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Avraham R, Simon-Tuval T, Van Dijk D. Determinants of physical activity habit formation: a theory-based qualitative study among young adults. Int J Qual Stud Health Well-being 2024; 19:2341984. [PMID: 38605587 PMCID: PMC11018029 DOI: 10.1080/17482631.2024.2341984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Accepted: 04/08/2024] [Indexed: 04/13/2024] Open
Abstract
PURPOSE Engagement in physical activity significantly contributes to reducing the onset and severity of chronic diseases. Nonetheless, establishing habits around this behaviour remains a persistent challenge. This research endeavours to discern the determinants influencing the formation of physical activity habit among young adults in Israel, drawing upon a socio-ecological model. METHODS A qualitative approach with phenomenological-hermeneutical method was used. In-depth interviews were carried to cover four levels of the socio-ecological model. RESULTS Interviewees were categorized into three subgroups according to their physical activity habit strength: Habitually physically active (n = 8), Variably physically active (n = 11), and physically inactive (n = 6). The content analysis yielded four overarching themes associated with physical activity habit formation. Intrapersonal determinants encompassed personal traits, perceptions and attitudes, perceived benefits, and emotional responses related to physical activity. Interpersonal determinants encompassed social support, modelling support, and peer pressure. Community determinants pertained to social norms, resource availability, and accessibility. Finally, public policy considerations encompassed educational policies as well as workplace policies and cultural influences. CONCLUSIONS This study highlights the unique determinants contributing to the formation of physical activity habit. As intrapersonal and interpersonal factors are significant determinants, interventions should focus on these elements in order to promote this behaviour among young adults.
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Affiliation(s)
- Rinat Avraham
- Department of Nursing, Recanati School of Community Health Professions, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Tzahit Simon-Tuval
- Department of Health Policy and Management, Guilford Glazer Faculty of Business and Management and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Dina Van Dijk
- Department of Health Policy and Management, Guilford Glazer Faculty of Business and Management and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
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Joyce CR, McLoughlin GM, Tripicchio GL, Jones GJ. An implementation evaluation of a sports-based health intervention for underrepresented middle school youth in Philadelphia. Transl Behav Med 2024; 14:588-597. [PMID: 39151026 DOI: 10.1093/tbm/ibae039] [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] [Indexed: 08/18/2024] Open
Abstract
Multicomponent, community-based programs aiming to improve health behaviors in youth are needed but can be challenging to implement. Research is needed to better understand the factors that facilitate and inhibit effective implementation of these programs especially for youth at increased risk of health disparities. This study aimed to identify and explore the implementation determinants and outcomes of a multicomponent health intervention conducted from 2021 to 2022 for middle school students living in underserved communities in Philadelphia, PA, USA. Mixed methods approaches, including self-report surveys and semi-structured qualitative interviews, were administered to 18 members of the implementation staff at the end of the program, including coaches (n = 7), assistant coaches (n = 2), school champions (n = 6), administrative leaders (n = 2), and a school district administrator (n = 1). Survey and interview questions were guided by the Consolidated Framework for Implementation Research (CFIR), and interviews were thematically coded following transcription based on 26 CFIR constructs. Innovation source, evidence strength and quality, cosmopolitanism, and the personal attributes of individuals were key constructs associated with implementation effectiveness. Data revealed three multidimensional themes that highlighted broader challenges influencing implementation: (i) broad consensus, different interpretations, (ii) staffing challenges, and (iii) continuity is key. The need for the program was clearly recognized and overall belief in the purpose of the intervention was strong among key program staff and administration. However, issues including limited engagement with training, staffing turnover, and the rotational programming design hindered implementation. Future projects aiming to implement multicomponent after-school time interventions must ensure a consistent vision among partners and continuity in program delivery.
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Affiliation(s)
- Cara R Joyce
- Department of Social and Behavioral Sciences, Center for Obesity Research and Education, Temple University, Philadelphia, PA, USA
| | - Gabriella M McLoughlin
- Department of Social and Behavioral Sciences, Center for Obesity Research and Education, Temple University, Philadelphia, PA, USA
- Washington University Implementation Science Center for Cancer Control, Brown School, Washington University in St. Louis, St Louis, MO, USA
| | - Gina L Tripicchio
- Department of Social and Behavioral Sciences, Center for Obesity Research and Education, Temple University, Philadelphia, PA, USA
| | - Gareth J Jones
- School of Sport, Tourism, and Hospitality Management, Temple University, Philadelphia, PA, USA
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Amponsah EB, Abdullah A, Eltigani B, Cluver LD. Risk and Protective Factors of Commercial Sexual Exploitation of Children and Adolescents in sub-Saharan Africa: A Systematic Review. TRAUMA, VIOLENCE & ABUSE 2024; 25:3177-3190. [PMID: 38554071 DOI: 10.1177/15248380241241021] [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: 04/01/2024]
Abstract
Commercial sexual exploitation of children (CSEC) has emerged as a critical child protection and public health concern in recent years. While the phenomenon is prevalent globally, its impact is compounded in sub-Saharan Africa owing to the cultural and socioeconomic challenges that leave many households in the region vulnerable. The present study synthesized existing evidence using the socioecological model as a guiding framework to assess the risk and protective factors associated with CSEC in sub-Saharan Africa. A protocol for the study was published in PROSPERO (CRD42022331832) with pre-specified inclusion and exclusion criteria. Studies were screened and extracted from eight databases: PsycINFO, Scopus, Web of Science, PROQUEST (Social Science Premium), PubMed, CINAHL, EMBASE, and MEDLINE via Ovid. After an initial screening of 4,377 papers, seven studies were found eligible for the final review. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guide for reporting systematic reviews. Included studies were appraised and rated using the Cambridge Quality Checklist and GRADE. Findings revealed risk factors, including adverse childhood experience and victimization, females aged 16 years and older, school dropouts, technology influence, child and parental alcohol use, and separation from caregivers. On the other hand, protective factors such as the number of female adolescents in a household, frequent health screening in schools, children being in school, and high parental monitoring were found to be associated with a lower risk of CSEC. Based on these findings, we recommend that interventions in sub-Saharan Africa adopt a holistic approach that addresses identified risk factors while harnessing protective factors to combat CSEC effectively.
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Affiliation(s)
| | | | | | - Lucie D Cluver
- University of Oxford, Oxford, UK
- University of Cape Town, Cape Town, South Africa
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Peral-Suárez Á, Sherar LB, Alosaimi N, Kingsnorth AP, Pearson N. Change in clusters of lifestyle behaviours from childhood to adolescence: a longitudinal analysis. Eur J Pediatr 2024; 183:4507-4518. [PMID: 39145886 DOI: 10.1007/s00431-024-05729-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Revised: 08/07/2024] [Accepted: 08/09/2024] [Indexed: 08/16/2024]
Abstract
This study aimed to identify changes in clusters of lifestyle behaviours (physical activity, screen time and diet) between the ages of 7 and 14 years, and to examine socio-demographic determinants of changes. Longitudinal analyses were performed on a sample of 9339 children from the UK Millennium Cohort Study (MCS) who had complete data on behaviours of interest at age 7 (wave 4) and 14 years (wave 6). Joint Correspondence Analysis (JCA) and k-means cluster analysis were used to identify clusters of lifestyle behaviours at both time waves. Multinomial logistic regressions were used to examine the associations between socio-economic variables and changes in cluster membership. Analyses were conducted separately for boys and girls. Clusters of behaviours at age 7 and 14 years were identified as healthy, mixed or unhealthy respectively. Compared to girls, a higher proportion of boys remained in the healthier cluster over time (19.1% vs. 13.1%) or became healthier (26.4% vs. 9.36%). A higher proportion of girls changed to an unhealthier cluster (57.2% vs. 33.9%). Indicators of lower socio-economic status, such as low family income, low parental education, and not living with both parents at age 7 were associated with unhealthier changes in cluster membership. Conclusion Lifestyle behaviours cluster in children and are susceptible to change over a 7-year period, with a high proportion of boys becoming healthier and a higher proportion of girls became unhealthier. Indicators of socio-economic status appear to be important in determining changes in clusters. What is Known: • Poor lifestyle behaviours (i.e. unhealthy dietary habits, low physical activity, and sedentary behaviours) tend to cluster in children and adolescents. What is New: • Lifestyle behaviours cluster in children and are susceptible to changes between childhood and adolescence. Changes occur differently in boys and girls. Indicators of low socio-economic status are associated with unhealthier changes in behavioural clusters.
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Affiliation(s)
- África Peral-Suárez
- Department of Nutrition and Food Sciences, Universidad Complutense de Madrid, Madrid, Spain.
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.
| | - Lauren B Sherar
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Noura Alosaimi
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Andrew P Kingsnorth
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Natalie Pearson
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
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Ruby E, McDonald SD, Berger H, Melamed N, Li J, Darling EK, Geary M, Barrett J, Murray-Davis B. A Social-Ecological Model Exploring Gestational Diabetes Mellitus Screening Practices Among Antenatal Health Care Providers. HEALTH EDUCATION & BEHAVIOR 2024; 51:748-756. [PMID: 38406976 PMCID: PMC11411845 DOI: 10.1177/10901981241232651] [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] [Indexed: 02/27/2024]
Abstract
Gestational diabetes mellitus (GDM) is associated with adverse health outcomes for the pregnant individual and their baby. Screening approaches for GDM have undergone several iterations, introducing variability in practice among healthcare providers. As such, our study aimed to explore the views of antenatal providers regarding their practices of, and counseling experiences on the topic of, GDM screening in Ontario. We conducted a qualitative, grounded theory study. The study population included antenatal providers (midwives, family physicians, and obstetricians) practicing in Hamilton, Ottawa, or Sudbury, Ontario. Semi-structured telephone interviews were conducted and transcribed verbatim. Transcripts were analyzed using inductive coding upon which codes, categories, and themes were developed to generate a theory grounded in the data. Twenty-two participants were interviewed. Using the social-ecological theory, we created a model outlining four contextual levels that shaped the experiences of GDM counseling and screening: Intrapersonal factors included beliefs, knowledge, and skills; interpersonal factors characterized the patient-provider interactions; organizational strengths and challenges shaped collaboration and health services infrastructure; and finally, guidelines and policies were identified as systemic barriers to health care access and delivery. A focus on patient-centered care was a guiding principle for all care providers and permeated all four levels of the model. Patient-centered care and close attention to barriers and facilitators across intrapersonal, interpersonal, organizational, and policy domains can minimize the impact of variations in GDM screening guidelines. Among care providers, there is a desire for additional skill development related to GDM counseling, and for national consensus on optimal screening guidelines.
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Affiliation(s)
- Emma Ruby
- McMaster University, Hamilton, Ontario, Canada
| | | | | | - Nir Melamed
- University of Toronto, Toronto, Ontario, Canada
| | - Jenifer Li
- McMaster University, Hamilton, Ontario, Canada
| | | | | | - Jon Barrett
- McMaster University, Hamilton, Ontario, Canada
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Martinsen Ånestad R, Andersson Nordbø EC, Ihlebæk C. Revisiting the conceptualization of social sustainability from a health promotion perspective: a scoping review. Scand J Public Health 2024:14034948241277863. [PMID: 39327710 DOI: 10.1177/14034948241277863] [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: 09/28/2024]
Abstract
AIMS Both social sustainability and health promotion emphasize the development of local communities that satisfy human needs and enhance health and well-being. This scoping review aimed to identify frameworks, components, and operationalizations of social sustainability described in peer-reviewed articles and systematize the results from a health promotion perspective. METHODS Six databases were searched for relevant articles following the JBI methodology and PRISMA guidelines. Articles were included if they provided a unique framework for social sustainability, that is, a conceptual model outlining the essential components of this concept. Information concerning the components of social sustainability and their operationalizations was analyzed through a six-step narrative synthesis. The final step involved categorizing the operationalizations of social sustainability into distinct levels by employing a socio-ecological model as an analytical tool. RESULTS This review identified 22 articles presenting a social sustainability framework. The frameworks covered 11 components, of which social equity, safety, and neighborhood quality were the most frequent, while only five included health and well-being. The frameworks commonly provided practical interpretations of the concept with limited theoretical considerations. Furthermore, the identified operationalizations revealed a diverse understanding of social sustainability, encompassing all levels of the socio-ecological model applied. CONCLUSIONS Health promotion research can offer theoretical and empirical insights that enhance the understanding of social sustainability, especially how societal, physical, and social determinants of health and well-being interact to create socially sustainable places. Likewise, the social sustainability literature may provide valuable knowledge underscoring the importance of contextual factors of health and well-being within the field of health promotion.
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Affiliation(s)
| | - Emma Charlott Andersson Nordbø
- Department of Public Health Science, Norwegian University of Life Sciences, Norway
- The Center for Evidence-Based Public Health, Norway
| | - Camilla Ihlebæk
- Department of Public Health Science, Norwegian University of Life Sciences, Norway
- Faculty of Health and Social Work Studies, Østfold University College, Norway
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Hesketh KD, Zheng M, Campbell KJ. Early life factors that affect obesity and the need for complex solutions. Nat Rev Endocrinol 2024:10.1038/s41574-024-01035-2. [PMID: 39313572 DOI: 10.1038/s41574-024-01035-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/27/2024] [Indexed: 09/25/2024]
Abstract
The prevalence of obesity increases with age but is apparent even in early life. Early childhood is a critical period for development that is known to influence future health. Even so, the focus on obesity in this phase, and the factors that affect the development of obesity, has only emerged over the past two decades. Furthermore, there is a paucity of iterative work in this area that would move the field forward. Obesity is a complex condition involving the interplay of multiple influences at different levels: the individual and biological level, the sociocultural level, and the environmental and system levels. This Review provides a brief overview of the evidence for these factors with a focus on aspects specific to early life. By spotlighting the complex web of interactions between the broad range of influences, both causal and risk markers, we highlight the complex nature of the condition. Much work in the early life field remains observational and many of the intervention studies are limited by a focus on single influences and a disjointed approach to solutions. Yet the complexity of obesity necessitates coordinated multi-focused solutions and joined-up action across the first 2,000 days from conception, and beyond.
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Affiliation(s)
- Kylie D Hesketh
- Institute for Physical Activity and Nutrition, Faculty of Health, Deakin University, Geelong, Victoria, Australia.
| | - Miaobing Zheng
- Institute for Physical Activity and Nutrition, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Karen J Campbell
- Institute for Physical Activity and Nutrition, Faculty of Health, Deakin University, Geelong, Victoria, Australia
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Pittalis C, Sackey C, Okeny P, Nandi B, Gajewski J. Surgical informed consent practices and influencing factors in sub-Saharan Africa: a scoping review of the literature. BMJ Qual Saf 2024; 33:653-662. [PMID: 38160058 DOI: 10.1136/bmjqs-2023-016823] [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: 10/12/2023] [Accepted: 12/11/2023] [Indexed: 01/03/2024]
Abstract
INTRODUCTION Current international standards in consent to surgery practices are usually derived from health systems in Western countries, while little attention has been given to other contexts such as sub-Saharan Africa (SSA), despite this region facing the highest burdens of disease amenable to surgery globally. The aim of this study was to examine how the concept of informed consent for surgery is interpreted and applied in the context of SSA, and factors affecting current practices. METHODS A systematic search of Medline, Embase and African Journal OnLine databases as well as grey sources was executed in May 2023 to retrieve relevant literature published since 2010 in English language against a set of given criteria. The socioecological framework for health was used for organising and summarising the identified evidence. RESULTS A total of 27 papers were included in the review. Findings revealed that consent to surgery practices is generally substandard across SSA and the process is not adequate. Patients' understanding of informed consent is limited, likewise awareness of their rights to decision-making. A range of factors at the individual, interpersonal, institutional and system/societal levels affect the informed consent process. CONCLUSION There is a need to find more culturally acceptable and ethical ways to include the participation of patients in the decision-making process for surgical treatment in the SSA and define standards more closely aligned with the local context.
