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Posada E, Mendoza N, Alonso-Vega C, Billot C, Mallén Muñoz B, de la Torre L, Paiva A, Villarroel L, Rabinovich R. Lessons from community engagement to improve COVID-19 diagnosis and treatment in Cochabamba, Bolivia. Glob Health Action 2024; 17:2358602. [PMID: 38860498 PMCID: PMC11168335 DOI: 10.1080/16549716.2024.2358602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 05/19/2024] [Indexed: 06/12/2024] Open
Abstract
BACKGROUND Community engagement is recognized as a vital component of health-related research and programs, particularly during infectious disease outbreaks and epidemics. Despite the importance of engaging communities in the response to COVID-19, relatively little research has examined how this was (or was not) achieved, and even less in low- and middle-income countries. This article describes the community engagement that accompanied efforts to strengthen COVID-19 diagnosis and treatment as part of the ECO Project in Cochabamba, Bolivia and highlights lessons for future pandemic response. METHODS Community engagement involved formative assessment, co-creation to develop a health information campaign, ongoing community listening and evaluation. Qualitative data were collected during workshops, project meetings and focus groups. Questionnaire-based surveys were conducted to assess COVID-19-related attitudes, knowledge and practices. RESULTS The collected data highlighted the value of working closely with well-established community health committees and involving community members with social media skills in the design of COVID-19-related messages to address on- and offline misinformation. Co-creation sessions enabled the adjustment of the information campaign in terms of content and approach based on the needs and preferences of community members and health staff. The continuous listening with community and health personnel facilitated the ongoing adaptation of project activities. CONCLUSION Through a stepped and multi-pronged approach, incorporating co-creation and community listening, the engagement could respond to emerging local challenges during the pandemic. The project created spaces for dialogue and opportunities for collaboration that strengthened links between the community and the health services.
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Affiliation(s)
- Elizabeth Posada
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
| | - Nilce Mendoza
- Fundación Ciencia y Estudios Aplicados para el Desarrollo en Salud y Medio Ambiente (CEADES Foundation), Cochabamba, Bolivia
| | | | - Claire Billot
- Fundación Ciencia y Estudios Aplicados para el Desarrollo en Salud y Medio Ambiente (CEADES Foundation), Cochabamba, Bolivia
| | - Beatriz Mallén Muñoz
- Fundación Ciencia y Estudios Aplicados para el Desarrollo en Salud y Medio Ambiente (CEADES Foundation), Cochabamba, Bolivia
| | | | - Adalid Paiva
- Consejo Social Municipal de Salud Cochabamba (CSMSC), Cochabamba, Bolivia
| | | | - Regina Rabinovich
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
- Harvard TH Chan School of Public Health, Boston, USA
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2
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Huang M, Ki EJ, Gong H. Linking Community OPR and Communication Infrastructure During a Public Health Crisis: A Study of Community Engagement in Shanghai, China. HEALTH COMMUNICATION 2024; 39:1988-1997. [PMID: 37641852 DOI: 10.1080/10410236.2023.2251747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
Engaging the public and community organizations in local health actions greatly assists disease prevention and control. However, it remains unclear how organization-public relationships (OPR) and communication networks within communities contribute to community health actions. To fill this gap, a survey was conducted among community members in Shanghai, China, who were challenged by the Omicron wave of the COVID-19 pandemic. Results revealed that integrated connectedness to a storytelling network (ICSN) was a significant predictor of residents' community engagement. Trust, control mutuality, commitment, and ICSN were positively associated with community engagement intentions through the sense of community and organizational efficacy. This study is a step toward understanding how organizations and members collectively respond to health crises at the community level.
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Affiliation(s)
- Miaohong Huang
- Department of Advertising and Public Relations, The University of Alabama
| | - Eyun-Jung Ki
- Department of Advertising and Public Relations, The University of Alabama
| | - He Gong
- Research Center of Journalism and Social Development, School of Journalism and Communication, Renmin University of China
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Orunta PC, Ndu CO, Ijioma CE, Ogedegbe OJ, Ogundipe FA, Eze-Njoku CP. Knowledge and Practice of Precautions and Prevention of COVID-19 Among Adolescents in Umuahia, Nigeria: A Cross-Sectional Study. Cureus 2024; 16:e64984. [PMID: 39161476 PMCID: PMC11332091 DOI: 10.7759/cureus.64984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2024] [Indexed: 08/21/2024] Open
Abstract
Background The coronavirus disease 2019 (COVID-19) pandemic has posed significant challenges worldwide, particularly in developing countries with limited healthcare resources. Among the various demographics, adolescents represent a crucial group in understanding and curbing the spread of the virus. Aim This research aims to assess the level of knowledge and practice of COVID-19 prevention measures among adolescents in a developing country. Methodology This study's descriptive cross-sectional study design was appropriate for capturing a snapshot of adolescents' understanding of COVID-19 in Umuahia, Abia State, Nigeria, a developing country. The study's participants were secondary school students in Umuahia's urban and rural secondary schools, aged 10-19. Fisher's formula was used to calculate the sample size. A multistage systematic sampling method was used to select 424 participants. Data were gathered using a self-administered questionnaire. The Statistical Package for the Social Sciences (SPSS) software version 25 (IBM SPSS Statistics, Armonk, NY) was used to handle and evaluate the data that had been obtained. Results All the respondents were aware of COVID-19, primarily informed through social media and television (TV). It is concerning that less than half correctly identify the disease as caused by a virus (46.9%), with some falsely attributing it to bacteria (31.1%) or fungi (15.6%). While the majority of respondents knew about the existence of COVID-19 vaccines, only 63.4% were aware that there was no definitive cure for the disease. The most worrying finding was the limited awareness and practice of recommended precautions to prevent the spread of COVID-19. Handwashing with soap and water, social distancing, and using hand sanitizers were the most frequently recognized precautions. However, even these were poorly practiced, with less than 30% of the respondents following them regularly. It was also noted that misconceptions about precautions exist, including unusual practices such as regularly drinking hot water or eating bitter kola/pepperfruit. Also, the most prominent reason for refusal among the respondents for COVID-19 vaccines was parental refusal, accounting for 57.5% of negative responses. Conclusion The study's findings underscore the urgent need for tailored, accessible, and effective health education strategies to improve adolescents' understanding and adoption of COVID-19 preventive measures in the region.
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MacFarlane A, Huschke S, Marques MJ, Gama A, Kinaan W, Hassan A, Papyan A, Phelan H, Severoni S, Kumar B, Dias S. Normalising participatory health research approaches in the WHO European region for refugee and migrant health: a paradigm shift. THE LANCET REGIONAL HEALTH. EUROPE 2024; 41:100837. [PMID: 39119099 PMCID: PMC11306213 DOI: 10.1016/j.lanepe.2024.100837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 12/01/2023] [Accepted: 01/04/2024] [Indexed: 08/10/2024]
Abstract
While people's involvement in health research is increasingly the encouraged norm in many countries, the involvement of refugees and migrants in research about their health is rare. Here, we call for a paradigm shift in the field of refugee and migrant health to make participatory health research routine, i.e. normalised. To disrupt 'business as usual', we synthesise evidence about meaningful research partnerships and features of inclusive participatory spaces. We present examples of decolonial, culturally attuned methods that can be used to reimagine and reinvigorate research practice because they encourage critical reflexivity and power-sharing: arts-based research using music and singing, participatory learning and action research, Photovoice and co-design (ideas generation) workshops. We consider the consequences of not making this paradigm shift. We conclude with recommendations for specific structural and policy changes and empirical research questions that are needed to inform the normalisation of participatory health research in this field.
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Affiliation(s)
- Anne MacFarlane
- WHO Collaborating Centre on Participatory Health Research with Refugees and Migrants, School of Medicine and Health Research Institute, University of Limerick, Limerick, Ireland
| | - Susann Huschke
- WHO Collaborating Centre on Participatory Health Research with Refugees and Migrants, School of Medicine and Health Research Institute, University of Limerick, Limerick, Ireland
| | - Maria J. Marques
- NOVA National School of Public Health, Public Health Research Centre, CHRC, REAL, NOVA University Lisbon, Lisbon, Portugal
| | - Ana Gama
- NOVA National School of Public Health, Public Health Research Centre, CHRC, REAL, NOVA University Lisbon, Lisbon, Portugal
| | - Walaa Kinaan
- NOVA National School of Public Health, Public Health Research Centre, CHRC, REAL, NOVA University Lisbon, Lisbon, Portugal
| | | | - Anna Papyan
- Shannon Family Resource Centre, Shannon, Co. Clare, Ireland
| | - Helen Phelan
- WHO Collaborating Centre on Participatory Health Research with Refugees and Migrants, School of Medicine and Health Research Institute, University of Limerick, Limerick, Ireland
| | | | - Bernadette Kumar
- Division of Health Services Research, Norwegian Institute of Public Health, Norway
- Co- Chair of The Regional Hub Europe Lancet Migration
| | - Sonia Dias
- NOVA National School of Public Health, Public Health Research Centre, CHRC, REAL, NOVA University Lisbon, Lisbon, Portugal
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Nan R, Chen J, Zhu W. Evolutionary game analysis of multiple subjects in the management of major public health emergencies. Heliyon 2024; 10:e29823. [PMID: 38698988 PMCID: PMC11064152 DOI: 10.1016/j.heliyon.2024.e29823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 04/06/2024] [Accepted: 04/16/2024] [Indexed: 05/05/2024] Open
Abstract
The frequent occurrence of major public health emergencies (MPHEs) significantly challenges national security, economic stability, social operation and the safety of people's lives and property worldwide. Consequently, enhancing the emergency management of MPHEs is critically urgent. This paper constructs a game model involving local government, social organisations, and the public for MPHE management, exploring strategy combinations and influencing factors across various scenarios. Several results were obtained. (1) Local government, social organisations, and the public each have positive and negative strategy choices based on cost-benefit analysis, leading to eight different strategy combinations. Furthermore, all three take positive strategies as the optimal way to achieve the game equilibrium. (2) The transformation of strategy combinations is primarily influenced by the cost-benefit gap and the strategic decisions of local government. (3) Altering a subject's initial strategy value doesn't change its final choice but impacts the time to achieve a stable strategy equilibrium. The severity of local government punishments on social organisations influences their strategic choices and the time to optimal strategy, whereas rewards to the public or social organisations only affect the time to achieve this strategy. The findings of this study can not only help improve the collaborative governance system of MPHEs but also provide scientific guidance on how governments can manage MPHEs.
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Affiliation(s)
- Rui Nan
- School of Law and Humanities, China University of Mining and Technology (Beijing), Beijing, 100083, China
| | - Jing Chen
- School of Law and Humanities, China University of Mining and Technology (Beijing), Beijing, 100083, China
| | - Wenjun Zhu
- School of Law and Humanities, China University of Mining and Technology (Beijing), Beijing, 100083, China
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Kemper S, de Vries M, de Weger E, Bongers M, Kupper F, Timen A. The public's considerations about implementing non-pharmaceutical interventions to manage a novel COVID-19 epidemic. Heliyon 2024; 10:e30390. [PMID: 38737250 PMCID: PMC11088335 DOI: 10.1016/j.heliyon.2024.e30390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 04/24/2024] [Accepted: 04/25/2024] [Indexed: 05/14/2024] Open
Abstract
In the future, new variants of the SARS-CoV-2 virus might emerge and cause outbreaks. If this occurs, the implementation of non-pharmaceutical interventions (NPIs) can be reconsidered. Consideration of the potential benefits and harms of implementing NPIs, and ultimately deciding about implementing NPIs, is currently mainly executed by experts and governments. However, general literature on public engagement suggests that integrating public perspectives into decision-making can enhance the quality of decisions and foster greater public understanding of them. In this study, a deliberative mini-public was conducted to integrate this public perspective. The aim was to elicit public considerations regarding non-pharmaceutical interventions by asking a diverse group of citizens to participate as decision-makers and convene, learn and deliberate about implementing non-pharmaceutical interventions during a hypothetical outbreak of a new SARS-CoV-2 variant. Participants emphasized the importance of early implementation during the outbreak, to prevent exceeding healthcare capacity, long-term mental health issues, educational deficits, and bankruptcies. Additionally, participants stressed taking public support into account, and shared ideas on maintaining support. Furthermore, participants wanted to give citizens personal responsibility and freedom in making their own assessment regarding adherence to interventions and how much risk of infection they would be willing to accept. Participants also expressed the need for the government to adopt a learning attitude towards improvements in pandemic response, and to generate more focus on long-term strategies. The deliberative mini-public, revealed public considerations that reflected public values and needs. These considerations might be helpful in better aligning epidemic management policies with public perspectives. Regarding the deliberative mini-public, uncertainties remain about the design and impact on a bigger scale.
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Affiliation(s)
- Sophie Kemper
- Centre for Infectious Disease Control (CIb), National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
- Athena Institute, Faculty of Science, VU Amsterdam, Amsterdam, the Netherlands
| | - Marion de Vries
- Centre for Infectious Disease Control (CIb), National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Esther de Weger
- Athena Institute, Faculty of Science, VU Amsterdam, Amsterdam, the Netherlands
| | - Marloes Bongers
- Centre for Infectious Disease Control (CIb), National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Frank Kupper
- Athena Institute, Faculty of Science, VU Amsterdam, Amsterdam, the Netherlands
| | - Aura Timen
- Centre for Infectious Disease Control (CIb), National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
- Athena Institute, Faculty of Science, VU Amsterdam, Amsterdam, the Netherlands
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, the Netherlands
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Gillibrand S, Watkinson R, Surgey M, Issa B, Sanders C. "We might not have been in hospital, but we were frontline workers in the community": a qualitative study exploring unmet need and local community-based responses for marginalised groups in Greater Manchester during the COVID-19 pandemic. BMC Health Serv Res 2024; 24:621. [PMID: 38741127 DOI: 10.1186/s12913-024-10921-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 03/28/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND The response to the COVID-19 pandemic saw a significant increase in demand for the voluntary, community, faith and social enterprise (VCFSE) sector to provide support to local communities. In Greater Manchester (GM), the VCFSE sector and informal networks provided health and wellbeing support in multiple ways, culminating in its crucial supportive role in the provision of the COVID-19 vaccination rollout across the GM city region. However, the support provided by the VCFSE sector during the pandemic remains under-recognised. The aims of the study were to: understand the views and experiences of marginalised communities in GM during the COVID-19 pandemic; explore how community engagement initiatives played a role during the pandemic and vaccine rollout; assess what can be learnt from the work of key stakeholders (community members, VCFSEs, health-system stakeholders) for future health research and service delivery. METHODS The co-designed study utilised a participatory approach throughout and was co-produced with a Community Research Advisory Group (CRAG). Focus groups and semi-structured interviews were conducted remotely between September-November 2021, with 35 participants from local marginalised communities, health and care system stakeholders and VCFSE representatives. Thematic framework analysis was used to analyse the data. RESULTS Local communities in GM were not supported sufficiently by mainstream services during the course of the COVID-19 pandemic, resulting in increased pressure onto the VCFSE sector to respond to local communities' need. Community-based approaches were deemed crucial to the success of the vaccination drive and in providing support to local communities more generally during the pandemic, whereby such approaches were in a unique position to reach members of diverse communities to boost uptake of the vaccine. Despite this, the support delivered by the VCFSE sector remains under-recognised and under-valued by the health system and decision-makers. CONCLUSIONS A number of challenges associated with collaborative working were experienced by the VSCE sector and health system in delivering the vaccination programme in partnership with the VCFSE sector. There is a need to create a broader, more inclusive health system which allows and promotes inter-sectoral working. Flexibility and adaptability in ongoing and future service delivery should be championed for greater cross-sector working.
