Section: Module 4: Lesson 1: Implementing the COPC Approach | Community-Oriented Primary Care | NextGenU.org

  • Learning Objectives:
    Upon completion of this lesson, you will be able to:
    • Understand COPC intervention design and setup.
    • Consider your role as a health care provider within the community.
    • Identify key community members.
    • Use available resources to develop a plan that follows the six steps of the COPC process.
    • Consider methods for evaluating your initiative and the importance of reassessment.
    • Describe how to approach different community problems to develop a plan following the COPC process.
    Approximate time required for the readings for this lesson (at 144 words/minute): 3 hours.

    Click here to start this lesson
    • Required Learning Resources and Activities
    • Read the entire article.  Ensure you examine Table 3 which outlines the stages of the COPC implementation process.

    • Read and study the article titled "Being Community-Responsive Physicians: Doing the Right Thing." It is a qualitative study that examines how family physicians respond to community needs in either community health centers or fee-for-service practices in Toronto, Ontario, Canada. Consider what experiences and challenges you might face as a physician.

    • In "Chapter 18. Section 3. Identifying Targets and Agents of Change: Who Can Benefit and Who Can Help" read the content under the "Main Section" and "Examples" tabs in order to help identify potential agents of change in the community where you are working.

    • Read the article titled "Training and Application of Community-Oriented Primary Care (COPC) Through Family Medicine in Catalonia, Spain" for a sense of how to teach COPC to other residents and how to cooperate with an established national health system. This article details how and why COPC was successful in Catalonia, Spain.

    • Scroll down and under the heading titled "Activities and Modules" click on the link titled "Module 4 - Developing and Monitoring Interventions".  Read through the slides to learn how to evaluate an intervention.  Lecture notes are available for download.

    • Read the article titled "Use of Clinical Indicators to Evaluate COPC Projects." Understand some of the potential methods and problems associated with the evaluation of COPC projects based on clinical indicators.

    • Read the entire page.

    • Read from the beginning of the article until the heading "The Promise of Integration."

    • In this activity, you will design and propose a small COPC project with the help of your community mentor, following the six principles of COPC, that pertain to the community that you have chosen to work with. You will not be required to implement this project, but rather to design a feasible plan that could be carried out by either yourself or someone else in the future.  Communicate with your mentor and peers throughout the development of your proposal, discussing challenges, next steps, and general questions of interest. This proposal may help members of the community you have been in contact with by outlining problems and a potential plan of action. A final copy of your proposal should be given to your community mentor. Keep in mind that you have already written portions of this proposal as part of the peer and mentored assignments completed in Modules 2 and 3. You may re-use these prior assignments as is or revised as needed. However, you are required to combine all of these assignments into one full project proposal.

      Step 1: When writing your project proposal, please follow the outline detailed below, answering each of the questions posed. There are three parts to include in your proposal. Within each part, there are specific elements to address, and these are outlined below: 

      1. Community assessment and diagnosis 
      2. Intervention plan
      3. Method of evaluation. 

      PART ONE: COMMUNITY ASSESSMENT AND DIAGNOSIS (1500-2100 words total)

      1.1) Define and characterize the health needs and available resources of the community in question (600-800 words).

      You can use the portion of the essay that you wrote in Module 2 which answers the question “How would you define and characterize this community?”  You may revise your original essay as needed. Your proposal should consider methods of community diagnosis, Geographic Information Systems (GIS), epidemiology, and the social determinants of health. In addition, include an outline of the community assets and resources.

      1.2) Describe how you would prioritize the needs of the community. Explain your answer in 300-400 words.

      You can use what you wrote for the mentored activity “Prioritization” in Module 3. You may revise your original essay as needed. Considering the first mentored activity in Module 3, discuss the method of prioritization in your specific community. Explain why you decided to prioritize in this way and identify the selected health condition. Engage community members whenever possible.