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Affiliation(s)
- Chiara Pittalis
- Institute of Global Surgery, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Cherie Sackey
- Institute of Global Surgery, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Paul Okeny
- Institute of Global Surgery, RCSI University of Medicine and Health Sciences, Dublin, Ireland
- Department of Surgery, Makerere University College of Health Sciences, Kampala, Uganda
| | - Bip Nandi
- Department of Surgery, Kamuzu Central Hospital, Lilongwe, Malawi
- Michael E Debakey Department of Surgery, Baylor College of Medicine, Houston, Texas, USA
| | - Jakub Gajewski
- Institute of Global Surgery, RCSI University of Medicine and Health Sciences, Dublin, Ireland
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Bronas UG, Marquez DX, Fritschi C, Petrarca K, Kitsiou S, Ajilore O, Tintle N. Ecological Momentary Intervention to Replace Sedentary Time With Physical Activity to Improve Executive Function in Midlife and Older Latino Adults: Pilot Randomized Controlled Trial. J Med Internet Res 2024; 26:e55079. [PMID: 39235836 PMCID: PMC11413544 DOI: 10.2196/55079] [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: 12/01/2023] [Revised: 06/07/2024] [Accepted: 06/30/2024] [Indexed: 09/06/2024] Open
Abstract
BACKGROUND Exercise interventions often improve moderate to vigorous physical activity, but simultaneously increase sedentary time due to a compensatory resting response. A higher level of sedentary time is associated with a lower level of executive function, while increased moderate to vigorous physical activity is associated with improved global cognition and working memory among Latino adults. Latino adults are the fastest-growing minority group in the United States and are at high risk for cognitive decline, spend more time sedentary compared to non-Hispanic populations, and engage in low levels of physical activity. Interventions that are culturally appropriate for Latino adults to replace sedentary time with physical activity are critically needed. OBJECTIVE This study aims to develop and test the feasibility and acceptability of an ecological momentary intervention (EMI; delivered in real time) that is individually designed to replace sedentary time with physical activity in Latino adults. METHODS This pilot study randomized 39 (n=26, 67% female; mean age 61, SD 5.8 years) community-dwelling, Spanish-speaking Latino adults (1:1 allocation) to either a 6-week EMI program designed to replace sitting time with physical activity (20/39, 51%) or physical activity guidelines education (19/39, 49%). The program was conducted on the web and in Spanish. The intervention was individualized based on individual interview responses. The intervention included the use of a Fitbit activity monitor, weekly didactic phone meetings, interactive tools (SMS text messages), and coach-delivered feedback. Feasibility and acceptability were assessed via study satisfaction (Likert scales), motivation (ecological momentary assessment), retention, and compliance. Sedentary time and physical activity were assessed via 7-day actigraphy. Cognitive performance was assessed via the trail making test part A and B (part B=executive function) and via the National Institutes of Health Toolbox remote cognitive assessment. Statistical analysis included a linear model on change score from baseline, adjusting for age, sex, and education, emphasizing effect size. RESULTS Participant satisfaction with EMI was high (9.4/10), with a high degree of motivation to replace sitting time with physical activity (9.8/10). The intervention compliance rate was 79% with low difficulty using the Fitbit (1.7/10). Weekly step count increased in the intervention group by 5543 steps (group difference: d=0.54; P=.05) and sedentary time decreased by a mean 348 (SD 485) minutes (group difference: d=0.47; P=.24) compared to controls, with moderately strong effect sizes. The trail making test part B improved in the intervention group (mean -35.26, SD 60.35 seconds), compared to the control group (mean 7.19, SD 46 seconds; group difference: d=0.74; P=.01). No group differences were observed in other cognitive measures. CONCLUSIONS An individualized EMI designed for midlife and older Latino adults has the potential to replace sitting time with physical activity and improve executive functioning. The intervention was feasible and well received with a high degree of satisfaction. TRIAL REGISTRATION ClinicalTrials.gov NCT04507464; https://tinyurl.com/44c4thk5.
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Affiliation(s)
- Ulf G Bronas
- School of Nursing, Columbia University, New York, NY, United States
- Division of Rehabilitation and Regenerative Medicine, Columbia University, New York, NY, United States
| | - David X Marquez
- Department of Biomedical and Health Information Sciences, University of Illinois Chicago, Chicago, IL, United States
| | - Cynthia Fritschi
- College of Nursing, University of Illinois Chicago, Chicago, IL, United States
| | - Katherine Petrarca
- College of Medicine, University of Illinois Chicago, Chicago, IL, United States
| | - Spyros Kitsiou
- Department of Biomedical and Health Information Sciences, University of Illinois Chicago, Chicago, IL, United States
| | - Olu Ajilore
- College of Medicine, University of Illinois Chicago, Chicago, IL, United States
| | - Nathan Tintle
- College of Nursing, University of Illinois Chicago, Chicago, IL, United States
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Khanna A, Govil M, Ayele N, Saadi A. Disparities in Delirium across the Continuum of Care and Associations with Social Determinants of Health. Semin Neurol 2024. [PMID: 39209285 DOI: 10.1055/s-0044-1788976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/04/2024]
Abstract
Disparities exist in the identification, treatment, and management of delirium. These disparities can be most holistically and comprehensively understood by using a social-ecological model-which acknowledges multilevel impacts including individual, interpersonal, organizational, community, and policy-level factors-as well as a social determinant of health framework, that considers nonmedical factors that influence health outcomes. This narrative review leverages both frameworks to identify and discuss existing literature pertaining to the intersection of these social risk factors and delirium, focusing specifically on disparities due to racial and/or ethnic identity, language ability, and socioeconomic differences. We also look at disparities and the potential role of these social risk factors throughout the continuum of care, including prehospitalization, hospitalization, and posthospitalization factors. Understanding and analyzing the role of these inequities is critical to ensuring better health outcomes for patients at risk of and/or with delirium.
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Affiliation(s)
- Anu Khanna
- Chobanian and Avedisian School of Medicine, Boston University, Boston, Massachusetts
| | - Malvika Govil
- Department of Neurology, New York Langone Health, New York University Grossman School of Medicine, New York City, New York
| | - Nohamin Ayele
- Department of Neurology, Northwestern Medicine, Feinberg School of Medicine, Chicago, Illinois
| | - Altaf Saadi
- Department of Neurology, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts
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11
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Prasetyo YA, Thanasilp S, Preechawong S. Adherence to treatment in pulmonary tuberculosis: Rodgers' evolutionary concept analysis. BELITUNG NURSING JOURNAL 2024; 10:368-377. [PMID: 39211465 PMCID: PMC11350354 DOI: 10.33546/bnj.3416] [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: 04/30/2024] [Revised: 05/29/2024] [Accepted: 07/22/2024] [Indexed: 09/04/2024] Open
Abstract
Background Adherence to treatment is essential for the management of pulmonary tuberculosis. Nurses and healthcare professionals play a significant role in promoting adherence behavior among this population. Nevertheless, defining adherence to treatment within this particular population remains complex. Objective This study aimed to explore and clarify the concept of adherence to treatment among individuals with pulmonary tuberculosis. Methods Rodgers' evolutionary concept analysis was employed in this study. A literature search was conducted in the PubMed and Scopus databases to identify relevant studies published between July 2013 and July 2023. Results The attributes of adherence to treatment in pulmonary tuberculosis consist of multiple components: biological, individual, social, health service, and policy-making processes. Antecedents include various patient-related factors as well as factors associated with clinical conditions and patient-health professional engagement. Three consequences of the concept have emerged: enhanced treatment efficacy, increased commitment to tuberculosis treatment adherence, and improved health service quality. Conclusion This study provides a comprehensive operational definition of adherence to tuberculosis treatment, including its attributes, antecedents, and consequences. This framework will assist nurses in evaluating adherence more effectively. However, further research into the experiences of individuals adhering to tuberculosis treatment is needed to confirm and enhance these strategies.
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Affiliation(s)
| | - Sureeporn Thanasilp
- Faculty of Nursing, Chulalongkorn University, Bangkok, Thailand
- Asian Wisdom Care Research Unit, Chulalongkorn University, Bangkok, Thailand
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Al-Juhaishi M, Lim CX, Chan V, Stupans I, Thrimawithana TR. Exploring Experiences and Asthma Management Among Middle Eastern Arabic-Speaking Migrants and Refugees with Asthma: A Qualitative Study. Patient Prefer Adherence 2024; 18:1789-1801. [PMID: 39220106 PMCID: PMC11365489 DOI: 10.2147/ppa.s471347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2024] [Accepted: 08/03/2024] [Indexed: 09/04/2024] Open
Abstract
Purpose Effective asthma management relies on individuals' knowledge, inhaler technique, and perceptions of asthma and medications. Investigating barriers and enablers to optimal asthma management is vital. This research pursues a comprehensive understanding of asthma control, asthma-related experiences, perceptions, inhaler technique, and knowledge among Arabic-speaking Middle Eastern migrants and refugees living in Australia. Furthermore, it aims to explore the factors influencing optimal asthma management within this demographic. Patients and Methods This study involved interviews with 17 participants, with nine identified as migrants and eight as refugees. All participants were Arabic-speaking Middle Eastern individuals residing in Australia and diagnosed with asthma. Interviews were thematically analysed, and findings were presented following the guidelines of the consolidated criteria for reporting qualitative research (COREQ). Results The thematic analysis yielded five key themes: (1) asthma experiences; (2) participant perspectives on asthma; (3) asthma management; (4) asthma health literacy; and (5) strategies to overcome obstacles in asthma management. Some disparities were noted between refugees and migrants in terms of their comprehension and views on asthma, medications use, interactions with healthcare providers, and inhaler technique. Refugees experienced more psychological distress and lacked social support, while migrants were more concerned about long-term medication use and preferred specialised care. Conclusion This research addresses a knowledge gap concerning asthma control among Middle Eastern immigrants. It provides insights into their beliefs and medication adherence. It underscores the importance of considering the unique characteristics of Middle Eastern migrants and refugees when delivering healthcare interventions to enhance overall health and medication adherence within these populations. To address these differences, the study recommends tailored education, specialised clinics, and culturally relevant asthma management plans to enhance self-management support for both groups. Future studies should explore the impact of modifying beliefs, attitudes, and knowledge regarding medications and asthma to enhance asthma management within this population.
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Affiliation(s)
- Malath Al-Juhaishi
- Discipline of Pharmacy, School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC, 3083, Australia
| | - Chiao Xin Lim
- Discipline of Pharmacy, School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC, 3083, Australia
- Department of Medicine, School of Clinical Sciences, Monash University, Clayton, VIC, 3168, Australia
| | - Vincent Chan
- Discipline of Pharmacy, School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC, 3083, Australia
| | - Ieva Stupans
- Discipline of Pharmacy, School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC, 3083, Australia
| | - Thilini R Thrimawithana
- Discipline of Pharmacy, School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC, 3083, Australia
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Tay HC, Rezaei N, Hoover AG, Pennell KG. Social ecological system framework as a decision-making tool for risk mitigation: A superfund site case study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 939:173595. [PMID: 38810738 PMCID: PMC11224932 DOI: 10.1016/j.scitotenv.2024.173595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 05/24/2024] [Accepted: 05/26/2024] [Indexed: 05/31/2024]
Abstract
Several studies have reported vapor intrusion (VI) occurring when volatile organic compound (VOC) vapors are transported through subsurface piping systems into building spaces (e.g. conduit VI). Site-specific risk assessment and risk management practices are complicated and evolving for conduit VI, especially at large hazardous waste sites, like Superfund sites, where many stakeholders are involved and have varied interests. Here, we propose a social ecological system (SES) framework as a decision-making tool to inform risk mitigation decisions. We demonstrate the SES framework using field data associated with a Superfund site near San Francisco, California. We evaluate sewer invert elevation and groundwater elevation data, as well as pre- and post- mitigation VOC concentration data within a sewer system. Unexpectedly, the sewer located above the groundwater table was determined to be a potential source of conduit VI risks. The SES framework describes how typical stakeholders associated with the site can affect and be affected by mitigation activities. It informs decisions about mitigation implementation and long-term operation efficacy by considering stakeholder roles and interests. Ultimately, gas siphons were selected as the mitigation technology for the example site. To date, approximately 6 gas siphons have been installed to mitigate conduit VI risks throughout the community. Collectively, our findings advance risk management decisions and highlight key considerations for risk mitigation approaches at hazardous waste sites, including Superfund sites, especially where VI risks are a concern.
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Affiliation(s)
- Hong Cheng Tay
- University of Kentucky, Department of Civil Engineering, Lexington, KY 40506, United States of America; University of Kentucky Superfund Research Center (UKSRC), Lexington, KY 40506, United States of America
| | - Nader Rezaei
- University of Kentucky, Department of Civil Engineering, Lexington, KY 40506, United States of America; University of Kentucky Superfund Research Center (UKSRC), Lexington, KY 40506, United States of America; University of California, Department of Civil and Environmental Engineering, Irvine, CA 92697, United States of America
| | - Anna G Hoover
- University of Kentucky Superfund Research Center (UKSRC), Lexington, KY 40506, United States of America; University of Kentucky, Department of Epidemiology & Environmental Health, Lexington, KY 40506, United States of America
| | - Kelly G Pennell
- University of Kentucky, Department of Civil Engineering, Lexington, KY 40506, United States of America; University of Kentucky Superfund Research Center (UKSRC), Lexington, KY 40506, United States of America.
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Tew GA, Peckham E, Ker S, Smith J, Hodgson P, Machaczek KK, Faires M. Physical activity in adult users of inpatient mental health services: A scoping review. PLoS One 2024; 19:e0301857. [PMID: 39159166 PMCID: PMC11332955 DOI: 10.1371/journal.pone.0301857] [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: 11/04/2023] [Accepted: 03/22/2024] [Indexed: 08/21/2024] Open
Abstract
People with severe mental illness engage in considerably less physical activity than those without. They also experience premature mortality of around 10-25 years. A large proportion of these premature deaths are attributed to modifiable behaviours, including physical activity. The inpatient environment provides an opportunity to support people to become more physically active; however, there is limited evidence on which interventions are most successful and what contextual factors affect their delivery. A scoping review was conducted to help understand the extent and type of evidence in this area and identify research gaps. We included studies of physical activity correlates and interventions in adult inpatient mental health services published in peer-reviewed journals. Reviews, meta-analyses, and papers focusing on eating disorder populations were excluded. We searched the MEDLINE, CINAHL, PsycINFO, ASSIA and Web of Science databases for relevant studies published in English. We extracted data on study design, participant characteristics, intervention and control conditions, key findings, and research recommendations. We used a descriptive analytical approach and results are presented in tables and figures. Of 27,286 unique records screened, 210 reports from 182 studies were included. Sixty-one studies reported on correlates of physical activity, and 139 studies reported on physical activity interventions. Most intervention studies used a single-group, pre-post design (40%) and included fewer than 100 participants (86%). Ninety percent of interventions delivered physical activity directly to participants, and 50% included group-based sessions. The duration, type, frequency and intensity of sessions varied. Mental health was the most commonly reported outcome (64%), whereas physical activity was rarely an outcome (13%). Overall, there is a modest but growing body of research on physical activity in adult users of inpatient mental health services. More high-quality trials are needed to advance the field, and future research should target neglected intervention types, outcomes, populations and settings.