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Affiliation(s)
- Stephanie Gillibrand
- Centre for Primary Care and Health Services Research, University of Manchester, Greater Manchester, England, UK.
| | - Ruth Watkinson
- NIHR Applied Research Collaboration for Greater Manchester, Greater Manchester, England, UK
| | - Melissa Surgey
- NIHR Applied Research Collaboration for Greater Manchester, Greater Manchester, England, UK
| | - Basma Issa
- Independent (public contributor), Greater Manchester, England, UK
| | - Caroline Sanders
- NIHR Applied Research Collaboration for Greater Manchester, Greater Manchester, England, UK
- Greater Manchester Patient Safety Research Centre, University of Manchester, Greater Manchester, England, UK
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Sahani MK, Maat H, Balabanova D, Woldie M, Richards P, Mayhew S. Engaging communities as partners in health crisis response: a realist-informed scoping review for research and policy. Health Res Policy Syst 2024; 22:56. [PMID: 38711067 PMCID: PMC11075189 DOI: 10.1186/s12961-024-01139-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 03/30/2024] [Indexed: 05/08/2024] Open
Abstract
BACKGROUND Health is increasingly affected by multiple types of crises. Community engagement is recognised as being a critical element in successful crisis response, and a number of conceptual frameworks and global guideline documents have been produced. However, little is known about the usefulness of such documents and whether they contain sufficient information to guide effective community engagement in crisis response. We undertake a scoping review to examine the usefulness of conceptual literature and official guidelines on community engagement in crisis response using a realist-informed analysis [exploring contexts, mechanisms, and outcomes(CMOs)]. Specifically, we assess the extent to which sufficient detail is provided on specific health crisis contexts, the range of mechanisms (actions) that are developed and employed to engage communities in crisis response and the outcomes achieved. We also consider the extent of analysis of interactions between the mechanisms and contexts which can explain whether successful outcomes are achieved or not. SCOPE AND FINDINGS We retained 30 documents from a total of 10,780 initially identified. Our analysis found that available evidence on context, mechanism and outcomes on community engagement in crisis response, or some of their elements, was promising, but few documents provided details on all three and even fewer were able to show evidence of the interactions between these categories, thus leaving gaps in understanding how to successfully engage communities in crisis response to secure impactful outcomes. There is evidence that involving community members in all the steps of response increases community resilience and helps to build trust. Consistent communication with the communities in time of crisis is the key for effective responses and helps to improve health indicators by avoiding preventable deaths. CONCLUSIONS Our analysis confirms the complexity of successful community engagement and the need for strategies that help to deal with this complexity to achieve good health outcomes. Further primary research is needed to answer questions of how and why specific mechanisms, in particular contexts, can lead to positive outcomes, including what works and what does not work and how to measure these processes.
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Affiliation(s)
- Mateus Kambale Sahani
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK.
| | - Harro Maat
- Knowledge, Technology, and Innovation Group, Department of Social Sciences, Wageningen University, Wageningen, The Netherlands
| | - Dina Balabanova
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Mirkuzie Woldie
- Department of Health Policy and Management, Jimma University, Jimma, Ethiopia
| | - Paul Richards
- School of Environmental Sciences, Njala University, Freetown, Sierra Leone
| | - Susannah Mayhew
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
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Merner B, Hill S, Saich F, Virgona A, Jin D, Pedrana A, Keren C, Chung RKY, Osborne D, Wilkinson AL, Coelho A, Gibbs L, Gibney KB, Hellard M, Lusher D, Ryan R. What Lies Beneath? The Role of Community Engagement in Translating COVID-19 Research Findings to Policy-Makers. Int J Health Policy Manag 2024; 13:8249. [PMID: 39099502 PMCID: PMC11270602 DOI: 10.34172/ijhpm.2024.8249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 03/25/2024] [Indexed: 08/06/2024] Open
Abstract
BACKGROUND Community engagement is key to developing local and context-specific strategies for the prevention and control of COVID-19. However, expedited research design and approval in the early days of the pandemic may have limited the opportunities for community members to influence pandemic-related research. In this study, we sought to understand how a Community Engagement Group (CEG) could impact a large longitudinal COVID-19 research project (Optimise), when involved solely in the interpretation and knowledge translation phases of the research. METHODS Seven community members were recruited for the CEG, representing a diverse range of groups. Each month, Optimise data of topical importance were compiled into a draft report. The CEG discussed the draft report at their monthly meeting and members' contributions were incorporated into the final report for distribution to policy-makers. In this study, a document analysis was undertaken of ten consecutive reports produced between February and November 2021. Each report was compared pre- and post- the inclusion of CEG contributions, which were then analysed using thematic analysis. RESULTS Community engagement in the interpretation and knowledge translation phases of Optimise had positive impacts on reports for policy-makers, including grounding the empirical findings in broader community perspectives, identifying policy issues affecting different groups and contributing unique insights beyond the empirical findings. Overall, the CEG contributions demonstrated the complexity of lived experience lying beneath the empirical data. CONCLUSION Community engagement in the translation of the Optimise findings resulted in research reports to policy-makers that were reflective of a broader range of community perspectives, and that provided potential solutions to emerging policy issues related to COVID-19. This study adds to the evidence base about the impact of community engagement in the later interpretation and knowledge translation phases of research, particularly in the context of reporting to policy-makers during a public health emergency.
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Affiliation(s)
- Bronwen Merner
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Sophie Hill
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
| | | | - Ariane Virgona
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Defeng Jin
- Burnet Institute, Melbourne, VIC, Australia
| | - Alisa Pedrana
- Disease Elimination, Burnet Institute, Melbourne, VIC, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Coral Keren
- Community Engagement Group, Optimise Study, Burnet Institute, Melbourne, VIC, Australia
| | - Rachel Kar Yee Chung
- Community Engagement Group, Optimise Study, Burnet Institute, Melbourne, VIC, Australia
| | | | - Anna Lee Wilkinson
- Disease Elimination, Burnet Institute, Melbourne, VIC, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | | | - Lisa Gibbs
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
- Centre for Disaster Management and Public Safety, University of Melbourne, Melbourne, VIC, Australia
| | - Katherine B. Gibney
- Victorian Infectious Diseases Service, Royal Melbourne Hospital, and Department of Infectious Diseases, University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Victoria, Australia
- Department of Infectious Diseases, University of Melbourne, Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
| | - Margaret Hellard
- Disease Elimination, Burnet Institute, Melbourne, VIC, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- Department of Infectious Diseases, The Alfred and Monash University, Melbourne, VIC, Australia
- Doherty Institute and Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Dean Lusher
- Centre for Transformative Innovation, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Rebecca Ryan
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
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Li Y, Ding L. Multiple disadvantages: class, social capital, and well-being of ethnic minority groups in the UK during the COVID-19 pandemic. FRONTIERS IN SOCIOLOGY 2024; 9:1215676. [PMID: 38375151 PMCID: PMC10875735 DOI: 10.3389/fsoc.2024.1215676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 01/03/2024] [Indexed: 02/21/2024]
Abstract
Introduction The COVID-19 pandemic has caused untold damage to the socio-economic lives of people all over the world. Research has also demonstrated great inequality in the pandemic experience. In the UK as in many other countries, people from ethnic minority backgrounds and in working-class positions have suffered disproportionately more than the majority group and those in salariat positions in terms of income loss, financial difficulty, and vulnerability to infection. Yet little is known about how people coped in the daily lives and tried to maintain their well-being during the most difficult days of the pandemic through social capital. Methods In this paper, we draw data from the COVID-19 Survey in Five National Longitudinal Studies to address these questions. The survey covered the period from May 2020 to February 2021, the height of the pandemic in the UK. It contains numerous questions on contact, help and support among family, friends, community members, socio-political trust, and physical and mental health. We conceptualise three types of social capital and one type of overall well-being and we construct latent variables from categorical indicator variables. We analyse the ethnic and socio-economic determinants of the three types of social capital and their impacts on well-being. Results Our analysis shows that social capital plays very important roles on well-being, and that ethnic minority groups, particularly those of Pakistani/Bangladeshi and Black heritages, faced multiple disadvantages: their poorer socio-economic positions prevented them from gaining similar levels of social capital to those of the white group. However, for people with the same levels of social capital, the effects on well-being are generally similar. Discussion Socio-economic (class) inequality is the root cause for ethnic differences in social capital which in turn affects people's well-being.
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Affiliation(s)
- Yaojun Li
- Department of Sociology, School of Social Sciences, Manchester University, Manchester, United Kingdom
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Serag H, Ghulmi L, Sallam HS, Ferguson M, Manakatt B. Addressing Chronic Conditions and Social Determinants of Health During the COVID-19 Pandemic. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2024; 1458:335-348. [PMID: 39102207 DOI: 10.1007/978-3-031-61943-4_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/06/2024]
Abstract
Chronic conditions or diseases are defined as persistent conditions lasting ≥ 1 year requiring either ongoing medical attention or limiting daily living or both (Agency for Healthcare Research and Quality (AHRQ) in Programs: SHARE approach workshop, Agency for Healthcare Research and Quality (AHRQ) (2016) Programs: SHARE approach workshop 2016. https://www.ahrq.gov/professionals/education/curriculum-tools/shareddecisionmaking/workshop/index.html . Accessed 20 Jan 2017). Physical chronic conditions, including diabetes, hypertension, heart disease, arthritis, and stroke, are prevalent, especially in the older population. Over 90% of older adults have at least 1 and 77% have ≥ 2 chronic conditions (American Diabetes Association (ADA) in Statistics about diabetes, American Diabetes Association (ADA) (2023) Statistics about diabetes. https://diabetes.org/about-us/statistics/about-diabetes . Accessed 20 Apr 2023). Chronic conditions account for $4.1 trillion of the nation's annual healthcare expenditure (Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion in Health and economic costs of chronic conditions, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion. Health and Economic Costs of Chronic Conditions (2022). https://www.cdc.gov/chronicdisease/about/costs/index.htm . Accessed 7 Jan 2023). There are marked disparities based on age, color, and income, with older people, people of color, and lower-income people having higher treatment costs or even lost wages in response to having chronic conditions. Chronic conditions are the on-the-top leading causes for death with diabetes being the top 7th in the USA in 2019 (Ferguson in Metabolic Syndrome Related Dis, Ferguson et al., Metab Syndr Relat Disord 21:177-187, 2023).
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Affiliation(s)
- Hani Serag
- John Sealy School of Medicine, The University of Texas Medical Branch, Galveston, Texas, USA
| | - Lima Ghulmi
- School of Health Professions, The University of Texas Medical Branch, Galveston, Texas, USA
| | - Hanaa S Sallam
- John Sealy School of Medicine, The University of Texas Medical Branch, Galveston, Texas, USA
- Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Monique Ferguson
- John Sealy School of Medicine, The University of Texas Medical Branch, Galveston, Texas, USA
| | - Bushra Manakatt
- School of Nursing, The University of Texas Medical Branch, Galveston, Texas, USA.
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Speers SJ, Lau LL, Neufeld HT, Servano D, Go DJ, Kipp A, Brubacher LJ, Dodd W. Caring in crisis: The experiences of local religious leaders meeting community food needs in the Philippines during the COVID-19 pandemic. WELLBEING, SPACE AND SOCIETY 2023; 5:100154. [PMID: 37360611 PMCID: PMC10278461 DOI: 10.1016/j.wss.2023.100154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 03/27/2023] [Accepted: 06/06/2023] [Indexed: 06/28/2023]
Abstract
To respond to the unintended consequences of prevention measures to reduce COVID-19 transmission, individuals and groups, including religious leaders, have collaborated to provide care to those negatively impacted by these measures. Amid these various efforts and interventions, there is a need to deepen our understanding of diverse expressions of care across various geographical and social contexts. To address this need, the objective of this study was to investigate how religious leaders in the Philippines practiced care for their communities by meeting emergency food needs amid the COVID-19 pandemic. Guided by an ethics of care theoretical orientation, we conducted 25 remote semi-structured interviews with Filipino religious leaders who partnered with a Philippines-based non-governmental organization (NGO) to mobilize essential food aid to their local communities. Through defining the efforts and activities of these religious leaders as care work, we found that religious leader experiences revolved around navigating care responsibilities, caring alongside others, and engaging holistically with the care work. Additionally, we observed how contextual factors such as the humanitarian settings where religious leaders worked, the partnership with an NGO, and the positionality of local religious leaders within their communities, fundamentally shaped the care work. This study expands our understanding of how care is practiced and experienced and also brings greater visibility to the experiences and efforts of local religious leaders in responding to humanitarian emergencies.
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Affiliation(s)
- Shoshannah Joanna Speers
- School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, Canada, N2L 3G1
| | - Lincoln Leehang Lau
- School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, Canada, N2L 3G1
- International Care Ministries, Unit 1701, 17th Floor, West Tower, Philippine Stock Exchange Center, Exchange Road, Ortigas Center, Pasig City, Metro Manila, Philippines, 1605
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario, Canada, M5T 3M7
| | - Hannah Tait Neufeld
- School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, Canada, N2L 3G1
| | - Danilo Servano
- International Care Ministries, Unit 1701, 17th Floor, West Tower, Philippine Stock Exchange Center, Exchange Road, Ortigas Center, Pasig City, Metro Manila, Philippines, 1605
| | - Daryn Joy Go
- International Care Ministries, Unit 1701, 17th Floor, West Tower, Philippine Stock Exchange Center, Exchange Road, Ortigas Center, Pasig City, Metro Manila, Philippines, 1605
| | - Amy Kipp
- School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, Canada, N2L 3G1
| | - Laura Jane Brubacher
- School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, Canada, N2L 3G1
| | - Warren Dodd
- School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, Canada, N2L 3G1
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Onwujekwe O, Mbachu C, Okeibunor J, Ezema GU, Ejiofor N, Braka F, Thiam A, Koua EL, Chamla D, Gueye AS. What are the research priorities for strengthening public health emergency preparedness and response in Africa? Health Res Policy Syst 2023; 21:107. [PMID: 37872548 PMCID: PMC10594758 DOI: 10.1186/s12961-023-01059-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 10/06/2023] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND Research evidence is needed to strengthen capacities in emergency preparedness and response (EPR). However, the absence of a clear research agenda limits the optimal use of research evidence. This paper reports on the prioritization of research questions and topics that could contribute to evidence-informed strengthening of EPR capacities in the African region. METHODS The priority-setting consisted of desk review and stakeholder consultation workshop. Twenty-nine people participated in the workshop, including representatives from WHO regional office and EPR focal points in Africa, representatives of research institutions, and partners from Science for Africa Foundation, United Nations Children's Fund and Africa Center for Disease Control. Modified Delphi technique was used to systematically arrive at specific and cross-cutting research priorities in the three broad areas of the EPR, which are program Implementation, Clinical and Epidemiology. The research questions/topics were ranked on five-point Likert scale (1 = very low to 5 = very high) based on seven agreed-on criteria. Research priority score was calculated for each question as the mean of the criteria scores. RESULTS A total of 123 research questions comprising, 29 on Epidemiology, 22 on Clinical, 23 on program Implementation, and 49 on cross-cutting issues were ranked. The top ten research priorities were: knowledge and skills of healthcare workers in detecting and responding effectively to disease outbreaks; quality of data (accuracy, timeliness, completeness) for epidemic prone diseases; determinants of vaccine hesitancy; determinants of infection transmission among health care workers during PHE; effective measures for protecting health workers from highly infectious pathogens in PHE; strategies to improve the effectiveness of contact tracing for epidemic prone diseases; effectiveness of current case definitions as screening tools for epidemic and pandemic prone diseases; measures to strengthen national and sub-national laboratory capacity for timely disease confirmation within the Integrated Diseases Surveillance and Response framework; factors affecting prompt data sharing on epidemic-prone diseases; and effective strategies for appropriate community participation in EPR. CONCLUSIONS The collaborative multi-stakeholder workshop produced a starting list of priority research questions and topics for strengthening EPR capacities in Africa. Action needs to be taken to continuously update the research agenda and support member States to contextualize the research priorities and commission research for timely generation and uptake of evidence.
