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Jandaghian-Bidgoli M, Kazemian E, Shaterian N, Abdi F. Focusing attention on the important association between food insecurity and psychological distress: a systematic review and meta-analysis. BMC Nutr 2024; 10:118. [PMID: 39243085 PMCID: PMC11378639 DOI: 10.1186/s40795-024-00922-1] [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: 02/08/2024] [Accepted: 08/20/2024] [Indexed: 09/09/2024] Open
Abstract
BACKGROUND Food insecurity has involved more than 750 million individuals worldwide. The association of food insecurity with socio-economic factors is also undeniable demand more consideration. Food insecurity will become a global priority by 2030. This systematic review and meta-analysis examined current literature concerning the association between food insecurity and psychological distress. METHODS Relevant researches were identified by searching databases including PubMed, EMBASE, Scopus, and Web of Science, ProQuest, and Cochrane Library up to June 2024 without language limitation. Then a snowball search was conducted in the eligible studies. The quality assessment was made through Newcastle-Ottawa Scale. RESULTS Data were available from 44 cross-sectional articles for systematic review and 17 eligible articles for meta-analysis with 2,267,012 and 1,953,636 participants, respectively. Findings support the growing segment of literature on the association between food insecurity and psychological distress. The highly represented groups were households with low income. Psychological and diabetic distress was directly associated with food insecurity as it increased the odds of distress to 329% (OR: 3.29; 95% CI: 2.46-4.40). Sleep problems, anxiety, depression, lower life satisfaction, obesity, and a higher rate of smoking were among the secondary outcomes. CONCLUSION Food insecurity was a common stressor that can have a negative impact on psychological well-being and even physical health. The findings should be considered in the public health and making policy-making process.
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Affiliation(s)
| | - Elham Kazemian
- Department of Medicine, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Negin Shaterian
- Student Research Committee, Kashan University of Medical Sciences, Kashan, Iran
| | - Fatemeh Abdi
- Nursing and Midwifery Care Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran.
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2
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Molina Y, Kao SY, Bergeron NQ, Strayhorn-Carter SM, Strahan DC, Asche C, Watson KS, Khanna AS, Hempstead B, Fitzpatrick V, Calhoun EA, McDougall J. The Integration of Value Assessment and Social Network Methods for Breast Health Navigation Among African Americans. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2023; 26:1494-1502. [PMID: 37301367 PMCID: PMC10530024 DOI: 10.1016/j.jval.2023.06.001] [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: 05/14/2022] [Revised: 05/10/2023] [Accepted: 06/01/2023] [Indexed: 06/12/2023]
Abstract
OBJECTIVES A major strategy to reduce the impact of breast cancer (BC) among African Americans (AA) is patient navigation, defined here as individualized assistance for reducing barriers to healthcare use. The primary focus of this study was to estimate the added value of incorporating breast health promotion by navigated participants and the subsequent BC screenings that network members may obtain. METHODS In this study, we compared the cost-effectiveness of navigation across 2 scenarios. First, we examine the effect of navigation on AA participants (scenario 1). Second, we examine the effect of navigation on AA participants and their networks (scenario 2). We leverage data from multiple studies in South Chicago. Our primary outcome (BC screening) is intermediate, given limited available quantitative data on the long-term benefits of BC screening for AA populations. RESULTS When considering participant effects alone (scenario 1), the incremental cost-effectiveness ratio was $3845 per additional screening mammogram. When including participant and network effects (scenario 2), the incremental cost-effectiveness ratio was $1098 per additional screening mammogram. CONCLUSION Our findings suggest that inclusion of network effects can contribute to a more precise, comprehensive assessment of interventions for underserved communities.
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Affiliation(s)
- Yamilé Molina
- University of Illinois at Chicago, Chicago, IL, USA.
| | - Szu-Yu Kao
- University of Minnesota, Minneapolis, MN, USA
| | | | | | | | - Carl Asche
- University of Illinois at Chicago, Chicago, IL, USA; Huntsman Cancer Institute, Salt Lake City, UT, USA
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3
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Pham TV, Doorley J, Kenney M, Joo JH, Shallcross AJ, Kincade M, Jackson J, Vranceanu AM. Addressing chronic pain disparities between Black and White people: a narrative review of socio-ecological determinants. Pain Manag 2023; 13:473-496. [PMID: 37650756 PMCID: PMC10621777 DOI: 10.2217/pmt-2023-0032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 08/10/2023] [Indexed: 09/01/2023] Open
Abstract
A 2019 review article modified the socio-ecological model to contextualize pain disparities among different ethnoracial groups; however, the broad scope of this 2019 review necessitates deeper socio-ecological inspection of pain within each ethnoracial group. In this narrative review, we expanded upon this 2019 article by adopting inclusion criteria that would capture a more nuanced spectrum of socio-ecological findings on chronic pain within the Black community. Our search yielded a large, rich body of literature composed of 174 articles that shed further socio-ecological light on how chronic pain within the Black community is influenced by implicit bias among providers, psychological and physical comorbidities, experiences of societal and institutional racism and biomedical distrust, and the interplay among these factors. Moving forward, research and public-policy development must carefully take into account these socio-ecological factors before scaling up pre-existing solutions with questionable benefit for the chronic pain needs of Black individuals.
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Affiliation(s)
- Tony V Pham
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA
| | - James Doorley
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Martha Kenney
- Department of Anesthesiology, Duke University Medical Centre, Durham, NC 27710, USA
| | - Jin Hui Joo
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Amanda J Shallcross
- Wellness & Preventative Medicine, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Michael Kincade
- Center for Alzheimer's Research & Treatment, Massachusetts Alzheimer's Disease Research Centre, Boston, MA 02129, USA
| | - Jonathan Jackson
- Department of Neurology, Harvard Medical School, Boston, MA 02115, USA
| | - Ana-Maria Vranceanu
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA
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4
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Fanfan D, Rodríguez C, Stacciarini JMR. Strès ak Pwoblèm Pap Janm Fini: Deciphering migration-related stress from the perspectives of Haitian immigrants in Florida. Transcult Psychiatry 2023; 60:717-732. [PMID: 37097922 DOI: 10.1177/13634615231164524] [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] [Indexed: 04/26/2023]
Abstract
Relocating and starting a new life in a foreign country may entail a constellation of new stressors for Haitian immigrants; thus, research that enhances our understanding of how this vulnerable population contextualizes migration-related stress is necessary. The objectives of this study were to: (a) identify what factors are associated with migration-related stress, and (b) describe which and why specific migration-related stressors were most significant from the perspective of those suffering from high migration-related stress post migration via the stress proliferation lens of the stress process model. In this mixed-methods, sequential, explanatory pilot study, first-generation Haitian immigrants (N = 76) were recruited to operationalize migration-related stress, using the Demands of Immigration Scale (DIS). Participants (n = 8), who scored 25 or higher on the DIS, completed an in-depth audio-recorded follow-up interview that consisted of open-ended questions and a stressor-ranking questionnaire. Descriptive statistics, Pearson correlations, multiple linear regression (quantitative), and thematic analysis with a double-coded approach (qualitative) were employed to analyze the data. Female gender, older age, English fluency, and migration after the age of 18 years were associated with higher migration-related stress. However, only gender and English fluency predicted migration-related stress. In interviews, participants ranked five migration-related stressors as most stressful: language barriers, financial strains, loss of social networks, family conflicts, and exposure to discrimination/stigma. A nuanced depiction of migration-related stressors and proliferation mechanisms of migration-related stress may help identify areas where support and preventive efforts should be directed to improve social integration, stress levels, and mental well-being among immigrants.
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Affiliation(s)
- Dany Fanfan
- College of Nursing, University of Florida, Gainesville, FL
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5
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Moore A. From education to empowerment: Redesigning the role of students in college health promotion. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:984-987. [PMID: 34197276 DOI: 10.1080/07448481.2021.1920603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 02/05/2021] [Accepted: 04/18/2021] [Indexed: 05/31/2023]
Abstract
College health promotion departments frequently employ peer health educators to disseminate relevant education and conduct outreach to their student body. While there are certainly benefits to these programs, this approach is outdated and does little to empower students or engage them in the process of health promotion. In this viewpoint article, I describe the Community Health Organizer model, which expands students' role in peer engagement and advocacy beyond the traditional peer educator or peer counseling programs. Finally, I provide recommendations for college health practitioners interested in implementing a similar model on their campuses.
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Affiliation(s)
- Andrea Moore
- Office for Health Promotion Strategy, Student Health, University of Southern California, Los Angeles, California, USA
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6
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Conley C, Gonzalez-Guarda R, Randolph S, Hardison-Moody A, Fisher EB, Lipkus I. Religious social capital and minority health: A concept analysis. Public Health Nurs 2022; 39:1041-1047. [PMID: 35436366 DOI: 10.1111/phn.13082] [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: 12/15/2021] [Revised: 03/28/2022] [Accepted: 03/30/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Optimizing resources within environments where people live, work, and pray can aid nurses in improving public health. Religion and social capital significantly influence the health of individuals and communities, particularly among racial and ethnic minorities in the United States. A concept analysis of religious social capital was conducted to clarify how this resource is used in the context of health. DESIGN AND SAMPLE Rodgers' evolutionary concept analysis method guided this analysis. A search of PubMed, CINAHL, and PsycINFO, using keywords "religious social capital" and "health" yielded 152 publications. RESULTS Antecedents were "defined religious social network," "voluntary membership," "shared values," and "trust." Attributes were "relationships (bonding bridging, and linking)," "information exchange and resource sharing," and "reciprocal participation." Consequences were "increased productivity," "increased resources," "better personal and community health," and "trust." A model case of African American women and HIV prevention was included to illustrate how religious social capital can be developed and optimized to promote health. CONCLUSION Religious social capital is defined as increased individual and collective capabilities that result from voluntary and reciprocal participation in bonding, bridging, or linking social network relationships and activities. Religious social capital is an accessible resource that can be leveraged to improve minority health.