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Affiliation(s)
- Garry A. Tew
- Institute for Health and Care Improvement, York St John University, York, United Kingdom
| | - Emily Peckham
- School of Medical and Health Sciences, Bangor University, Bangor, United Kingdom
| | - Suzy Ker
- Tees Esk and Wear Valleys NHS Foundation Trust, Darlington, United Kingdom
| | - Jo Smith
- Tees Esk and Wear Valleys NHS Foundation Trust, Darlington, United Kingdom
| | - Philip Hodgson
- Institute for Health and Care Improvement, York St John University, York, United Kingdom
- Tees Esk and Wear Valleys NHS Foundation Trust, Darlington, United Kingdom
| | - Katarzyna K. Machaczek
- College of Health, Wellbeing and Life Sciences, Sheffield Hallam University, Sheffield, United Kingdom
| | - Matthew Faires
- Institute for Health and Care Improvement, York St John University, York, United Kingdom
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Umstattd Meyer MR, Houghtaling B, Wende ME, Kheshaifaty KH, Delgado H, Eze SA, Mecate C, Summerall Woodward R, Morgan RL, Krey KJ. A scoping review of policies to encourage breastfeeding, healthy eating, and physical activity among rural people and places in the United States. BMC Public Health 2024; 24:2160. [PMID: 39123168 PMCID: PMC11313091 DOI: 10.1186/s12889-024-19173-7] [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: 12/29/2023] [Accepted: 06/17/2024] [Indexed: 08/12/2024] Open
Abstract
BACKGROUND Rural U.S. residents experience a disproportionate burden of diet and physical activity (PA) related chronic disease compared to urban residents, due to resource and economic challenges. Diverse policy approaches for chronic disease prevention have been implemented to address barriers to breastfeeding, healthy eating, and PA. Therefore, the purpose of this paper is to describe policy supports for breastfeeding, healthy eating, and/or PA occurring in rural U.S. areas. METHODS A scoping review was conducted March-June 2020 to identify policy, systems, and environment change approaches occurring in the rural U.S. for breastfeeding, healthy eating, and PA. Search procedures were guided by the PRISMA-ScR, Arksey and O'Malley's work (2007), and a science librarian. Medline, PubMed, Web of Science, and Agricola were used to identify peer-reviewed research. ProQuest Dissertations and Theses A&I were used to identify dissertation research. Grey literature searches included Google, Google Scholar, government pages, and public health, federal nutrition assistance program, Cooperative Extension Services, and related webpages. Policy results are reported and inclusion criteria were: (1) breastfeeding, healthy eating, and/or PA focus; (2) about policy factors; (3) specific to U.S. rural populations/places; and (4) English language. Outcomes (study/source design, objective(s), methods/measurement, setting, population characteristics, behavioral focus, policy-specific results) were extracted into a standardized Excel document. RESULTS Results include 122 total sources: original research, with some sources referencing multiple behaviors, (n = 74 sources: 8 breastfeeding, 41 healthy eating, 42 PA), grey literature (n = 45 sources: 16 breastfeeding, 15 healthy eating, 27 PA), and graduate research (n = 3 sources: 1 breastfeeding, 2 healthy eating, 1 PA). Breastfeeding policy initiatives included policies or programs at hospitals, increasing access to resources, and improving culture or norms at workplaces. Healthy eating policy initiatives included increasing access to healthy foods, reducing financial burden, implementing programs, food assistance programs, and healthy food prescriptions at healthcare facilities. PA policy initiatives focused on Complete Streets, joint or shared use efforts, Safe Routes to Schools, master plans for greenways, trails, and/or transportation, school health plans, and childcare/school standards. CONCLUSIONS Results from this scoping review compile and offer commentary on existing policy solutions to improve breastfeeding, healthy eating, and/or PA in the rural U.S.
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Affiliation(s)
- M Renée Umstattd Meyer
- Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, TX, USA.
| | | | - Marilyn E Wende
- Department of Health Education and Behavior, College of Health and Human Performance University of Florida, Gainesville, FL, USA
| | - Khawlah H Kheshaifaty
- School of Nutrition and Food Science, Louisiana State University Agricultural Center, Louisiana State University, Baton Rouge, LA, USA
| | - Haley Delgado
- Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, TX, USA
| | - Stephanie A Eze
- Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, TX, USA
| | - Cassady Mecate
- Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, TX, USA
| | - Rebekah Summerall Woodward
- Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, TX, USA
| | | | - Kathy J Krey
- School of Education, Baylor University, Waco, TX, USA
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Hodwitz K, Wigle J, Juando-Prats C, Allan K, Li X, Fallon B, Birken CS, Maguire JL, Parsons JA. Physicians' perspectives on COVID-19 vaccinations for children: a qualitative exploration in Ontario, Canada. BMJ Open 2024; 14:e081694. [PMID: 39025822 PMCID: PMC11288156 DOI: 10.1136/bmjopen-2023-081694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 06/27/2024] [Indexed: 07/20/2024] Open
Abstract
OBJECTIVES Parents' decisions to vaccinate their children against COVID-19 are complex and often informed by discussions with primary care physicians. However, little is known about physicians' perspectives on COVID-19 vaccinations for children or their experiences counselling parents in their decision-making. We explored physicians' experiences providing COVID-19 vaccination recommendations to parents and their reflections on the contextual factors that shaped these experiences. DESIGN We conducted an interpretive qualitative study using in-depth interviews. We analyzed the data using reflexive thematic analysis and a socioecological framework. SETTING This study involved primary care practices associated with The Applied Research Group for Kids (TARGet Kids!) primary care research network in the Greater Toronto Area, Ontario, Canada. PARTICIPANTS Participants were 10 primary care physicians, including family physicians, paediatricians and paediatric subspecialists. RESULTS Participants discussed elements at the individual level (their identity, role, and knowledge), the interpersonal level (their relationships with families, responsiveness to parents' concerns, and efforts to build trust) and structural level (contextual factors related to the evolving COVID-19 climate, health system pandemic response, and constraints on care delivery) that influenced their experiences providing recommendations to parents. Our findings illustrated that physicians' interactions with families were shaped by a confluence of their own perspectives, their responses to parents' perspectives, and the evolving landscape of the broader pandemic. CONCLUSIONS Our study underscores the social and relational nature of vaccination decision-making and highlights the multiple influences on primary care physicians' experiences providing COVID-19 vaccination recommendations to parents. Our findings offer suggestions for future COVID-19 vaccination programmes for children. Delivery of new COVID-19 vaccinations for children may be well suited within primary care offices, where trusting relationships are established, but physicians need support in staying knowledgeable about emerging information, communicating available evidence to parents to inform their decision-making and dedicating time for vaccination counselling.
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Affiliation(s)
- Kathryn Hodwitz
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Jannah Wigle
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Clara Juando-Prats
- 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
| | - Kate Allan
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Xuedi Li
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Barbara Fallon
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Catherine S. Birken
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Pediatrics, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Jonathon L. Maguire
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
- Department of Pediatrics, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Janet A. Parsons
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
- Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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Park MH, Song HY. Transtheoretical model to predict the stages of changes in smoking cessation behavior among adolescents. Front Public Health 2024; 12:1399478. [PMID: 39081357 PMCID: PMC11286591 DOI: 10.3389/fpubh.2024.1399478] [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: 03/15/2024] [Accepted: 06/24/2024] [Indexed: 08/02/2024] Open
Abstract
Introduction Previous studies on adolescent smoking cessation behavior based on the transtheoretical model have primarily focused on the development of cessation programs. Attempting to quit smoking is a prerequisite for executing smoking cessation. Appropriate methods must be selected based on the characteristics and intentions of individuals to increase smokers' satisfaction and success rates in quitting. Therefore, this study aimed to identify changing processes influencing the stages of change associated with successful smoking cessation among adolescents and examined the related factors. This descriptive study explored a transtheoretical model of different stages of changes in smoking cessation behavior among adolescent smokers. Methods The participants included 237 middle and high school students in South Korea. We examined the differences in stages of changes in smoking cessation behaviors based on general characteristics, smoking-related characteristics, smoking cessation change processes (cognitive and behavioral), smoking decisional balance (pros and cons of smoking), and self-efficacy. Results The probability of reaching the preparation stage of smoking cessation was significantly lower among participants who did not know their father's educational level than among those who knew their father's educational level. Conversely, this probability was significantly higher among participants whose mothers had a college or higher education level and those who did not know their mother's educational level than in those whose mothers had a high school or lower education level. Conclusion These findings indicated that parental education is a significant predictor of the preparation stage of smoking cessation, highlighting the importance of the family environment in facilitating smoking cessation among adolescents. Accordingly, communication and support at home could help reinforce adolescents' determination to quit smoking and make relevant plans. Thus, smoking cessation support should stress the need to enhance communication at home.
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Affiliation(s)
- Min Hee Park
- Department of Nursing, Wonkwang University, Iksan, Republic of Korea
| | - Hye-Young Song
- College of Nursing, Woosuk University, Jeonju, Republic of Korea
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Love B, Ghosh C, Oestman K, Aquino M, Coffman R, Shah M, Dermid G, Rechis R. Understanding the impact of community-based sun safety interventions on a college campus in Texas. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024:1-8. [PMID: 38995616 DOI: 10.1080/07448481.2024.2367989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 06/09/2024] [Indexed: 07/13/2024]
Abstract
Objective: Examine the impact of a community-based, multi-component sun intervention on the campus of Lee College in Baytown, Texas. Participants: 735 respondents completed the survey as part of a range of campus topics. Methods: Survey data on the program were gathered through an emailed campus-wide survey to better understand the community's perceptions and awareness as well as campaign effectiveness over time. Results: Sun safety self-efficacy and awareness of the importance of sun safety behaviors were high in the community. Students reported a lower level of sun safety self-efficacy than employees. Open-ended responses also offered insight into complex views some community members hold about sun-safety behavior, raising questions about the effectiveness of sunscreen and the need for vitamin D. Conclusions: The paper found high awareness of sun-safe behaviors, high self-efficacy in taking personal action, and appreciation for the institutional effort to care for the community.
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Affiliation(s)
- Brad Love
- Stan Richards School of Advertising and Public Relations, The University of Texas at Austin, Austin, Texas, USA
| | - Charulata Ghosh
- Center for Health Communication, The University of Texas at Austin, Austin, Texas, USA
| | - Katherine Oestman
- Cancer Prevention and Control Platform, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Mayra Aquino
- Be Well Communities Team, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | | | - Mansi Shah
- Stan Richards School of Advertising and Public Relations, The University of Texas at Austin, Austin, Texas, USA
| | - Gerold Dermid
- Stan Richards School of Advertising and Public Relations, The University of Texas at Austin, Austin, Texas, USA
| | - Ruth Rechis
- Cancer Prevention and Control Platform, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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Moucheraud C, Wollum A, Awan MA, Dow WH, Friedman W, Koulidiati JL, Sabasaba A, Shah M, Wagner Z. A multi-component intervention to reduce bias during family planning visits: qualitative insights on implementation from Burkina Faso, Pakistan and Tanzania. Contracept Reprod Med 2024; 9:34. [PMID: 38978108 PMCID: PMC11232190 DOI: 10.1186/s40834-024-00296-6] [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: 04/19/2024] [Accepted: 06/27/2024] [Indexed: 07/10/2024] Open
Abstract
Beyond Bias was an intervention introduced in Burkina Faso, Pakistan and Tanzania, with the aim of reducing health worker bias toward young, unmarried and nulliparous women seeking family planning services. This study used qualitative methods - based on interviews with health workers who participated in the intervention, managers at health facilities that participated in the intervention, and policy and program stakeholders at the national level - to understand implementation experiences with the intervention. The results offer insights for organizations or countries seeking to implement Beyond Bias or similar programs, and point to some other key implementation challenges for multi-component interventions in lower-resource settings. The intervention, developed using a human-centered design approach, was seen as key for successful implementation but there were logistical challenges. The digital intervention was disruptive and distracting to many. In addition, the non-financial rewards intervention was perceived as complex, and some participants expressed feeling discouraged when they did not receive a reward. Beyond Bias did not sufficiently attend to the "outer setting," and this was perceived as a major implementation barrier as it limited individuals' capacity to fully achieve the desired behavior change; for example, space constraints meant that some health facilities could not ensure private services for all clients. There were scalability concerns related to cost, and there is uncertainty whether diversity of contexts (within and across countries) might constrain implementation of Beyond Bias at scale.
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Affiliation(s)
- Corrina Moucheraud
- Department of Public Health Policy and Management, New York University School of Global Public Health, New York, NY, USA.
| | - Alexandra Wollum
- Department of Community Health Sciences, University of California Los Angeles Fielding School of Public Health, Los Angeles, CA, USA
| | - Muhammad Ali Awan
- APPNA Institute of Public Health, Jinnah Sindh Medical University, Karachi, Pakistan
| | - William H Dow
- Department of Health Policy and Management, University of California Berkeley School of Public Health, Berkeley, CA, USA
| | - Willa Friedman
- Department of Economics, University of Houston, Houston, TX, USA
| | - Jean-Louis Koulidiati
- Institut Supérieur des Sciences de la Santé, Université Nazi Boni, Bobo‑Dioulasso, Burkina Faso
| | - Amon Sabasaba
- Health for A Prosperous Nation (H-PON), Dar es salaam, Tanzania
| | - Manisha Shah
- University of California Berkeley Goldman School of Public Policy, Berkeley, CA, USA
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Leung E, Yazdi H, Drayton M, Davis D, Middleton D, Senter L. Building the African American/Black Community's Capacity to Elucidate Factors for High Smoking Rates in Jackson, MS: Results from Implementing a Community-Led Needs Assessment. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-02066-1. [PMID: 38969927 DOI: 10.1007/s40615-024-02066-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 06/14/2024] [Accepted: 06/18/2024] [Indexed: 07/07/2024]
Abstract
INTRODUCTION Although smoking has decreased dramatically over the last 50 years, reductions are uneven by race and income, specifically in the Southern United States. There is a need for intentional collaboration with communities located where large tobacco disparities exist to make lasting change. Using community-based participatory research principles, we provided intensive capacity building to a community advisory group (CAG) of 14 Jackson, MS, residents to conduct a community-led needs assessment. The aim of the community-led needs assessment was to investigate firsthand why the community smokes and the impacts of smoking-giving the CAG voice and choice to work towards reducing tobacco-related harms and inequities. METHODS From October 2020 to September 2021, CAG members conducted thirteen interviews and nine focus groups, reaching 54 residents. We analyzed the data using a thematic and in vivo approach. RESULTS Participants reported smoking is used to cope with systemic socio-economic issues (e.g., racism, poverty). Smoking is normalized in the community through continued use, ease of purchase, visibility of tobacco retailers, and lack of conversations or questioning surrounding smoking. Participants felt that peer and family use, addiction, and inaccessible smoking resources were the most influential factors driving smoking behaviors. CONCLUSION This community engagement approach empowered residents to design and implement a comprehensive needs assessment resulting in rich data-a needed approach for a community experiencing enduring health inequities. Communities need to be engaged and invested in from the beginning as equal partners to learn, investigate, and develop community-relevant and innovative solutions to address tobacco social norms.