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Affiliation(s)
- Obinna Onwujekwe
- Health Policy Research Group, Department of Pharmacology and Therapeutics, College of Medicine, University of Nigeria, Enugu, 400001, Nigeria
- Department of Health Administration and Management, College of Medicine, University of Nigeria, Enugu, 400001, Nigeria
| | - Chinyere Mbachu
- Health Policy Research Group, Department of Pharmacology and Therapeutics, College of Medicine, University of Nigeria, Enugu, 400001, Nigeria.
- Department of Community Medicine, College of Medicine, University of Nigeria, Enugu, 400001, Nigeria.
| | - Joseph Okeibunor
- World Health Organisation Regional Office for Africa (AFRO), Brazzaville, Congo
| | - Godwin Uchenna Ezema
- Health Policy Research Group, Department of Pharmacology and Therapeutics, College of Medicine, University of Nigeria, Enugu, 400001, Nigeria
- Department of Health Administration and Management, College of Medicine, University of Nigeria, Enugu, 400001, Nigeria
- Enugu State Primary Healthcare Development Agency, Enugu, Nigeria
| | - Nonso Ejiofor
- World Health Organisation Regional Office for Africa (AFRO), Brazzaville, Congo
| | - Fiona Braka
- World Health Organisation Regional Office for Africa (AFRO), Brazzaville, Congo
| | - Adama Thiam
- World Health Organisation Regional Office for Africa (AFRO), Brazzaville, Congo
| | - Etien Luc Koua
- World Health Organisation Regional Office for Africa (AFRO), Brazzaville, Congo
| | - Dick Chamla
- World Health Organisation Regional Office for Africa (AFRO), Brazzaville, Congo
| | - Abdou Salam Gueye
- World Health Organisation Regional Office for Africa (AFRO), Brazzaville, Congo
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Hamuli RP, Mayhew SH, Sahani MK. Humanitarian sector (international non-governmental organisations) support to the community in Goma city/DRC during the COVID-19 pandemic period: Expectations and reality. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002086. [PMID: 37862286 PMCID: PMC10588899 DOI: 10.1371/journal.pgph.0002086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 08/21/2023] [Indexed: 10/22/2023]
Abstract
COVID-19 was the largest public health emergency to disrupt social life and health systems worldwide. The pandemic affected all world continents creating fear and stress in many aspects of social life. The pandemic spread from China to Europe, then to Africa carrying with it all the negative impacts affecting population wellbeing. The COVID-19 pandemic was declared in the Democratic Republic of Congo (DRC) in March 2020 and created huge shock and stress countrywide. Goma city accommodates more than 30 international non-governmental humanitarian organisations (HO) who have sought to support local communities to help them overcome COVID-19 stress. Few studies to date have considered the role of these HO from the perspective of the beneficiary populations. This is a descriptive, analytical study, reporting data collected from a survey questionnaire to 100 community members (including 21 healthcare professionals) in Karisimbi health zone in Goma city in DRC. The study's main aim was to explore how community members viewed the contribution and impact of HO actions during COVID-19 in Goma city. We identified some important mis-matches between community expectations and HO actions which must be addressed in future outbreaks. First, community members had big expectations of HO in terms of practice support to tackle the pandemic (including providing handwashing devices and mobile support teams), yet the vast majority of respondents reported seeing little or no such actions. This can create resentment against HO and it is critically important that they rapidly engage with communities at the start of any outbreak to understand their needs and concerns and develop strategies to directly respond to these. Second, HO played a very limited role in dissemination of information about COVID-19 and were not trusted messengers. Our findings showed that most people's preferred source of information about COVID-19, specifically vaccines, was local healthcare workers-particularly those who were known well and therefore trusted. HO (and national responders) should therefore map trusted spokespersons (including healthcare professionals) in the targeted communities and involve them in the planning and implementation of interventions as essential steps in the response. Among our respondents, social media played a large role in information sharing. Further research is needed to understand the role that social media (particularly Facebook and WhatsApp which were most frequently used) could play in sharing messages from trusted sources, including official government communications. Collectively, these actions could help create a positive attitude towards COVID-19 vaccine and similar interventions in future outbreaks.
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Affiliation(s)
- Roger Paluku Hamuli
- Department of Research and Diseases Prevention, Centre Medical Hope, Goma city, Democratic Republic of Congo
| | - Susannah H. Mayhew
- Faculty of Public Health and Policy, Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Mateus Kambale Sahani
- Faculty of Public Health and Policy, Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, United Kingdom
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15
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Licht A, Wetzker W, Scholz J, Scherag A, Weis S, Pletz MW, Bauer M, Dickmann P. Public health risk communication through the lens of a quarantined community: Insights from a coronavirus hotspot in Germany. PLoS One 2023; 18:e0292248. [PMID: 37824455 PMCID: PMC10569635 DOI: 10.1371/journal.pone.0292248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 09/17/2023] [Indexed: 10/14/2023] Open
Abstract
BACKGROUND Quarantine is one of the most effective interventions to contain an infectious disease outbreak, yet it is one of the most disruptive. We investigated the quarantine of an entire village to better understand risk communication requirements for groups. METHODS We conducted a cross-sectional, mixed-methods survey study on a single cohort of adult residents in Neustadt am Rennsteig, Germany, six weeks after the removal of a 14-day mandatory community quarantine. The survey response rate was 33% (289/883 residents). FINDINGS Survey participants reported a lack of information on the quarantine implementation process. What authorities communicated was not necessarily what residents desired to know. While inhabitants used social media and telephones to communicate with each other, the official information sources were regional radio, television, newspapers and official websites. Public health authorities did not employ social media communication to engage with their communities. Despite a lack of information, the majority of respondents stated that they had complied with the quarantine and they expressed little sympathy for those who violated the quarantine. After lifting the quarantine, many respondents continued to avoid places where they suspected a significant risk of infection, such as family and friends' homes, doctor's offices and grocery stores. INTERPRETATION The survey participants utilised existing social networks to disseminate vital information and stabilise its group identity and behaviour (quarantine compliance). The authorities communicated sparsely in a unidirectional, top-down manner, without engaging the community. Despite the lack of official information, the social coherency of the group contributed to considerate and compliant conduct, but participants expressed dissatisfaction with official leadership and asked for more attention. CONCLUSION Public health risk communication must engage with communities more effectively. This necessitates a deeper comprehension of groups, their modes of communication and their social needs.
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Affiliation(s)
- Annika Licht
- Department of Anaesthesiology and Intensive Care Medicine, Jena University Hospital, Friedrich Schiller University, Jena, Germany
| | - Wibke Wetzker
- Department of Anaesthesiology and Intensive Care Medicine, Jena University Hospital, Friedrich Schiller University, Jena, Germany
| | - Juliane Scholz
- Department of Anaesthesiology and Intensive Care Medicine, Jena University Hospital, Friedrich Schiller University, Jena, Germany
| | - André Scherag
- Institute of Medical Statistics, Computer and Data Sciences, Jena University Hospital, Friedrich Schiller University, Jena, Germany
| | - Sebastian Weis
- Department of Anaesthesiology and Intensive Care Medicine, Jena University Hospital, Friedrich Schiller University, Jena, Germany
- Institute for Infectious Diseases and Infection Control, Jena University Hospital, Friedrich Schiller University, Jena, Germany
- Leibniz Institute for Infection Biology and Natural Product Research, Leibniz Institute for Natural Product Research and Infection Biology, Hans Knoell Institute, Jena, Germany
| | - Mathias W. Pletz
- Institute for Infectious Diseases and Infection Control, Jena University Hospital, Friedrich Schiller University, Jena, Germany
| | - Michael Bauer
- Department of Anaesthesiology and Intensive Care Medicine, Jena University Hospital, Friedrich Schiller University, Jena, Germany
| | - Petra Dickmann
- Department of Anaesthesiology and Intensive Care Medicine, Jena University Hospital, Friedrich Schiller University, Jena, Germany
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Vanden Bossche D, Zhao QJ, Ares-Blanco S, Peña MPA, Decat P, Kondo N, Kroneman M, Nishioka D, Petrazzuoli F, Rortveit G, Schaubroeck E, Stark S, Pinto AD, Willems S. Addressing health inequity during the COVID-19 pandemic through primary health care and public health collaboration: a multiple case study analysis in eight high-income countries. Int J Equity Health 2023; 22:171. [PMID: 37653472 PMCID: PMC10472729 DOI: 10.1186/s12939-023-01968-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 07/19/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic substantially magnified the inequity gaps among vulnerable populations. Both public health (PH) and primary health care (PHC) have been crucial in addressing the challenges posed by the pandemic, especially in the area of vulnerable populations. However, little is known about the intersection between PH and PHC as a strategy to mitigate the inequity gap. This study aims to assess the collaboration between PHC and PH with a focus on addressing the health needs of vulnerable populations during the COVID-19 pandemic across jurisdictions. METHODS We analyzed and compared data from jurisdictional reports of COVID-19 pandemic responses in PHC and PH in Belgium, Canada (Ontario), Germany, Italy, Japan, the Netherlands, Norway, and Spain from 2020 to 2021. RESULTS Four themes emerge from the analysis: (1) the majority of the countries implemented outreach strategies targeting vulnerable groups as a means to ensure continued access to PHC; (2) digital assessment in PHC was found to be present across all the countries; (3) PHC was insufficiently represented at the decision-making level; (4) there is a lack of clear communication channels between PH and PHC in all the countries. CONCLUSIONS This study identified opportunities for collaboration between PHC and PH to reduce inequity gaps and to improve population health, focusing on vulnerable populations. The COVID-19 response in these eight countries has demonstrated the importance of an integrated PHC system. Consequently, the development of effective strategies for responding to and planning for pandemics should take into account the social determinants of health in order to mitigate the unequal impact of COVID-19. Careful, intentional coordination between PH and PHC should be established in normal times as a basis for effective response during future public health emergencies. The pandemic has provided significant insights on how to strengthen health systems and provide universal access to healthcare by fostering stronger connections between PH and PHC.
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Affiliation(s)
- Dorien Vanden Bossche
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
| | - Q Jane Zhao
- Institute of Health Policy, Management and Evaluation (IHPME), University of Toronto, Toronto, ON, Canada
| | - Sara Ares-Blanco
- Federica Montseny Primary Care Centre, Madrid, Spain
- Patient Safety Working Party of semFYC (Spanish Society for Family and Community Medicine), Madrid, Spain
| | - Maria Pilar Astier Peña
- Patient Safety Working Party of semFYC (Spanish Society for Family and Community Medicine), Madrid, Spain
- Territorial Healthcare Quality Unit, Camp de Tarragona, Health Department Generalitat de Catalunya, Healthcare Institute of Catalonia, Tarragona, Spain
| | - Peter Decat
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Naoki Kondo
- Department of Social Epidemiology, University of Kyoto, Kyoto, Japan
| | - Madelon Kroneman
- Nivel (Netherlands Institute of Health Services Research), Utrecht, the Netherlands
| | - Daisuke Nishioka
- Department of Medical Statistics, Research & Development Center, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Ferdinando Petrazzuoli
- Department of Clinical Sciences, Centre for Primary Health Care Research, Lund University, Malmö, Sweden
| | - Guri Rortveit
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Emmily Schaubroeck
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- Institute of General Practice, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Stefanie Stark
- Institute of General Practice, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Andrew D Pinto
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
- St Michael's Hospital, Toronto, ON, Canada
| | - Sara Willems
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
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Dhillon P, Unisa S, Gupta A, Saraswat A, Km S, Pedgaonkar S. Utilisation of ANC services before and after the COVID-19 pandemic in selected resource-poor blocks of India: role of community health workers in Swabhimaan programme area. BMC Health Serv Res 2023; 23:864. [PMID: 37580689 PMCID: PMC10426095 DOI: 10.1186/s12913-023-09781-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 07/03/2023] [Indexed: 08/16/2023] Open
Abstract
INTRODUCTION COVID-19 has disrupted maternal and child health services. Community Health Workers (CHWs) supported the women by visiting pregnant women's homes and providing the MCH services as required. This study attempts to understand the role of CHW and its impact on the Ante-Natal Care (ANC) services pre-pandemic and post-Pandemic in the poor resource setting. METHODS The Swabhimaan programme interventions were carried out in the selected blocks in the Indian States of Bihar, Odisha and Chhattisgarh with the objective to improve the nutritional status of mothers, pregnant women and adolescents living in resource-poor blocks of three selected states during 2016-2022. Cross-sectional surveys, namely pre-pandemic (2018-19) and post-pandemic (2021-22) of pregnant and mothers of under two children, utilised to fulfil the objectives of this study. These surveys are part of Swabhimaan evaluation, a community-based non-randomised controlled study. RESULTS The ANC services received by women have increased over time from 2015 to 2022. Our findings confirm that the ground-level community and health systems were active during the pandemic, and the results show significant improvement. Additionally, the women supported by the CHW have substantially improved pregnancy registration, first ANC, Tetanus injection, consumption of Iron Folic Acid, Calcium and deworming tablets than those who did not. Propesnsity Score Matching analysis shows that the average treatment effect on the various ANC services of having the support of CHW is significant. CONCLUSION This study shows the vital role of CHWs in utilising various Maternal and Child Health services. Better linkage and networking of the CHWs with the community will ensure health service delivery regularly and in an emergency like a pandemic and develop resilience.