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Affiliation(s)
- Cherie Conley
- Duke University School of Nursing, Durham, North Carolina, USA
| | | | | | | | - Edwin B Fisher
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Isaac Lipkus
- Duke University School of Nursing, Durham, North Carolina, USA
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7
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Avery H, Sjögren Forss K, Rämgård M. Empowering communities with health promotion labs: result from a CBPR programme in Malmö, Sweden. Health Promot Int 2022; 37:daab069. [PMID: 34263320 PMCID: PMC8851348 DOI: 10.1093/heapro/daab069] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Health promotion is thus not only a participatory practice, but a practice for empowerment and social justice. The study describes findings from a community-based participatory and challenge-driven research program. that aimed to improve health through health promotion platform in an ethnically diverse low-income neighbourhood of Malmö, Sweden. Local residents together with lay health promoters living in the area were actively involved in the planning phase and decided on the structure and content of the program. Academic, public sector and commercial actors were involved, as well as NGOs and residents. Empowerment was used as a lens to analyse focus group interviews with participants (n=322) in six co-creative health-promoting labs on three occasions in the period 2017-2019. The CBPR interview guide focused on the dimensions of participation, collaboration and experience of the activities. The CBPR approach driven by community member contributed to empowerment processes within the health promotion labs: Health promotors building trust in social places for integration, Participants motivate each other by social support and Participants acting for community health in wider circle. CBPR Health promotion program should be followed up longitudielly with community participants to be able to see the processes of change and empowerment on the community level.
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Affiliation(s)
- Helen Avery
- Center for Middle Eastern studies, Lund University, Lund, Sweden
| | - Katarina Sjögren Forss
- Faculty of Health and Society, Department of Care Science, Malmö university, Malmö, Sweden
| | - Margareta Rämgård
- Faculty of Health and Society, Department of Care Science, Malmö university, Malmö, Sweden
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Social Capital and Sustainable Social Development—How Are Changes in Neighbourhood Social Capital Associated with Neighbourhood Sociodemographic and Socioeconomic Characteristics? SUSTAINABILITY 2021. [DOI: 10.3390/su132313161] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The development of social capital is acknowledged as key for sustainable social development. Little is known about how social capital changes over time and how it correlates with sociodemographic and socioeconomic factors. This study was conducted in 46 neighbourhoods in Umeå Municipality, northern Sweden. The aim was to examine neighbourhood-level characteristics associated with changes in neighbourhood social capital and to discuss implications for local policies for sustainable social development. We designed an ecological study linking survey data to registry data in 2006 and 2020. Over 14 years, social capital increased in 9 and decreased in 15 neighbourhoods. Higher levels of social capital were associated with specific sociodemographic factors, but these differed in urban and rural areas. Urban neighbourhoods with a higher proportion of older pensioners (OR = 1.49, CI: 1.16–1.92), children under 12 (OR= 2.13, CI: 1.31–3.47), or a lower proportion of foreign-born members (OR= 0.32, CI: 0.19–0.55) had higher odds for higher social capital levels. In rural neighbourhoods, a higher proportion of single-parent households was associated with higher levels of social capital (OR = 1.44, 95% CI = 1.04–1.98). Neighbourhood socioeconomic factors such as income or educational level did not influence neighbourhood social capital. Using repeated measures of social capital, this study gives insights into how social capital changes over time in local areas and the factors influencing its development. Local policies to promote social capital for sustainable social development should strive to integrate diverse demographic groups within neighbourhoods and should increase opportunities for inter-ethnic interactions.
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9
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Lee S, Deason K, Rancourt D, Gray HL. Disentangling the Relationship between Food Insecurity and Poor Sleep Health. Ecol Food Nutr 2021; 60:580-595. [PMID: 34032535 DOI: 10.1080/03670244.2021.1926245] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The COVID-19 pandemic has created disruptions in global and national food supply chains. Along with an increase in the unemployment rate, this resulted in a rise in food insecurity at the community-level, threatening individual and family well-being. Food insecurity is associated with inadequate nutrient intakes, weight gain, and psychological distress, including anxiety and depressive symptoms, all of which are known to affect sleep. Yet, little is known about whether and how food insecurity is associated with sleep health, a critical but underrecognized health outcome. This paper reviews literature describing associations between food insecurity and sleep, summarizes key findings based on proposed mechanisms, and discusses directions for future research.
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Affiliation(s)
- Soomi Lee
- School of Aging Studies, University of South Florida, Tampa, Florida, USA
| | - Karley Deason
- School of Aging Studies, University of South Florida, Tampa, Florida, USA
| | - Diana Rancourt
- Department of Psychology, University of South Florida, Tampa, Florida, USA
| | - Heewon L Gray
- College of Public Health, University of South Florida, Tampa, Florida, USA
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10
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Moore de Peralta A, Prieto Rosas V, Smithwick J, Timmons SM, Torres ME. A Contribution to Measure Partnership Trust in Community-Based Participatory Research and Interventions With Latinx Communities in the United States. Health Promot Pract 2021; 23:672-685. [PMID: 33890505 DOI: 10.1177/15248399211004622] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Given the growing diversity in the United States, responsiveness to the needs of diverse communities is paramount. Latinx communities in the United States often state mistrust in outside institutions because of adverse experiences. Community-based participatory research (CBPR) is considered a trust-building process and is one approach to understand disparities. However, the conceptualization and evaluation of trust as a CBPR outcome are understudied. This article summarizes a community-engaged research process conducted for the cultural and linguistic refinement of a partnership trust survey tool to assess partnership trust as an outcome of CBPR (CBPR-PTS), by using Perinatal Awareness for Successful Outcomes (PASOs) as a case study and cross-cultural cognitive interviewing (CCCI) methodology. The participants were 21 diverse stakeholders of PASOs, a community-based health organization that serves the Latinx population in South Carolina. A modified version of the multidimensional measure of trust model informed instrument development. The team analyzed the CCCI data using compiling informal analysis to identify which survey items' wordings must be changed or adapted based on the participants' accounts. Sixteen of 28 questions subjected to CCCI required modifications due to translation errors, culturally specific errors, or general cognitive problems. The new survey instrument has 19 scales and 195 items categorized into nine dimensions of the modified multidimensional measure of trust model. CCCI was a useful tool to address the cross-cultural understanding issues of the CBPR-PTS. Measurement instruments should be able to capture the socioeconomic, cultural, and geographic/environmental variability of community stakeholders to help understand the diversity of the comprehension and views of the communities involved in disparities' reduction efforts.
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11
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Revens KE, Gutierrez D, Paul R, Reynolds AD, Price R, DeHaven MJ. Social Support and Religiosity as Contributing Factors to Resilience and Mental Wellbeing in Latino Immigrants: A Community-Based Participatory Research Study. J Immigr Minor Health 2021; 23:904-916. [PMID: 33715112 DOI: 10.1007/s10903-021-01179-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/03/2021] [Indexed: 11/28/2022]
Abstract
Latino immigrants are at increased risk for mental disorders due to social/economic disadvantages and stressful conditions associated with migration. Resilience-the ability to recover from stress-may provide protection given its association with lower rates of anxiety and depression. This study examines the relationship between protective factors, resilience, and psychological distress in Latino immigrants. A community-based participatory research study conducted with a Latino agency using in-person surveys to obtain the following data: Brief Resilience Scale, Brief Symptom Inventory, Duke University Religion Index, Multi-group Ethnic Identity measure, and the Interpersonal Support Evaluation List. Linear regression, and mediation analysis was performed using SPSS. There are 128 participants. Resilience was positively related to social support (p = 0.001) and religiosity (p = 0.006); inversely related to psychological distress (p = 0.001); and mediated the relationship between the two (p = 0.006). Promoting social support and religion in Latino communities can improve wellbeing by increasing resilience and reducing distress.
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Affiliation(s)
- Keri E Revens
- Camino Community Center, 133 Stetson Dr., Charlotte, 28262, USA.
| | | | - Rajib Paul
- University of North Carolina at Charlotte, Charlotte, NC, USA
| | | | - Rusty Price
- Camino Community Center, 133 Stetson Dr., Charlotte, 28262, USA
| | - Mark J DeHaven
- University of North Carolina at Charlotte, Charlotte, NC, USA
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O'Brien J, Fossey E, Palmer VJ. A scoping review of the use of co-design methods with culturally and linguistically diverse communities to improve or adapt mental health services. HEALTH & SOCIAL CARE IN THE COMMUNITY 2021; 29:1-17. [PMID: 32686881 DOI: 10.1111/hsc.13105] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 06/19/2020] [Accepted: 06/19/2020] [Indexed: 05/21/2023]
Abstract
Mental health services are increasingly encouraged to use co-design methodologies to engage individuals and families affected by mental health problems in service design and improvement. This scoping review aimed to identify research that used co-design methods with Culturally and Linguistically Diverse (CALD) communities in mental health services, and to identify methodological considerations for working with this population. In October 2019, we searched five electronic databases (CINAHL, PsycINFO, EMBASE, MEDLINE, Web of Science) to identify papers published in which people from CALD backgrounds were engaged in the co-design of a mental health service or program. Searches were limited to peer-reviewed articles published in English in the last 25 years (1993-2019). The search identified nine articles that matched the inclusion criteria. Using a scoping review methodology, the first author charted the data using extraction fields and then used qualitative synthesis methods to identify themes. Data were grouped into themes relevant to the research question. The two key themes relate first, to improving the experience for CALD communities when engaging in co-design research and second, to the development of co-design methods themselves. These findings support the need for further research into the transferability of co-design tools with CALD communities, particularly if co-design is to become a best practice method for service design and improvement. This scoping review identified methodological and practical consideration for researchers looking to use co-design with CALD communities for mental health service design, re-design or quality improvement initiatives. Further research is required to explore experiences of co-design methods, including documented protocols such as experience-based co-design, with CALD communities. This review indicates that explanatory models of mental health, community and co-design impact partnerships with CALD communities, and need to be understood to optimise the quality of these relationships when using co-design methods.
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Affiliation(s)
- Jennifer O'Brien
- Department of Occupational Therapy, Monash University Peninsula Campus, Frankston, Vic., Australia
- School of Occupational Therapy, Australian Catholic University, Melbourne, Vic., Australia
| | - Ellie Fossey
- School of Occupational Therapy, Australian Catholic University, Melbourne, Vic., Australia
| | - Victoria J Palmer
- Integrated Mental Health Research Program & Co-Design Living Lab, Department of General Practice, Melbourne Medical School, The University of Melbourne, Melbourne, Vic., Australia
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13
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Salway S, Such E, Preston L, Booth A, Zubair M, Victor C, Raghavan R. Reducing loneliness among migrant and ethnic minority people: a participatory evidence synthesis. PUBLIC HEALTH RESEARCH 2020. [DOI: 10.3310/phr08100] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Background
To date, there has been little research into the causes of, and solutions to, loneliness among migrant and ethnic minority people.
