing or improving their services.

Disease - from old French and Latin, ‘dis-ease’ literally meant absence of ‘ease’ or ‘elbow room’; an impediment to free unrestricted movement; today, the word lacks the hyphen and is used to refer to a disorder of structure or loss of function; it is a pathological process involving a deviation from the biological norm that is in some way injurious to the host organism and/or impairs to a significant degree the daily functioning and well-being of the host organism; from the dictionary (L dis + Fr aise ease); (1) a condition of abnormal vital function involving any structure, part, or system of any organism; (2) a specific illness or disorder characterized by a recognizable set of signs and symptoms, attributable to heredity, infection, diet or environment.

Disparity - the lack of equality between people or things; the condition of being unequal, as in age, rank, or degree; different, incongruent or dissimilar in some respect; unlikeness;

Faith-Based Organization - any group/organization created by or for religious or spiritual group including, but not limited to, individual places of worship, groups of community or tribal elders/spiritual leaders, intra- or interdenominational community coalitions, faith connected health and human service agencies, denominational hierarchies/governance bodies, religious orders and schools of divinity.
From ‘Sharing a Legacy of Caring - Partnerships between Health Care and Faith-Based Organizations’ Nat’l Ctr for Cultural Competence, Georgetown Univ Med Ctr and the Faith Partnership Initiative, BPHC, HRSA, DHHS, Winter 2001.

Goals - are broad, general statements that identify the overall main purpose of a program/project; a goal is the statement of the ultimate result of the change being sought or the outcome desired.

Guiding principles - serve to guide an organization throughout its life in all circumstances, irrespective of changes in its goals, strategies, type of work, or the top management. Guiding principles are the consequence of an action plan intended to inform or shape all subsequent decision‑making, which also provides normative criteria allowing policy‑makers to accept, reject or modify policy interventions and activities.

Healing - the word ‘healing’ comes from the Greek word ‘heilen’ which means “to become whole”; “to set right”; or “to restore”; the medical concept of healing means ‘the act or process in which normal structural and functional characteristics of health are restored to diseased, dysfunctional, or damaged tissues, organs, or systems of the body’; the Biblical concept of healing means far more than relief from physical pain and symptoms; it means wholeness of body and spirit ; in John 5:6, Jesus asked the invalid lying by the pool of Bethesda near the Sheep Gate in Jerusalem, “Wilt thou be made whole?” (KJV); God offers healing in three ways: (1) through new birth - 2 Corinthians 5:17; (2) through confession of sin - Psalm 103:3-4; and (3) through miracles in keeping with His sovereign will and responding to prayer - James 5:14-16.

Health - complete state of physical, mental, spiritual and social well-being and not merely an absence of disease; (World Health Organization); (1) the overall condition of an organism at a given time; (2) Soundness, especially of body or mind; (3) The condition of optimal well-being; (The American Heritage Dictionary, 1995).

Health Center - a health center is a facility that provides direct primary health care services to individuals. Health centers come in a variety of types including stand-alone community-based facilities to those affiliated with larger institutions like Academic Health Science Centers and hospitals. Health Centers may be public, private, not-for-profit or for-profit facilities. In addition to delivery of health care services, a health center may provide health education, residency training, health information and substance abuse treatment. A health center is licensed and regulated by state and federal agencies and is staffed primarily by paid professionals. Rigorous federal standards related to quality of care and services as well as cost are applied to those health centers receiving cost-based reimbursement under Medicaid and Medicare law. As far as the federal government is concerned, Health Centers refer to all the diverse public and non‑profit organizations and programs that receive federal funding under section 330 of the Public Health Service (PHS) Act, as amended by the Health Centers Consolidated Act of 1996 (P.L. 104‑299) and the Safety Net Amendments of 2002. They include Community Health Centers, Migrant Health Centers, Health Care for the Homeless Health Centers, and Primary Care Public Housing Health Centers. Health centers are characterized by five essential elements that differentiate them from other providers:
They must be located in or serve a high need community, i.e. “medically underserved areas” or “medically underserved populations”;
They must provide comprehensive primary care services as well as supportive services such as translation and transportation services that promote access to health care;
Their services must be available to all residents of their service areas, with fees adjusted upon patients’ ability to pay;
They must be governed by a community board with a majority of members health center patients; and,
They must meet other performance and accountability requirements regarding their administrative, clinical, and financial operations.