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Affiliation(s)
- Preeti Dhillon
- Department of Survey Research & Data Analystics, International Institute for Population Sciences, Mumbai, India
| | - Sayeed Unisa
- Department of Bio-Statistics and Epidemiology, International Institute for Population Sciences, Mumbai, India.
| | - Ajay Gupta
- Swabhimaan Project, International Institute for Population Sciences, Mumbai, India
| | - Abhishek Saraswat
- Swabhimaan Project, International Institute for Population Sciences, Mumbai, India
| | - Sulaiman Km
- Swabhimaan Project, International Institute for Population Sciences, Mumbai, India
| | - Sarang Pedgaonkar
- Department of Family & Generations, International Institute for Population Sciences, Mumbai, India
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Kemper S, van den Broek R, van Hameren S, Kupper JFH, Bongers MEJ, de Weger E, de Vries M, Timen A. Voices of society: the emergence of civil-society practices aiming to engage in the management of the COVID-19 pandemic in the Netherlands. BMJ Glob Health 2023; 8:e012875. [PMID: 37607772 PMCID: PMC10445389 DOI: 10.1136/bmjgh-2023-012875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 08/08/2023] [Indexed: 08/24/2023] Open
Abstract
During the COVID-19 pandemic, public groups mobilised themselves in civil-society engagement practices (CSEPs) aiming to improve or suggest alternative epidemic management. This study explores the motivation to establish CSEPs and their perceived contributions to epidemic management, to gain insight whether integrating views of CSEPs could add value. A systematic online search was executed to identify CSEPs focused on COVID-19 management between January 2020 and January 2022 in the Netherlands. In order to create a comprehensible overview of the identified CSEPs, relevant characteristics were gathered and mapped, for example, local or national scope, subject of action and goals. A selection of CSEPs was interviewed between April and June 2022 to study their motivators to start the CSEPs and perceived contributions to management. The search resulted in the identification of 22 CSEPs, of which members of 14 CSEPs were interviewed. These members indicated several issues that motivated the start of their CSEP, namely; shortage of equipment, sense of solidarity, and a perceived lack of governmental action, lack of democratic values and lack in diversity of perspectives in epidemic management. All respondents believed to have contributed to policy or society, by influencing opinions, and occasionally by altering policy. However, respondents encountered obstacles in their attempts to contribute such as inability to establish contact with authorities, feeling unheard or undermined, and complications due to the interplay of political interests. In conclusion, CSEPs have fulfilled various roles such as providing alternative management policies, producing equipment, representing the needs of vulnerable populations, and supporting citizens and providing citizens with other viewpoints and information. The identified motivators to establish CSEPs in this study uncover room for improvements in policy. These insights, together with the identified perceived barriers of CSEPs, can be used to improve the connection between (future) epidemic management and public priorities and interests.
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Affiliation(s)
- Sophie Kemper
- National Coordination Centre for Communicable Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
- Athena Institute, Faculty of Science, VU University Amsterdam, Amsterdam, The Netherlands
| | - Renate van den Broek
- National Coordination Centre for Communicable Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
- Athena Institute, Faculty of Science, VU University Amsterdam, Amsterdam, The Netherlands
| | - Sarah van Hameren
- National Coordination Centre for Communicable Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
- Athena Institute, Faculty of Science, VU University Amsterdam, Amsterdam, The Netherlands
| | - J Frank H Kupper
- Athena Institute, Faculty of Science, VU University Amsterdam, Amsterdam, The Netherlands
| | - Marloes E J Bongers
- National Coordination Centre for Communicable Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Esther de Weger
- Athena Institute, Faculty of Science, VU University Amsterdam, Amsterdam, The Netherlands
| | - Marion de Vries
- National Coordination Centre for Communicable Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Aura Timen
- Athena Institute, Faculty of Science, VU University Amsterdam, Amsterdam, The Netherlands
- Primary and Community Care, Radboud University Medical Centre, Nijmegen, The Netherlands
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Wojczewski S, Grohma P, Kutalek R. Risk communication and community engagement with vulnerable groups: Perceptions of social-services CSOs during Covid-19. INTERNATIONAL JOURNAL OF DISASTER RISK REDUCTION : IJDRR 2023; 94:103817. [PMID: 37360248 PMCID: PMC10284614 DOI: 10.1016/j.ijdrr.2023.103817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 05/08/2023] [Accepted: 06/20/2023] [Indexed: 06/28/2023]
Abstract
Risk communication enables people to be prepared, respond and recover from public health risks which can only be realized with a considerable amount of community engagement. Enabling community involvement is necessary in order to reach and protect vulnerable people during epidemics. In situations of acute emergency, it is difficult to reach everyone, which makes it necessary to work with intermediaries such as social and care facilities and civil society organizations (CSOs) who work to support the most vulnerable in our societies. This paper analyses the perceptions of experts working in social facilities or CSOs of Covid-19 RCCE efforts in Austria. It starts from a broad understanding of vulnerability which combines medical, social and economic determinants. We conducted 21 semi-structured interviews with CSO and social facility managers. The UNICEF core community engagement standards (2020) were used as a framework for qualitative content analysis. The results show that CSO's and social facilities were essential for allowing community involvement of vulnerable people in Austria during the pandemic. For the CSO's and social facilities participation of their vulnerable clients was a real challenge especially because direct contact was difficult and public services were switched to digital only. Nonetheless, they all put a lot of effort into adapting and discussing Covid-19 regulations and measures with their clients and employees which in many cases led to acceptance of public health measures. The study gives recommendations on how community engagement could be enhanced especially from government actors and how CSO's could be addressed more as essential partners.
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Affiliation(s)
- Silvia Wojczewski
- Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Austria
- Department of Primary Care Medicine, Center for Public Health, Medical University of Vienna, Austria
| | - Paul Grohma
- Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Austria
| | - Ruth Kutalek
- Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Austria
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Moreira I, Ferrer M, Vilagut G, Mortier P, Felez-Nobrega M, Domènech-Abella J, Haro JM, Alonso J. Social inequalities in mental and physical health derived from the COVID-19 pandemic in Spain beyond SARS-CoV-2 infection. Int J Equity Health 2023; 22:136. [PMID: 37488575 PMCID: PMC10367254 DOI: 10.1186/s12939-023-01933-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 06/12/2023] [Indexed: 07/26/2023] Open
Abstract
BACKGROUND Understanding the impact of the COVID-19 crisis on health involves conducting longitudinal studies to evaluate the inequalities that may have been exacerbated by the pandemic. The purpose of this study was to estimate differences in physical and mental health derived from the COVID-19 pandemic, beyond SARS-CoV-2 infection, in the Spanish general population according to the participants' level of education; and to assess the evolution of these differences from June 2020 (just after the lockdown) to nine months later (February-March 2021). METHODS This is a longitudinal prospective study of a representative sample of non-institutionalized Spanish adults, through computer-assisted telephone interviews. Mobility, self-care, usual activities, pain/discomfort and anxiety/depression problems were measured with EQ-5D-5L. Prevalence ratio (PR) between high and low education levels and adjusted PR were estimated by Poisson regression models. Analyses were stratified by gender. RESULTS A total of 2,000 participants answered both surveys. Individuals with low level of education reported more health problems in both genders, and absolute inequalities remained quite constant (mobility and self-care problems) or decreased (pain/discomfort and anxiety/depression problems). The greatest relative inequalities were observed just after the lockdown, with age-adjusted PR ranging from 1.31 (95%CI 1.08-1.59) for women and 1.34 (95%CI 1.05-1.69) for men in pain/discomfort to 2.59 (95%CI 0.98-6.81) for women and 4.03 (95%CI 1.52-10.70) for men in self-care; aPR decreased after nine months for most dimensions. CONCLUSIONS Prevalence of health problems increased during the COVID-19 pandemic in all education groups, but the increase was higher in women and men with a high level of education, suggesting that its impact appeared later in this group. Further analysis on the role of governmental economic aid given to vulnerable people might shed light on this evolution.
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Affiliation(s)
- Isabel Moreira
- Health Services Research Group, Hospital del Mar Research Institute, Doctor Aiguader 88, office 144, Barcelona, 08003, Spain
- Preventive Medicine and Public Health Training Unit PSMar-UPF-ASPB (Parc de Salut Mar - Universitat Pompeu Fabra - Agència de Salut Pública de Barcelona), Barcelona, Spain
| | - Montse Ferrer
- Health Services Research Group, Hospital del Mar Research Institute, Doctor Aiguader 88, office 144, Barcelona, 08003, Spain.
- CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain.
| | - Gemma Vilagut
- Health Services Research Group, Hospital del Mar Research Institute, Doctor Aiguader 88, office 144, Barcelona, 08003, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Philippe Mortier
- Health Services Research Group, Hospital del Mar Research Institute, Doctor Aiguader 88, office 144, Barcelona, 08003, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | | | - Joan Domènech-Abella
- Parc Sanitari Sant Joan de Déu, Barcelona, Spain
- CIBER de Salud Mental (CIBERSAM), Madrid, Spain
| | - Josep-Maria Haro
- Parc Sanitari Sant Joan de Déu, Barcelona, Spain
- CIBER de Salud Mental (CIBERSAM), Madrid, Spain
- Instituto de Investigación del Hospital de la Princesa, Madrid, Spain
| | - Jordi Alonso
- Health Services Research Group, Hospital del Mar Research Institute, Doctor Aiguader 88, office 144, Barcelona, 08003, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain
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21
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Gautier L, Di Ruggiero E, Jackson C, Bentayeb N, Blain MJ, Chowdhury F, Gueye STM, Haydary M, Maillet L, Mahmoudi L, Mondal S, Ouffouet Bessiranthy A, Pluye P, Ziam S, Touati N. Learning from intersectoral initiatives to respond to the needs of refugees, asylum seekers, and migrants without status in the context of COVID-19 in Quebec and Ontario: a qualitative multiple case study protocol. Health Res Policy Syst 2023; 21:59. [PMID: 37340475 DOI: 10.1186/s12961-023-00991-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 05/08/2023] [Indexed: 06/22/2023] Open
Abstract
BACKGROUND Refugees, asylum seekers, and migrants without status experience precarious living and working conditions that disproportionately expose them to coronavirus disease 2019 (COVID-19). In the two most populous Canadian provinces (Quebec and Ontario), to reduce the vulnerability factors experienced by the most marginalized migrants, the public and community sectors engage in joint coordination efforts called intersectoral collaboration. This collaboration ensures holistic care provisioning, inclusive of psychosocial support, assistance to address food security, and educational and employment assistance. This research project explores how community and public sectors collaborated on intersectoral initiatives during the COVID-19 pandemic to support refugees, asylum seekers, and migrants without status in the cities of Montreal, Sherbrooke, and Toronto, and generates lessons for a sustainable response to the heterogeneous needs of these migrants. METHODS This theory-informed participatory research is co-created with socioculturally diverse research partners (refugees, asylum seekers and migrants without status, employees of community organizations, and employees of public organizations). We will utilize Mirzoev and Kane's framework on health systems' responsiveness to guide the four phases of a qualitative multiple case study (a case being an intersectoral initiative). These phases will include (1) building an inventory of intersectoral initiatives developed during the pandemic, (2) organizing a deliberative workshop with representatives of the study population, community, and public sector respondents to select and validate the intersectoral initiatives, (3) interviews (n = 80) with community and public sector frontline workers and managers, municipal/regional/provincial policymakers, and employees of philanthropic foundations, and (4) focus groups (n = 80) with refugees, asylum seekers, and migrants without status. Qualitative data will be analyzed using thematic analysis. The findings will be used to develop discussion forums to spur cross-learning among service providers. DISCUSSION This research will highlight the experiences of community and public organizations in their ability to offer responsive services for refugees, asylum seekers, and migrants without status in the context of a pandemic. We will draw lessons learnt from the promising practices developed in the context of COVID-19, to improve services beyond times of crisis. Lastly, we will reflect upon our participatory approach-particularly in relation to the engagement of refugees and asylum seekers in the governance of our research.
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Affiliation(s)
- Lara Gautier
- School of Public Health, University of Montreal, Suite 3076, 7101 Av du Parc, Montreal, QC, H3N 1X9, Canada.
- Centre de recherche en Santé Publique (CReSP), University of Montréal and CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montréal, Canada.
- SHERPA University Institute, CIUSSS West Central Montreal, Montreal, Canada.
| | - Erica Di Ruggiero
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Carly Jackson
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Naïma Bentayeb
- SHERPA University Institute, CIUSSS West Central Montreal, Montreal, Canada
- École Nationale d'Administration Publique, Montreal, Canada
- McGill University, Montreal, Canada
| | - Marie-Jeanne Blain
- Centre de recherche et de partage des savoirs InterActions, Université de Montréal, Montreal, Canada
| | - Fariha Chowdhury
- School of Rehabilitation Sciences, McMaster University, Hamilton, Canada
| | | | | | - Lara Maillet
- École Nationale d'Administration Publique, Montreal, Canada
| | - Laila Mahmoudi
- School of Public Health, University of Montreal, Suite 3076, 7101 Av du Parc, Montreal, QC, H3N 1X9, Canada
| | - Shinjini Mondal
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Armel Ouffouet Bessiranthy
- School of Public Health, University of Montreal, Suite 3076, 7101 Av du Parc, Montreal, QC, H3N 1X9, Canada
| | | | - Saliha Ziam
- École des Sciences de l'administration, Université TÉLUQ, Montreal, Canada
| | - Nassera Touati
- École Nationale d'Administration Publique, Montreal, Canada
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22
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Boonstra B, Rommens N. Bringing resilience together: On the co-evolutionary capacities of boundary organizations during the COVID-19 pandemic in Rotterdam. CITIES (LONDON, ENGLAND) 2023:104420. [PMID: 37359081 PMCID: PMC10247882 DOI: 10.1016/j.cities.2023.104420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 04/24/2023] [Accepted: 06/03/2023] [Indexed: 06/28/2023]
Abstract
For a city to maintain its vitality during a crisis like the COVID-19 pandemic, social resilience is pivotal. It is a manifestation of adaptive and transformative capacities in a city, through a multitude of interactions between initiatives and organizations, including local government. Resilience can take many forms: coping, adaptive, transformative; community-based, organizational, and institutional. Due to this hybridity and multiplicity, it remains to be seen how all forms of resilience interact and mutually benefit from one another in a city under crisis. Building further in the relational and dynamic dimensions of resilience, we conceptualize these mutual influences as co-evolution and hypothesise that for mutually beneficial co-evolution a city requires boundary organizations, i.e., organizations that facilitate collaboration and information-flow between differently organized societal domains. In our study of the activities of boundary organizations in the Dutch city Rotterdam during the COVID-19 pandemic, we found that boundary organizations were indeed supportive in building social and especially community resilience, but mainly coping and adaptive. Evidence for co-evolutions between various forms of resilience and institutional transformative resilience remained limited. Transformative potential seemed to get lost in procedural translations, was jeopardized by recentralization policies, and seemed only possible on the currents of already ongoing change.
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Affiliation(s)
- Beitske Boonstra
- Erasmus University Rotterdam, Erasmus School of Social and Behavioural Science, the Netherlands
- Resilient Delta Initiative, the Netherlands
| | - Naomi Rommens
- Erasmus University Rotterdam, Erasmus School of Social and Behavioural Science, the Netherlands
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23
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Renedo A, Stuart R, Kühlbrandt C, Grenfell P, McGowan CR, Miles S, Farrow S, Marston C. Community-led responses to COVID-19 within Gypsy and Traveller communities in England: A participatory qualitative research study. SSM. QUALITATIVE RESEARCH IN HEALTH 2023; 3:100280. [PMID: 37200551 PMCID: PMC10156409 DOI: 10.1016/j.ssmqr.2023.100280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 03/31/2023] [Accepted: 05/01/2023] [Indexed: 05/20/2023]
Abstract
Individuals were asked to play an active role in infection control in the COVID-19 pandemic. Yet while government messages emphasised taking responsibility for the public good (e.g. to protect the National Health Service), they appeared to overlook social, economic and political factors affecting the ways that people were able to respond. We co-produced participatory qualitative research with members of Gypsy and Traveller communities in England between October 2021 and February 2022 to explore how they had responded to COVID-19, its containment (test, trace, isolate) and the contextual factors affecting COVID-19 risks and responses within the communities. Gypsies and Travellers reported experiencing poor treatment from health services, police harassment, surveillance, and constrained living conditions. For these communities, claiming the right to health in an emergency required them to rely on community networks and resources. They organised collective actions to contain COVID-19 in the face of this ongoing marginalisation, such as using free government COVID-19 tests to support self-designed protective measures including community-facilitated testing and community-led contact tracing. This helped keep families and others safe while minimising engagement with formal institutions. In future emergencies, communities must be given better material, political and technical support to help them to design and implement effective community-led solutions, particularly where government institutions are untrusted or untrustworthy.