Objectives
The objectives were to synthesise available evidence and produce new insights relating to initiatives that aim to address loneliness among these populations, plus the logic, functioning and effects of such initiatives.
Data sources
Electronic database searches (MEDLINE, Applied Social Sciences Index and Abstracts and Social Science Citation Index via Web of Science – no date restrictions were applied), grey literature searches, and citation and reference searching were conducted. Data were generated via nine workshops with three consultation panels involving 34 public contributors, and one practitioner workshop involving 50 participants.
Review methods
Guided by ‘systems thinking’, a theory-driven synthesis was combined with an effectiveness review to integrate evidence on the nature and causes of loneliness, interventional types and programme theory, and intervention implementation and effectiveness.
Results
The theory review indicated that common conceptualisations of ‘loneliness’ can be usefully extended to recognise four proximate determinants when focusing on migrant and ethnic minority populations: positive social ties and interactions, negative social ties and interactions, self-worth, and appraisal of existing ties. A total of 170 interventions were included. A typology of eight interventions was developed. Detailed logic models were developed for three common types of intervention: befriending, shared-identity social support groups and intercultural encounters. The models for the first two types were generally well supported by empirical data; the third was more tentative. Evaluation of intervention processes and outcomes was limited by study content and quality. Evidence from 19 qualitative and six quantitative studies suggested that social support groups have a positive impact on dimensions of loneliness for participants. Evidence from nine qualitative and three quantitative studies suggested that befriending can have positive impacts on loneliness. However, inconsistent achievements of the befriending model meant that some initiatives were ineffective. Few studies on intercultural encounters reported relevant outcomes, although four provided some qualitative evidence and three provided quantitative evidence of improvement. Looking across intervention types, evidence suggests that initiatives targeting the proximate determinants – particularly boosting self-worth – are more effective than those that do not. No evidence was available on the long-term effects of any initiatives. UK intervention (n = 41) and non-intervention (n = 65) studies, together with consultation panel workshop data, contributed to a narrative synthesis of system processes. Interlocking factors operating at individual, family, community, organisational and wider societal levels increase risk of loneliness, and undermine access to, and the impact of, interventions. Racism operates in various ways throughout the system to increase risk of loneliness.
Limitations
There was a lack of high-quality quantitative studies, and there were no studies with longer-term follow-up. UK evidence was very limited. Studies addressing upstream determinants operating at the community and societal levels did not link through to individual outcome measures. Some elements of the search approach may mean that relevant literature was overlooked.
Conclusions
Theory regarding the causes of loneliness, and functioning of interventions, among migrant and ethnic minority populations was usefully developed. Evidence of positive impact on loneliness was strongest for shared-identity social support groups. Quantitative evidence was inadequate. The UK evidence base was extremely limited.
Future work
UK research in this area is desperately needed. Co-production of interventional approaches with migrant and ethnic minority people and evaluation of existing community-based initiatives are priorities.
Study registration
This study is registered as PROSPERO CRD42017077378.
Funding
This project was funded by the National Institute for Health Research Public Health Research programme and will be published in full in Public Health Research; Vol. 8, No. 10. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Sarah Salway
- Department of Sociological Studies, University of Sheffield, Sheffield, UK
| | - Elizabeth Such
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Louise Preston
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Andrew Booth
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Maria Zubair
- Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, UK
| | - Christina Victor
- College of Health and Life Sciences, Brunel University London, London, UK
| | - Raghu Raghavan
- School of Nursing and Midwifery, De Montfort University, Leicester, UK
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Coulter K, Ingram M, McClelland DJ, Lohr A. Positionality of Community Health Workers on Health Intervention Research Teams: A Scoping Review. Front Public Health 2020; 8:208. [PMID: 32612967 PMCID: PMC7308474 DOI: 10.3389/fpubh.2020.00208] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 05/06/2020] [Indexed: 11/13/2022] Open
Abstract
Community health workers (CHWs) are increasingly involved as members of health intervention research teams. Given that CHWs are engaged in a variety of research roles, there is a need for better understanding of the ways in which CHWs are incorporated in research and the potential benefits. This scoping review synthesizes evidence regarding the kinds of health research studies involving CHWs, CHWs' roles in implementing health intervention research, their positionality on research teams, and how their involvement benefits health intervention research. The scoping review includes peer-reviewed health intervention articles published between 2008-2018 in the U.S. A search of PubMed, Embase and CINAHL identified a total of 3,129 titles and abstracts, 266 of which met the inclusion criteria and underwent full text review. A total of 130 articles were identified for a primary analysis of the research and the level of CHWs involvement, and of these 23 articles were included in a secondary analysis in which CHWs participated in 5 or more intervention research phases. The scoping review found that CHWs are involved across the spectrum of research, including developing research questions, intervention design, participant recruitment, intervention implementation, data collection, data analysis, and results dissemination. CHW positionality as research partners varied greatly across studies, and they are not uniformly integrated within all stages of research. The majority of these studies employed a community based participatory research (CBPR) approach, and CBPR studies included CHWs as research partners in more phases of research relative to non-CBPR studies. This scoping review documents specific benefits from the inclusion of CHWs as partners in health intervention research and identifies strategies to engage CHWs as research partners and to ensure that CHW contributions to research are well-documented.
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Affiliation(s)
- Kiera Coulter
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, United States
| | - Maia Ingram
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, United States
| | - Deborah Jean McClelland
- University of Arizona Health Sciences Library, University of Arizona, Tucson, AZ, United States
| | - Abby Lohr
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, United States
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A qualitative study of social connectedness and its relationship to community health programs in rural Chiapas, Mexico. BMC Public Health 2020; 20:852. [PMID: 32493280 PMCID: PMC7271512 DOI: 10.1186/s12889-020-09008-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Accepted: 05/28/2020] [Indexed: 12/04/2022] Open
Abstract
Background Social connectedness is an important predictor of health outcomes and plays a large role in the physical and mental health of an individual and a community. The presence of a functioning health clinic with a community health worker program may indirectly improve health outcomes by increasing the social connectedness of the community in addition to providing direct patient care. This study examines the social connectedness of the inhabitants of three Mexican towns within the catchment area of a healthcare Non-Government Organization (NGO) through a qualitative analysis. Methods Willing participants were videotaped answering open-ended questions about their community and use of healthcare resources. Interviews were then coded for relevant themes and analyzed for content relating to social connectedness, social isolation, and health. Results Respondents reported that having a functioning community clinic had improved their lives significantly through direct provision of care and by reducing the financial burden of travel to seek medical care elsewhere. Respondents from each town differed slightly in their primary means of social support. One town relied more heavily on organized groups (i.e., religious groups) for their support system. Social isolation was reported most frequently by housewives who felt isolated in the home and by respondents that had to deal with personal illness. Respondents that self-identified as Community Health Workers (CHWs) in their respective communities acknowledged that their roles bestowed physical and psychological health benefits upon themselves and their families. Conclusions Overall, a long-term health intervention may directly impact the relative social isolation and social connectedness of a community’s inhabitants. The social connectedness of the community is an important quality that must be considered when evaluating and planning health interventions.
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Oppenheim CE, Axelrod K, Menyongai J, Chukwuezi B, Tam A, Henderson DC, Borba CPC. The HEAAL Project: Applying Community-Based Participatory Research (CBPR) Methodology in a Health and Mental Health Needs Assessment With an African Immigrant and Refugee Faith Community in Lowell, Massachusetts. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2020; 25:E1-E6. [PMID: 30507809 DOI: 10.1097/phh.0000000000000707] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Community-based participatory research methodology is driven by community interests and rooted in community involvement throughout the research process. This article describes the use of community-based participatory research methodology in the HEAAL project (Health and Mental Health Education and Awareness for Africans in Lowell), a research collaboration between Christ Jubilee International Ministries-a nondenominational Christian church in Lowell, Massachusetts, that serves an African immigrant and refugee congregation-and the Massachusetts General Hospital Department of Psychiatry. The objective of the HEAAL project was to better understand the nature, characteristics, scope, and magnitude of health and mental health issues in this faith community. The experience of using community-based participatory research in the HEAAL project has implications for research practice and policy as it ensured that research questions were relevant and meaningful to the community; facilitated successful recruitment and navigation through challenges; and can expedite the translation of data to practice and improved care.