      1.3) Assess the selected health condition (600-900 words)

      You can use what you wrote for the mentored activity: “Detailed Assessment of Selected Health Problems” in Module 3. You may revise your original essay as necessary. Include any additional research on the selected health condition. Engage your mentor and other community members whenever possible.

      PART TWO: INTERVENTION PLAN (300-500 words total)

      With regard to your specific health priority in your specific community, design an intervention strategy with the help of your mentor, peers, and community members (300-500 words). Utilize the DC AHEC document on “Intervention” and the CTB chapter on “Deciding Where to Start” as additional guides. Within your project plan, including responses to all of the following:

      Preliminary Research

      2.1) Outline the work carried out by the health service and other organizations thus far.

      2.2) Outline the work carried out by the community thus far.

      2.3) Describe what methods you will use or have used to engage the community. Describe how you will or how you have identified key personnel and stake-holders. Describe the level of involvement and willingness of the community to engage with you. Describe some of the challenges and benefits of community involvement.

      Objectives

       2.4) Indicate one to two short-term objectives, one to three intermediate objectives, and one long-term objective for the plan.

      2.5) Describe at least one activity or action for each one of the objectives outlined above. Provide the references that demonstrate the effectiveness of the activities or actions.

      Necessary Resources

      2.6) List the resources (personnel, materials and equipment) that would be needed to carry out your intervention.

      Budget

      2.7) Outline a realistic, estimated budget to carry out your intervention.

      Timeline

      2.8) Estimate the time required to accomplish your intervention.

      Accountability

      2.9) Describe how the gathered information will be communicated to different members of the team and community.

      PART THREE: METHOD OF EVALUATION (250-300 words total)

      Utilize the DC AHEC document on “Evaluation” and the CTB resources on evaluation as additional guides.  Your plan should contain 250-300 words.  Ensure that your plan addresses each of the points outlined below.

      3.1) Describe the methods of surveillance and evaluation that will best suit the activities or actions. Be sure your answer considers not only the community in question, but resources, preliminary data, and the project proposal outlined above.

      3.2) Describe how the steps will be assessed.

      Step 2:  Submit your assignment for peer review by clicking “add a new discussion topic” below and completing the fields.

      Step 3: Review the work of one of your peers by asking yourself the questions listed below and comment on their post stating that their post meets these requirements.

      • Does my peer's proposal include each stage of the COPC process by clearly answering each of the numbered elements in all three parts of the Proposal Activity?
      • Does my peer's proposal include a well-researched and developed community assessment and diagnosis?
      • Does my peer's proposal include preliminary research as well as the methods required for involving the community?
      • Does my peer's proposal contain clearly defined objectives, a realistic budget, a resource list, a time frame, and a strategy for communicating the gathered information to the community?
      • Does my peer's proposal describe methods for evaluation?
      • Is my peer's proposal both feasible and logical?
    • To access the quiz, click on the name of the quiz provided above. On the following screen, click the "Preview quiz now" button to respond to the questions.
    • Additional Learning Options
    • Read the article titled "Patients and Community Together", which details a COPC approach in an urban private practice in the United States, if you are either working in a urban community in the United States or are interested in encouraging community involvement in a private practice setting elsewhere.

    • "A Community-Oriented Primary Care Demonstration Project" details another example of COPC in an African-American community in the Southeastern United States. Read this if you are either working with similar communities or if the priority health needs, in your chosen community, are diabetes or cardiovascular disease.

    • Read the content under the heading "Outline" in the chapter titled "12. Evaluating the Initiative." This resource provides links to other chapter sections. Click on these links to gain an overall understanding of what is involved in the evaluation of an initiative. Use this resource as a reference as you read the other materials in this section and follow any links toward topics that you do not understand or would like to know more about.

    • Use the discussion forum to ask your peers about any concerns or problems you may be having with your project proposal. You should comment on at least one other posting, and if someone comments on your posting, you should respond back to them.