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Affiliation(s)
- Alicia Renedo
- Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
| | - Rachel Stuart
- College of Business, Arts and Social Sciences, Brunel University London, Kingston Lane, Middlesex, UB8 3PH, UK
| | - Charlotte Kühlbrandt
- Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
| | - Pippa Grenfell
- Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
| | - Catherine R. McGowan
- Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
| | - Sam Miles
- Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
| | | | - Cicely Marston
- Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
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24
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Handlovsky I, Wonsiak T, Amato AT, Halpin M, Ferlatte O, Kia H. Between two pandemics: Older, gay men's experiences across HIV/AIDS and COVID-19. SSM. QUALITATIVE RESEARCH IN HEALTH 2023; 3:100233. [PMID: 36777813 PMCID: PMC9905043 DOI: 10.1016/j.ssmqr.2023.100233] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 02/06/2023] [Accepted: 02/07/2023] [Indexed: 02/11/2023]
Abstract
Pandemics are a component of human life, and have had great bearing on the trajectory of human evolution. Historically, the biomedical aspects of pandemics have been overrepresented, but there is growing recognition of the degree to which pandemics are socially and culturally embedded, highlighting how virus perception is socially and politically informed. Older (50+), gay men represent a population who have experienced two global pandemics in their lifespans: HIV/AIDS and COVID-19. Although governments and health officials largely failed gay men during the HIV/AIDS pandemic, gay men represent an important source of pandemic information and their experiences have much to offer health professionals and policymakers. As such, a small but growing body of literature has compared gay men's experiences amidst the two pandemics. The current study drew on constructivist grounded theory methods to examine how living through the HIV/AIDS pandemic has influenced older gay men's perspectives of COVID-19. Twenty Canadian-based gay men aged 50+ participated in semi-structured interviews via Zoom. Analysis revealed three key processes: (1) uncertainty and the familiarity of loss, (2) witnessing pandemic inequities, and, (3) navigating constantly evolving (mis)information. We highlight the utility of this knowledge to informing future pandemic planning and policies.
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Affiliation(s)
- Ingrid Handlovsky
- School of Nursing, University of Victoria, 3800 Finnerty Road, Victoria, BC, V8P 5C2, Canada
- Institute on Aging & Lifelong Health, University of Victoria, 3800 Finnerty Road, Victoria, BC, V8P 5C2, Canada
| | - Tessa Wonsiak
- School of Nursing, University of Victoria, 3800 Finnerty Road, Victoria, BC, V8P 5C2, Canada
| | - Anthony T Amato
- Institute on Aging & Lifelong Health, University of Victoria, 3800 Finnerty Road, Victoria, BC, V8P 5C2, Canada
- School of Public Health and Social Policy, University of Victoria, 3800 Finnerty Road, Victoria, BC, V8P 5C2, Canada
- Community-Based Research Centre, 1007-808 Nelson Street, Vancouver, BC, V6Z 2H2, Canada
| | - Michael Halpin
- Department of Sociology and Social Anthropology, Dalhousie University, Box 15000, Halifax, Nova Scotia, B3H 4R2, Canada
| | - Olivier Ferlatte
- École de Santé Publique de l'Université de Montréal, 7101 Ave. du Parc Montreal, Quebec, H3N 1X9, Canada
- Centre de Recherche en Santé Publique, Université de Montréal et CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Canada
| | - Hannah Kia
- UBC School of Social Work, 2080 West Mall, Vancouver, British Columbia, V6T 2Z3, Canada
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25
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Rahbari Bonab M, Rajabi F, Majdzadeh R. Barriers and Facilitators to Participatory Governance in Iran Health Policymaking: A Qualitative Study. Med J Islam Repub Iran 2023; 37:51. [PMID: 37426482 PMCID: PMC10329506 DOI: 10.47176/mjiri.37.51] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Indexed: 07/11/2023] Open
Abstract
Background Community participation has been accepted as a promising approach to promoting health and health equality. Based on Iran's constitution and the general health policies, community participation in health is addressed as a right, and during recent decades, some measures have been put in place. However, it is critical to improve public participation in Iran's health system and institutionalize community participation in health policymaking. This study aimed to identify barriers and facilities affecting public participation in Iran's health policymaking. Methods Semi-structured qualitative interviews with health policymakers, health managers and planners, and other stakeholders were conducted to collect data. The conventional content analysis approach was used to analyze the data. Results Two themes-including community level and government level-and 10 categories were identified through the qualitative analysis. Cultural and motivational factors, lack of awareness of the right to participate, and lack of sufficient knowledge and skills are among the identified barriers in the process of establishing effective interaction. From the health governance perspective, a lack of political will is identified as one of the obstacles. Conclusion A culture of community involvement and political will are pivotal in the sustainability of community participation in health policymaking. The provision of a suitable context for participatory processes and capacity building on the community and government levels can be useful in institutionalizing community participation in the health system.
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Affiliation(s)
- Maryam Rahbari Bonab
- Community-based Participatory Research Center, Tehran University of
Medical Sciences, Tehran, Iran
| | - Fatemeh Rajabi
- Community-based Participatory Research Center, Tehran University of
Medical Sciences, Tehran, Iran
- University Research and Development Center, Tehran University of
Medical Sciences, Tehran, Iran
| | - Reza Majdzadeh
- Community-based Participatory Research Center, Tehran University of
Medical Sciences, Tehran, Iran
- Knowledge Utilization Research Center, Tehran University of Medical
Sciences, Tehran, Iran
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26
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Kühlbrandt C, McGowan CR, Stuart R, Grenfell P, Miles S, Renedo A, Marston C. COVID-19 vaccination decisions among Gypsy, Roma, and Traveller communities: A qualitative study moving beyond "vaccine hesitancy". Vaccine 2023:S0264-410X(23)00515-7. [PMID: 37202271 DOI: 10.1016/j.vaccine.2023.04.080] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 04/07/2023] [Accepted: 04/28/2023] [Indexed: 05/20/2023]
Abstract
BACKGROUND Many people refuse vaccination and it is important to understand why. Here we explore the experiences of individuals from Gypsy, Roma, and Traveller groups in England to understand how and why they decided to take up or to avoid COVID-19 vaccinations. METHODS We used a participatory, qualitative design, including wide consultations, in-depth interviews with 45 individuals from Gypsy, Roma, and Traveller, communities (32 female, 13 male), dialogue sessions, and observations, in five locations across England between October 2021 and February 2022. FINDINGS Vaccination decisions overall were affected by distrust of health services and government, which stemmed from prior discrimination and barriers to healthcare which persisted or worsened during the pandemic. We found the situation was not adequately characterised by the standard concept of "vaccine hesitancy". Most participants had received at least one COVID-19 vaccine dose, usually motivated by concerns for their own and others' health. However, many participants felt coerced into vaccination by medical professionals, employers, and government messaging. Some worried about vaccine safety, for example possible impacts on fertility. Their concerns were inadequately addressed or even dismissed by healthcare staff. INTERPRETATION A standard "vaccine hesitancy" model is of limited use in understanding vaccine uptake in these populations, where authorities and health services have been experienced as untrustworthy in the past (with little improvement during the pandemic). Providing more information may improve vaccine uptake somewhat; however, improved trustworthiness of health services for GRT communities is essential to increase vaccine coverage. FUNDING This paper reports on independent research commissioned and funded by the National Institute for Health Research (NIHR) Policy Research Programme. The views expressed in this publication are those of the authors and not necessarily those of the NHS, the NIHR, the Department of Health and Social Care or its arm's length bodies, and other Government Departments.
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Affiliation(s)
- Charlotte Kühlbrandt
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom
| | - Catherine R McGowan
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom
| | - Rachel Stuart
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom; College of Business, Arts and Social Sciences, Brunel University London, Kingston Lane, Uxbridge, Middlesex UB8 3PH, United Kingdom
| | - Pippa Grenfell
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom
| | - Sam Miles
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom; Barts & The London School of Medicine and Dentistry, Queen Mary University of London E1 2AD, United Kingdom
| | - Alicia Renedo
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom
| | - Cicely Marston
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom.
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27
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Jackson SF, Morgan GT, Gloger A, Luca S, Cerda E, Poland B. Relationships are everything: The underpinnings of grassroots community action in the COVID-19 pandemic in Toronto. CITIES (LONDON, ENGLAND) 2023; 134:104163. [PMID: 36593904 PMCID: PMC9797416 DOI: 10.1016/j.cities.2022.104163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 12/15/2022] [Accepted: 12/17/2022] [Indexed: 06/17/2023]
Abstract
Most government emergency/pandemic response plans feature top-down decision making and communication strategies and a focus on 'hard' (physical) infrastructure. There is nothing about the importance of the ideas and communications originating from communities, the social infrastructure that supports their impact locally and their contribution to the central administration. In this study, we found that the 'soft' (social) infrastructure within communities and between communities and formal institutions is key to an inclusive and more equitable response to large-scale crises like the COVID-19 pandemic. Grassroots leaders in six Toronto neighbourhoods were interviewed between the first and second waves of the COVID-19 pandemic in Toronto about what helped or hindered community action. Three themes emerged: (1) Grassroots leaders and community organizations were able to act as key connection points in a two-way flow of information and resources with residents and service providers; (2) Grassroots leaders and groups were challenged to engage in this work in a sustained capacity without adequate resourcing; and (3) there was a disconnect between community-centred grassroots approaches and the City's emergency response. We conclude that there needs to be pre-disaster investment in community level planning and preparation that fosters two-way connections between all municipal emergency/disaster and pandemic preparedness plans and community-centred organizations and grassroots leaders working in marginalized communities.
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Affiliation(s)
- Suzanne F Jackson
- Dalla Lana School of Public Health, University of Toronto, 155 College St. 5th Floor, Toronto, Ontario M5T 3M7, Canada
| | - Garrett T Morgan
- Department of Geography and Planning, University of Toronto, 100 St. George Street, Room 5047, Toronto, Ontario M5S 3G3, Canada
| | - Anne Gloger
- Centre for Connected Communities (C3), 832 College St., Suite 301, Toronto, Ontario M6G 1C8, Canada
| | - Sarah Luca
- Centre for Connected Communities, 832 College St., Suite 301, Toronto, Ontario M6G 1C8, Canada
| | - Ewa Cerda
- Centre for Connected Communities, 832 College St., Suite 301, Toronto, Ontario M6G 1C8, Canada
| | - Blake Poland
- Dalla Lana School of Public Health, University of Toronto, 155 College St. 5th Floor, Toronto, Ontario M5T 3M7, Canada
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28
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Govender I. The role of family medicine and primary health care and its impact on the climate crisis. S Afr Fam Pract (2004) 2023; 65:e1-e2. [PMID: 36861908 PMCID: PMC9982468 DOI: 10.4102/safp.v65i1.5658] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 11/07/2022] [Indexed: 02/15/2023] Open
Abstract
No abstract available.
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Affiliation(s)
- Indiran Govender
- Department Family Medicine and Primary Health Care, Faculty of Health Sciences, Sefako Makgatho Health Sciences University, Pretoria.
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29
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An Ethnographic Study of Multiple Factors Influencing Perceptions, Attitudes, and Observance of COVID-19 Preventive Measures among Rural and Urban Slum Dwellers in Ghana. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2023; 2023:1598483. [PMID: 36761244 PMCID: PMC9904884 DOI: 10.1155/2023/1598483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 10/03/2022] [Accepted: 11/01/2022] [Indexed: 02/05/2023]
Abstract
Background The COVID-19 pandemic and government-led interventions to tackle it have had life-changing effects on vulnerable populations, especially rural and urban slum dwellers in developing countries. This ethnographic study explored how the Ghanaian government's management of COVID-19, socio-cultural factors, infrastructural challenges, and poverty influenced community perceptions, attitudes, and observance of COVID-19 prevention measures in Ghana. Methods The study employed focused ethnography using in-depth interviews (IDIs), focus group discussions (FGDs), and nonparticipant observations to collect data from an urban slum and a rural community as well as from government officials, from October 2020 to January 2021. The data were triangulated and analyzed thematically with the support of qualitative software NVivo 12. All ethical procedures were followed. Results The Ghanaian government's strategy of communicating COVID-19-related information to the public, health-related factors such as health facilities failing to follow standard procedures in testing and tracing persons who came into contact with COVID-19-positive cases, poverty, and lack of social amenities contributed to the poor observance of COVID-19 preventive measures. In addition, the government's relaxation of COVID-19 restrictions, community and family values, beliefs, and misconceptions contributed to the poor observance of COVID-19 preventive measures. Nevertheless, some aspects of the government's intervention measures and support to communities with COVID-19 prevention items, support from nongovernmental organizations (NGOs), and high knowledge of COVID-19 and its devastating effects contributed to positive attitudes and observance of COVID-19 preventive measures. Conclusion There is a need for the government to use the existing community structures to engage vulnerable communities so that their concerns are factored into interventions to ensure that appropriate interventions are designed to suit the context. Moreover, the government needs to invest in social amenities in deprived communities. Finally, the government has to be consistent with the information it shares with the public to enhance trust relations.
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30
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Fan R, Chen F, Wang Y, Wang Y, Chen R. Study on population behavior under home quarantine policies of COVID-19 in China based on double-layer network evolutionary games. JOURNAL OF INTELLIGENT & FUZZY SYSTEMS 2023. [DOI: 10.3233/jifs-221594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
In the practice of COVID-19 prevention and control in China, the home quarantine policy directly connects and manages the residents, which plays a significant role in preventing the spread of the epi-demic in the community. We evaluate the effectiveness of current home quarantine policy in the actual execution process based on the evolutionary game relationship between the community and res-idents. This paper establishes a double-layer coupled complex network game model, and uses the multi-agent modeling method to study the game relationship between the community and residents in the context of home quarantine policies. The results show that initial strategy of the community with strict supervision and reasonable government reward allocation will increase the proportion of the residents complying with the quarantine rule. When 80% of the communities chose to supervise strictly at the beginning, people are more likely to follow the rules. While when the residents can only get 20% of the government’s reward, the proportion of choosing to violate the quarantine rules is much higher than that when they can get 80% of the reward. Besides, the structure of small-world network and environmental noise will also affect the residents’ strategy. As the probability of reconnection of the small-world network rises from 0.2 to 0.8, the proportion of residents who choose to comply with the strategy becomes much higher. When the environmental noise reaches 0.5, the ratio of residents who choose to violate the strategy is higher than the ratio of complianc. The study is helpful to provide the basis for the government to formulate the quarantine policy and propose an optimization for making effective quarantine measures. In this way, the government can adjust the parameters to make residents achieve the possible level of compliance with quarantine policies as high as possible to contain the spread of the epidemic.