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Affiliation(s)
- Claire E Oppenheim
- Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts (Ms Oppenheim and Drs Tam, Henderson, and Borba); Department of Psychiatry, Boston Medical Center, Boston, Massachusetts (Ms Oppenheim and Drs Tam, Henderson, and Borba); Innovations in Healthcare, Duke University, Durham, North Carolina (Ms Axelrod); and Christ Jubilee International Ministries, Lowell, Massachusetts (Mr Menyongai and Ms Chukwuezi)
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Radlick RL, Svedberg P, Nygren JM, Przedpelska S, Gammon D. Digitally Enhanced Mentoring for Immigrant Youth Social Capital: Protocol for a Mixed Methods Pilot Study and a Randomized Controlled Trial. JMIR Res Protoc 2020; 9:e16472. [PMID: 32181746 PMCID: PMC7109612 DOI: 10.2196/16472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 12/14/2019] [Accepted: 12/15/2019] [Indexed: 11/30/2022] Open
Abstract
Background There are large disparities between immigrants and native Norwegians in domains such as health, education, and employment. Reducing such disparities is essential for individual and societal well-being. Social capital is associated with positive effects on these domains, and mentoring programs have the potential to boost social capital. However, few studies have assessed mentoring as a social capital intervention among youth or the potential barriers and facilitators of implementing digitally augmented mentoring. Objective The goal of this paper is to describe a protocol for assessing the implementation and effectiveness of a digitally augmented mentoring program for immigrant youth as a health intervention to promote social capital. The two-stage analytical framework for a pilot study followed by a randomized controlled trial (RCT) is presented. The pilot aims to assess program fidelity and make necessary intervention adjustments before the RCT. The RCT aims to assess the effects of the implemented intervention program on social capital and the relationship between program fidelity and effects. Methods Both the pilot and RCT will use mixed methods with a process evaluation approach used to structure the intervention and a pre-post test survey component to measure social capital and fidelity of program implementation. Interviews will also be used to enrich the quantitative data from the survey. Results The pilot study is scheduled to begin in fall 2019. Based on data analyses in spring 2020, potential adjustments will be made to the intervention, with findings used in preparation for the full-scale RCT study. Conclusions Digitally enhanced mentoring programs may be a helpful intervention for providing immigrant youth with tools for increasing their social capital and indirectly improving health outcomes. This protocol provides new knowledge about the implementation and evaluation of such programs. International Registered Report Identifier (IRRID) PRR1-10.2196/16472
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Affiliation(s)
| | - Petra Svedberg
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Jens M Nygren
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | | | - Deede Gammon
- Center for Shared Decision-Making and Collaborative Care Research, Oslo University Hospital, Oslo, Norway.,Norwegian Centre for E-health Research, University Hospital of North Norway, Tromsø, Norway
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Adams C. Toward an institutional perspective on social capital health interventions: lay community health workers as social capital builders. SOCIOLOGY OF HEALTH & ILLNESS 2020; 42:95-110. [PMID: 31674684 DOI: 10.1111/1467-9566.12992] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
This article argues that social capital health research should move beyond a mere focus on social cohesion and network perspectives to integrate an institutional approach into the development of social capital health interventions. An institutional perspective, which is unique in its emphasis on linking social capital in addition to the bonding and bridging forms, contextualises social capital, allowing researchers to confront the complexity of social relationships. This perspective allows for the construction of interventions that draw on the resources of diverse actors, particularly the state. One intervention strategy with the potential to create community linkages involves lay community health workers (LCHWs), individuals who are trained to perform a variety of health-related functions but lack a formal professional health education. This article begins with a review of the institutional social capital-building literature. It then goes on to briefly review the social capital and health literature and discuss the state of intervention research. Thereafter, it describes LCHWs and discusses studies that have utilised LCHWs to tackle community health problems. In doing so, this article presents an institutional-based systematic framework for how LCHWs can build social capital, including a discussion of the ways in which LCHWs can successfully promote bonding, bridging and linking social capital.
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Affiliation(s)
- Crystal Adams
- Department of Sociology and Anthropology, Muhlenberg College, Allentown, Pennsylvania, USA
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Manjunath C, Ifelayo O, Jones C, Washington M, Shanedling S, Williams J, Patten CA, Cooper LA, Brewer LC. Addressing Cardiovascular Health Disparities in Minnesota: Establishment of a Community Steering Committee by FAITH! (Fostering African-American Improvement in Total Health). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E4144. [PMID: 31661826 PMCID: PMC6862476 DOI: 10.3390/ijerph16214144] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 10/22/2019] [Indexed: 12/11/2022]
Abstract
Despite its rank as the fourth healthiest state in the United States, Minnesota has clear cardiovascular disease disparities between African-Americans and whites. Culturally-tailored interventions implemented using community-based participatory research (CBPR) principles have been vital to improving health and wellness among African-Americans. This paper delineates the establishment, impact, and lessons learned from the formation of a community steering committee (CSC) to guide the Fostering African-American Improvement in Total Health (FAITH!) Program, a CBPR cardiovascular health promotion initiative among African-Americans in Minnesota. The theory-informed CSC implementation process included three phases: (1) Membership Formation and Recruitment, (2) Engagement, and (3) Covenant Development and Empowerment. The CSC is comprised of ten diverse community members guided by mutually agreed upon bylaws in their commitment to FAITH!. Overall, members considered the CSC implementation process effective and productive. A CBPR conceptual model provided an outline of proximal and distal goals for the CSC and FAITH!. The CSC implementation process yielded four lessons learned: (1) Have clarity of purpose and vision, (2) cultivate group cohesion, (3) employ consistent review of CBPR tenets, and (4) expect the unexpected. A robust CSC was established and was instrumental to the success and impact of FAITH! within African-American communities in Minnesota.
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Affiliation(s)
- Chandrika Manjunath
- Department of Cardiovascular Medicine, Mayo Clinic College of Medicine, Rochester, MN 55905, USA.
| | | | | | | | - Stanton Shanedling
- Cardiovascular Health Unit, Minnesota Department of Health, St. Paul, MN 55164, USA.
| | - Johnnie Williams
- Full Proof Ministry Church of God in Christ, Crystal, MN 55429, USA.
| | - Christi A Patten
- Department of Psychiatry and Psychology, Mayo Clinic College of Medicine, Rochester, MN 55905, USA.
| | - Lisa A Cooper
- Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA.
| | - LaPrincess C Brewer
- Department of Cardiovascular Medicine, Mayo Clinic College of Medicine, Rochester, MN 55905, USA.
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Gonzalez M, Sanders-Jackson A, Henriksen L. Social Capital and Tobacco Retail Outlet Density: An Empirical Test of the Relationship. Am J Health Promot 2019; 33:1020-1027. [PMID: 31195802 DOI: 10.1177/0890117119853716] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To examine the relationship between tobacco outlet density and social capital. PARTICIPANTS Parents of at least one teen (N = 2734) in a representative sample of US households with teens (ages 13-16). DESIGN Population-based, cross-sectional survey of a web panel of adolescent-parent pairs matched with spatial data for address to characterize household neighborhoods. SETTING US households identified by latitude and longitude with a 50-ft random shift. MEASURES Perceived social capital (trust and informal social control as reported by parents), tobacco outlet density (retailers per land area in 1/2-mile buffer around each household), neighborhood demographics (derived from American Community Survey), and parent demographics. ANALYSIS Multivariable regression examined the relationship between tobacco outlet density and social capital controlling for household buffer and individual-level covariates, including correlates of social capital. RESULTS Tobacco outlet density was inversely correlated with perceived trust in neighbors (B = -1.12, P = .0004), but not social control (B = 0.11, P = .731). CONCLUSION This study is the first we are aware of to find that social capital is related to tobacco outlet density. The results imply that individuals with low social capital may benefit from policies regulating tobacco outlet density and may benefit from policies that address neighborhood inequality by increasing social capital and reducing poverty.
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Affiliation(s)
- Mariaelena Gonzalez
- 1 Department of Public Health, University of California, Merced, CA, USA.,2 Nicotine and Cannabis Policy Center, University of California, Merced, CA, USA
| | | | - Lisa Henriksen
- 4 Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA, USA
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Molina Y, San Miguel LG, Tamayo L, Robledo C, Díaz CS, Lucio A, Coronado N, Ferrans CE. The "Empowering Latinas to Obtain Breast Cancer Screenings" study: Rationale and design. Contemp Clin Trials 2018; 71:1-8. [PMID: 29803815 DOI: 10.1016/j.cct.2018.05.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 05/08/2018] [Accepted: 05/22/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Latinas suffer disproportionately from breast cancer (BC) in part due to lower guideline-concordant screening. Multiple intervention approaches have been developed to promote screening through direct patient education and empowerment approaches (i.e., training community members to share BC information). This study compares the relative effects of these approaches on: 1) women's BC screening; and, 2) women's dissemination of BC information within their social networks. DESIGN/METHODS Our quasi-experimental trial is being implemented in community venues in two predominantly Latino neighborhoods in South and West Chicago. Eligible participants: 1) are female; 2) are 52-74 years old; 3) have not obtained a mammogram in the past 2 years; and, 4) have not previously participated in health-related volunteerism. Based on their geographic location, participants are assigned to one of two group-based interventions. Both interventions consist of three two-hour sessions, which includes BC early detection education. The education intervention sessions also covers BC prevention (diet, physical activity), whereas the empowerment intervention covers sharing information with family/friends, and health volunteerism. Navigation is provided for all women who wish to obtain mammograms. Primary outcomes include: 1) receipt of BC screening; and, 2) participants' dissemination of BC information. Secondary outcomes include positive changes in 1) participants' self-reported psychosocial facilitators; and, 2) social network members' BC behaviors. DISCUSSION The design of our program allows for a preliminary comparison of the effectiveness of these two approaches. This work will inform larger comparativeness trials and offers a new approach to intervention evaluation via social network analysis.
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Molina Y, McKell MS, Mendoza N, Barbour L, Berrios NM, Murray K, Ferrans CE. Health Volunteerism and Improved Cancer Health for Latina and African American Women and Their Social Networks: Potential Mechanisms. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2018; 33:59-66. [PMID: 27328950 PMCID: PMC5179314 DOI: 10.1007/s13187-016-1061-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Health volunteerism has been associated with positive health outcomes for volunteers and the communities they serve. This work suggests that there may be an added value to providing underserved populations with information and skills to be agents of change. The current study is a first step toward testing this hypothesis. The purpose is to identify how volunteerism may result in improved cancer health among Latina and African American women volunteers. A purposive sample of 40 Latina and African American female adults who had participated in cancer volunteerism in the past 5 years was recruited by community advocates and flyers distributed throughout community venues in San Diego, CA. This qualitative study included semi-structured focus groups. Participants indicated that volunteerism not only improved their health but also the health of their family and friends. Such perceptions aligned with the high rates of self-report lifetime cancer screening rates among age-eligible patients (e.g., 83-93 % breast; 90-93 % cervical; 79-92 % colorectal). Identified mechanisms included exposure to evidence-based information, health-protective social norms and support, and pressure to be a healthy role model. Our findings suggest that train-the-trainer and volunteer-driven interventions may have unintended health-protective effects for participating staff, especially Latina and African American women.
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Affiliation(s)
- Yamile Molina
- University of Illinois at Chicago, Chicago, IL, USA.