Health Disparities - are differences in the incidence, prevalence, mortality, and burden of diseases and quality of health care that exist among and between specific population groups when compared to non‑Hispanic Whites. The Health Resources and Services Administration defines health disparities as "population‑specific differences in the presence of disease, health outcomes, or access to health care." These differences are usually the result of a complex interactions involving a multitude of factors including genetic, social, economic, ethnic, cultural, behavioral, geographic, and environmental. In addition, access to health care, health promotion, diagnostic screening and personal lifestyle choices are key elements of the health disparities equation. In some situations, a health disparity may be judged to be inappropriate and avoidable based on present day knowledge, research, resources and interventions and thus constitute a health inequity. In essence, health disparities refer to gaps in the quality of health and health care across racial and ethnic groups. A health inequity is a lack of fair and appropriate distribution of resources such that all individuals have ‘fair and equal’ opportunity to achieve their full health potential through affordable access to the known pre-requisites and treatments for good health and disease prevention.

Health Equity - refers to a concept of fairness in distribution and access such that all individuals have ‘fair and equal’ opportunity to achieve their full health potential through access to the known pre-requisites for good health and disease prevention. Conversely, 'health inequity' refers to differences in health, or opportunities for health, that are judged to be unfair and avoidable.

Health Indicators or Determinants of Health - identifiable factors that play a key role in a persons health status, health risks and health outcomes. According to the World Health Organization (WHO), founded in 1948 as a specialized agency of the United Nations to address international health matters, the key determinants of health include: (a) the social and economic environment; (b) the physical environment, and (c) the person’s individual characteristics and behaviours. Healthy People 2010 has identified the following 10 factors as ‘Leading Health Indicators’: (a) Physical Activity; (b) Overweight and Obesity; (c) Tobacco Use; (d) Substance Abuse; (e) Responsible Sexual Behavior; (f) Mental Health; (g) Injury and Violence; (h) Environmental Quality; (I) Immunization; and, (j) Access to Health Care.

Health Literacy - the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions (Healthy People 2010); health literacy includes dispelling myths and informing people – especially rural residents – of clinical prevention trials; helping people to understand common health care communications and information, such as prescription and health provider instructions, test results and insurance forms; educating the public about steps they can take to become better health consumers and the relationship between physical activity and health.

Health Minister - a health minister is someone who, through specialized preparation, promotes whole person health and healing as a member of the faith community they serve. A health minister works at expanding and enhancing the integration of faith and health within the local faith community and in the community at large. The activities of a health minister serve to promote an awareness of how justice, lifestyles, relationships and spirituality affect health and wholeness. In addition, the activities performed by a health minister through the faith community provide invaluable opportunity for individuals to achieve their full potential for self‑sufficiency and healthy independent living. A health minister offers hope, healing, wholistic health and well‑being. A health minister does not deliver health care services.

Health Policy - the development by government and other policy makers of present and future objectives pertaining to health care and the health care system, and the articulation of arguments and decisions regarding these objectives in legislation, judicial opinions, regulations, guidelines, standards, etc. that affect health care and public health. Health policy literature includes works that describe the roles played by both government and non‑governmental entities and individuals in the policy process; studies of economic, technological, social, cultural and other influences on policy development; and the effects of resulting policies, guidelines, standards and protocols. Health policy also includes garnering expertise and disseminating information in areas of education, prevention, early intervention, treatment and population-based care management. Activities should include calling meetings of public policy makers and developing collaborative partnerships with local, state, regional and national organizations.

Health Policy Research - the multidisciplinary field of scientific investigation that studies how social factors, financing systems, organizational structures and processes, health policies, health technologies and personal behaviors affect access to health care, the quality and cost of health care, and ultimately the health and well‑being of individuals, families, communities and populations (adapted from AcademyHealth, 2000). Health services research involves the integration of statistical, epidemiological, and social and behavioral research techniques in the study of health services, including randomized controlled trials, qualitative research, health care surveys, systematic reviews and meta‑analysis. Examples of research topics include evaluation of practice variations, guideline adherence, and diffusion of innovation; quantitative and qualitative analysis of inequalities in health status and health care; assessment of patient attitudes to health, health seeking behavior, acceptance of health care, willingness to pay, and compliance with treatment.
National Library of Medicine