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Affiliation(s)
- Ruguo Fan
- School of Economics and Management, Wuhan University, Wuchang District, Wuhan, China
| | - Fangze Chen
- School of Economics and Management, Wuhan University, Wuchang District, Wuhan, China
| | - Yitong Wang
- School of Economics and Management, Wuhan University, Wuchang District, Wuhan, China
| | - Yuanyuan Wang
- School of Economics and Management, Wuhan University, Wuchang District, Wuhan, China
| | - Rongkai Chen
- School of Economics and Management, Wuhan University, Wuchang District, Wuhan, China
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Development and Application of a Comprehensive Measure of Access to Health Services to Examine COVID-19 Health Disparities. Healthcare (Basel) 2023; 11:healthcare11030354. [PMID: 36766929 PMCID: PMC9914001 DOI: 10.3390/healthcare11030354] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 01/18/2023] [Accepted: 01/20/2023] [Indexed: 01/27/2023] Open
Abstract
Research on access to health services during the COVID-19 pandemic is limited, and the conceptualization of access has not typically included access to community resources. We developed and tested an access-to-health-services measure and examined disparities in access among individuals in the U.S. during the pandemic. Data are from a U.S. sample of 1491 respondents who completed an online survey in August 2021. Linear regression models assessed the relationships between the access-to-health-services-measure components, including impact on access to medicine and medical equipment, impact on access to healthcare visits, and confidence in accessing community resources, and predictor variables, including sociodemographic- and health-related factors. Disparities in access to healthcare during the pandemic were associated with sociodemographic characteristics (i.e., race, gender, and age) and health-related characteristics (i.e., chronic illness, mental health condition, and disability). Factors such as race, gender, income, and age were associated with individuals' degree of confidence in accessing community services. Our study presents a new access-to-health-services measure, sheds light on which populations may be most vulnerable to experiencing reduced access to health services, and informs the development of programmatic interventions to address the salient needs of these populations.
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Yamazaki C, Nakai H. Understanding Mothers' Worries about the Effects of Disaster Evacuation on Their Children: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1850. [PMID: 36767215 PMCID: PMC9914362 DOI: 10.3390/ijerph20031850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 01/16/2023] [Accepted: 01/17/2023] [Indexed: 06/18/2023]
Abstract
In Japan, there is an imminent threat of major earthquakes and floods. Children's health is increasingly at risk from climate-change-related disasters. The purpose of this study was to identify factors related to mothers' worries about the effects of evacuation on their children. Participants were mothers whose children attended a childcare center in one municipality in Ishikawa, Japan. A cross-sectional design was used. A questionnaire was developed based on previous studies, and it was used to conduct a survey. A total of 1298 individuals who provided valid data were included in the analysis. The following factors were related to mothers' worries about the effects of evacuation on their children: not having prepared a grab bag as a disaster risk reduction strategy, having no neighbors to help them in case of disaster, having children aged <3 years, and having children with allergies. The mothers of children <3 years old with allergies who are unprepared and have no social support are likely to worry about evacuating their children. Policymakers must be aware that the mothers of children aged <3 years and the mothers of children with allergies experience substantial concerns about the effects of evacuation on their children.
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Affiliation(s)
| | - Hisao Nakai
- Correspondence: ; Tel.: +81-76-286-2211 (ext. 7586)
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Moran VH, Ceballos-Rasgado M, Fatima S, Mahboob U, Ahmad S, McKeown M, Zaman M. Participatory action research to co-design a culturally appropriate COVID-19 risk communication and community engagement strategy in rural Pakistan. Front Public Health 2023; 11:1160964. [PMID: 37168074 PMCID: PMC10166109 DOI: 10.3389/fpubh.2023.1160964] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 04/05/2023] [Indexed: 05/13/2023] Open
Abstract
Background Community engagement has shown to be fundamental component of the response to previous disease outbreaks. This study aimed co-design and implement a culturally appropriate COVID-19 risk communication and community engagement strategy with a resource-poor rural community in Northwest Pakistan. Methods Participatory Action Research (PAR) was conducted from January 2021 to March 2022. Five PAR meetings took place with community members (n = 30) to: (1) explore how the COVID-19 pandemic impacted on the community; (2) identify challenges to limit the spread of the virus; (3) identify and implement solutions to these challenges; and (4) highlight the enablers, challenges and knowledge of the cultural context needed to optimize safety during emergencies. Focus group discussions (N = 6) with community members not involved in the PAR meetings (N = 50) and children of the community (N = 26) were conducted following the PAR meetings. Thematic analysis of the PAR and focus group data was conducted. Results Delivery of messages on how to keep families safe, provision of personal protective equipment and improved water systems were part of the strategies taken by the community to create awareness and reduce the spread of COVID-19. Nine themes were identified: Attitudes to the pandemic: From skepticism to acceptance, Changing attitudes about vaccination: rumors and trust, COVID-19 and Faith, Social impact of the pandemic, Access to water, Resource mobilization: personal protective equipment, Spaces where collaborative effort can bring to solutions, Agents of change, and Empowerment of women. Discussion The participatory approach of this research allowed understanding of the challenges faced by the community to engage in behavior change strategies to reduce the spread of COVID-19 and enabled the community to find sustainable solutions. Engagement with the community empowered men and women to be agents of change and promoted necessary precautionary actions to reduce the risk of infection within their community. Conclusion Participatory approach highlighted the importance of engaging with and integrating to local culture and values to overcome challenges such as gender imbalance and distrust. Findings of this study are relevant to others working in diverse cultural settings in similar crises events regardless of particular cultural variations.
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Affiliation(s)
- Victoria Hall Moran
- Centre for Global Development, University of Central Lancashire, Preston, United Kingdom
| | | | - Sadia Fatima
- Institute of Basic Medical Sciences, Khyber Medical University, Peshawar, Pakistan
- *Correspondence: Sadia Fatima,
| | - Usman Mahboob
- Institute of Health Professions Education and Research, Khyber Medical University, Peshawar, Pakistan
| | - Salman Ahmad
- Department of Sociology, Abdul Wali Khan University, Mardan, Pakistan
| | - Michael McKeown
- School of Nursing, University of Central Lancashire, Preston, United Kingdom
| | - Mukhtiar Zaman
- Department of Pulmonology, Rehman Medical Institute, Peshawar, Pakistan
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Jarvis MA, Pillay SR, Norton LM, Hiraman N, Baloyi OB. Delivering a psychosocial program for older people living in retirement homes during the Covid-19 pandemic: A process evaluation and recommendations for community interventions. JOURNAL OF COMMUNITY PSYCHOLOGY 2023; 51:31-50. [PMID: 35562188 PMCID: PMC9348144 DOI: 10.1002/jcop.22876] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 04/22/2022] [Accepted: 04/23/2022] [Indexed: 06/15/2023]
Abstract
The Covid-19 pandemic lockdown regulations caused retirement homes to temporarily ban in-person visitation potentially increasing the mental health risks of older people. An opportunity arose for a multistakeholder community collaboration to design a mental health program for older people. To evaluate the process of delivering a 12-week psychosocial program aimed at preventing loneliness, countering boredom, and providing older people in restricted settings with education about Covid-19 during the lockdown, in Durban, South Africa. A qualitative retrospective design was used. Data from two focus groups and six semistructured individual interviews conducted with stakeholders (volunteers, social workers, and residents) postproject were analyzed using reflexive thematic analysis. Stakeholders had varied experiences of the project, in terms of content, processes of engagement, and implementation, resulting in five themes. The study concluded with recommendations. A strong need exists for multistakeholder community collaborations when implementing a program where the context restricts physical access.
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Affiliation(s)
- Mary Ann Jarvis
- School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Suntosh R Pillay
- King Dinuzulu Hospital Complex, Durban, South Africa
- Department of Clinical Medicine (Psychiatry), Nelson R. Mandela School of Medicine, University of KwaZulu-Natal (UKZN), Durban, South Africa
| | - Lynn M Norton
- South African Depression and Anxiety Group (SADAG), KwaZulu-Natal, South Africa
| | - Nemisha Hiraman
- Lead Behavioural Therapist, The Star Academy, Durban, South Africa
| | - Olivia B Baloyi
- School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
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Mattila P, Davies J, Mabetha D, Tollman S, D’Ambruoso L. Burden of mortality linked to community-nominated priorities in rural South Africa. Glob Health Action 2022; 15:2013599. [PMID: 35060841 PMCID: PMC8786241 DOI: 10.1080/16549716.2021.2013599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 11/26/2021] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Community knowledge is a critical input for relevant health programmes and strategies. How community perceptions of risk reflect the burden of mortality is poorly understood. OBJECTIVE To determine the burden of mortality reflecting community-nominated health risk factors in rural South Africa, where a complex health transition is underway. METHODS Three discussion groups (total 48 participants) representing a cross-section of the community nominated health priorities through a Participatory Action Research process. A secondary analysis of Verbal Autopsy (VA) data was performed for deaths in the same community from 1993 to 2015 (n = 14,430). Using population attributable fractions (PAFs) extracted from Global Burden of Disease data for South Africa, deaths were categorised as 'attributable at least in part' to community-nominated risk factors if the PAF of the risk factor to the cause of death was >0. We also calculated 'reducible mortality fractions' (RMFs), defined as the proportions of each and all community-nominated risk factor(s) relative to all possible risk factors for deaths in the population . RESULTS Three risk factors were nominated as the most important health concerns locally: alcohol abuse, drug abuse, and lack of safe water. Of all causes of deaths 1993-2015, over 77% (n = 11,143) were attributable at least in part to at least one community-nominated risk factor. Causes of attributable deaths, at least in part, to alcohol abuse were most common (52.6%, n = 7,591), followed by drug abuse (29.3%, n = 4,223), and lack of safe water (11.4%, n = 1,652). In terms of the RMF, alcohol use contributed the largest percentage of all possible risk factors leading to death (13.6%), then lack of safe water (7.0%), and drug abuse (1.3%) . CONCLUSION A substantial proportion of deaths are linked to community-nominated risk factors. Community knowledge is a critical input to understand local health risks.
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Affiliation(s)
- Pyry Mattila
- South Karelia Social and Health Care District (Eksote), Finland
| | - Justine Davies
- Institute of Applied Health Research University of Birmingham, UK
| | - Denny Mabetha
- Aberdeen Centre for Health Data Science (ACHDS), Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, Scotland
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Stephen Tollman
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- International Network for the Demographic Evaluation of Populations and Their Health (INDEPTH), Accra, Ghana
| | - Lucia D’Ambruoso
- Aberdeen Centre for Health Data Science (ACHDS), Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, Scotland
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
- Public Health, National Health Service, Grampian, Scotland, UK
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Nyatela A, Nqakala S, Singh L, Johnson T, Gumede S. Self-care can be an alternative to expand access to universal health care: What policy makers, governments and implementers can consider for South Africa. FRONTIERS IN REPRODUCTIVE HEALTH 2022; 4:1073246. [PMID: 36545492 PMCID: PMC9760858 DOI: 10.3389/frph.2022.1073246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 11/15/2022] [Indexed: 12/12/2022] Open
Abstract
As a result of collaboration amongst the various decision-makers in the field of healthcare, there has been an improvement in the access to healthcare and living conditions globally. Nonetheless, poorer communities continue to benefit the least from public investment. To bridge the gap, self-care can be a viable alternative as it allows individuals and communities to reduce their dependence on government healthcare solutions. Barriers to self-care do exist. Some of these are cost effectiveness, usability of self-care instruments, differentiated strategies and linkage to care. In identifying these obstacles, it is also worthwhile to investigate how they can be mitigated. To encourage sustained self-care in the HIV continuum, contextual factors as well as the manner in which individuals and communities engage with self-care must be considered. In South Africa, multiple variables come into play: literacy levels, cultural influences, socio-economic conditions and access to resources are some of these. Evidence demonstrates how self-care can be promoted by various stakeholders re-strategising to tweak and in some cases totally change existing structures. This paper explores some of the transformations, like at a governmental level where the supply of HIV self-testing kits is increased, at a production level where instructions for use are reformatting, in communities where sports programmes fulfil the dual purpose of developing sport skills and providing HIV education concurrently, and at an individual level where greater awareness invites greater participation in self-care. While self-care is a promising proposal, it is not a replacement for traditional health-care practices, but a complementary approach.
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Affiliation(s)
- Athini Nyatela
- Ezintsha, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa,Correspondence: Athini Nyatela
| | - Sizwe Nqakala
- Ezintsha, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Leanne Singh
- Ezintsha, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Taylor Johnson
- Ezintsha, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Siphamandla Gumede
- Ezintsha, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa,Department of Interdisciplinary Social Science, Utrecht University, Utrecht, The Netherlands
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Mejia-Lancheros C, Lachaud J, Gogosis E, Thulien N, Stergiopoulos V, Da Silva G, Nisenbaum R, O’Campo P, Hwang S. Providing Housing First services for an underserved population during the early wave of the COVID-19 pandemic: A qualitative study. PLoS One 2022; 17:e0278459. [PMID: 36454981 PMCID: PMC9714853 DOI: 10.1371/journal.pone.0278459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 11/16/2022] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE We assessed the critical role of Housing First (HF) programs and frontline workers in responding to challenges faced during the first wave of the COVID-19 pandemic. METHOD Semi-structured interviews were conducted with nine HF frontline workers from three HF programs between May 2020 and July 2020, in Toronto, Canada. Information was collected on challenges and adjustments needed to provide services to HF clients (people experiencing homelessness and mental disorders). We applied the Analytical Framework method and thematic analysis to our data. RESULTS Inability to provide in-person support and socializing activities, barriers to appropriate mental health assessments, and limited virtual communication due to clients' lack of access to digital devices were among the most salient challenges that HF frontline workers reported during the COVID-19 pandemic. Implementing virtual support services, provision of urgent in-office or in-field support, distributing food aid, connecting clients with online healthcare services, increasing harm reduction education and referral, and meeting urgent housing needs were some of the strategies implemented by HF frontline workers to support the complex needs of their clients during the pandemic. HF frontline workers experienced workload burden, job insecurity and mental health problems (e.g. distress, worry, anxiety) as a consequence of their services during the first wave of the COVID-19 pandemic. CONCLUSION Despite the several work-, programming- and structural-related challenges experienced by HF frontline workers when responding to the needs of their clients during the first wave of the COVID-19 pandemic, they played a critical role in meeting the communication, food, housing and health needs of their clients during the pandemic, even when it negatively affected their well-being. A more coordinated, integrated, innovative, sustainable, effective and well-funded support response is required to meet the intersecting and complex social, housing, health and financial needs of underserved and socio-economically excluded groups during and beyond health emergencies.