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
| | | | | | - Lynda Barbour
- American Cancer Society Cancer Action Network, Washington, DC, USA
| | | | - Kate Murray
- University of California, San Diego, CA, USA
- Queensland University of Technology, Brisbane, Australia
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Caxaj CS, Kolol Qnan Tx'otx' Parroquia de San Miguel Ixtahuacan. A community-based intervention to build community harmony in an Indigenous Guatemalan Mining Town. Glob Public Health 2018; 13:1670-1681. [PMID: 29363397 DOI: 10.1080/17441692.2018.1427273] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The presence of large-scale mining operations poses many threats to communities. In a rural community in Guatemala, community leaders were motivated to address divisiveness and local conflict that have been exacerbated since the arrival of a mining company in the region. Prior research by our team identified spiritual and cultural strengths as important sources of strength and resilience in the community. We piloted a community-based intervention centred on spiritual and cultural practices in the region, to address divisiveness and build community harmony. One hundred and seventeen participants from over 18 villages in the municipality participated in the workshops and follow-up focus groups. Community leaders facilitated the intervention and partnered with the academic researcher throughout the research process. Overall, community members and facilitators expressed satisfaction with the workshop. Further, our analysis revealed three important processes important to the development of community harmony in the region: (a) mutual recognition and collectivisation; (b) affirmation of ancestral roots and connections to Mother Earth and (c) inspiring action and momentum towards solutions. These mechanisms, and the socio-political contexts that undermine them, have important implications for how global health programmes are developed and how collective processes for well-being are understood within an inequitable, conflict-laden world.
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Affiliation(s)
- Claudia Susana Caxaj
- a Faculty of Health and Social Development, School of Nursing , University of British Columbia , Kelowna , Canada
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Rivera YM. Reducing Cancer Health Disparities among U.S. Latinos: A Freireian Approach. INTERNATIONAL JOURNAL OF HUMAN RIGHTS IN HEALTHCARE 2018; 11:368-379. [PMID: 31032065 PMCID: PMC6485949 DOI: 10.1108/ijhrh-02-2018-0021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE – This paper applies Paulo Freire's writings from Pedagogy of the Oppressed to critique current efforts to reduce cancer health disparities (CHDs) among Latinos in the U.S. DESIGN/METHODOLOGY/APPROACH – Freire's writings on oppression, critical consciousness, praxis and dialogical education are applied to recent efforts to reduce CHDs among Latinos in the U.S. through the use of promotores. FINDINGS – Freireian teachings can provide insight on ways to engage Latino communities in culturally sensitive conversations that respect deeply rooted beliefs, and address the political and socioeconomic inequities many continue to face. Programs must revisit Freire's political and transformative roots to ensure efforts to reduce CHDs also promote health equity and community empowerment. PRACTICAL IMPLICATIONS – Public health initiatives should incorporate Freireian principles of dialogical education and critical consciousness in the development of cancer prevention and screening programs tailored to Latinos in the U.S. to ensure program longevity and success. SOCIETAL IMPLICATIONS – Approaching conversations and interactions dialogically can foster critical engagement and empower collective action among Latino communities in efforts to improve their environments and reduce health disparities. ORIGINALITY/VALUE – This is a multi-layered analysis of different social and structural factors influencing CHDs among Latinos in the U.S., and is coupled with a historical overview of colonialism and oppression in Latin America. It culminates in suggestions on ways to improve future public health efforts that embrace Freireian approaches and promote health equity. CLASSIFICATION – Conceptual paper.
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Affiliation(s)
- Yonaira M Rivera
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA, 787-529-9015,
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Harada K, Masumoto K, Katagiri K, Fukuzawa A, Chogahara M, Kondo N, Okada S. Community intervention to increase neighborhood social network among Japanese older adults. Geriatr Gerontol Int 2017; 18:462-469. [DOI: 10.1111/ggi.13208] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 08/28/2017] [Accepted: 09/15/2017] [Indexed: 12/12/2022]
Affiliation(s)
- Kazuhiro Harada
- Active Aging Research Hub, Graduate School of Human Development and Environment; Kobe University; Kobe Japan
| | - Kouhei Masumoto
- Active Aging Research Hub, Graduate School of Human Development and Environment; Kobe University; Kobe Japan
| | - Keiko Katagiri
- Active Aging Research Hub, Graduate School of Human Development and Environment; Kobe University; Kobe Japan
| | - Ai Fukuzawa
- Active Aging Research Hub, Graduate School of Human Development and Environment; Kobe University; Kobe Japan
| | - Makoto Chogahara
- Active Aging Research Hub, Graduate School of Human Development and Environment; Kobe University; Kobe Japan
| | - Narihiko Kondo
- Active Aging Research Hub, Graduate School of Human Development and Environment; Kobe University; Kobe Japan
| | - Shuichi Okada
- Active Aging Research Hub, Graduate School of Human Development and Environment; Kobe University; Kobe Japan
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Alaofè H, Asaolu I, Ehiri J, Moretz H, Asuzu C, Balogun M, Abosede O, Ehiri J. Community Health Workers in Diabetes Prevention and Management in Developing Countries. Ann Glob Health 2017; 83:661-675. [PMID: 29221543 DOI: 10.1016/j.aogh.2017.10.009] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Accepted: 10/17/2017] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND There is limited evidence regarding the effect of community health worker (CHW) interventions for prevention and management of the burgeoning epidemic of noncommunicable diseases (NCDs) in low- and middle-income countries (LMICs). The objective of this review was to critically appraise evidence regarding the effectiveness of CHW interventions for prevention and management of type 2 diabetes mellitus (T2DM) in LMICs. METHODS To identify studies that reported the effect of CHW interventions for prevention and management of T2DM in LMICs, Medline/PubMed, EMBASE, Web of Science (Science and Social Science Citation Indices), EBSCO (PsycINFO and CINAHL), POPLINE, the Cochrane Metabolic and Endocrine Disorders Group's Specialized Register, the Cochrane Central Register of Controlled Trials, the Grey literature (Google, Google Scholar), and reference lists of identified articles were searched from inception to May 31, 2017. FINDINGS Ten studies were included (4 pre- and post-studies, 2 randomized controlled trials, 2 cohort studies, 1 cross-sectional study, and 1 case-control study). The role of CHWs consisted of patient education, identification and referral of high-risk individuals to physicians, and provision of social support through home visits. Positive outcomes were reported in 7 of 10 studies. These outcomes included increased knowledge of T2DM symptoms and prevention measures; increased adoption of treatment-seeking and prevention measures; increased medication adherence; and improved fasting blood sugar, glycated hemoglobin, and body mass index. Three studies showed no significant outcomes. CONCLUSIONS CHWs have the potential to improve knowledge, health behavior, and health outcomes related to prevention and management of T2DM in LMICs. Given the limited number of studies included in this review, robust conclusions cannot be drawn at the present time.
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Affiliation(s)
- Halimatou Alaofè
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona
| | - Ibitola Asaolu
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona
| | - Jennifer Ehiri
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona
| | - Hayley Moretz
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona
| | - Chisom Asuzu
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona
| | - Mobolanle Balogun
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Olayinka Abosede
- Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria
| | - John Ehiri
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona.
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Nagy E, Moore S. Social interventions: An effective approach to reduce adult depression? J Affect Disord 2017; 218:131-152. [PMID: 28472703 DOI: 10.1016/j.jad.2017.04.043] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 02/09/2017] [Accepted: 04/23/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND Social interventions that aim to facilitate bonds and interaction among individuals could reduce depression at a population level; yet, the scope and effectiveness of these interventions remain unclear. This systematic review classifies and reports on social interventions that have been implemented to target depression in adults. METHODS Search terms related to 'intervention', 'depression', and 'social' were entered into databases, including: The Cochrane Database of Systematic Reviews, MEDLINE, Embase, PsycInfo, CINAHL, and TRoPHI. Inclusion criteria included: (1) depression was an intervention outcome, (2) depression was not attributable to concomitant illnesses or circumstances (e.g., chronic illness or exposure to natural disasters), (3) the intervention facilitated social interaction, (4) the intervention targeted adults (18-64), (5) the sample was community-based, (6) the study was available in English, and (7) within-group or between-group comparison group information was available. RESULTS Of the 24 studies meeting the inclusion criteria, 17 reported reductions in depressive symptoms. Social interventions often incorporated multiple strategies to improve depressive symptoms, including: peer support (n=17), skill building (n=11), group-based activities (n =11), psycho-education (n =9), psychotherapy (n =5), exercise (n =5), and links to community resources (n=3). LIMITATIONS Findings of this review may not be generalizable to specific population subgroups with depression, including those who have chronic illnesses or postpartum depression. CONCLUSIONS Various types of social interventions can be effective in reducing adult depression. Social interventions can be tailored to diverse groups, are feasible in resource-scarce communities, and have the potential to reduce population-level depression due to their group formats.
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Affiliation(s)
- Emma Nagy
- School of Kinesiology & Health Studies, Queen's University, 28 Division St, Kingston K7L 3N6, Ontario, Canada.
| | - Spencer Moore
- School of Kinesiology & Health Studies, Queen's University, 28 Division St, Kingston K7L 3N6, Ontario, Canada; Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
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Drinking and Driving among Recent Latino Immigrants: The Impact of Neighborhoods and Social Support. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13111055. [PMID: 27801856 PMCID: PMC5129265 DOI: 10.3390/ijerph13111055] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2016] [Revised: 10/19/2016] [Accepted: 10/22/2016] [Indexed: 12/13/2022]
Abstract
Latinos are disproportionately impacted by drinking and driving arrests and alcohol-related fatal crashes. Why, and how, these disparities occur remains unclear. The neighborhood environments that recent Latino immigrants encounter in their host communities can potentially influence health behaviors over time, including the propensity to engage in drinking and driving. This cross-sectional study utilizes a sample of 467 documented and undocumented adult recent Latino immigrants in the United States to answer the following research questions: (a) How do neighborhood-level factors, combined with social support, impact drinking and driving risk behaviors?; and (b) Does acculturative stress moderate the effects of those associations? Results indicate neighborhood-level factors (informal social control and social capital) have protective effects against drinking and driving risk behaviors via the mediating mechanism of social support. Acculturative stress moderated associations between neighborhood informal social control and social support, whereby the protective effects of informal social control on social support were not present for those immigrants with higher levels of acculturative stress. Our findings contribute to the limited knowledge of drinking and driving among Latino immigrants early in the immigration process and suggest that, in the process of developing prevention programs tailored to Latino immigrants, greater attention must be paid to neighborhood-level factors.