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Affiliation(s)
- Emily Leung
- CAI (Cicatelli Associates Inc.), 505 Eighth Ave., Suite 1900, New York, NY, 10018, USA.
| | - Hanaan Yazdi
- CAI (Cicatelli Associates Inc.), 505 Eighth Ave., Suite 1900, New York, NY, 10018, USA
| | - Maisha Drayton
- CAI (Cicatelli Associates Inc.), 505 Eighth Ave., Suite 1900, New York, NY, 10018, USA
| | - David Davis
- CAI (Cicatelli Associates Inc.), 505 Eighth Ave., Suite 1900, New York, NY, 10018, USA
| | - Dawn Middleton
- CAI (Cicatelli Associates Inc.), 505 Eighth Ave., Suite 1900, New York, NY, 10018, USA
| | - Lindsay Senter
- CAI (Cicatelli Associates Inc.), 505 Eighth Ave., Suite 1900, New York, NY, 10018, USA
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Batool S, Hansen EE, Sethi RKV, Rettig EM, Goguen LA, Annino DJ, Uppaluri R, Edwards HA, Faden DL, Schnipper JL, Dohan D, Reich AJ, Bergmark RW. Perspectives on Referral Pathways for Timely Head and Neck Cancer Care. JAMA Otolaryngol Head Neck Surg 2024; 150:545-554. [PMID: 38753343 PMCID: PMC11099838 DOI: 10.1001/jamaoto.2024.0917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 03/22/2024] [Indexed: 05/19/2024]
Abstract
Importance Timely diagnosis and treatment are of paramount importance for patients with head and neck cancer (HNC) because delays are associated with reduced survival rates and increased recurrence risk. Prompt referral to HNC specialists is crucial for the timeliness of care, yet the factors that affect the referral and triage pathway remain relatively unexplored. Therefore, to identify barriers and facilitators of timely care, it is important to understand the complex journey that patients undertake from the onset of HNC symptoms to referral for diagnosis and treatment. Objective To investigate the referral and triage process for patients with HNC and identify barriers to and facilitators of care from the perspectives of patients and health care workers. Design, Participants, and Setting This was a qualitative study using semistructured interviews of patients with HNC and health care workers who care for them. Participants were recruited from June 2022 to July 2023 from HNC clinics at 2 tertiary care academic medical centers in Boston, Massachusetts. Data were analyzed from July 2022 to December 2023. Main Outcomes and Measures Themes identified from the perspectives of both patients and health care workers on factors that hinder or facilitate the HNC referral and triage process. Results In total, 72 participants were interviewed including 42 patients with HNC (median [range] age, 60.5 [19.0-81.0] years; 27 [64%] females) and 30 health care workers (median [range] age, 38.5 [20.0-68.0] years; 23 [77%] females). Using thematic analysis, 4 major themes were identified: the HNC referral and triage pathway is fragmented; primary and dental care are critical for timely referrals; efficient interclinician coordination expedites care; and consistent patient-practitioner engagement alleviates patient fear. Conclusions and Relevance These findings describe the complex HNC referral and triage pathway, emphasizing the critical role of initial symptom recognition, primary and dental care, patient information flow, and interclinician and patient-practitioner communication, all of which facilitate prompt HNC referrals.
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Affiliation(s)
- Sana Batool
- Department of Surgery, Center for Surgery and Public Health, Brigham and Women’s Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - Elisabeth E. Hansen
- Department of Otolaryngology–Head and Neck Surgery, Harvard Medical School and Massachusetts Eye and Ear, Boston
| | - Rosh K. V. Sethi
- Department of Surgery, Center for Surgery and Public Health, Brigham and Women’s Hospital, Boston, Massachusetts
- Department of Otolaryngology–Head and Neck Surgery, Harvard Medical School, Boston, Massachusetts
- Division of Otolaryngology–Head and Neck Surgery, Brigham and Women’s Hospital, Boston, Massachusetts
- Center for Head and Neck Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Eleni M. Rettig
- Department of Surgery, Center for Surgery and Public Health, Brigham and Women’s Hospital, Boston, Massachusetts
- Department of Otolaryngology–Head and Neck Surgery, Harvard Medical School, Boston, Massachusetts
- Division of Otolaryngology–Head and Neck Surgery, Brigham and Women’s Hospital, Boston, Massachusetts
- Center for Head and Neck Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Laura A. Goguen
- Department of Otolaryngology–Head and Neck Surgery, Harvard Medical School, Boston, Massachusetts
- Division of Otolaryngology–Head and Neck Surgery, Brigham and Women’s Hospital, Boston, Massachusetts
- Center for Head and Neck Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Donald J. Annino
- Department of Otolaryngology–Head and Neck Surgery, Harvard Medical School, Boston, Massachusetts
- Division of Otolaryngology–Head and Neck Surgery, Brigham and Women’s Hospital, Boston, Massachusetts
- Center for Head and Neck Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Ravindra Uppaluri
- Department of Otolaryngology–Head and Neck Surgery, Harvard Medical School, Boston, Massachusetts
- Division of Otolaryngology–Head and Neck Surgery, Brigham and Women’s Hospital, Boston, Massachusetts
- Center for Head and Neck Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Heather A. Edwards
- Department of Otolaryngology, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts
| | - Daniel L. Faden
- Department of Otolaryngology–Head and Neck Surgery, Harvard Medical School and Massachusetts Eye and Ear, Boston
- Department of Otolaryngology, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts
| | - Jeffrey L. Schnipper
- Hospital Medicine Unit and Division of General Internal Medicine and Primary Care, Brigham and Women’s Hospital, Boston, Massachusetts
- Department of Medicine, Harvard Medical School, Boston, Massachusetts
| | - Daniel Dohan
- Department of Surgery, Center for Surgery and Public Health, Brigham and Women’s Hospital, Boston, Massachusetts
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco
| | - Amanda J. Reich
- Department of Surgery, Center for Surgery and Public Health, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Regan W. Bergmark
- Department of Surgery, Center for Surgery and Public Health, Brigham and Women’s Hospital, Boston, Massachusetts
- Department of Otolaryngology–Head and Neck Surgery, Harvard Medical School and Massachusetts Eye and Ear, Boston
- Department of Otolaryngology–Head and Neck Surgery, Harvard Medical School, Boston, Massachusetts
- Division of Otolaryngology–Head and Neck Surgery, Brigham and Women’s Hospital, Boston, Massachusetts
- Center for Head and Neck Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
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Zapf AJ, Schuh HB, Dudley MZ, Rimal RN, Harvey SA, Shaw J, Balgobin K, Salmon DA. Knowledge, attitudes, and intentions regarding COVID-19 vaccination in the general population and the effect of different framing messages for a brief video on intentions to get vaccinated among unvaccinated individuals in the United States during July 2021. PATIENT EDUCATION AND COUNSELING 2024; 124:108258. [PMID: 38608538 DOI: 10.1016/j.pec.2024.108258] [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: 02/08/2023] [Revised: 02/26/2024] [Accepted: 03/19/2024] [Indexed: 04/14/2024]
Abstract
OBJECTIVE To identify knowledge, attitudes, and beliefs (KABs) associated with COVID-19 vaccination intentions and assess the impact of vaccine-promoting messages on vaccination intentions. METHODS Our nationally representative survey measured KABs of COVID-19 vaccination and incorporated a randomized experiment to assess the impact of different framing messages for a video encouraging vaccination intentions among unvaccinated adults in the US. Multivariable multinomial logistic regression models were fitted to investigate the relationships of KABs, trust in public health authorities (PHAs), and vaccine confidence with vaccination intentions. Difference-in-difference estimation was conducted to assess the impact of framing messages for a video on unvaccinated individuals' vaccination intentions. RESULTS We observed that people with increasingly favorable vaccine KABs, trust in PHAs, and vaccine confidence were more likely to be vaccinated or intend to get vaccinated against COVID-19. Difference-in-difference estimates indicated a positive impact of exposure to the video on vaccination intentions while framing messages in some cases appeared to lower vaccination intentions. Associations between the video and vaccination intentions were more pronounced among Black/African American and Hispanic/Latinx populations and Democrats; however, associations did not vary by trust in PHAs or vaccine confidence. CONCLUSION Videos that encourage people to get vaccinated may provide an efficient approach to nudge vaccine-hesitant individuals towards getting vaccinated. However, framing messages may negatively impact vaccination intentions and need to be developed carefully. PRACTICE IMPLICATIONS This study provides solid experimental evidence for the importance of tailoring message framing to the characteristics and experience of the audience, while cautioning potential negative impacts of framing that does not match its intended audience. Our findings are applicable to health communication strategies on the population level, such as mass media campaigns, and the use of framing for messages to encourage vaccination but may also be informative for healthcare professionals consulting hesitant individuals about COVID-19 vaccinations.
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Affiliation(s)
- Alexander J Zapf
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Holly B Schuh
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Institute for Vaccine Safety, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Matthew Z Dudley
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Institute for Vaccine Safety, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Rajiv N Rimal
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Steven A Harvey
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jana Shaw
- Department of Pediatrics, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Kristian Balgobin
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Daniel A Salmon
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Institute for Vaccine Safety, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
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Iglesia EGA, Fleischer DM, Abrams EM. Health Promotion of Early and Sustained Allergenic Food Introduction for the Prevention of Food Allergy. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2024; 12:1670-1683.e9. [PMID: 38796104 DOI: 10.1016/j.jaip.2024.05.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 05/20/2024] [Accepted: 05/20/2024] [Indexed: 05/28/2024]
Abstract
Observational studies and landmark randomized control trials support early and sustained allergenic food introduction in infancy as an effective preventive strategy against food allergy development. Despite a consensus regarding the intended goals of early and sustained allergenic food introduction, there have been myriad policy recommendations among health authorities in how to achieve both individual and population-level health outcomes for food allergy prevention. This clinical management review provides an overview on the data that informs early and sustained allergenic food introduction strategies, suggestions on how to advise allergenic food introduction, principles of prevention programs as they relate to food allergy prevention, and health promotion and systems-level challenges that impede achievement of food allergy prevention goals.
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Affiliation(s)
- Edward G A Iglesia
- Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tenn
| | - David M Fleischer
- Section of Allergy and Immunology, Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colo
| | - Elissa M Abrams
- Section of Allergy and Immunology, Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
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de Lisser R, Lauderdale J, Dietrich MS, Ramanujam R, Stolldorf DP. The Social Ecology of Burnout: A framework for research on nurse practitioner burnout. Nurs Outlook 2024; 72:102188. [PMID: 38788272 DOI: 10.1016/j.outlook.2024.102188] [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: 10/06/2023] [Revised: 03/08/2024] [Accepted: 04/27/2024] [Indexed: 05/26/2024]
Abstract
BACKGROUND The U.S. health system is burdened by rising costs, workforce shortages, and unremitting burnout. Well-being interventions have emerged in response, yet data suggest that the work environment is the problem. Nurse practitioner (NP) burnout is associated with structural and relational factors in the work environment, practice autonomy, and hierarchical leadership. PURPOSE We explore the unique social, cultural, and political environment in which NPs work through the lens of social ecology and present the Social Ecology of Burnout (SEB) framework. METHODS We review current burnout frameworks in the context of the NP practice environment and discuss the SEB, specifically exploring psychological safety and its influence on burnout. FINDINGS Psychological safety, work environment, and policy are presented within the SEB and solutions which empower NPs are considered. DISCUSSION Our framework can serve as a guide for future nursing research, practice, and policy.
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Affiliation(s)
- Rosalind de Lisser
- School of Nursing, Vanderbilt University, Nashville, TN; Department of Community Health Systems, School of Nursing, University of California San Francisco, San Francisco, CA.
| | | | - Mary S Dietrich
- School of Nursing, Vanderbilt University, Nashville, TN; Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN
| | - Rangaraj Ramanujam
- Center for Health Care Programs, Owen Graduate School of Management, Vanderbilt University, Nashville, TN
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25
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Roude GD, Wu K, Richardson L, Tucker A, Moss L, Kondo M, Morrison CN, Branas CC, Gustat J, Theall KP. The Impact of Vacant and Abandoned Property on Health and Well-Being: A Qualitative Inquiry. APPLIED RESEARCH IN QUALITY OF LIFE 2024; 19:2125-2145. [PMID: 39211005 PMCID: PMC11349791 DOI: 10.1007/s11482-024-10325-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Accepted: 05/03/2024] [Indexed: 09/04/2024]
Abstract
This qualitative study explored the role of neglected properties and neighborhood environment characteristics on a sample of New Orleans, Louisiana residents' health and well-being, sense of community, sense of safety, and civic engagement. We hypothesized that residents would identify conditions of their neighborhood's physical environment, including neglected properties, as one factor that impacted their health and other aspects of well-being. Seventy-four (N = 74) participants, including women, men, youth, young adults, and community leaders, took part in 11 focus groups (n = 51) and 23 key informant interviews. Thematic content analysis through inductive and deductive coding cycles of interview transcripts revealed five main categories related to urban neighborhood-built and social environments: 1) health and well-being, 2) sense of community, 3) sense of safety, 4) civic engagement, and 5) youth and family violence. Ten themes were developed and included, for example, the role of neighborhoods in delineating access to health-promoting characteristics and resources; the role of neighborhood social networks as crime prevention strategies; resident-led decision-making in neighborhood improvements; the negative impact of neglected properties; and the role of the local government in improving physical infrastructure. These findings affirm that residents were aware of and impacted by the cyclical nature of built environment neglect on health and well-being, community violence, neighborhood cohesion, civic engagement, and youth violence. Participants recommended improving neighborhood conditions to shift resident mindsets about the health of neighborhoods, reduce violence, and improve quality of life.
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Affiliation(s)
| | - Kimberly Wu
- School of Public Health & Tropical Medicine, Tulane University, New Orleans, LA USA
| | | | - Amber Tucker
- School of Public Health & Tropical Medicine, Tulane University, New Orleans, LA USA
- Tulane Mary Amelia Center for Women’s Health Equity Research, New Orleans, LA USA
| | - Lolita Moss
- School of Public Health & Tropical Medicine, Tulane University, New Orleans, LA USA
- Tulane Mary Amelia Center for Women’s Health Equity Research, New Orleans, LA USA
- Tulane Violence Prevention Institute, New Orleans, LA USA
| | - Michelle Kondo
- USDA Forest Service, Northern Research Station, Philadelphia, PA USA
| | - Christopher N. Morrison
- Mailman School of Public Health, Department of Epidemiology, Columbia University, New York, NY USA
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive, Medicine, Monash University, Melbourne, Australia
| | - Charles C. Branas
- Mailman School of Public Health, Department of Epidemiology, Columbia University, New York, NY USA
| | - Jeanette Gustat
- School of Public Health & Tropical Medicine, Tulane University, New Orleans, LA USA
| | - Katherine P. Theall
- School of Public Health & Tropical Medicine, Tulane University, New Orleans, LA USA
- Tulane Mary Amelia Center for Women’s Health Equity Research, New Orleans, LA USA
- Tulane Violence Prevention Institute, New Orleans, LA USA
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26
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Walsh EI, Sargent GM, Gooyers L, Masters J, Laachir K, Vardoulakis S. How researchers can translate health evidence into books for children. Health Promot Int 2024; 39:daae035. [PMID: 38722020 PMCID: PMC11079950 DOI: 10.1093/heapro/daae035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2024] Open
Abstract
The health promotion literature that considers how scientific evidence can be effectively communicated tends to focus on evaluating the effectiveness of communication materials. This has resulted in a knowledge gap regarding effective knowledge translation processes. This study explores the process, reasoning and practices for developing books for children that incorporate evidence-based information to aid understanding of scientific evidence about health and environmental or natural disasters. This study is informed by a systematic review of the literature combined with responses to an email interview with authors of books for children. Nine published studies were included in the systematic review. Twenty-two authors responded to the email survey (25% response rate, following 86 invitations). We report seven key findings to guide the development of health-promoting books for children: (i) understand the needs and expectations of the audience, (ii) articulate the topic and research evidence, (iii) assemble a team with a mix of content knowledge and creative expertise, (iv) format should be chosen to suit the user group and guided by the creative team, (v) early testing with children and their support system is crucial, (vi) develop a dissemination strategy to reach the user group and (vii) engage in reflexivity through evaluation of effectiveness of messaging. The current investigation can guide the process, reasoning and practice of developing books for children that incorporate evidence about health and environmental disasters.