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Affiliation(s)
- Cilia Mejia-Lancheros
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, Toronto, Ontario, Canada
- Research Group in Nursing Care and Practice, Family Health Nursing and Health Measures; Nursing Faculty, Universidad Nacional de Colombia, Bogotá, Colombia
- * E-mail:
| | - James Lachaud
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Evie Gogosis
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Naomi Thulien
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Vicky Stergiopoulos
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - George Da Silva
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Rosane Nisenbaum
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Applied Health Research Centre, Li Ka Shing Knowledge Institute, St Michael’s Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Patricia O’Campo
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Stephen Hwang
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Division of General Internal Medicine, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
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Recio-Vivas AM, Mansilla-Domíngez JM, Belzunegui-Eraso Á, Peña-Otero D, Díaz-Pérez D, Lorenzo-Allegue L, Font-Jiménez I. Compliance with COVID-19 Prevention Measures in the Spanish Population during the New Normal: Will the Need for Greater Community Involvement Be One of the Lessons Learned? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15983. [PMID: 36498056 PMCID: PMC9737321 DOI: 10.3390/ijerph192315983] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 11/16/2022] [Accepted: 11/26/2022] [Indexed: 06/17/2023]
Abstract
Throughout the pandemic, national and international health authorities have called on the population to collaborate and contribute with their behavior to control the problem. The aim of this study is to analyze the implementation of the protective measures against COVID-19 and to determine the factors involved in their compliance. To respond to the objectives, a cross-sectional study was performed involving a total of 5560 individuals. An ad hoc online questionnaire was created and shared through social networks, scientific societies, and various health institutions. The probability of high or total compliance with the protective measures was higher in women (OR = 1.401) and as age increases, with an OR = 2.524 in the interval between 31 and 64 years old and an OR = 2.896 in the oldest interval (65 and over). This study shows the characteristics of the population that considers it more likely to be infected by SARS-CoV-2, thus adopting greater adherence to prevention measures. Knowing which factors are associated with adherence to protective measures is essential for establishing effective pandemic control measures. Our findings may be useful for designing future awareness campaigns adapted to different socio-demographic characteristics in settings affected by COVID-19.
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Affiliation(s)
- Ana María Recio-Vivas
- Department of Nursing, Faculty of Biomedical and Health Science, Universidad Europea de Madrid, 28670 Madrid, Spain
| | | | - Ángel Belzunegui-Eraso
- Medical Anthropology Research Center, Faculty of Nursing, Rovira i Virgili University, 43002 Tarragona, Spain
| | - David Peña-Otero
- Sub-Directorate of Caring, Cantabrian Health Service, Material Resources Unit, Management of Products, Equipment and Health Technology, Hospital Universitario Marqués de Valdecilla, 39011 Cantabria, Spain
- Nursing Area, IDIVAL Research Institutes Valdecilla, 39011 Cantabria, Spain
- Respiratory Nursing Department at Sociedad Española de Neumología y Cirugía Torácica (SEPAR), 08029 Barcelona, Spain
| | - David Díaz-Pérez
- Respiratory Nursing Department at Sociedad Española de Neumología y Cirugía Torácica (SEPAR), 08029 Barcelona, Spain
- Pneumology and Thoracic Surgery Service of the Hospital Universitario Nuestra Señora de Candelaria, 38010 Santa Cruz de Tenerife, Spain
| | - Laura Lorenzo-Allegue
- Department of Nursing, Faculty of Biomedical and Health Science, Universidad Europea de Madrid, 28670 Madrid, Spain
| | - Isabel Font-Jiménez
- Department of Nursing, Faculty of Biomedical and Health Science, Universidad Europea de Madrid, 28670 Madrid, Spain
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Alhaffar M, Mkhallalati H, Alrashid Alhiraki O, Marzouk M, Khanshour A, Douedari Y, Howard N. "They cannot afford to feed their children and the advice is to stay home. How‥?": A qualitative study of community experiences of COVID-19 response efforts across Syria. PLoS One 2022; 17:e0277215. [PMID: 36331972 PMCID: PMC9635699 DOI: 10.1371/journal.pone.0277215] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 10/24/2022] [Indexed: 11/06/2022] Open
Abstract
Introduction COVID-19 highlighted the importance of meaningful engagement between communities and health authorities. This is particularly challenging in conflict-affected countries such as Syria, where social protection and food security needs can hinder adherence to non-pharmaceutical interventions (NPIs) and vaccine uptake. This study explored community perspectives of COVID-19 and health authority responses across the three main areas of control in Syria, i.e. Syrian government-controlled areas (GCA), autonomous administration-controlled areas (AACA), and opposition-controlled areas (OCA). Methods We conducted a qualitative study, interviewing 22 purposively-sampled Syrians accessing health services in AACA, GCA, or OCA in 2021 to provide approximately equal representation by governance area and gender. We analysed data thematically using deductive and inductive coding. Findings Interviewees in all areas described how their fears of COVID-19 and willingness to adhere to NPIs decreased as their local COVID-19 epidemics progressed and NPIs disrupted access to household essentials such as work and food. Community-level responses were minimal and ad hoc, so most people focused on personal or household protective efforts and many mentioned relying on their faith for comfort. Misinformation and vaccine hesitancy were common in all areas, linked to lack of transparency from and mistrust of local health authorities and information sources. Conclusions The COVID-19 pandemic has increased health actors’ need to engage with communities to control disease spread, yet most NPIs implemented in Syria were inappropriate and adherence decreased as the pandemic progressed. This was exemplified by lockdowns and requirements to self-isolate, despite precarious reliance on daily wages, no subsidies for lost income, individual self-reliance, and mistrust/weak communication between communities and health authorities. We found minimal community engagement efforts, consisting entirely of informing with no efforts to consult, involve, collaborate, or empower. This contributed to failures of health actors to contextualise interventions in ways that respected community understandings and needs.
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Affiliation(s)
- Mervat Alhaffar
- Syria Research Group (SyRG), Co-hosted by the London School of Hygiene and Tropical Medicine and Saw Swee Hock School of Public Health, London, United Kingdom
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom
- * E-mail:
| | - Hala Mkhallalati
- Syria Research Group (SyRG), Co-hosted by the London School of Hygiene and Tropical Medicine and Saw Swee Hock School of Public Health, London, United Kingdom
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Omar Alrashid Alhiraki
- Syria Research Group (SyRG), Co-hosted by the London School of Hygiene and Tropical Medicine and Saw Swee Hock School of Public Health, London, United Kingdom
| | - Manar Marzouk
- Syria Research Group (SyRG), Co-hosted by the London School of Hygiene and Tropical Medicine and Saw Swee Hock School of Public Health, London, United Kingdom
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Ahmad Khanshour
- Syria Research Group (SyRG), Co-hosted by the London School of Hygiene and Tropical Medicine and Saw Swee Hock School of Public Health, London, United Kingdom
| | - Yazan Douedari
- Syria Research Group (SyRG), Co-hosted by the London School of Hygiene and Tropical Medicine and Saw Swee Hock School of Public Health, London, United Kingdom
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Free Aleppo University, Aleppo, Syria
| | - Natasha Howard
- Syria Research Group (SyRG), Co-hosted by the London School of Hygiene and Tropical Medicine and Saw Swee Hock School of Public Health, London, United Kingdom
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
- Free Aleppo University, Aleppo, Syria
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Frimpong LK, Okyere SA, Diko SK, Abunyewah M, Erdiaw‐Kwasie MO, Commodore TS, Hernandez DO, Kita M. Actor-network analysis of community-based organisations in health pandemics: evidence from the COVID-19 response in Freetown, Sierra Leone. DISASTERS 2022; 46:903-927. [PMID: 34477244 PMCID: PMC8652973 DOI: 10.1111/disa.12508] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Freetown, Sierra Leone, is confronted with health risks that are compounded by rapid unplanned urbanisation and weak capacities of local government institutions. Addressing them implies a shared responsibility between government and non-state actors. In low-income areas, the role of community-based organisations (CBOs) in combating health disasters is well-recognised. Yet, empirical evidence on how they have utilised their networks and coordinated community-level strategies in responding to the COVID-19 pandemic is scant. This paper, based on a qualitative study in two informal settlements in Freetown, employs actor-network theory to understand how CBOs problematise COVID-19 as a health risk, interact with other entities, and the subsequent tensions that arise. The findings show that community vulnerabilities and past experiences of health disasters informed CBOs' perception of COVID-19 as a communal emergency. In response, they coordinated sensitisation and mobilisation programmes by relying on a network of actors to support COVID-19 risk reduction strategies. Nonetheless, misunderstandings among them caused friction.
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Affiliation(s)
- Louis Kusi Frimpong
- Lecturer at the Department of Geography and Earth ScienceUniversity of Environment and Sustainable DevelopmentGhana
| | - Seth Asare Okyere
- Assistant Professor at the Graduate School of EngineeringOsaka UniversityJapan
| | - Stephen Kofi Diko
- Assistant Professor at the Department of City and Regional PlanningUniversity of MemphisUnited States
| | - Matthew Abunyewah
- Adjunct Senior Lecturer at the School of Architecture and Built EnvironmentUniversity of NewcastleAustralia
| | | | - Tracy Sidney Commodore
- PhD Candidate at the Institute of Statistical, Social and Economic ResearchUniversity of GhanaGhana
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Caperon L, Saville F, Ahern S. Developing a socio-ecological model for community engagement in a health programme in an underserved urban area. PLoS One 2022; 17:e0275092. [PMID: 36155664 PMCID: PMC9512167 DOI: 10.1371/journal.pone.0275092] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 09/11/2022] [Indexed: 11/18/2022] Open
Abstract
Despite a recent increase in community engagement in health initiatives during the COVID-19 pandemic, health inequalities and health inequities remain a serious problem for society, often affecting those in underserved communities the most. Often individualised incentives such as payment for vaccinations have been used to increase involvement in health initiatives but evidence suggests that these do not always work and can be ineffective. This paper addresses the real world problem of a lack of involvement of communities in health programmes and subsequent health inequalities. Using data from nine workshops with community members evaluating a large community health programme, we develop a socio-ecological model [SEM] of influences on community engagement in health programmes to identify holistic and systemic barriers and enablers to such engagement. To date SEM has not been used to develop solutions to improve community engagement in health programmes. Such an approach holds the potential to look beyond individualised conceptualisations of behaviour and instead consider a multitude of social and cultural influences. This knowledge can then be used to develop multi-faceted and multi-layered solutions to tackle the barriers to community engagement in health programmes. Our SEM highlights the overarching importance of the socio-cultural environment in influencing community engagement. Within the socio-cultural environment were factors such as trust, social support and community mindedness. We also found that other factors affecting community engagement fall within individual, economic, technological, political and physical environments. Such factors include engagement in community organisation governance and processes, access to and ability to use technology and access to safe outdoor spaces. We propose further testing our socioecological model in other communities.
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Affiliation(s)
- Lizzie Caperon
- Bradford Institute for Health Research, Bradford, United Kingdom
- * E-mail:
| | - Fiona Saville
- Better Start Bradford, Mayfield Centre, Bradford, United Kingdom
| | - Sara Ahern
- Bradford Institute for Health Research, Bradford, United Kingdom
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Kemper S, Kupper F, Kengne Kamga S, Brabers A, De Jong J, Bongers M, Timen A. Public engagement in decision-making regarding the management of the COVID-19 epidemic: Views and expectations of the 'publics'. Health Expect 2022; 25:2807-2817. [PMID: 36148630 PMCID: PMC9538976 DOI: 10.1111/hex.13583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 06/23/2022] [Accepted: 08/07/2022] [Indexed: 11/28/2022] Open
Abstract
Background In the management of epidemics, like COVID‐19, trade‐offs have to be made between reducing mortality and morbidity and minimizing socioeconomic and political consequences. Traditionally, epidemic management (EM) has been guided and executed attentively by experts and policymakers. It can, however, still be controversial in the public sphere. In the last decades, public engagement (PE) has been successfully applied in various aspects of healthcare. This leads to the question if PE could be implemented in EM decision‐making. Methods From June to October 2020, seven deliberative discussion focus groups were executed with 35 Dutch citizens between 19 and 84 years old. Their views on PE in COVID‐19 management were explored. The deliberative approach allows for the education of participants on the topic before the discussion. The benefits, barriers, timing and possible forms of PE in EM were discussed. Results Almost all participants supported PE in EM, as they thought that integrating their experiences and ideas would benefit the quality of EM, and increase awareness and acceptance of measures. A fitting mode for PE was consultation, as it was deemed important to provide the public with possibilities to share ideas and feedback; however, final authority remained with experts. The publics could particularly provide input about communication campaigns and control measures. PE could be executed after the first acute phase of the epidemic and during evaluations. Conclusions This paper describes the construction of an empirically informed framework about the values and conditions for PE in EM from the perspective of the public. Participants expressed support to engage certain population groups and considered it valuable for the quality and effectiveness of EM; however, they expressed doubts about the feasibility of PE and the capabilities of citizens. In future studies, these results should be confirmed by a broader audience. Patient or Public Contribution No patients or members of the public were involved in the construction and execution of this study. This study was very exploratory, to gain a first insight into the views of the public in the Netherlands, and will be used to develop engagement practices accordingly. At this stage, the involvement of the public was not yet appropriate.
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Affiliation(s)
- Sophie Kemper
- National Coordination Centre for Communicable Disease Control, The National Institute for Public Health and the Environment, Bilthoven, The Netherlands.,Athena Institute, Faculty of Science, VU University Amsterdam, Amsterdam, 1081 HV, The Netherlands
| | - Frank Kupper
- Athena Institute, Faculty of Science, VU University Amsterdam, Amsterdam, 1081 HV, The Netherlands
| | - Sandra Kengne Kamga
- National Coordination Centre for Communicable Disease Control, The National Institute for Public Health and the Environment, Bilthoven, The Netherlands.,Athena Institute, Faculty of Science, VU University Amsterdam, Amsterdam, 1081 HV, The Netherlands
| | - Anne Brabers
- NIVEL, The Netherlands Institute for Health Services Research, Utrecht, 3513 CR, The Netherlands
| | - Judith De Jong
- NIVEL, The Netherlands Institute for Health Services Research, Utrecht, 3513 CR, The Netherlands.,Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Marloes Bongers
- National Coordination Centre for Communicable Disease Control, The National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Aura Timen
- National Coordination Centre for Communicable Disease Control, The National Institute for Public Health and the Environment, Bilthoven, The Netherlands.,Athena Institute, Faculty of Science, VU University Amsterdam, Amsterdam, 1081 HV, The Netherlands.,Department of Primary and Community Care, Radboud University Medical Centre, Nijmegen, The Netherlands
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43
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Pandemic management, citizens and the Indian Smart cities: Reflections from the right to the smart city and the digital divide. CITY, CULTURE AND SOCIETY 2022. [PMCID: PMC9384542 DOI: 10.1016/j.ccs.2022.100474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The technologically endowed Smart Cities take credit for managing the COVID-19 pandemic more effectively than other urban centers. However, Indian smart cities seemed unprepared for the outbreak, with reported highest cases of death and positivity rates. Thus, it becomes essential to understand why these smart cities could not handle the pandemic despite their technologically advanced infrastructures and the citizen’s role in managing it. This paper analyzes the impact of the Smart City Mission (SCM) interventions from a citizen-centric perspective and its influence on pandemic management and citizen inclusivity. The study draws from the right to the smart city framework along with stages of the digital divide. The study conducted a content analysis using secondary sources like published and unpublished papers, policy reports, and news analyses spanning the timeline of 2015-2022. The analysis infers that the lack of initiatives to link marginalized citizens with Information and Communication Technologies (ICTs) through the SCM policy led to the underutilization of the various initiatives launched during the pandemic, deepening the digital divide. The deduction from the analysis highlights that the ‘chatur citizens’ act as a solution by transitioning their formal access to ICTs into effective access enabling the marginalized communities to bridge the divide.