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Parental social capital and children's sleep disturbances. Sleep Health 2016; 2:330-334. [PMID: 29073391 DOI: 10.1016/j.sleh.2016.09.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2016] [Revised: 08/22/2016] [Accepted: 09/08/2016] [Indexed: 11/23/2022]
Abstract
OBJECTIVES Sleep plays a critical role in the health and well-being of children. Individual and household factors, including parent's social connections, may impact children's sleep. Our study assessed the association between children's sleep disturbances and parent's social capital in a sample of Canadian households. DESIGN Cross-sectional, observational study. SETTINGS AND PARTICIPANTS Data came from 339 children and their parents who completed a telephone and follow-up survey in 2013 as part of the Canada Brain-to-Society study. Participants were parents (73.1% female) with children aged 6 to 12years residing in Montreal, Canada. MEASUREMENTS Parental social capital was assessed using a position generator, and children's sleep disturbances were measured with the Children's Sleep Habits Questionnaire. Other household demographic and socioeconomic characteristics were measured, including parental and child age and sex, foreign-born status, and income. Linear regression was used to examine the association between parental social capital and children's sleep disturbances while controlling for possible confounders. RESULTS Parental social capital was negatively associated with children's sleep disturbances (β=-0.02, SE=0.01, P<.05), when controlling for demographic factors (sex of parent, household income, foreign-born status, parent's age, sex and age of child, suggesting that children of parents with higher social capital had fewer sleep disturbances. CONCLUSIONS Parents with higher social capital tended to have children with few total sleep disturbances than did parents with lower social capital. Parental social capital may be a potentially modifiable aspect of the home environment that has implications for children's health.
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Stacciarini JMR, Vacca R, Wiens B, Loe E, LaFlam M, Pérez A, Locke B. FBO Leaders' Perceptions of the Psycho-social Contexts for Rural Latinos. Issues Ment Health Nurs 2016; 37:19-25. [PMID: 26818929 PMCID: PMC4955657 DOI: 10.3109/01612840.2015.1076914] [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] [Indexed: 11/13/2022]
Abstract
Latinos comprise the largest minority rural population in the US, and they are often exposed to adverse social health determinants that can detrimentally affect their mental health. Guided by community-based participatory research (CBPR) principles, this study aimed to describe faith-based organizations (FBOs) leaders' perceptions of the contexts affecting the mental well-being of rural Latino immigrants and potential approaches to mental health promotion for these immigrants. This is a descriptive, qualitative arm of a larger study in which community-academic members have partnered to develop a culturally-tailored mental health promotion intervention among rural Latinos. FBO leaders (N = 15) from different denominations in North Florida were interviewed until saturation was reached. FBO leaders remarked that in addition to religiosity, which Latinos already have, more community building and involvement are necessary for the promotion of mental health.
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Affiliation(s)
| | - Raffaele Vacca
- a University of Florida, College of Nursing , Gainesville , Florida , USA
| | - Brenda Wiens
- b University of Florida, College of Public Health and Health Professions , Gainesville , Florida , USA
| | - Emily Loe
- a University of Florida, College of Nursing , Gainesville , Florida , USA
| | - Melody LaFlam
- c Meridian Behavioral Healthcare, Inc. , Bronson , Florida , USA
| | - Awilda Pérez
- d Holy Family Catholic Church , Williston , Florida , USA
| | - Barbara Locke
- e Public Health Department , Levy County , Bronson , Florida , USA
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Mao L, Stacciarini JMR, Smith R, Wiens B. An individual-based rurality measure and its health application: A case study of Latino immigrants in North Florida, USA. Soc Sci Med 2015; 147:300-8. [PMID: 26615336 DOI: 10.1016/j.socscimed.2015.10.064] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Revised: 09/19/2015] [Accepted: 10/27/2015] [Indexed: 11/16/2022]
Abstract
Rurality has been frequently noted by researchers as pathways to understand human health in rural and remote areas. Current measures of rurality are mostly oriented to places, not individuals, and have not accounted for individual mobility, thus inappropriate for studying health and well-being at an individual level. This research proposed a new concept of individual-based rurality by integrating personal activity spaces. A feasible method was developed to quantify individuals' rural experience using household travel surveys and geographic information systems (GIS). For illustration, the proposed method was applied to understand the well-being and social isolation among rural Latino immigrants, who had participated in a community-based participatory research (CBPR) study in North Florida, USA. The resulting individuals' rurality indices were paired with their scores of well-being and social isolation to identify potential associations. The correlation analysis showed that the proposed rurality can be related to the social isolation, mental and physical well-being of individuals in different gender groups, and hence could be a suitable tool to investigate rural health issues.
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Affiliation(s)
- Liang Mao
- Department of Geography, University of Florida, 3141 Turlington Hall, Gainesville, FL, 32611, USA.
| | | | - Rebekah Smith
- Community Health Center of Waterbury, 51 North Elm ST, Waterbury, CT, 06702, USA.
| | - Brenda Wiens
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, 1225 Center Drive, Gainesville, FL, 32610, USA.
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Chen X, Wang P, Wegner R, Gong J, Fang X, Kaljee L. Measuring Social Capital Investment: Scale Development and Examination of Links to Social Capital and Perceived Stress. SOCIAL INDICATORS RESEARCH 2015; 120:669-687. [PMID: 25648725 PMCID: PMC4310564 DOI: 10.1007/s11205-014-0611-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Individuals with greater social capital have better health outcomes. Investment in social capital likely increases one's own social capital, bearing great implications for disease prevention and health promotion. In this study, the authors developed and validated the Social Capital Investment Inventory (SCII). Direct effects of social capital investment on perceived stress, and indirect effects through social capital were examined. 397 Participants from Beijing and Wuhan, China completed surveys. Analyses demonstrated that the SCII has a single factor structure and strong internal consistency. Structural equation modeling showed that individuals who invested more in social capital had greater bonding social capital, and subsequently less perceived stress. Results suggest that disease prevention and health promotion programs should consider approaches to encourage social capital investment; individuals may be able to reduce stress by increasing their investment in social capital. Future research is needed to provide additional empirical support for the SCII and observed structural relationships.
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Affiliation(s)
- Xinguang Chen
- Wuhan University Global Health Center, Wuhan, China
- School of Medicine, Wayne State University, Detroit, MI, USA
- Wuhan Centers for Disease Prevention and Control, Wuhan, China
- Department of Epidemiology, University of Florida, Gainesville, FL, USA
| | - Peigang Wang
- Wuhan University Global Health Center, Wuhan, China
- School of Medicine, Wayne State University, Detroit, MI, USA
| | - Rhiana Wegner
- School of Medicine, Wayne State University, Detroit, MI, USA
- Psychology Department, Wayne State University, Detroit, MI, USA
| | - Jie Gong
- Wuhan Centers for Disease Prevention and Control, Wuhan, China
| | - Xiaoyi Fang
- Beijing Normal University Developmental Institute, Beijing, China
| | - Linda Kaljee
- School of Medicine, Wayne State University, Detroit, MI, USA
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Kelly UA, Pich K. Community-based PTSD treatment for ethnically diverse women who experienced intimate partner violence: a feasibility study. Issues Ment Health Nurs 2014; 35:906-13. [PMID: 25426746 DOI: 10.3109/01612840.2014.931496] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The objectives of this study were to: (1) Determine the feasibility of a community-based intervention for Latinas with PTSD who experienced IPV; (2) Explore the intervention effectiveness in reducing PTSD and improving quality of life, social support and self-efficacy. This was a feasibility study, using intervention pre-test/post-test qualitative and quantitative data. The experience of living through and surviving IPV was far more important than ethnicity in cultural identity. Significant reductions in PTSD and MDD and increased self-efficacy were sustained 6-months post-intervention. Culturally relevant mental health IPV interventions can be feasible and appropriate across ethnic groups.
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Affiliation(s)
- Ursula A Kelly
- Atlanta VAMC, Nursing and Patient Care Services, Decatur, Georgia, USA and Emory University, Nell Hodgson Woodruff School of Nursing, Atlanta , Georgia , USA
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Verduin F, Smid GE, Wind TR, Scholte WF. In search of links between social capital, mental health and sociotherapy: A longitudinal study in Rwanda. Soc Sci Med 2014; 121:1-9. [DOI: 10.1016/j.socscimed.2014.09.054] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2013] [Revised: 09/25/2014] [Accepted: 09/29/2014] [Indexed: 10/24/2022]
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Angier H, Wiggins N, Gregg J, Gold R, DeVoe J. Increasing the relevance of research to underserved communities: lessons learned from a retreat to engage community health workers with researchers. J Health Care Poor Underserved 2014; 24:840-9. [PMID: 23728049 DOI: 10.1353/hpu.2013.0086] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
This article presents information on a community retreat developed to seek input from community health workers (CHWs) to increase the relevance of our research to underserved communities in Oregon. Retreats facilitating dialogue between researchers and CHWs could yield important insight to enhance the significance of research for communities.
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Affiliation(s)
- Heather Angier
- Oregon Health & Science University, Portland, Oregon 97239, USA.
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Garroutte EM, Anderson HO, Nez-Henderson P, Croy C, Beals J, Henderson JA, Thomas J, Manson SM. Religio-Spiritual Participation in Two American Indian Populations. JOURNAL FOR THE SCIENTIFIC STUDY OF RELIGION 2014; 53:17-37. [PMID: 26582964 PMCID: PMC4646059 DOI: 10.1111/jssr.12084] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Following a previous investigation of religio-spiritual beliefs in American Indians, this article examined prevalence and correlates of religio-spiritual participation in two tribes in the Southwest and Northern Plains (N = 3,084). Analysis suggested a "religious profile" characterized by strong participation across three traditions: aboriginal, Christian, and Native American Church. However, sociodemographic variables that have reliably predicted participation in the general American population, notably gender and age, frequently failed to achieve significance in multivariate analyses for each tradition. Religio-spiritual participation was strongly and significantly related to belief salience for all traditions. Findings suggest that correlates of religious participation may be unique among American Indians, consistent with their distinctive religious profile. Results promise to inform researchers' efforts to understand and theorize about religio-spiritual behavior. They also provide tribal communities with practical information that might assist them in harnessing social networks to confront collective challenges through community-based participatory research collaborations.