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Affiliation(s)
- Erin I Walsh
- PHXchange (Population Health Exchange), National Centre for Epidemiology and Population Health, Australian National University, 62 Mills Rd, Acton 2601, Canberra, ACT, Australia
| | - Ginny M Sargent
- PHXchange (Population Health Exchange), National Centre for Epidemiology and Population Health, Australian National University, 62 Mills Rd, Acton 2601, Canberra, ACT, Australia
| | - Laura Gooyers
- Australian Child and Adolescent Trauma, Loss & Grief Network, Australian National University, Building 4 Level 2 The Canberra Hospital Yamba Drive, Garran 2605, Canberra, ACT, Australia
| | - Jessica Masters
- Australian Child and Adolescent Trauma, Loss & Grief Network, Australian National University, Building 4 Level 2 The Canberra Hospital Yamba Drive, Garran 2605, Canberra, ACT, Australia
- School of Literature, Arts and Media, University of Sydney, John Woolley Building, A20 Science Rd, Camperdown 2050, Sydney, NSW, Australia
| | - Karima Laachir
- Centre for Arab and Islamic Studies, Australian National University, 127 Ellery Cres, Acton 2601, Canberra, ACT, Australia
| | - Sotiris Vardoulakis
- Healthy Environments And Lives (HEAL) National Research Network, Australia
- National Centre for Epidemiology and Population Health, Australian National University, 62 Mills Rd, Acton 2601, Canberra, ACT, Australia
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27
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Wiedicke A, Rattei F, Reifegerste D. Assigning Responsibility for Depression and Diabetes: Frame Building Factors in Health Coverage. HEALTH COMMUNICATION 2024; 39:1418-1428. [PMID: 37219397 DOI: 10.1080/10410236.2023.2216485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Although frame building is a crucial part of framing in health communication, it is much less understood than media frames or their effects on audiences (i.e. frame setting). To address this research gap, we analyzed the individual, organizational, and external factors of influence contributing to the media's portrayal of responsibility for two major health issues: depression and diabetes. To identify relevant factors, we conducted 23 semi-structured interviews with German journalists who regularly report on these health issues. Our findings indicate that the way in which media coverage portrays responsibilities in depression and diabetes is affected by a variety of factors. These include individual (journalist role perception, journalistic routines, academic background and personal experiences with depression, diabetes-related knowledge, and personal values and beliefs), organizational (editorial lines, space limits, time limitations and payment, and newsroom structures), and external (health news sources, audience interest, newsworthiness, and social norms) factors. Notably, there are differences between depression and diabetes coverage - especially regarding individual factors - confirming that frame building, similar to framing in general, should be examined with regard to specific issues. Nevertheless, some factors that seem important across different topics could be identified.
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Affiliation(s)
| | - Franziska Rattei
- Department of Media and Communication Research, University of Erfurt
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28
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Fritz M, Grimm M, My Hanh HT, Koot JAR, Nguyen GH, Nguyen TPL, Probandari A, Widyaningsih V, Lensink R. Effectiveness of community-based diabetes and hypertension prevention and management programmes in Indonesia and Viet Nam: a quasi-experimental study. BMJ Glob Health 2024; 9:e015053. [PMID: 38777393 PMCID: PMC11116884 DOI: 10.1136/bmjgh-2024-015053] [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: 01/11/2024] [Accepted: 05/05/2024] [Indexed: 05/25/2024] Open
Abstract
INTRODUCTION Non-communicable diseases (NCDs) have surpassed infectious diseases as the leading global cause of death, with the Southeast Asian region experiencing a significant rise in NCD prevalence over the past decades. Despite the escalating burden, screening for NCDs remains at very low levels, resulting in undetected cases, premature mortality and high public healthcare costs. We investigate whether community-based NCD prevention and management programmes are an effective solution. METHODS In Indonesia, we compare participants in the community-based NCD screening and management programme Pos Pembinaan Terpadu-Penyakit Tidak Menular with matched non-participants with respect to their uptake of screening activities, health-related behaviour and knowledge and metabolic risk factors. We use statistical matching to redress a possible selection bias (n=1669). In Viet Nam, we compare members of Intergenerational Self-Help Clubs, which were offered similar NCD health services, with members of other community groups, where such services were not offered. We can rely on two waves of data and use a double-difference approach to redress a possible selection bias and to measure the impacts of participation (n=1710). We discuss strengths and weaknesses of the two approaches in Indonesia and Viet Nam. RESULTS In Indonesia, participants have significantly higher uptake of screening for hypertension and diabetes (+13% from a control mean of 88% (95% CI 9% to 17%); +93% from a control mean of 48% (95% CI 79% to 108%)). In both countries, participants show a higher knowledge about risk factors, symptoms and complications of NCDs (Indonesia: +0.29 SD (0.13-0.45), Viet Nam: +0.17 SD (0.03-0.30)). Yet, the improved knowledge is only partly reflected in improved health behaviour (Viet Nam: fruit consumption +0.33 SD (0.15-0.51), vegetable consumption +0.27 SD (0.04-0.50)), body mass index (BMI) (Viet Nam: BMI -0.07 SD (-0.13 to -0.00)) or metabolic risk factors (Indonesia: systolic blood pressure: -0.13 SD (-0.26 to -0.00)). CONCLUSION Community-based NCD programmes are well suited to increase screening and to transmit health knowledge. Due to their extensive outreach within the community, they can serve as a valuable complement to the screening services provided at the primary healthcare level. Yet, limited coverage, insufficient resources and a high staff turnover remain a problem. TRIAL REGISTRATION NUMBER NCT05239572.
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Affiliation(s)
- Manuela Fritz
- Department of Economics, Econometrics and Finance, University of Groningen, Groningen, The Netherlands
- School of Business, Economics and Information Systems, University of Passau, Passau, Germany
| | - Michael Grimm
- School of Business, Economics and Information Systems, University of Passau, Passau, Germany
- IZA Institute of Labor Economics, Bonn, Germany
| | | | - Jaap A R Koot
- Department of Health Sciences, University Medical Center Groningen, Groningen, The Netherlands
| | | | - Thi-Phuong-Lan Nguyen
- Faculty of Public Health, Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen City, Viet Nam
| | - Ari Probandari
- Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Central Java, Indonesia
| | - Vitri Widyaningsih
- Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Central Java, Indonesia
| | - Robert Lensink
- Department of Economics, Econometrics and Finance, University of Groningen, Groningen, The Netherlands
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Konstantinou P, Theofanous V, Karekla M, Kassianos AP. Mapping the needs of healthcare workers caring for COVID-19 patients using the socio-ecological framework: a rapid scoping review. HUMAN RESOURCES FOR HEALTH 2024; 22:29. [PMID: 38773594 PMCID: PMC11110340 DOI: 10.1186/s12960-024-00919-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 05/16/2024] [Indexed: 05/24/2024]
Abstract
Undoubtedly, the mental health of healthcare workers (HCWs) was negatively affected because of caring for patients during the COVID-19 pandemic. However, literature is limited on mapping the challenges and needs of HCWs during COVID-19 pandemic. A widely used framework in public health for mapping evidence includes the socio-ecological models, suggesting behavior can be influenced by individual, interpersonal, organizational, and community factors. The aim of this rapid scoping review was to use the socio-ecological model to map and compile lessons learnt from the literature regarding primarily the challenges and needs and secondly available psychological interventions for HCWs caring for COVID-19 patients. PubMed, CINAHL and Scopus databases were searched, with 21 studies finally included examining challenges and needs of HCWs and 18 studies presenting psychological interventions. Organizational-level challenges and needs such as inadequate staff preparation and supplies of protective equipment, flexible work policies and paid rest periods were the most reported. Individual-level challenges and needs included COVID-19-related fears and reduced mental health, whereas interpersonal-related needs included support provision. Community-level challenges included societal stigma. Certain psychological interventions were found to be promising for HCWs, but these were utilized to address only individual-level challenges and needs. Given that well-being entails an interaction of factors, multi-level interventions addressing multiple socio-ecological levels (interpersonal, organizational, community) and that place HCWs in their social context should be administrated to increase and maintain intervention' effects long-term and possibly aid in better coping with future pandemics.
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Affiliation(s)
| | - Vaso Theofanous
- Department of Psychology, University of Cyprus, Nicosia, Cyprus
| | - Maria Karekla
- Department of Psychology, University of Cyprus, Nicosia, Cyprus
| | - Angelos P Kassianos
- Department of Psychology, University of Cyprus, Nicosia, Cyprus.
- Department of Nursing, Cyprus University of Technology, 3041, Limassol, Cyprus.
- Department of Applied Health Research, UCL, London, United Kingdom.
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30
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James ME, Arbour-Nicitopoulos KP, Kwan M, King-Dowling S, Cairney J. Physical Activity and Motor Skill Development During Early Childhood: Investigating the Role of Parent Support. Pediatr Exerc Sci 2024:1-10. [PMID: 38734419 DOI: 10.1123/pes.2023-0074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 02/22/2024] [Accepted: 03/01/2024] [Indexed: 05/13/2024]
Abstract
PURPOSE This study examined the relationship between parent physical activity (PA) support and children's motor skill development and PA during early childhood and explored the potential moderating effect of child PA and motor skills on these relationships. METHODS Participants (N = 589, 250 girls, meanage = 4.93 [0.59] y) were part of a larger, longitudinal cohort study. Motor skills were assessed using the Movement Assessment Battery for Children-Second Edition. Moderate to vigorous PA (MVPA) was measured using ActiGraph accelerometers. Five items were used to measure parent support frequency (1 = none, 3 = 3-4 times, 5 = daily). Moderation analyses were conducted to examine the moderating effect of MVPA and motor skills on the relationship between parent support and motor skills and MVPA, respectively. RESULTS Parent support was significantly related to motor skills (B = 14.45, P = .007), and child MVPA significantly moderated this relationship (B = -0.17, P = .021). The relationship between parent support and child MVPA did not reach significance (B = 2.89, P = .051); however, motor skills had a significant moderating effect (B = -0.08, P = .022). CONCLUSIONS These novel findings suggest parent PA support is related to child motor skills and PA during early childhood, but this relationship is context dependent. Child-level characteristics should be considered in future parent PA support research.
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Affiliation(s)
- Maeghan E James
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON,Canada
- INfant, Child and youth Health (INCH) Lab, Department of Family Medicine, McMaster University, Hamilton, ON,Canada
| | | | - Matthew Kwan
- INfant, Child and youth Health (INCH) Lab, Department of Family Medicine, McMaster University, Hamilton, ON,Canada
- Department of Child and Youth Studies, Brock University, St Catharines, ON,Canada
| | - Sara King-Dowling
- INfant, Child and youth Health (INCH) Lab, Department of Family Medicine, McMaster University, Hamilton, ON,Canada
- Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA,USA
| | - John Cairney
- INfant, Child and youth Health (INCH) Lab, Department of Family Medicine, McMaster University, Hamilton, ON,Canada
- Health and Well-Being Centre for Research Innovation, School of Human Movement and Nutrition Sciences, University of Queensland, St Lucia, QLD,Australia
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Sagastume D, Barrenechea-Pulache A, Ruiz-Alejos A, Polman K, Beňová L, Ramírez-Zea M, Peñalvo JL. Quantifying Overlapping Forms of Malnutrition Across Latin America: A Systematic Literature Review and Meta-Analysis of Prevalence Estimates. Adv Nutr 2024; 15:100212. [PMID: 38493876 PMCID: PMC11015105 DOI: 10.1016/j.advnut.2024.100212] [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: 11/22/2023] [Revised: 02/07/2024] [Accepted: 03/05/2024] [Indexed: 03/19/2024] Open
Abstract
Estimating the prevalence of double burden of malnutrition (DBM) is challenging in the Latin American and Caribbean (LAC) region where various DBM typologies (e.g., obesity and stunting) are heterogeneous and estimates are scattered across literature This study aimed to assess the prevalence of DBM typologies in the LAC region. We searched PubMed, Embase, Scopus, and Web of Science to identify studies on the prevalence of DBM published between 1 January, 2000, and 23 January, 2023. Outcomes were the prevalence of the identified DBM typologies at the household, individual, or across life course levels. Random-effect meta-analyses of proportions were used to estimate pooled period prevalence for all outcomes. Heterogeneity was explored using meta-regressions. From 754 records identified, 60 (8%) studies were eligible, with a median of 4379 individuals. Studies reported data from 27 LAC countries collected between 1988 and 2017. Most studies used nationally representative surveys (68%) and scored as low risk of bias (70%). We identified 17 DBM typologies for which 360 estimates were analyzed. The prevalence of the identified DBM typologies ranged between 0% and 24%, with the DBM typology of "adult with overweight and child with anemia" having the highest prevalence (24.3%; 95% CI: 18.8%, 30.2%). The most frequently reported DBM typology was "adult with overweight and child with stunting," with a prevalence of 8.5% (95% CI: 7.7, 9.3). All prevalences carried large heterogeneity (I2>90%), modestly explained by subregions and countries. DBM across the life course could not be estimated owing to insufficient estimates. In conclusion, using available data, our study suggests that the burden of DBM in the LAC region ranges between 0% and 24%. In the most frequent DBM typologies, overweight was a common contributor. Substantial progress can be made in curbing the burden of DBM in the LAC region through strategies addressing excess weight within these population groups. This study was registered at PROSPERO as CRD42023406755.