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44
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McGowan CR, Takahashi E, Romig L, Bertram K, Kadir A, Cummings R, Cardinal LJ. Community-based surveillance of infectious diseases: a systematic review of drivers of success. BMJ Glob Health 2022; 7:bmjgh-2022-009934. [PMID: 35985697 PMCID: PMC9396156 DOI: 10.1136/bmjgh-2022-009934] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Accepted: 07/24/2022] [Indexed: 11/22/2022] Open
Abstract
Introduction Community-based surveillance may improve early detection and response to disease outbreaks by leveraging the capacity of community members to carry out surveillance activities within their communities. In 2021, the WHO published a report detailing the evidence gaps and research priorities around community-centred approaches to health emergencies. In response, we carried out a systematic review and narrative synthesis of the evidence describing the drivers of success of community-based surveillance systems. Methods We included grey literature and peer-reviewed sources presenting empirical findings of the drivers of success of community-based surveillance systems for the detection and reporting of infectious disease-related events. We searched for peer-reviewed literature via MEDLINE, EMBASE, Global Health, SCOPUS and ReliefWeb. We carried out grey literature searches using Google Search and DuckDuckGo. We used an evaluation quality checklist to assess quality. Results Nineteen sources (17 peer-reviewed and 2 grey literature) met our inclusion criteria. Included sources reported on community-based surveillance for the detection and reporting of a variety of diseases in 15 countries (including three conflict settings). The drivers of success were grouped based on factors relating to: (1) surveillance workers, (2) the community, (3) case detection and reporting, (4) and integration. Discussion The drivers of success were found to map closely to principles of participatory community engagement with success factors reflecting high levels of acceptability, collaboration, communication, local ownership, and trust. Other factors included: strong supervision and training, a strong sense of responsibility for community health, effective engagement of community informants, close proximity of surveillance workers to communities, the use of simple and adaptable case definitions, quality assurance, effective use of technology, and the use of data for real-time decision-making. Our findings highlight strategies for improving the design and implementation of community-based surveillance. We suggest that investment in participatory community engagement more broadly may be a key surveillance preparedness activity. PROSPERO registration number CRD42022303971.
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Affiliation(s)
- Catherine R McGowan
- Department of Public Health, Environments & Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Emi Takahashi
- Humanitarian Public Health Technical Unit, Save the Children Fund, London, UK
| | - Laura Romig
- Department of Humanitarian Response, Save the Children Federation, Washington, District of Columbia, USA
| | - Kathryn Bertram
- Department of Health, Behavior, and Society, Johns Hopkins University, Baltimore, Maryland, USA
| | - Ayesha Kadir
- Humanitarian Public Health Technical Unit, Save the Children Fund, London, UK
| | - Rachael Cummings
- Department of Public Health, Environments & Society, London School of Hygiene & Tropical Medicine, London, UK.,Humanitarian Department, Save the Children International, London, UK
| | - Laura J Cardinal
- Department of Humanitarian Response, Save the Children Federation, Washington, District of Columbia, USA
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45
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Sproson L, Mills N, Pryde L, Adebajo A, Coyle D, Preston J, Blackburn D, Christensen H, Lanfranchi V. Keeping patient and public partnership at the heart of medical technology development during Covid-19: examples of adaptive practice. J Med Eng Technol 2022; 46:472-481. [PMID: 35895020 DOI: 10.1080/03091902.2022.2089258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
NIHR (National Institute for Health Research) Devices for Dignity MedTech Cooperative (D4D) and NIHR Children and Young People MedTech Cooperative (CYPMedTech) have established track records in keeping patient and public involvement (PPI) at the core of medical technology development, evaluation and implementation. The 2020 global COVID-19 pandemic presented significant challenges to maintaining this crucial focus. In this paper we describe prior successful methodologies and share examples of the adaptations made in order to continue to engage with patients and the public throughout the pandemic and beyond. We reflect on learning gained from these experiences, and new areas of scope and focus relating to broadening the reach of engagement and representation, along with associated resource requirements and impact metrics.
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Affiliation(s)
- Lise Sproson
- NIHR, Devices for Dignity MedTech Co-operative, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, Uk
| | - Nathaniel Mills
- NIHR, Devices for Dignity MedTech Co-operative, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, Uk.,NIHR Children and Young People MedTech Co-operative, Sheffield Children's NHS Foundation Trust, Sheffield, UK
| | - Liz Pryde
- NIHR, Devices for Dignity MedTech Co-operative, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, Uk
| | - Ade Adebajo
- NIHR, Devices for Dignity MedTech Co-operative, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, Uk
| | - David Coyle
- NIHR, Devices for Dignity MedTech Co-operative, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, Uk
| | - Jennifer Preston
- NIHR Children and Young People MedTech Co-operative, Sheffield Children's NHS Foundation Trust, Sheffield, UK
| | - Daniel Blackburn
- NIHR, Devices for Dignity MedTech Co-operative, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, Uk.,University of Sheffield, Sheffield, UK
| | | | - Vitaveska Lanfranchi
- NIHR, Devices for Dignity MedTech Co-operative, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, Uk.,University of Sheffield, Sheffield, UK
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46
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Nunes N, Adamo G, Ribeiro M, Nisi V. Modeling adoption, security and privacy of COVID-19 apps: findings and recommendations from an empirical study using UTAUT. JMIR Hum Factors 2022; 9:e35434. [PMID: 35862671 PMCID: PMC9484482 DOI: 10.2196/35434] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 06/25/2022] [Accepted: 07/18/2022] [Indexed: 12/28/2022] Open
Abstract
Background The global health crisis caused by COVID-19 has drastically changed human society in a relatively short time. However, this crisis has offered insights into the different roles that such a worldwide virus plays in the lives of people and how those have been affected, as well as eventually proposing new solutions. From the beginning of the pandemic, technology solutions have featured prominently in virus control and in the frame of reference for international travel, especially contact tracing and passenger locator applications. Objective The objective of this paper is to study specific areas of technology acceptance and adoption following a unified theory of acceptance and use of technology (UTAUT) research model. Methods We presented a research model based on UTAUT constructs to study the determinants for adoption of COVID-19–related apps using a questionnaire. We tested the model via confirmatory factor analysis (CFA) and structural equation modeling (SEM) using travelers’ data from an insular tourist region. Results Our model explained 90.3% of the intention to use (N=9555) and showed an increased understanding of the vital role of safety, security, privacy, and trust in the usage intention of safety apps. Results also showed how the impact of COVID-19 is not a strong predictor of adoption, while age, education level, and social capital are essential moderators of behavioral intention. Conclusions In terms of scientific impact, the results described here provide important insights and contributions not only for researchers but also for policy and decision makers by explaining the reasons behind the adoption and usage of apps designed for COVID-19.
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Affiliation(s)
- Nuno Nunes
- ITI / LARSyS, Instituto Superior Técnico, University of Lisbon, Campus Alameda, Av. Rovisco Pais, Lisbon, PT
| | | | - Miguel Ribeiro
- ITI / LARSyS, Instituto Superior Técnico, University of Lisbon, Campus Alameda, Av. Rovisco Pais, Lisbon, PT
| | - Valentina Nisi
- ITI / LARSyS, Instituto Superior Técnico, University of Lisbon, Campus Alameda, Av. Rovisco Pais, Lisbon, PT
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47
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Experience of a National Cancer Institute-Designated Community Outreach and Engagement Program in Supporting Communities During the COVID-19 Pandemic. J Community Health 2022; 47:862-870. [PMID: 35819548 DOI: 10.1007/s10900-022-01115-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/13/2022] [Indexed: 11/27/2022]
Abstract
Coronavirus disease of 2019 (COVD-19) continues to disrupt cancer care delivery efforts and exacerbate existing health inequities. Here we describe the impact of COVID-19 on community outreach organizations partnering with a National Cancer Institute-designated Community Outreach and Engagement (COE) office in New York City (NYC) and lessons learned from these experiences. Between July and September of 2020, we conducted 16 semi-structured interviews with community key-informants to validate and inform efforts to support community organizations in response to COVID-19. Key-informants represented organizations performing a broad range of health and cancer care activities serving historically underserved, low-income, marginalized communities of color in NYC. All interviews were recorded, transcribed, and analyzed using rapid qualitative approaches. We summarize our response to challenges raised by partnering organizations. Themes included the impact of COVID-19 on communities served, challenges faced by organizations, and solutions to address COVID-19 related challenges. The COE and community organizations had to shift priorities and adapt engagement efforts to address the more urgent needs of the community (e.g., emotional distress, food insecurity). COVID-19 disrupted traditional community engagement activities for cancer outreach-calling for creativity and innovation in the community engagement process and shift in priorities. The COE responded by maintaining ongoing dialogue with community partners, by being flexible in scope/priorities beyond cancer prevention and control, and by providing education, outreach, fundraising and other resources, and developing new partnerships to meet needs of community organizations and the populations they serve.
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48
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Shih P, Hallam L, Clay-Williams R, Carter SM, Brown A. Reimagining consumer involvement: Resilient system indicators in the COVID-19 pandemic response in New South Wales, Australia. Health Expect 2022; 25:1988-2001. [PMID: 35789158 PMCID: PMC9327835 DOI: 10.1111/hex.13556] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 05/02/2022] [Accepted: 05/31/2022] [Indexed: 11/28/2022] Open
Abstract
Background Reflections on the response to the COVID‐19 pandemic often evoke the concept of ‘resilience’ to describe the way health systems adjusted and adapted their functions to withstand the disturbance of a crisis, and in some cases, improve and transform in its wake. Drawing from this, this study focuses on the role of consumer representatives in healthcare services in initiating changes to the way they participated in the pandemic response in the state of New South Wales in Australia. Methods In‐depth interviews were conducted with two cohorts of consumer representatives. Cohort A included experienced and self‐identified consumer leaders, who worked together in a COVID‐19 Consumer Leaders Taskforce; Cohort B included participants outside of this group, and purposively included consumer representatives from rural and regional areas, and culturally and linguistically diverse communities. Results The pause in consumer engagement to support health service decision‐making in responding to the pandemic forced consumer representatives to consider alternative approaches to participate. Some initiated networking with each other, forming new collaborations to produce consumer‐led research and guidelines on pandemic‐related patient care. Others mobilized support from community and politicians to lobby for specific healthcare issues in their local areas. Conclusion The response to the COVID‐19 pandemic made visible the brittle nature of previous engagement processes of involving consumers in organizational design and governance. However, the momentum for proactive self‐organization in an unexpected crisis created space for consumer representatives to reset and reimagine their role as active partners in health services. Their ability to adapt and adjust ways of working are key assets for a resilient health system. Patient or Public Contribution This project is a collaborative study between academic researchers and health consumer (patient and public) representatives. It followed the principles of codesign and coresearch, whereby both consumer representatives and academic researchers contributed equally to all stages of the project. The study was cofunded by both academic institutions and consumer representative organizations.
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Affiliation(s)
- Patti Shih
- Australian Centre for Health Engagement Evidence and Values (ACHEEV), School of Health and Society, University of Wollongong, Wollongong, New South Wales, Australia
| | - Laila Hallam
- Sydney Local Health District, Sydney, New South Wales, Australia.,Centre for Disability Research and Policy (CDRP), The University of Sydney, Sydney, New South Wales, Australia
| | - Robyn Clay-Williams
- Centre for Healthcare Resilience and Implementation Science (CHRIS), Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Stacy M Carter
- Australian Centre for Health Engagement Evidence and Values (ACHEEV), School of Health and Society, University of Wollongong, Wollongong, New South Wales, Australia
| | - Anthony Brown
- Australian Centre for Health Engagement Evidence and Values (ACHEEV), School of Health and Society, University of Wollongong, Wollongong, New South Wales, Australia.,Health Consumers, Sydney, New South Wales, Australia
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49
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Sunder M V, Prashar A. State and citizen responsiveness in fighting a pandemic crisis: A systems thinking perspective. SYSTEMS RESEARCH AND BEHAVIORAL SCIENCE 2022; 40:SRES2849. [PMID: 35941990 PMCID: PMC9348510 DOI: 10.1002/sres.2849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 05/02/2022] [Accepted: 05/06/2022] [Indexed: 06/15/2023]
Abstract
Management scholars have recognized organizational responsiveness among the essential capabilities of social organizations. It becomes essential for a social change to occur during a crisis, where the uncertainty or environmental dynamism is high. However, a social change cannot be successful unless constituent subsystems of a social organization exhibit responsiveness. Using systems theory, we conceptualize 'nation' as a social system and examine its responsiveness towards environmental uncertainly, taking an example of the COVID-19 pandemic. How can state and citizen community responsiveness help fight a pandemic crisis? We test these direct and moderating effects on data representing 14 countries. We perform a hierarchical regression analysis on the restructured, balanced country-wise panel data. Our findings highlight the importance of state and community interaction effects in controlling pandemic growth. Accordingly, we claim that only a collaborative approach by citizen communities with the respective governments will enable handling an uncertain situation.
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50
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Nöstlinger C, Van Landeghem E, Vanhamel J, Rotsaert A, Manirankunda L, Ddungu C, Reyniers T, Katsuva D, Vercruyssen J, Dielen S, Meudec M. COVID-19 as a social disease: qualitative analysis of COVID-19 prevention needs, impact of control measures and community responses among racialized/ethnic minorities in Antwerp, Belgium. Int J Equity Health 2022; 21:67. [PMID: 35578292 PMCID: PMC9108705 DOI: 10.1186/s12939-022-01672-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 04/27/2022] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND In high income countries, racialized/ethnic minorities are disproportionally affected by COVID-19. Despite the established importance of community involvement in epidemic preparedness, we lack in-depth understanding of these communities' experiences with and responses to COVID-19. We explored information and prevention needs, coping mechanisms with COVID-19 control measures and their impact on lived experiences among selected racialized/ethnic minority communities. METHODS This qualitative rapid assessment conducted in Antwerp/Belgium used an interpretative and participatory approach. We included migrant communities with geographic origins ranging from Sub-Saharan Africa, North-Africa to the Middle East, Orthodox Jewish communities and professional community workers. Data were collected between May 2020-May 2021 through key informant-, in-depth interviews and group discussions (N = 71). Transcripts were analyzed inductively, adopting a reflexive thematic approach. A community advisory board provided feedback throughout the research process. RESULTS Participants indicated the need for tailored information in terms of language and timing. At the start of the epidemic, they perceived official public health messages as insufficient to reach all community members. Information sources included non-mainstream (social) media and media from home countries, hampering a nuanced understanding of virus transmission mechanisms and local and national protection measures. Participants felt the measures' most negative impact on their livelihoods (e.g. loss of income, disruption of social and immigration support). Economic insecurity triggered chronic stress and fears at individual and family level. High degrees of distrust in authorities and anticipated stigma were grounded in previously experienced racial and ethnic discrimination. Community-based initiatives mitigated this impact, ranging from disseminating translated and tailored information, providing individual support, and successfully reaching community members with complex needs (e.g. the elderly, digitally illiterate people, those with small social networks or irregular legal status). CONCLUSION Study participants' narratives showed how coping with and responding to COVID-19 was strongly intertwined with socio-economic and ethnic/racial characteristics. This justifies conceptualizing COVID-19 a social disease. At the same time, communities demonstrated resilience in responding to these structural vulnerabilities. From a health equity perspective, we provide concrete policy recommendations grounded in insights into communities' structural vulnerabilities and resilience.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Stef Dielen
- Department of Public Health, Antwerp, Belgium
| | - Marie Meudec
- Department of Public Health, Antwerp, Belgium
- Outbreak Research Team, Institute of Tropical Medicine, Antwerp, Belgium
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