Health Promotion - is the process of enabling people to increase control over, and to improve, their health. To reach a state of complete physical, mental and social well‑being, an individual or group must be able to identify and to realize aspirations, to satisfy needs, and to change or cope with the environment. Health is, therefore, seen as a resource for everyday life, not the objective of living. Health is a positive concept emphasizing social and personal resources, as well as physical capacities. Therefore, health promotion goes beyond healthy life‑styles to well‑being. Health promotion involves changing behaviors and since individual and group behaviors are learned, various programs, projects and strategies can be implemented to produce health enhancing behaviors. Some strategic directions for the promotion of health have focused on capacity‑building and promoting social change through social marketing efforts. Other activities have included health promotion leadership, health promotion financing, strategic partnerships for health education and governance and improved health communication.
World Health Organization

Health-Related Qualify of Life (HRQL, HRQoL) - is a complex, abstract, and multidimensional concept that encompasses the physical, emotional, mental, spiritual and social domains associated with a person's health status including illness, treatment and/or outcome. Quality of life is a common term used to convey an overall sense of well-being and satisfaction with life as a whole. HRQL encompasses those aspects of overall quality of life that can be shown to affect health. It is important to remember that quality of life and health status are distinct constructs; quality of life is broad and subjective determined not only by a person's health status and/or health outcome, but also by a person's emotional, mental and spiritual response to illness and/or treatment. In contrast, health status and health outcomes are rather specific and objective constructs to measure. It is also important to remember that non-health factors such as employment, income, financial status, level of education, housing, are usually not taken into account when measuring HRQL; however, these related domains do contribute to overall quality of life.

Healthy Community - is one that embraces the belief that health is more than merely an absence of disease; a healthy community includes those elements that enable people to maintain a high quality of life and productivity. For example: (a) a healthy community offers access to health care services that focus on both treatment and prevention for all members of the community; (b) a healthy community is safe; (c) a healthy community has roads, schools, playgrounds, and other services to meet the needs of the people in that community; and (d) a healthy community has a healthy and safe environment.
From ‘Healthy People in Healthy Communities’ USDHHS
February 2001; ISBN 0-16-042815-7

Healthy People 2010 - is the current phase of a national health agenda document that began in 1979 as an effort designed to make communities healthier and happier places. Healthy People 2010 is designed to achieve two overarching goals: (1) to increase the quality and years of healthy life, and (2) to eliminate health disparities. These two goals are supported by 467 objectives contained within 28 focus areas. In addition, Healthy People 2010 identifies a smaller set of health priorities that reflect 10 major public health concerns across the US that are referred to as ‘Leading Health Indicators.’ Healthy People 2010 seeks to encourage local and state leaders to develop community-wide and state-wide efforts that promote healthy behaviors, create healthy environments, and increase access to high quality health care. It is well known that individual health and community health are often inseparable and therefore it is critical that both the individual and the community do their parts to increase life expectancy and improve quality of life. One of the more interesting statements in the document regarding health equity is as follows: "regardless of age, gender, race, ethnicity, income, education, geographic location, disability, and sexual orientation - every person in every community across the Nation deserves equal access to comprehensive, culturally competent, community-based health care systems that are committed to serving the needs of the individual and promoting community health.” For more information about Healthy People 2010, see:
From ‘Healthy People in Healthy Communities’ USDHHS
February 2001; ISBN 0-16-042815-7

Holistic Health - is actually an approach to life. Rather than focusing on illness or specific parts of the body, this ancient approach to health considers the whole person and how he or she interacts with his or her environment. It emphasizes the connection of mind, body, and spirit. The goal is to achieve maximum well‑being, where everything is functioning the very best that is possible. With Holistic Health people accept responsibility for their own level of well‑being, and everyday choices are used to take charge of one's own health.
From the American Holistic Health Assoc (AHHA)

Holistic Health Care - a system of comprehensive or total patient care that considers the physical, emotional, social, economic, and spiritual needs of the person, the response to illness, and the impact of the illness on the person’s ability to meet self-care needs. (Mosby’s Pocket Dictionary 1994); Whole person health refers to a process of wholeness that exits when there is harmony among the three dimensions of our lives - body, mind and spirit. (Health Ministries and Parish Nursing - The Basics, HMA) “Wholistic approaches focus on the person who has the illness rather than on the illness the person has.”