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Affiliation(s)
- Diana Sagastume
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium; Global Health Institute, University of Antwerp, Wilrijk, Belgium.
| | | | | | - Katja Polman
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium; Department of Health Sciences, Vrije Universiteit (VU) Amsterdam, Netherlands
| | - Lenka Beňová
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Manuel Ramírez-Zea
- INCAP Research Center for the Prevention of Chronic Diseases (CIIPEC), Institute of Nutrition of Central America and Panama (INCAP), Guatemala City, Guatemala
| | - José L Peñalvo
- Global Health Institute, University of Antwerp, Wilrijk, Belgium; National Center for Epidemiology, Carlos III Institute of Health (ISCIII), Madrid, Spain
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Day S, Tahlil KM, Shah SJ, Fidelak L, Wilson EC, Shah SK, Nwaozuru U, Chima K, Obiezu-Umeh C, Chikwari CD, Mwaturura T, Phiri N, Babatunde AO, Gbajabiamila T, Rennie S, Iwelunmor J, Ezechi O, Tucker JD. The HI V O pen Call on I nformed C onsent and E thics in Research (VOICE) for Adolescents and Young Adults: A Digital Crowdsourcing Open Call in Low- and Middle-Income Countries. Sex Transm Dis 2024; 51:359-366. [PMID: 38346417 PMCID: PMC11018461 DOI: 10.1097/olq.0000000000001949] [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] [Indexed: 02/22/2024]
Abstract
BACKGROUND Many adolescents and young adults (AYAs; 10-24 years old) are excluded from HIV research because of social, ethical, and legal challenges with informed consent, resulting in limited AYA-focused data. We use a participatory approach to identify strategies for improving AYA consent processes in HIV research in low- and middle-income countries (LMICs). METHODS We conducted a digital crowdsourcing open call for ideas to improve AYA consent to HIV research in LMICs. Crowdsourcing involves engaging a group of people in problem-solving, then sharing emergent solutions. Submissions were evaluated by 3 independent judges using predefined criteria, with exceptional strategies receiving prizes. Demographic data were collected, and textual data were qualitatively analyzed for emergent themes in barriers and facilitators for improving AYA consent in HIV research, guided by a socioecological model. RESULTS We received 110 strategies total; 65 were eligible for evaluation, 25 of which were identified as finalists. Fifty-eight participants from 10 LMICs submitted the 65 eligible submissions, of which 30 (52%) were 18 to 24 years old. Thematic analysis identified 10 barriers to AYA consent, including HIV stigma, limited education, and legal/regulatory barriers. Strategies for improving AYA consent processes revealed 7 potential facilitators: enhancing AYA engagement in research, involving parents/guardians, improving education/awareness, improving institutional practices/policy, making research participation more AYA-friendly, enhancing engagement of other key communities of interest, and empowering AYA. CONCLUSIONS Diverse communities of interest in LMICs developed compelling strategies to enhance informed consent that may improve AYA inclusion in HIV research. These data will be used to develop practical guidance on improving AYA consent processes.
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Affiliation(s)
- Suzanne Day
- Department of Medicine, Division of Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Kadija M. Tahlil
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Sonam J. Shah
- Institute of Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Lauren Fidelak
- Current undergraduate student (degree not yet granted) in the Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Erin C. Wilson
- San Francisco Department of Public Health, San Francisco, California, USA
| | - Seema K. Shah
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
| | - Ucheoma Nwaozuru
- Department of Implementation Science, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Kelechi Chima
- Clinical Sciences Department, Nigerian Institute of Medical Research, Lagos, Nigeria
| | - Chisom Obiezu-Umeh
- Department of Behavioral Science & Health Education, College for Public Health and Social Justice, St. Louis University, St. Louis, Missouri, USA
| | - Chido Dziva Chikwari
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
- Biomedical Research and Training Institute, Harare, Zimbabwe
| | | | - Nomsa Phiri
- Jomo Kenyatta University of Agriculture and Technology, Juja, Kenya
| | | | - Titilola Gbajabiamila
- Clinical Sciences Department, Nigerian Institute of Medical Research, Lagos, Nigeria
- Department of Behavioral Science & Health Education, College for Public Health and Social Justice, St. Louis University, St. Louis, Missouri, USA
| | - Stuart Rennie
- Department of Social Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- UNC Center for Bioethics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Juliet Iwelunmor
- Department of Behavioral Science & Health Education, College for Public Health and Social Justice, St. Louis University, St. Louis, Missouri, USA
| | - Oliver Ezechi
- Clinical Sciences Department, Nigerian Institute of Medical Research, Lagos, Nigeria
| | - Joseph D. Tucker
- Department of Medicine, Division of Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
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Nguyen TA, Jing Teo AK, Zhao Y, Quelapio M, Hill J, Morishita F, Marais BJ, Marks GB. Population-wide active case finding as a strategy to end TB. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2024; 46:101047. [PMID: 38827931 PMCID: PMC11143452 DOI: 10.1016/j.lanwpc.2024.101047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 02/26/2024] [Accepted: 03/04/2024] [Indexed: 06/05/2024]
Abstract
Tuberculosis (TB) is the leading infectious cause of morbidity and mortality globally. Despite available tools for preventing, finding, and treating TB, many people with TB remain undiagnosed. In high-incidence settings, TB transmission is ubiquitous within the community, affecting both high-risk groups and the general population. In fact, most people who develop TB come from the general population. To disrupt the chain of transmission that sustains the TB epidemic, we need to find and treat everyone with infectious TB as early as possible, including those with minimal symptoms or subclinical TB who are unlikely to present for care. Important elements of an effective active case-finding strategy include effective social mobilisation and community engagement, using sensitive screening tools that can be used at scale, and embracing population-wide screening in high-incidence ('hot spot') areas. We require a better description of feasible delivery models, 'real-life' impact and cost effectiveness to enable wider implementation.
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Affiliation(s)
- Thu-Anh Nguyen
- The University of Sydney Vietnam Institute, Ho Chi Minh City, Vietnam
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- The University of Sydney Institute for Infectious Diseases (Sydney ID) and the Centre of Research Excellence in Tuberculosis (TB-CRE), Sydney, NSW, Australia
| | - Alvin Kuo Jing Teo
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- The University of Sydney Institute for Infectious Diseases (Sydney ID) and the Centre of Research Excellence in Tuberculosis (TB-CRE), Sydney, NSW, Australia
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Yanlin Zhao
- Chinese Centre for Disease Control and Prevention, Beijing, China
| | | | - Jeremy Hill
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- The University of Sydney Institute for Infectious Diseases (Sydney ID) and the Centre of Research Excellence in Tuberculosis (TB-CRE), Sydney, NSW, Australia
| | - Fukushi Morishita
- World Health Organization, Regional Office for the Western Pacific, Manila, Philippines
| | - Ben J. Marais
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- The University of Sydney Institute for Infectious Diseases (Sydney ID) and the Centre of Research Excellence in Tuberculosis (TB-CRE), Sydney, NSW, Australia
| | - Guy B. Marks
- The University of Sydney Institute for Infectious Diseases (Sydney ID) and the Centre of Research Excellence in Tuberculosis (TB-CRE), Sydney, NSW, Australia
- School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
- Woolcock Institute of Medical Research, Sydney, Australia
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Purkait T. Farm to Preschool Programs and Its Impact on Children's Dietary Health: Evaluation Through Bronfenbrenner's Socio-Ecological Model. Ecol Food Nutr 2024; 63:191-203. [PMID: 38456668 DOI: 10.1080/03670244.2024.2327619] [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] [Indexed: 03/09/2024]
Abstract
Children's development is shaped by the world around them. According to Bronfenbrenner's theory, children are influenced by direct interactions and the broader environment, which includes family, community, and society. This concept aligns with initiatives like farm-to-preschool programs. These programs forge connections between communities and local food sources, introducing gardening and nutritional education. This approach aligns seamlessly with Bronfenbrenner's theory, creating a multi-layered learning experience and fostering children's healthier eating habits. This review delves into how farm-to-preschool efforts enhance young children's diets through the ecological model evaluation framework, encompassing health, education, economics, and the environment.
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Affiliation(s)
- Tirna Purkait
- Department of Nutrition & Health Sciences, University of Nebraska-Lincoln, Lincoln, Nebraska, USA
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35
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Williams O, Ting T, Matthews L, Block G, Block T, Teresi J, Eimicke J, Kong J, Silver S, Ravenell J, Mallaiah J, Jammalamadaka S, Nelson LM, Karmally W, Hankerson S. Community Health workers United to Reduce Colorectal cancer and cardiovascular disease among people at Higher risk (CHURCH): study protocol for a randomized controlled trial. Trials 2024; 25:283. [PMID: 38671470 PMCID: PMC11046862 DOI: 10.1186/s13063-024-08110-z] [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: 01/30/2024] [Accepted: 04/12/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Colorectal cancer (CRC) is the second most lethal cancer in the United States (U.S.) with the highest incidence and mortality rates among African Americans (AAs) compared to other racial groups. Despite these disparities, AAs are the least likely to undergo CRC screening, have precancerous colorectal polyps removed, and have CRC detected at stages early enough for curative excision. In addition, compelling evidence links inflammatory dietary patterns to increased CRC and cardiovascular disease risk. Studies show that AA churches can successfully engage in health promotion activities including those related to cancer control. The current study seeks to leverage church-placed Community Health Workers (CHWs) to increase CRC screening and reduce CRC risk. DESIGN AND METHODS We aim to (1) increase guideline concordant CRC screening uptake using church-placed CHWs trained in screening with a validated instrument, Brief Intervention using Motivational Interviewing, and Referral to Treatment (SBIRT); and (2) reduce dietary risk factors (inflammatory dietary patterns) linked to CRC. The latter will be addressed by culturally adapting an existing, web-based lifestyle program called Alive!. Using a Hybrid Type 1 Implementation-Effectiveness cluster randomized design, we will randomize 22 AA churches into either the dual intervention arm (CHW-led SBIRT intervention plus Alive!) or a usual care arm comprised of CRC prevention educational pamphlets and a list of CRC screening sites. We will recruit 440 subjects and evaluate the effects of both arms on screening uptake (colonoscopy, fecal DNA) (primary outcome) and dietary inflammation score (secondary outcome) at 6-month follow-up, and Life Simple7 (LS7)-a cardiovascular disease (CVD) risk score-at 6 months and 1 year (secondary outcome). Finally, guided by a racism-conscious adaptation of the Consolidated Framework for Implementation Research (CFIR), we will conduct a mixed-methods process evaluation with key stakeholders to understand multi-level influences on CRC screening and CVD risk behaviors. DISCUSSION Church-placed CHWs are trusted influential connectors between communities and health systems. Studies have shown that these CHWs can successfully implement health prevention protocols in churches, including those related to cancer control, making them potentially important community mediators of CRC screening uptake and CRC/CVD risk reduction. TRIAL REGISTRATION NCT05174286; clinicaltrials.gov; August 31st, 2023.
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Affiliation(s)
- Olajide Williams
- Columbia University Irving Medical Center, 710 West 168th Street, New York, NY, 10032, USA
| | - Tina Ting
- Columbia University Irving Medical Center, 710 West 168th Street, New York, NY, 10032, USA.
| | - Lisa Matthews
- Columbia University Irving Medical Center, 710 West 168th Street, New York, NY, 10032, USA
| | - Gladys Block
- NutritionQuest and Turnaround Health, Berkeley, CA, USA
| | - Torin Block
- NutritionQuest and Turnaround Health, Berkeley, CA, USA
| | - Jeanne Teresi
- Division of Medicine, Data Coordinating Center Unit, Columbia University Irving Medical Center, Stroud Center at New York State Psychiatric Institute, 622 West 168th Street, New York, NY, 10032, USA
| | - Joseph Eimicke
- Division of Medicine, Data Coordinating Center Unit, Columbia University Irving Medical Center, Stroud Center at New York State Psychiatric Institute, 622 West 168th Street, New York, NY, 10032, USA
| | - Jian Kong
- Division of Medicine, Data Coordinating Center Unit, Columbia University Irving Medical Center, Stroud Center at New York State Psychiatric Institute, 622 West 168th Street, New York, NY, 10032, USA
| | - Stephanie Silver
- Division of Medicine, Data Coordinating Center Unit, Columbia University Irving Medical Center, Stroud Center at New York State Psychiatric Institute, 622 West 168th Street, New York, NY, 10032, USA
| | - Joseph Ravenell
- New York University Grossman School of Medicine, Manhattan, NY, USA
| | - Janhavi Mallaiah
- Columbia University Irving Medical Center, 710 West 168th Street, New York, NY, 10032, USA
| | - Soujanya Jammalamadaka
- Columbia University Irving Medical Center, 710 West 168th Street, New York, NY, 10032, USA
| | - Laura Maudene Nelson
- Columbia University Irving Medical Center, 710 West 168th Street, New York, NY, 10032, USA
| | - Wahida Karmally
- Columbia University Irving Medical Center, 710 West 168th Street, New York, NY, 10032, USA
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Noggle B, Ball KM, Vansickel AR. A reduced exposure heated tobacco product was introduced then abruptly taken off United States shelves: results from a tobacco harm reduction natural experiment. Harm Reduct J 2024; 21:84. [PMID: 38659033 PMCID: PMC11040862 DOI: 10.1186/s12954-024-01000-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 04/04/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND A heated tobacco product (HTP) authorized for purchase in the United States by the Food and Drug Administration as a reduced harm product was removed from the market after about 2 years of sales. Adults who used the HTP were surveyed to determine the impact of the introduction and removal of the HTP on past and current tobacco behaviors. METHODS Adults who were using the HTP before its United States market removal (n = 502) completed a cross-sectional online survey to determine their tobacco use behaviors at three timepoints: prior to HTP initiation, just before HTP market removal, and at the time of the survey which was administered approximately 10 months post-removal. Descriptive statistics summarized outcome variables and paired bivariate testing was used to compare percent change between timepoints. Multivariable logistic regression and general linear models estimated associations of tobacco use behaviors and cigarette consumption. RESULTS Overall, significantly fewer adults consumed cigarettes while using HTP than before they tried the product (63.0% vs. 89.9%, p value < 0.0001) and the number of cigarettes consumed per week (CPW) decreased (106.3-39.0, p value < 0.0001). After HTP removal, the percent of adults who consumed cigarettes increased non-significantly (63.0-67.5%, p value = 0.0544) while CPW increased significantly (39.0-76.6 CPW, p value < 0.0001). At the time of the survey, over 25% of the sample continued to use the HTP and 7.2% reported use of no tobacco products. Electronic nicotine delivery system use had increased significantly from the prior period (27.4% increase, p value < 0.0001). CONCLUSION This study demonstrates reduction or elimination of combustible cigarette smoking while adults were using HTPs and some increased smoking after market removal, albeit at lower levels. If unable to find satisfying alternatives, adults who smoke and transition to reduced harm products may return to smoking or purchase products illicitly if their preferred products are removed from the regulated market.
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Affiliation(s)
- Brendan Noggle
- Center for Research and Technology, Altria Client Services LLC, 601 East Jackson Street, Richmond, VA, 23219, USA.
| | - Kevin M Ball
- Center for Research and Technology, Altria Client Services LLC, 601 East Jackson Street, Richmond, VA, 23219, USA
| | - Andrea Rae Vansickel
- Center for Research and Technology, Altria Client Services LLC, 601 East Jackson Street, Richmond, VA, 23219, USA
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Guan H, Wang W. Factors Impacting Chinese Older Adults' Intention to Prevent COVID-19 in the Post-COVID-19 Pandemic Era: Survey Study. JMIR Form Res 2024; 8:e53608. [PMID: 38630517 PMCID: PMC11025601 DOI: 10.2196/53608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 12/21/2023] [Accepted: 01/14/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Understanding the factors influencing individuals' health decisions is a dynamic research question. Particularly, after China announced the deregulation of the COVID-19 epidemic, health risks escalated rapidly. The convergence of "no longer controlled" viruses and the infodemic has created a distinctive social period during which multiple factors may have influenced people's decision-making. Among these factors, the precautionary intentions of older individuals, as a susceptible health group, deserve special attention. OBJECTIVE This study aims to examine the intention of older adults to engage in preventive behaviors and the influencing factors, including social, media, and individual factors, within the context of the postepidemic era. Drawing upon the structural influence model of communication, this study tests the potential mediating roles of 3 different types of media exposure between cognitive and structural social capital and protective behavior intention, as well as the moderating role of negative emotions between social capital and media exposure. METHODS In this study, a web survey was used to collect self-reported quantitative data on social capital, media exposure, negative emotions, and the intention to prevent COVID-19 among older adults aged ≥60 years (N=399) in China. RESULTS The results indicate that cognitive social capital significantly influenced protective behavior intention (P<.001), with cell phone exposure playing an additional impactful role (P<.001). By contrast, newspaper and radio exposure and television exposure mediated the influence of structural social capital on protective behavior intention (P<.001). Furthermore, negative emotions played a moderating role in the relationship between cognitive social capital and cell phone exposure (P<.001). CONCLUSIONS This study suggests that using tailored communication strategies across various media channels can effectively raise health awareness among older adults dealing with major pandemics in China, considering their diverse social capital characteristics and emotional states.