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Affiliation(s)
| | | | | | - Calvin Croy
- Centers for American Indian and Alaska Native Health, University of Colorado Denver
| | - Janette Beals
- Centers for American Indian and Alaska Native Health, University of Colorado Denver
| | | | - Jacob Thomas
- Centers for American Indian and Alaska Native Health, University of Colorado Denver
| | - Spero M Manson
- Centers for American Indian and Alaska Native Health, University of Colorado Denver
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O'Neill J, Tabish H, Welch V, Petticrew M, Pottie K, Clarke M, Evans T, Pardo Pardo J, Waters E, White H, Tugwell P. Applying an equity lens to interventions: using PROGRESS ensures consideration of socially stratifying factors to illuminate inequities in health. J Clin Epidemiol 2014; 67:56-64. [DOI: 10.1016/j.jclinepi.2013.08.005] [Citation(s) in RCA: 513] [Impact Index Per Article: 51.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2013] [Revised: 08/12/2013] [Accepted: 08/14/2013] [Indexed: 12/16/2022]
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Samuel LJ, Commodore-Mensah Y, Himmelfarb CRD. Developing Behavioral Theory With the Systematic Integration of Community Social Capital Concepts. HEALTH EDUCATION & BEHAVIOR 2013; 41:359-75. [PMID: 24092886 DOI: 10.1177/1090198113504412] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Health behavior theories state that social environments influence health behaviors, but theories of how this occurs are relatively underdeveloped. This article systematically surveys community social capital concepts in health behavior literature and proposes a conceptual framework that integrates these concepts into existing behavioral theory. Fifty-three studies tested associations between community social capital concepts and physical activity (38 studies), smoking (19 studies), and diet (2 studies). Trustworthiness of community members was consistently associated with more health-promoting and less disease-promoting behaviors in 19 studies. Neighborly reciprocity showed mixed results in 10 studies. Reporting a good sense of community was associated with more physical activity in only 5 of 16 studies. Neighborhood collective efficacy, which includes social cohesion and informal social control, was inconsistently associated with behaviors in 22 studies. Behavioral social norms were associated with smoking and physical activity in 2 of 6 studies, and neighborhood modeling of physical activity was associated with increased activity in 12 of 17 studies, with 1 opposing result. This review identifies several community social capital-related concepts that are, at times, associated with both health-promoting and disease-promoting behaviors and often have no associations. Theory explains these findings by describing the relationships and interactions among these concepts. Using these findings, this article proposes a conceptual framework that integrates community social capital concepts into existing behavioral theory. Iterative empirically based theory development is needed to address these concepts, which affect behaviors. These results can also inform theoretically based community-based and socially tailored interventions.
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Affiliation(s)
- Laura J Samuel
- Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD, USA
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Dowrick C, Chew-Graham C, Lovell K, Lamb J, Aseem S, Beatty S, Bower P, Burroughs H, Clarke P, Edwards S, Gabbay M, Gravenhorst K, Hammond J, Hibbert D, Kovandžić M, Lloyd-Williams M, Waheed W, Gask L. Increasing equity of access to high-quality mental health services in primary care: a mixed-methods study. PROGRAMME GRANTS FOR APPLIED RESEARCH 2013. [DOI: 10.3310/pgfar01020] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BackgroundEvidence-based interventions exist for common mental health problems. However, many people are unable to access effective care because it is not available to them or because interactions with caregivers do not address their needs. Current policy initiatives focus on supply-side factors, with less consideration of demand.Aim and objectivesOur aim was to increase equity of access to high-quality primary mental health care for underserved groups. Our objectives were to clarify the mental health needs of people from underserved groups; identify relevant evidence-based services and barriers to, and facilitators of, access to such services; develop and evaluate interventions that are acceptable to underserved groups; establish effective dissemination strategies; and begin to integrate effective and acceptable interventions into primary care.Methods and resultsExamination of evidence from seven sources brought forward a better understanding of dimensions of access, including how people from underserved groups formulate (mental) health problems and the factors limiting access to existing psychosocial interventions. This informed a multifaceted model with three elements to improve access: community engagement, primary care quality and tailored psychosocial interventions. Using a quasi-experimental design with a no-intervention comparator for each element, we tested the model in four disadvantaged localities, focusing on older people and minority ethnic populations. Community engagement involved information gathering, community champions and focus groups, and a community working group. There was strong engagement with third-sector organisations and variable engagement with health practitioners and commissioners. Outputs included innovative ways to improve health literacy. With regard to primary care, we offered an interactive training package to 8 of 16 practices, including knowledge transfer, systems review and active linking, and seven agreed to participate. Ethnographic observation identified complexity in the role of receptionists in negotiating access. Engagement was facilitated by prior knowledge, the presence of a practice champion and a sense of coproduction of the training. We developed a culturally sensitive well-being intervention with individual, group and signposting elements and tested its feasibility and acceptability for ethnic minority and older people in an exploratory randomised trial. We recruited 57 patients (57% of target) with high levels of unmet need, mainly through general practitioners (GPs). Although recruitment was problematic, qualitative data suggested that patients found the content and delivery of the intervention acceptable. Quantitative analysis suggested that patients in groups receiving the well-being intervention improved compared with the group receiving usual care. The combined effects of the model included enhanced awareness of the psychosocial intervention among community organisations and increased referral by GPs. Primary care practitioners valued community information gathering and access to the Improving Access to Mental Health in Primary Care (AMP) psychosocial intervention. We consequently initiated educational, policy and service developments, including a dedicated website.ConclusionsFurther research is needed to test the generalisability of our model. Mental health expertise exists in communities but needs to be nurtured. Primary care is one point of access to high-quality mental health care. Psychosocial interventions can be adapted to meet the needs of underserved groups. A multilevel intervention to increase access to high-quality mental health care in primary care can be greater than the sum of its parts.Study registrationCurrent Controlled Trials ISRCTN68572159.FundingThe National Institute for Health Research Programme Grants for Applied Research programme.
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Affiliation(s)
- C Dowrick
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK
| | - C Chew-Graham
- Institute of Population Health, University of Manchester, Manchester, UK
- Institute of Primary Care and Health Sciences, Keele University, Keele, UK
| | - K Lovell
- Institute of Population Health, University of Manchester, Manchester, UK
| | - J Lamb
- Institute of Population Health, University of Manchester, Manchester, UK
| | - S Aseem
- Institute of Population Health, University of Manchester, Manchester, UK
| | - S Beatty
- Institute of Population Health, University of Manchester, Manchester, UK
| | - P Bower
- Institute of Population Health, University of Manchester, Manchester, UK
| | - H Burroughs
- Institute of Population Health, University of Manchester, Manchester, UK
- Institute of Primary Care and Health Sciences, Keele University, Keele, UK
| | - P Clarke
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK
| | - S Edwards
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK
- College of Medicine, Swansea University, Swansea, UK
| | - M Gabbay
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK
| | - K Gravenhorst
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK
| | - J Hammond
- Institute of Population Health, University of Manchester, Manchester, UK
| | - D Hibbert
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK
| | - M Kovandžić
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK
| | - M Lloyd-Williams
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK
| | - W Waheed
- Institute of Population Health, University of Manchester, Manchester, UK
| | - L Gask
- Institute of Population Health, University of Manchester, Manchester, UK
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Howarter AD, Bennett KK. Perceived discrimination and health-related quality of life: testing the Reserve Capacity Model in Hispanic Americans. The Journal of Social Psychology 2013; 153:62-79. [PMID: 23421006 DOI: 10.1080/00224545.2012.703973] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
This study tested aspects of the Reserve Capacity Model (Gallo & Matthews, 2003; Gallo, Penedo Espinosa de los Monteros, & Arguelles, 2009) as a means of understanding disparities in health-related quality of life appraisals among Hispanic Americans. Questionnaire data were collected from 236 Hispanic participants, including measures of perceived discrimination, optimism, social support, symptoms of trait anxiety, and physical and mental health-related quality of life. Path analysis indicated direct, negative associations between perceived discrimination and both forms of health-related quality of life. Results also showed that these relationships were partially mediated by the reserve capacity variable of optimism and by symptoms of anxiety, though evidence for mediation by anxiety was stronger than for optimism. Findings suggest that perceived discrimination depletes intrapersonal reserves in Hispanic Americans, which, in turn, induces negative emotions. Implications for community-level interventions are discussed.
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Affiliation(s)
- Alisha D Howarter
- University of Missouri-Kansas City, Department of Psychology, 5030 Cherry St., Room 302, Kansas City, MO 66410, USA
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Gask L, Bower P, Lamb J, Burroughs H, Chew-Graham C, Edwards S, Hibbert D, Kovandžić M, Lovell K, Rogers A, Waheed W, Dowrick C, Group AMPR. Improving access to psychosocial interventions for common mental health problems in the United Kingdom: narrative review and development of a conceptual model for complex interventions. BMC Health Serv Res 2012; 12:249. [PMID: 22889290 PMCID: PMC3515797 DOI: 10.1186/1472-6963-12-249] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2011] [Accepted: 06/25/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In the United Kingdom and worldwide, there is significant policy interest in improving the quality of care for patients with mental health disorders and distress. Improving quality of care means addressing not only the effectiveness of interventions but also the issue of limited access to care. Research to date into improving access to mental health care has not been strongly rooted within a conceptual model, nor has it systematically identified the different elements of the patient journey from identification of illness to receipt of care. This paper set out to review core concepts underlying patient access to mental health care, synthesise these to develop a conceptual model of access, and consider the implications of the model for the development and evaluation of interventions for groups with poor access to mental health care such as older people and ethnic minorities. METHODS Narrative review of the literature to identify concepts underlying patient access to mental health care, and synthesis into a conceptual model to support the delivery and evaluation of complex interventions to improve access to mental health care. RESULTS The narrative review adopted a process model of access to care, incorporating interventions at three levels. The levels comprise (a) community engagement (b) addressing the quality of interactions in primary care and (c) the development and delivery of tailored psychosocial interventions. CONCLUSIONS The model we propose can form the basis for the development and evaluation of complex interventions in access to mental health care. We highlight the key methodological challenges in evaluating the overall impact of access interventions, and assessing the relative contribution of the different elements of the model.