Holistic medicine - is a system of health care which fosters a cooperative relationship among all those involved, leading towards optimal attainment of the physical, mental emotional, social and spiritual aspects of health. It emphasizes the need to look at the whole person, including analysis of physical, nutritional, environmental, emotional, social, spiritual and lifestyle values. It encompasses all stated modalities of diagnosis and treatment including drugs and surgery if no safe alternative exists. Holistic medicine focuses on education and responsibility for personal efforts to achieve balance and well being.
From the Canadian Holistic Medical Association

Integrative Medicine - is the practice of medicine that reaffirms the importance of the relationship between practitioner and patient, focuses on the whole person, is informed by evidence, and makes use of all appropriate therapeutic approaches, healthcare professionals and disciplines to achieve optimal health and healing. From the Consortium of Academic Health Centers for Integrative Medicine (CAHCIM)

Inequality - the difference between two measurable items such that one item is better than the other.

Inequity - not equitable; unfair; injustice by virtue of not conforming with certain rules or standards.

Integrative Wellness - is the cooperative practice between members of the faith community and members of the health care professions that fully recognizes the interdependence of physical, mental, emotional and spiritual domains of the whole person. This cooperative practice supports and endorses integrative approaches that lead to whole person health, wellness, harmony, and optimal well-being; such as, health promotion and wellness education, health screenings, early intervention/treatments and enhanced self-care management, home care services, and continuum of care.

Intermediary Organization - an organization that is strategically positioned to help smaller organizations operate and manage their programs effectively, access funding from varied sources, develop and train staff, expand the types and reach of social and health services programs in their communities, and replicate promising programs. In addition, intermediary organizations who have access to funding sources may sub-grant awards to qualified smaller faith‑based and community organizations (FBO/CBOs) to expand or replicate promising or best practices in their communities.

Intervention - any action, activity, method or procedure that is performed to assist in altering or changing a person’s biological and/or behavioral patterns to prevent harm or injury to that person. Interventions may prevent adverse health outcomes and/or arrest/control the advancement of a pathologic process.

Kindness - is defined as an intentional selfless kind of gentle love that involves concentrating on the needs of others rather than self. It is the opposite of indifference, neglect, self-pity and cruelty. Kindness is a health-enhancing and and life-enriching virtue that carries a double blessing, transforming both the life of the giver and the life of the receiver.
From “Kindness and Joy - Expressing the Gentle Love” by Harold G. Koenig, MD

Long‑term care (LTC) - refers to the services and supports needed when the ability to care for oneself has been reduced by chronic illness, disability, or aging. Long‑term care is provided in a number of different settings, including at home by family and friends, in the community through services such as home health and adults day care, or in institutional settings, such as nursing homes. Often, long‑term care users will need a combination of these types of care over the course of their lifetimes.

Metropolitan statistical area (MSA) - a county or group of counties with the presence of a city with 50,000 or more inhabitants, or the presence of an urbanized area and a total population of at least 100,000;
A Primary metropolitan statistical area (PMSA) is a county or group of counties that qualify as an MSA and have a total population of 1 million or more.

Mission - a mission statement is a brief description of an organization’s fundamental purpose; it answers the question, “Why do we exist?” It defines the core purpose of existence of the organization. The mission statement articulates an organization’s purpose both for those in the organization and for the public.

Objectives - are clear, concise, specific, measurable, manageable, achievable, realistic, time-bound statements that stepping stones to achieving goals and are tied to the statement of need. Objectives do not describe methods. Objectives are SMART (Specific, Measurable, Achievable, Realistic, Time-Bound).

Parish Nurse - is a professional nurse who reclaims the historic roots of health and healing found in many religious traditions. The parish nurse understands health to be a dynamic and integrated process, involving physical, mental, emotional and spiritual dimensions of a person. The parish nurse assists and supports individuals, families, and communities in becoming more active partners in the stewardship of personal and communal health resources. The parish nurse serves, advocating with compassion, mercy and justice. The parish nurse, in collaboration with the pastoral staff, congregants, and a Health Committee, participates in the ongoing transformation of the faith community into a source of health and healing. A parish nurse serves a variety of roles in a local faith community and neighborhood. These roles may include the following:

Integrator of Faith and Health
- Assists parishioners to achieve higher levels of wellness by improving both spiritual and physical health.