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Affiliation(s)
- Huixin Guan
- USC-SJTU Institute of Cultural and Creative Industry, Shanghai Jiao Tong University, Shanghai, China
| | - Wei Wang
- USC-SJTU Institute of Cultural and Creative Industry, Shanghai Jiao Tong University, Shanghai, China
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Marques FRDM, Laranjeira C, Carreira L, Gallo AM, Baccon WC, Goes HDF, Salci MA. Managing long COVID symptoms and accessing health services in Brazil: A grounded theory analysis. Heliyon 2024; 10:e28369. [PMID: 38571660 PMCID: PMC10988007 DOI: 10.1016/j.heliyon.2024.e28369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 03/17/2024] [Accepted: 03/18/2024] [Indexed: 04/05/2024] Open
Abstract
Background The worldwide community has shown significant interest in researching the management of Long COVID. However, there is scarce evidence about the daily experiences of people living with Long COVID and their insights into the healthcare services provided to them. Aims This study aims to understand the experience of Long COVID sufferers with their symptoms and in accessing health services. Method We employed Charmaz's grounded theory methodology, informed by constructivism, and applied the COREQ guidelines for qualitative research. Sixty-six Brazilians living with Long COVID participated in the study. The data was collected using semi-structured telephone interviews and analyzed using a constant comparative process. Findings The findings refer firstly to the consequences of persistent Long COVID symptoms. Secondly, they describe how the disease trajectory required Long COVID sufferers to reorganize their routines and develop adaptive strategies. Lastly, they reflect a diverse array of both positive and negative interactions inside the healthcare system conveyed by individuals suffering from Long COVID. These elements converge towards the core category of the study: "The limbo of Long COVID sufferers: between the persistence of symptoms and access to health services". Conclusions Long COVID is characterized by its varied nature, including a range of physical and emotional repercussions experienced by individuals. There is a need for enhanced comprehension and discourse about Long COVID across several domains, including the general public, policy-making entities, and healthcare professionals. In this sense, the development of specialized services or the reinforcement of existing services to support long COVID sufferers is imperative.
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Affiliation(s)
| | - Carlos Laranjeira
- School of Health Sciences, Polytechnic University of Leiria, Campus 2, Morro do Lena, Alto do Vieiro, Apartado 4137, 2411-901, Leiria, Portugal
- Centre for Innovative Care and Health Technology (ciTechCare), Polytechnic University of Leiria, Campus 5, Rua das Olhalvas, 2414-016 Leiria, Portugal
- Comprehensive Health Research Centre (CHRC), University of Évora, 7000-801, Évora, Portugal
| | - Lígia Carreira
- Departamento de Pós-Graduação em Enfermagem, Universidade Estadual de Maringá, Avenida Colombo, 5790—Campus Universitário, Maringá, 87020-900, PR, Brazil
| | - Adriana Martins Gallo
- Departamento de Pós-Graduação em Enfermagem, Universidade Estadual de Maringá, Avenida Colombo, 5790—Campus Universitário, Maringá, 87020-900, PR, Brazil
| | - Wanessa Cristina Baccon
- Departamento de Pós-Graduação em Enfermagem, Universidade Estadual de Maringá, Avenida Colombo, 5790—Campus Universitário, Maringá, 87020-900, PR, Brazil
| | - Herbert de Freitas Goes
- Departamento de Pós-Graduação em Enfermagem, Universidade Estadual de Maringá, Avenida Colombo, 5790—Campus Universitário, Maringá, 87020-900, PR, Brazil
| | - Maria Aparecida Salci
- Departamento de Pós-Graduação em Enfermagem, Universidade Estadual de Maringá, Avenida Colombo, 5790—Campus Universitário, Maringá, 87020-900, PR, Brazil
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Benjakul S, Nakju S, Thitavisiddho Wongsai W, Junjula T. Using an ecological model of health behaviour to identify factors associated with smoking behaviour among Buddhist novices in Thailand: a cross-sectional digital survey. BMJ Open 2024; 14:e082734. [PMID: 38626965 PMCID: PMC11029314 DOI: 10.1136/bmjopen-2023-082734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Accepted: 03/28/2024] [Indexed: 04/19/2024] Open
Abstract
OBJECTIVE Buddhist novices reside in Buddhist temples, which are legally designated as smoke-free areas. Nevertheless, similar to other men in their age group, they are susceptible to various risk factors that lead to smoking. This digital survey aimed to examine tobacco smoking and its associated factors among Buddhist novices in Thailand. DESIGN A cross-sectional digital survey. SETTING 88 temple-based schools in Thailand. PARTICIPANTS A stratified two-stage cluster sampling method was employed to select 5371 novices. Data were collected between June and August 2022 using self-administered electronic questionnaires. MEASURE Descriptive statistics and multivariable logistic regression analysis were used to identify the associated factors. RESULTS Overall, 32.8% of the respondents reported they had tried smoking, and the average age of initiation was 12.4 years. In the past 30 days, 25.7% had smoked any tobacco product. Multiple factors following the ecological model of health behaviour were found to be statistically associated with smoking by 37.3%. Among these were intrapersonal-level factors, such as age, living in the southern region and attempted smoking. Two were interpersonal-level factors: the smoking behaviour of close relatives, specifically parents, and their respected monks. Two were institutional-level factors: perceiving that temple-based schools are smoke-free areas and exposure to secondhand smoke. Three factors at the community and policy levels were noticed tobacco advertising at the point of sale, social media and tobacco promotion. CONCLUSION The findings of this study support the development of comprehensive intervention programmes that address the multiple factors to prevent Buddhist novices from smoking.
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Affiliation(s)
- Sarunya Benjakul
- Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand
| | - Saroj Nakju
- Faculty of Public Health, Ramkhamhaeng University, Bangkok, Thailand
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Williams O, Ting T, Matthews L, Block G, Block T, Teresi J, Eimicke J, Kong J, Silver S, Ravenell J, Mallaiah J, Jammalamadaka S, Nelson LM, Karmally W, Hankerson S. Community Health workers United to Reduce Colorectal cancer and cardiovascular disease among people at Higher risk (CHURCH): study protocol for a randomized controlled trial. RESEARCH SQUARE 2024:rs.3.rs-3797889. [PMID: 38659874 PMCID: PMC11042434 DOI: 10.21203/rs.3.rs-3797889/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
Background: Colorectal cancer (CRC) is the second most lethal cancer in the United States (U.S.) with the highest incidence and mortality rates among African Americans (AAs) compared to other racial groups. Despite these disparities, AAs are the least likely to undergo CRC screening, have precancerous colorectal polys removed, and have CRC detected at stages early enough for curative excision. In addition, compelling evidence links inflammatory dietary patterns to increased CRC and cardiovascular disease risk. Studies show that AA churches can successfully engage in health promotion activities including those related to cancer control. The current study seeks to leverage church-placed Community Health Workers (CHWs) to increase CRC screening and reduce CRC risk. Design and Methods: We aim to (1) increase guideline concordant CRC screening uptake using church-placed CHWs trained in screening with a validated instrument, Brief Intervention using Motivational Interviewing, and Referral to Treatment (SBIRT); and (2) reduce dietary risk factors (inflammatory dietary patterns) linked to CRC. The latter will be addressed by culturally adapting an existing, web-based lifestyle program called Alive!. Using a Hybrid Type 1 Implementation-Effectiveness cluster randomized design, we will randomize 22 AA churches into either the dual intervention arm (CHW-led SBIRT intervention plus Alive!) or a usual care arm comprised of CRC prevention educational pamphlets and a list of CRC screening sites. We will recruit 440 subjects and evaluate the effects of both arms on screening uptake (colonoscopy, fecal DNA) (primary outcome) and dietary inflammation score (secondary outcome) at 6-months follow up, and Life Simple7 (LS7) - a cardiovascular disease (CVD) risk score - at 6 months and 1-year (secondary outcome). Finally, guided by a racism-conscious adaptation of the Consolidated Framework for Implementation Research (CFIR), we will conduct a mixed- methods process evaluation with key stakeholders to understand multi-level influences on CRC screening and CVD risk behaviors. Discussion: Church-placed CHWs are trusted influential connectors between communities and health systems. Studies have shown that these CHWs can successfully implement health prevention protocols in churches, including those related to cancer control, making them potentially important community mediators of CRC screening uptake and CRC/CVD risk reduction. Trial registration: NCT05174286.
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Ganguly AP, Oren H, Jack HE, Abe R. Equity M&M - Adaptation of the Morbidity and Mortality Conference to Analyze and Confront Structural Inequity in Internal Medicine. J Gen Intern Med 2024; 39:867-872. [PMID: 37904072 PMCID: PMC11043282 DOI: 10.1007/s11606-023-08487-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 10/13/2023] [Indexed: 11/01/2023]
Abstract
BACKGROUND At morbidity and mortality (M&M) conferences, medical teams review cases for medical education and system improvement. Adverse outcomes are often driven by social inequity, but processes to analyze such outcomes are lacking. AIM Adapt quality improvement and patient safety (QIPS) tools in the M&M format to systematically analyze adverse patient outcomes rooted in social and structural determinants of health (SSDH). SETTING One-hour conferences conducted in health systems in Seattle, WA, and Dallas, TX. PARTICIPANTS Equity M&M conferences were held 11 times, each with approximately 45 participants comprised of internal medicine trainees, faculty, and non-medical staff. PROGRAM DESCRIPTION Conferences included a case narrative and counternarrative highlighting SSDH, an equity-framed root cause analysis, and potential interventions. PROGRAM EVALUATION Conferences were received well across both institutions. Following conferences, most respondents reported increased identification of opportunities for action towards equity (88.5%) and confidence in discussing equity issues with colleagues (92.3%). DISCUSSION Equity M&M conferences are a structured tool for deconstructing and confronting structural inequity that leads to adverse patient outcomes. Evaluations demonstrate educational impact on participants. Anecdotal examples suggest institutional impact. Other health systems could adopt this model for similar advocacy and system improvement.
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Affiliation(s)
- Anisha P Ganguly
- Center of Innovation and Value at Parkland, Parkland Health, Dallas, TX, USA.
- Division of General Internal Medicine, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA.
| | - Hannah Oren
- Division of General Internal Medicine, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Helen E Jack
- Division of General Internal Medicine, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Ryan Abe
- Division of General Internal Medicine, Department of Medicine, University of Washington, Seattle, WA, USA
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Yuan B. How the interplay of late retirement, health care, economic insecurity, and electronic social contact affects the mental health amongst older workers? Stress Health 2024; 40:e3309. [PMID: 37621258 DOI: 10.1002/smi.3309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 08/12/2023] [Accepted: 08/17/2023] [Indexed: 08/26/2023]
Abstract
The delayed retirement initiative has become increasingly emphasised to cope with the population ageing. Based on the social-ecological model, this study explores the interplay of late retirement, health care, economic insecurity, and electronic social contact on mental health of older workers. Using data from the Survey of Health, Ageing and Retirement in Europe (wave 8), results show that the late retirement, health care quality, and electronic social contact are all negatively associated with the mental health problems among older workers. Besides, the influence of health care quality and electronic social contact on mental health problems are buffered by the economic insecurity respectively. It is concluded that more targeted policy response is in need to achieve better health outcomes among older workers.
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Passos L, Tavares J, Batchelor M, Figueiredo D. Interventions to address mealtime support needs in dementia: A scoping review. PLoS One 2024; 19:e0300987. [PMID: 38527044 PMCID: PMC10962800 DOI: 10.1371/journal.pone.0300987] [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: 10/28/2023] [Accepted: 03/06/2024] [Indexed: 03/27/2024] Open
Abstract
The decrease in cognitive and physical ability among people with dementia can significantly affect eating performance, resulting in mealtime support needs that could lead to inadequate oral intake, weight loss, malnutrition, and reduced functionality in activities of daily living. This scoping review aimed to identify and summarize available research literature on mealtime interventions for people with dementia, and their impact on older people with dementia living in a residential care setting, care staff, and care context/environment. A scoping review of available research published in English, French, Portuguese, or Spanish, was conducted according to the methodology established by The Joanna Briggs Institute. The search was conducted between November 2022 and February 2023 in the following databases: MEDLINE, Web of Science, Scopus, CINAHL Complete, and SciELO. A total of 275 articles were retrieved, of which 33 studies were selected according to inclusion criteria. The interventions were classified into four general categories: environmental, mealtime assistance, staff training, and multicomponent. Most studies demonstrated effectiveness in increasing oral intake and improving behaviors such as agitation and aggression in people with dementia. The impact of interventions on care staff was linked to greater knowledge and attitudes towards mealtime support needs. There is a lack of reporting on the impact of interventions on the care context/environment. Most interventions examined the effects exclusively on residents, focusing on their oral intake and behavioral patterns, particularly agitation among individuals with dementia. However, it is crucial to conduct studies that evaluate the impact on administrators, to comprehend the viewpoints of various hierarchical levels within an organization regarding challenges associated with mealtime. The findings of this scoping review can support the development of new supportive programs, or strategies to improve mealtime experience with positive impact according to the reality and needs of each person or institution.
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Affiliation(s)
- Lígia Passos
- Center for Health Technology and Services Research (CINTESIS@RISE), Department of Education and Psychology, University of Aveiro, Aveiro, Portugal
- Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal
| | - João Tavares
- Center for Health Technology and Services Research (CINTESIS@RISE), School of Health Sciences, University of Aveiro, Aveiro, Portugal
| | - Melissa Batchelor
- School of Nursing, George Washington University, Washington, DC, United States of America
| | - Daniela Figueiredo
- Center for Health Technology and Services Research (CINTESIS@RISE), School of Health Sciences, University of Aveiro, Aveiro, Portugal
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Dhital SR, Chojenta C, Loxton D. Multi-level factors associated with utilization of water, sanitation and hygiene services by mothers in Nepal. PLoS One 2024; 19:e0283379. [PMID: 38507421 PMCID: PMC10954160 DOI: 10.1371/journal.pone.0283379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 06/06/2023] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND Providing improved water, sanitation, and hygiene (WASH) at a household level remains one of the major public health challenges in Nepal. Household mothers are likely to have limited access to combined WASH services, this is influenced by individual, and community factors. Individual components of an improved water source, sanitary toilet, fixed place for handwashing, and availability of soap and water were merged into one and called combined WASH. This paper aimed to identify the individual and community factors associated with combined WASH facilities and practices among mothers with children under five years in Nepal. METHODS A cross-sectional study was conducted using data from the Nepal Demographic and Health Survey (NDHS), 2016. The weighted sample size of this study was 4887 mothers with children under five years. The independent variables within the mothers included age, education, occupation, and caste/ethnicity in addition to education of the husband, wealth index, exposure to the newspaper, radio and television, residence, ecological zones, provinces, distance and participation in health mother groups were analyzed with the outcome variable of combined WASH. A multi-level mixed effects logistic regression model was used to assess the relationship of explanatory variables with WASH. RESULTS At an individual level, a rich wealth index was positively associated with combined WASH (AOR = 6.29; 95%CI: 4.63-8.54). Higher education levels and exposure to television had higher odds of having combined WASH. At the community level, the hill zone, urban residence, and Sudurpashim Provinces were positively associated with combined WASH while Madesh and Karnali Provinces and distance to water source greater than 31 minutes were associated with lower access to combined WASH. CONCLUSION Educated and rich household have positive association with combined WASH. It is recommended that both the health and other sectors may be instrumental in improving the combined WASH service for mothers at households.