Health Educator
- Provides opportunities for the congregation to learn about health issues, individually and in groups.

Health Counselor
- Discusses health concerns, emphasizing early response to small problems and encouraging healthy lifestyle changes.

Referral Advisor
- Provides referral to healthcare and social services within the community.

Health Advocate - Speaks out to help members of the congregation or community obtain needed health-related services.

Developer of Support Groups
- Facilitates the development of support groups for the faith community and others served.

Volunteer Coordinator
- Recruits, prepares and oversees congregational volunteers who help those in need.
In summary, through partnership with other community health resources, parish nursing fosters new and creative responses to health and wellness concerns.

Patient‑Centered Care - is defined as health care that establishes a partnership among practitioners, patients and their families (when appropriate) to ensure that decisions respond to and respect patients' wants, needs and preferences and solicit patients' input on the education and support they need to make decisions and participate in their own care. Essential dimensions of patient‑centered care include but are not limited to: 1) accessible and customized information, communication, and education; 2) continuous collaboration, coordination and integration of care among providers, across conditions and settings; 3) shared decision‑making of clinicians with patients and their families; 4) self‑efficacy and self‑management skills for patients; 5) patients' experience of care; 6) provider‑patient partnership; and, 7) enhanced cultural competence of health care providers.

Positive Youth Development - Positive youth development includes, but is not limited to promoting a sense of safety; providing appropriate structure; creating supportive relationships; providing opportunities to belong; providing social norms, such as rules for behavior; giving youth responsibilities and meaningful challenges; providing opportunities for skill building; and coordinating family, school, and community programming. From ACF Grant Announcement‑2007‑ACF‑OCS‑IC‑0141.html

Prospective study - a study in which the subjects are identified and then followed forward in time. In evaluations of the effects of healthcare interventions, a prospective study is one in which people are divided into groups that are exposed or not exposed to the intervention(s) of interest before the outcomes have occurred. Randomised controlled trials are always prospective studies and case control studies never are. Concurrent cohort studies are prospective studies, whereas historical cohort studies are not although in epidemiology a prospective study is sometimes used as a synonym for cohort study. A cohort study involves identification of two groups (cohorts) of patients, one which received the exposure of interest, and one which did not, and following these cohorts forward for the outcome of interest. By comparison a cross-sectional study involves the observation of a defined population at a signal point in time or time interval. Exposure and outcome are determined simultaneously.

Quality of care - is the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge.
“Medicare: A Strategy for Quality Assurance” Vol I, Institute of Medicine, 1990, page 4.

Rural - is a term commonly used, poorly understood and difficult to define. The Federal Government has more than eight different definitions for rural. Basically, three different ‘area-based’ units of measure are used: county, census tract and population density (persons per sq mi). Why is a definition of rural important? The Federal Government uses a rural definition when determining eligibility and reimbursement levels for more than 30 federal programs, including Medicare reimbursement levels. The OMB definition is used extensively in federal policy and is county-based – counties are designated metropolitan (n=1090) or nonmetropolitan (n=2052). Recently OMB has further defined nonmetropolitan with a term ‘micropolitan’ – based on the presence of an urban cluster (areas with more than 2,500 but less than 50,000) with a population of 10,000 or more. Others consider rural to mean geographic areas that consist of open country and settlements with fewer than 2,500 residents, according to the U.S. Census Bureau – the nation has 3,141 counties (2,100 rural and 1,141 urban), 65,000 census tracts and more than 30,000 zip code areas. In comparison, Urban Areas (UAs) have a central city and surrounding settled territory that together have a population of 50,000 or more and a population density generally exceeding 1,000 people per square mile. Other population density definitions consider rural to mean a population density of 6-10 people per square mile and less than 6 people per square mile as frontier. OMB designates areas as metro (metropolitan statistical area - MSA) those areas which include a city with 50,000 or more inhabitants. A newer definition, Rural Urban Commuting-Area (RUCA), uses census tract-level demographic and work-commuting data to define 33 categories of rural and urban census tracts. The census tract version of the RUCAs is further fine-tuned by supplementing with a zip code-based version.

Social Capital - are those specific processes among people and organizations, working collaboratively in an atmosphere of trust, that lead to accomplishing a goal of mutual social benefit. The principles of social capital – collaboration, partnerships, alliances, coalitions – are cornerstones for community health promotion strategies. In nearly all conceptualizations of social capital, trust and reciprocity are foundational aspects. Trust builds bonds that strengthen the overall social fabric and enables participants to act and work together effectively. Reciprocity has special relevance when it comes to interactions and exchanges that are necessary working with multiple organizations collaborating on common ground for a common cause. Reciprocity is an expectation that there will be a return on one’s investment – that is to say, working together on a common cause will advance the common good.
From: Kreuter, M.W. Lezin, N.A., Koplan, A.N., & Young, L.A. (2001). Social Capital: Evaluation Implications for Community Health Promotion. In I. Rootman, M. Goodstadt, D. McQueen, L. Potvin, J. Springett, & Ziglio (Eds.), Evaluation in Health Promotion: Principles and Perspectives. Copenhagen: European Regional Office of the World Health Organization

Social Norms - are the behaviors or attitudes of the majority of a group of people or the majority of any community. For instance, if most people in a community do not smoke, then not smoking is not only the ‘normative’ accepted behavior, or the social norm, but may well be the expected behavior in that population. Social norms is becoming a scientific approach to health promotion and disease prevention as a way of explaining and shaping human behavior based upon the powerful role of perceptions. Social norms theory maintains that people’s behavior is strongly influenced by their perceptions of the attitudes and behaviors of their peers. Thus, ‘perceptions of social norms’ are people’s beliefs about the norms of their peers. Unfortunately, many people misperceive a particular behavior as the accepted norm and compounding this picture is that fear of social disapproval makes others reluctant to intervene and stop dangerous behaviors that are believed to be socially sanctioned. Social norms theory is founded on the ‘science of the positive’ and thus social norms campaigns focus on health-enhancing behaviors of the majority with the hopes that positive behaviors and attitudes will be the end result.

Strategic objectives - are broadly‑defined targets that an organization must achieve to make its strategy succeed. Strategic objectives are, in general, externally focused and (according to the management guru Peter Drucker) fall into eight major classifications: (1) Market standing: desired share of the present and new markets; (2) Innovation: development of new goods and services, and of skills and methods required to supply them; (3) Human resources: selection and development of employees; (4) Financial resources: identification of the sources of capital and their use. (5) Physical resources: equipment and facilities and their use; (6) Productivity: efficient use of the resources relative to the output; (7) Social responsibility: awareness and responsiveness to the effects on the wider community of the stakeholders; and, (8) Profit requirements: achievement of measurable financial well being and growth.

Thrive - is to grow in a strong, vigorous and healthy way; to make steady progress; to prosper and flourish; to be at the high point in one's career or reach a high point in historical significance or importance; "The new student is thriving".

Translational Research - is the process of applying ideas, insights, and discoveries generated through basic scientific inquiry to the treatment or prevention of disease or injury. The value of translational research is usually determined by the likelihood that achievement of research objectives will move future investigations toward some type of therapy development.

Vision - a vision of any organization is how the stakeholders see (envision) their future and their desired overarching long-term goal. It is an ‘inspirational and aspirational’ image of the future that an organization is aiming to achieve, the framework for all strategic planning.

Well-Being - achievement of an optimum and satisfactory level of daily functioning across physical, mental, emotional, spiritual, relational, recreational and environmental dimensions of life as defined by an individual.

Wraparound Services - are a comprehensive set of community-based services built on multi-agency collaborations that provide a system-of-care intervention designed for a specific individual or target population. The wraparound approach is a team-driven process involving the individual and family members, natural supports, agencies, and community services working together to develop, implement, and evaluate the individualized service plan. Wraparound is a philosophy of care that includes a definable planning process involving an individual and family members that results in a unique set of community-based services and natural supports individualized for the recipient to achieve a positive set of outcomes. The label of ‘wraparound’ to describe an individualized system-of-care intervention with linkages to community-based services was first used by Dr. Lenore Behar in 1985. Since then a number of U.S. law suits have encouraged states to consider the ‘wraparound process’ as an alternative community-based individualized system-of-care in lieu of institutional placement.

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