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Affiliation(s)
- Shalik Ram Dhital
- Ministry of Health and Population, National Health Education, Information and Communication Center, Kathmandu, Nepal
- Centre for Women’s Health Research, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia
- School of Health and Allied Sciences, Pokhara University, Lekhnath, Nepal
- Concern Center for Rural Youth, Kathmandu, Nepal
| | - Catherine Chojenta
- Centre for Women’s Health Research, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia
| | - Deborah Loxton
- Centre for Women’s Health Research, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia
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Robbers GML, Cousins N, Lim YL, Estoesta J, Botfield JR. Views and experiences of young women from a migrant or refugee background regarding the contraceptive implant in Australia. CULTURE, HEALTH & SEXUALITY 2024:1-18. [PMID: 38497422 DOI: 10.1080/13691058.2024.2328223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 03/05/2024] [Indexed: 03/19/2024]
Abstract
Young people comprise a significant proportion of migrants and refugees in Australia. Many encounter challenges in accessing contraception information and services. This study explored the views and experiences of young women from migrant and/or refugee backgrounds regarding the contraceptive implant and related decision-making. Interviews were conducted with 33 women, aged 15-24, living in New South Wales, Australia, who spoke a language other than English and had some experience of the implant. Three themes were developed from the data as follows: 'Finding your own path': contraception decision-making (in which participants described sex and contraception as being taboo in their community, yet still made independent contraceptive choices); Accessing 'trustworthy' contraception information and navigating services (in which participants consulted online resources and social media for contraception information, and preferred discussions with healthcare providers from outside their community); and Views and experiences of the contraceptive implant (while the implant was described as a 'Western' method, most participants regarded it as an acceptable, convenient, cost-effective, and confidential means of contraception). Decision-making regarding the implant is influenced by many factors which must be considered in health promotion efforts and when providing clinical care. Consideration of more informative health promotion resources, peer education strategies, and healthcare provider training is warranted to support contraception decision-making and choice.
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Affiliation(s)
| | | | - Yen Li Lim
- Family Planning Australia, Newington, NSW, Australia
| | - Jane Estoesta
- Family Planning Australia, Newington, NSW, Australia
| | - Jessica R Botfield
- Family Planning Australia, Newington, NSW, Australia
- Monash University, Clayton, VIC, Australia
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Darabos K, Manne SL, Devine KA. The association between neighborhood social and built environment on loneliness among young adults with cancer. J Cancer Surviv 2024:10.1007/s11764-024-01563-w. [PMID: 38499963 DOI: 10.1007/s11764-024-01563-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 03/07/2024] [Indexed: 03/20/2024]
Abstract
PURPOSE Young adults with cancer (YAs, aged 18-39) are at increased risk of experiencing loneliness due to their unique challenges of coping with a cancer diagnosis and treatment during young adulthood. Understanding factors that impact loneliness is critical to improving survivorship outcomes for this vulnerable YA population. Neighborhoods are key determinants of health. However, little is known about how such neighborhood characteristics are associated with loneliness among YA survivors. METHODS YA survivors (N = 181) drawn from the National Institutes of Health All of Us Research Program completed measures of neighborhood social environment (e.g., shared values), aspects of their neighborhood built environment (e.g., access to transit, recreational activities), and loneliness. Two total scores were calculated with higher scores reflecting higher neighborhood social cohesion and higher neighborhood walkability/bikeability (i.e., built environment). Hierarchical linear regression examined associations between the social and built environment on loneliness. RESULTS Higher levels of neighborhood social cohesion (β = - 0.28, 95% confidence interval (CI) = - 0.44, - 0.11) and neighborhood walkability/bikeability (β = - 0.15, 95% CI = - 0.31, - 0.006) were significantly associated with lower levels of loneliness. CONCLUSIONS Findings suggest that living within a cohesive social environment with neighborhood walkability/bikeability to built environment amenities such as green space, grocery stores, and public transportation is protective against loneliness among YA survivors. More longitudinal research is necessary to understand the dynamic changes in loneliness among YA survivors living in diverse social and built environments. IMPLICATIONS FOR CANCER SURVIVORS YA survivors may benefit from cultivating neighbor relationships and living within neighborhoods with walkability/bikeability.
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Affiliation(s)
- Katie Darabos
- Department of Health Behavior, Society, and Policy, Rutgers School of Public Health, The State University of New Jersey, 683 Hoes Lane West, Rm 327, Piscataway, NJ, 08854, USA.
- Rutgers Cancer Institute of New Jersey, 195 Little Albany Street, New Brunswick, NJ, 08901, USA.
| | - Sharon L Manne
- Rutgers Cancer Institute of New Jersey, 195 Little Albany Street, New Brunswick, NJ, 08901, USA
| | - Katie A Devine
- Rutgers Cancer Institute of New Jersey, 195 Little Albany Street, New Brunswick, NJ, 08901, USA
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Pitchford K, Shangani S, Dawson C, Masa R, Heron K. Community Health Care Providers' Perspectives on Human Immunodeficiency Virus Pre-Exposure Prophylaxis Use Among Black Women in Eastern Virginia. AIDS Patient Care STDS 2024; 38:123-133. [PMID: 38471092 DOI: 10.1089/apc.2023.0199] [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] [Indexed: 03/14/2024] Open
Abstract
The most at-risk population among women for human immunodeficiency virus (HIV) diagnosis in the United States are Black women, accounting for 61% of all new HIV cases. Pre-exposure prophylaxis (PrEP) is a safe and effective HIV prevention method for people at risk of HIV acquisition. Although disproportionately affected by HIV, Black women's knowledge, perceived benefits, and uptake of PrEP remain low. The socioecological model (SEM) may be useful for understanding why there is a low uptake of PrEP among Black women. The current study used the SEM to explore provider perspectives on the barriers and facilitators of PrEP uptake among Black women in Eastern Virginia. Semistructured interviews were conducted with a total sample of 15 community health care providers. Barriers of PrEP uptake at the societal (e.g., PrEP advertisements focus on gay men), community/organizational (e.g., time constraints in the workplace), interpersonal (e.g., perceived monogamy), and individual (e.g., unmet basic needs) levels were identified. Providers also identified facilitators of PrEP uptake at the societal (e.g., PrEP advertisements that target women), community/organizational (e.g., PrEP education), interpersonal (e.g., HIV-positive partner), and individual (e.g., PrEP awareness and perceived susceptibility to HIV) levels. These findings highlight unique barriers to accessing and taking PrEP for Black women in the United States, and potential factors that could facilitate PrEP use. Both barriers and facilitators may be important targets for interventions to improve PrEP uptake. Future research focused on improving PrEP uptake among Black women in the United States should consider multi-level interventions that target barriers and facilitators to reduce rates of HIV infections.
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Affiliation(s)
- Kayla Pitchford
- The Virginia Consortium Program in Clinical Psychology, Old Dominion University, Norfolk, Virginia, USA
- Department of Psychology, Old Dominion University, Norfolk, Virginia, USA
| | - Sylvia Shangani
- Department of Community Health Sciences, School of Public Health, Boston University, Boston, Massachusetts, USA
- Social and Behavioral Sciences Department, Yale School of Public Health, New Haven, Connecticut, USA
| | - Charlotte Dawson
- The Virginia Consortium Program in Clinical Psychology, Old Dominion University, Norfolk, Virginia, USA
| | - Rainier Masa
- School of Social Work, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Kristin Heron
- The Virginia Consortium Program in Clinical Psychology, Old Dominion University, Norfolk, Virginia, USA
- Department of Psychology, Old Dominion University, Norfolk, Virginia, USA
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Portela-Pino I, Brea-Castro M, Portela-Pino C, Pino-Juste M. Health literacy and pandemic coping in Leisure Time Monitors. Glob Health Promot 2024; 31:15-24. [PMID: 37609824 DOI: 10.1177/17579759231191501] [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] [Indexed: 08/24/2023]
Abstract
INTRODUCTION Health literacy allows us to make appropriate decisions about our self-care and to use health services appropriately, therefore, it conditions people's health. OBJECTIVES The aim of this study was to describe the level of health literacy of leisure time monitors and the influence of self-perception of health in times of pandemic. STUDY DESIGN We used a cross-sectional observational design with non-probabilistic purposive sampling among leisure time monitors in the Autonomous Community of Galicia (Spain). METHOD For this purpose, the HLS-EU-Q47 questionnaire measuring health literacy and a questionnaire measuring perception of COVID-19 were used. RESULTS The results verify that the monitors consider that the pandemic affects their daily life, that it will be a situation that will last for a long time, and they are very worried. The low level of health literacy of the leisure time monitors is also confirmed. CONCLUSIONS Therefore, it seems urgent to evaluate the existing training programme and to include health education contents in this programme, given the involvement of leisure time monitors in the training of children and adolescents.
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Affiliation(s)
- Iago Portela-Pino
- Department of Health Sciences, Faculty of Health Sciences, Isabel I University, Burgos, Spain
- Research Group on Education, Physical Activity and Health (GIES10), Galicia Sur Research Institute (IIS Galicia Sur), SERGAS-UVIGO, Vigo, Spain
| | - Millán Brea-Castro
- Research Group on Education, Physical Activity and Health (GIES10), Galicia Sur Research Institute (IIS Galicia Sur), SERGAS-UVIGO, Vigo, Spain
- Department of Psychoeducational Analysis and Intervention, Faculty of Education, University of Vigo, Ourense, Spain
| | - Clara Portela-Pino
- Internal Medicine Service, Complejo Hospitalario Universitario de Vigo, Galicia Sur Research Institute (IIS Galicia Sur), SERGAS-UVIGO, Vigo, Spain
| | - Margarita Pino-Juste
- Research Group on Education, Physical Activity and Health (GIES10), Galicia Sur Research Institute (IIS Galicia Sur), SERGAS-UVIGO, Vigo, Spain
- Department of Didactics, School Organization and Research Methods, Faculty of Education and Sport Sciences, University of Vigo, Spain
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Nelson TJ, Butcher BDC, Delgado A, McLemore MR. Perspectives of Certified Nurse-Midwives and Physicians on the Structural and Institutional Barriers that Contribute to the Reproductive Inequities of Black Birthing People in the San Francisco Bay Area. J Midwifery Womens Health 2024. [PMID: 38369871 DOI: 10.1111/jmwh.13614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 10/31/2023] [Indexed: 02/20/2024]
Abstract
INTRODUCTION Black birthing people in the United States disproportionately endure inequitable experiences and outcomes during pregnancy and childbirth via structural, interpersonal, and obstetric racism. In this study, the researchers explore provider perspectives of how racism is perpetuated in institutional perinatal and reproductive health care. METHODS Critical Race Theory, Reproductive Justice, and midwifery theory were operationalized through secondary thematic analysis of existing qualitative data from the Community Racial Equity and Training Interventions and Evaluation of Current and Future Healthcare Clinicians Study. Twenty-four perinatal providers (certified nurse-midwives [n = 7] and physicians [n = 17]) voluntarily participated in interviews. A comparative approach was used to determine how professional identity and model of care influence physicians' and certified nurse-midwives' perceptions of equity. RESULTS Thematic analysis produced 5 themes: racism as a comorbidity, health care systems' inability to address the needs of Black birthing people, health care systems prioritizing providers over patients are failed systems, patients are the experts in the optimal health care model, and benefits of interprofessional teams grounded in Reproductive Justice. Additionally, both physicians and midwives expressed a need for a new care model. DISCUSSION With these findings, our team proposes a modification of the midwifery model for application by all provider types that could radically shift the experience and outcomes of perinatal and reproductive health care and reduce mortality. Using a human rights approach to care, a Reproductive Justice-Public Health Critical Race praxis-informed midwifery model may be operationalized by all perinatal and reproductive health care providers. This novel model reflects an iterative process that may offer institutions and providers methods to build on past research supporting midwifery-centered care for improving outcomes for all patients by specifically focusing on improving care of Black birthing people. The implications of this work offer broad application in current clinical practice, quality improvement, research, technology, and patient resources.
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Affiliation(s)
- Tamara J Nelson
- Department of Family Health Care Nursing School of Nursing, University of California San Francisco, San Francisco, California
| | - Brittany D Chambers Butcher
- Department of Human Ecology, Human Development and Family Studies, University of California Davis, Davis, California
| | - Ana Delgado
- Department of Family Health Care Nursing School of Nursing, University of California San Francisco, San Francisco, California
| | - Monica R McLemore
- Department of Family Health Care Nursing School of Nursing, University of California San Francisco, San Francisco, California
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Fuller TJ, Lambert DN, DiClemente RJ, Wingood GM. Reach and Capacity of Black Protestant Health Ministries as Sites of Community-Wide Health Promotion: A Qualitative Social Ecological Model Examination. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-01926-0. [PMID: 38319551 DOI: 10.1007/s40615-024-01926-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 12/29/2023] [Accepted: 01/31/2024] [Indexed: 02/07/2024]
Abstract
Black communities in the Southeast United States experience a disproportionate burden of illness and disease. To address this inequity, public health practitioners are partnering with Black Protestant churches to deliver health promotion interventions. Yet, the reach of these programs beyond the organizational level of the Social Ecological Model (SEM) is not well defined. Thus, the aim of this study is to understand Black Protestant church leaders' and members' perceptions about the capacity of their ministries to reach into their communities, beyond their congregations, as providers or hosts of health education or promotion interventions. From 20 Black Protestant churches in Atlanta, GA, 92 church leaders and members participated in semi-structured interviews. Grounded theory guided data analysis and a diverse team coded the interviews. Most participating churches had health ministries. Participants saw the boundaries between their churches at the organizational level of the SEM and the broader Black community to be porous. Those who described their "community" as being broader than their congregation also tended to describe community-wide health promotion their church engaged in. They described church-based health fairs as a strategy to promote engagement in their communities. Some participants, particularly those in a health-related profession, discussed visions of how to utilize their church as a site for community-wide health promotion. We suggest these participants may be boundary leaders who can build relationships between public health professionals, pastors, and congregants. Based on the findings, we suggest that church-based health fairs may be effective sites of community-wide health promotion.
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Affiliation(s)
- Tyler J Fuller
- Graduate Program in Religion, Boston University, Boston, MA, USA.
| | - Danielle N Lambert
- Department of Epidemiology and Biostatistics, University of Georgia, Athens, GA, USA
| | - Ralph J DiClemente
- Department of Social and Behavioral Sciences, New York University, New York, NY, USA
| | - Gina M Wingood
- Department of Sociomedical Sciences, Columbia University, New York, NY, USA
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