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Affiliation(s)
- Linda Gask
- Manchester Academic Health Science Centre, Health Sciences Research Group, University of Manchester, Manchester, 5th Floor Williamson Building, Oxford Road, M13 9PL, UK
| | - Peter Bower
- Manchester Academic Health Science Centre, Health Sciences Research Group, University of Manchester, Manchester, 5th Floor Williamson Building, Oxford Road, M13 9PL, UK
| | - Jonathan Lamb
- Manchester Academic Health Science Centre, Health Sciences Research Group, University of Manchester, Manchester, 5th Floor Williamson Building, Oxford Road, M13 9PL, UK
| | - Heather Burroughs
- Manchester Academic Health Science Centre, Health Sciences Research Group, University of Manchester, Manchester, 5th Floor Williamson Building, Oxford Road, M13 9PL, UK
| | - Carolyn Chew-Graham
- Manchester Academic Health Science Centre, Health Sciences Research Group, University of Manchester, Manchester, 5th Floor Williamson Building, Oxford Road, M13 9PL, UK
| | - Suzanne Edwards
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK
| | - Derek Hibbert
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK
| | - Marija Kovandžić
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK
| | - Karina Lovell
- Manchester Academic Health Science Centre, School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, 5th Floor Williamson Building, Oxford Road, M13 9PL, UK
| | - Anne Rogers
- Manchester Academic Health Science Centre, Health Sciences Research Group, University of Manchester, Manchester, 5th Floor Williamson Building, Oxford Road, M13 9PL, UK
| | - Waquas Waheed
- Lancashire Care NHS Foundation Trust, Lancashire, UK
| | - Christopher Dowrick
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK
| | - AMP Research Group
- Manchester Academic Health Science Centre, Health Sciences Research Group, University of Manchester, Manchester, 5th Floor Williamson Building, Oxford Road, M13 9PL, UK
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK
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Valencia-Garcia D, Simoni JM, Alegría M, Takeuchi DT. Social capital, acculturation, mental health, and perceived access to services among Mexican American women. J Consult Clin Psychol 2012; 80:177-85. [PMID: 22329824 PMCID: PMC3314148 DOI: 10.1037/a0027207] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE We examined whether individual-level social capital-the intangible resources in a community available through membership in social networks or other social structures and perceived trust in the community-was associated with acculturation, depression and anxiety symptoms, and perceived access to services among women of Mexican ancestry. METHOD Recruited through venue-based targeted sampling in King County, Washington, 205 women of Mexican descent ages 18 to 64 years who differed in socioeconomic status and nativity completed a cross-sectional survey. Half completed the survey in Spanish and half in English. Structural equation modeling was used for model testing. RESULTS Social capital increased with level of acculturation and was negatively related to depression and anxiety; it had no direct association with perceived access to services. Social capital mediated the relation between acculturation and both depression and anxiety symptoms. Acculturation had no direct association with psychological distress but was directly associated with perceived access to services. This community sample of women reported high levels of psychological distress, with 20% to 26% of women meeting diagnostic criteria for depression or anxiety. CONCLUSIONS Social capital can be assessed at the individual level, increases with acculturation, and may be a potential target for interventions to improve mental health among Mexican American women residing in the United States.
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Stacciarini JMR, Rosa A, Ortiz M, Munari DB, Uicab G, Balam M. Promotoras in mental health: a review of English, Spanish, and Portuguese literature. FAMILY & COMMUNITY HEALTH 2012; 35:92-102. [PMID: 22367256 DOI: 10.1097/fch.0b013e3182464f65] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Promotoras have worked in various areas of public health; however, there is a lack of understanding about their work in mental health. This article reviews the literature in 3 different cultures/languages (English, Spanish, and Portuguese) and aims to describe promotoras' roles, training, and interventions and their outcomes related to mental health activities. Results demonstrate that in different cultures/languages, promotoras empower community members to promote mental health and prevent exacerbation of individuals' mental illness. Promotoras, when trained carefully, have the ability to increase awareness and to promote mental health in populations that would otherwise have limited or no access to care.
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Affiliation(s)
- Jeanne-Marie R Stacciarini
- Department of Health Care Environments and Systems, College of Nursing, University of Florida, Gainesville, FL 32611, USA.
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Spencer MS, Rosland AM, Kieffer EC, Sinco BR, Valerio M, Palmisano G, Anderson M, Guzman JR, Heisler M. Effectiveness of a community health worker intervention among African American and Latino adults with type 2 diabetes: a randomized controlled trial. Am J Public Health 2011; 101:2253-60. [PMID: 21680932 PMCID: PMC3222418 DOI: 10.2105/ajph.2010.300106] [Citation(s) in RCA: 252] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/03/2010] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We tested the effectiveness of a culturally tailored, behavioral theory-based community health worker intervention for improving glycemic control. METHODS We used a randomized, 6-month delayed control group design among 164 African American and Latino adult participants recruited from 2 health systems in Detroit, Michigan. Our study was guided by the principles of community-based participatory research. Hemoglobin A1c (HbA1c) level was the primary outcome measure. Using an empowerment-based approach, community health workers provided participants with diabetes self-management education and regular home visits, and accompanied them to a clinic visit during the 6-month intervention period. RESULTS Participants in the intervention group had a mean HbA1c value of 8.6% at baseline, which improved to a value of 7.8% at 6 months, for an adjusted change of -0.8 percentage points (P < .01). There was no change in mean HbA1c among the control group (8.5%). Intervention participants also had significantly greater improvements in self-reported diabetes understanding compared with the control group. CONCLUSIONS This study contributes to the growing evidence for the effectiveness of community health workers and their role in multidisciplinary teams engaged in culturally appropriate health care delivery.
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Affiliation(s)
- Michael S Spencer
- University of Michigan, School of Social Work, Ann Arbor, MI 48109-1106, USA.
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Balcazar H, Rosenthal EL, Brownstein JN, Rush CH, Matos S, Hernandez L. Community health workers can be a public health force for change in the United States: three actions for a new paradigm. Am J Public Health 2011; 101:2199-203. [PMID: 22021280 PMCID: PMC3222447 DOI: 10.2105/ajph.2011.300386] [Citation(s) in RCA: 167] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2011] [Indexed: 11/04/2022]
Abstract
Community health workers (CHWs) have gained increased visibility in the United States. We discuss how to strengthen the roles of CHWs to enable them to become collaborative leaders in dramatically changing health care from "sickness care" systems to systems that provide comprehensive care for individuals and families and supports community and tribal wellness. We recommend drawing on the full spectrum of CHWs' roles so that they can make optimal contributions to health systems and the building of community capacity for health and wellness. We also urge that CHWs be integrated into "community health teams" as part of "medical homes" and that evaluation frameworks be improved to better measure community wellness and systems change.
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Affiliation(s)
- Hector Balcazar
- Health Science Center Houston, El Paso Regional Campus, University of Texas School of Public Health, El Paso, 79968, USA.
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Marlow E, Nyamathi A, Grajeda WT, Bailey N, Weber A, Younger J. Nonviolent communication training and empathy in male parolees. JOURNAL OF CORRECTIONAL HEALTH CARE 2011; 18:8-19. [PMID: 22095007 DOI: 10.1177/1078345811420979] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The purpose of this study was to determine the impact of a behavioral intervention, nonviolent communication (NVC), on the development of empathic coping and communication skills in a sample of male parolees enrolled in substance abuse treatment (SAT; N = 30). At the end of the 8-week intervention, results revealed a significant increase (p = .01) in participants' empathy levels. Findings also revealed the acceptability and utility of NVC training to men on parole. Results suggest that NVC training may (a) be a useful addition to substance abuse treatment programs for parolees, (b) be effective in addressing problematic coping and communication styles resulting from incarceration and criminal behavior, and (c) assist paroled individuals in building and sustaining positive social support networks.
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Affiliation(s)
- Elizabeth Marlow
- Department of Family Health Care Nursing, UCSF School of Nursing, San Francisco, California 04612, USA.
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Review: Community-based participatory research approach to address mental health in minority populations. Community Ment Health J 2011; 47:489-97. [PMID: 20464489 DOI: 10.1007/s10597-010-9319-z] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2010] [Accepted: 04/28/2010] [Indexed: 10/19/2022]
Abstract
In this review, a synthesis of studies employing community-based participatory research (CBPR) to address mental health problems of minorities, strengths and challenges of the CBPR approach with minority populations are highlighted. Despite the fact that minority community members voiced a need for innovative approaches to address culturally unique issues, findings revealed that most researchers continued to use the traditional methods in which they were trained. Moreover, researchers continued to view mental health treatment from a health service perspective.
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Wiggins N. Popular education for health promotion and community empowerment: a review of the literature. Health Promot Int 2011; 27:356-71. [PMID: 21835843 DOI: 10.1093/heapro/dar046] [Citation(s) in RCA: 128] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
While there is now general agreement that the most effective way to promote health and decrease health inequities is by creating more just economic, social and political conditions, there is much less agreement about concrete ways in which public health practitioners can work with communities to address inequities such as poverty, racism and powerlessness. Practical strategies are desperately needed. Popular education, also known as Freirian and empowerment education, has been used successfully to create more equitable conditions around the world for >50 years. Its use to improve health has been documented in the public health literature since the early 1980s. Nonetheless, it remains largely unknown and its potential unrealized in mainstream public health circles in the industrialized world. In order to explore the potential of popular education as a tool to address inequities and improve health, a systematic review of the peer-reviewed international literature was conducted. Findings revealed that popular education is an effective method for enhancing empowerment and improving health. However, the existing literature does not provide empirical evidence that popular education is more effective than traditional education at increasing health knowledge and empowerment and changing health behavior. In order to fully understand the potential of popular education as a tool to eliminate health inequities and to advocate effectively for its use, further studies are needed that utilize mixed methods, participatory approaches and experimental or quasi-experimental designs.
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Affiliation(s)
- Noelle Wiggins
- Multnomah County Health Department, Community Capacitation Center, 10317 E Burnside St., Portland, OR 97217, USA.
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Martinez IL, Carter-Pokras O, Brown PB. Addressing the challenges of Latino health research: participatory approaches in an emergent urban community. J Natl Med Assoc 2010; 101:908-14. [PMID: 19806848 DOI: 10.1016/s0027-9684(15)31038-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Challenges to recruitment of Latinos in health research may include language, cultural and communication barriers, trust issues, heterogeneity of legal status, and a high percent of uninsured when compared to the US population. This paper highlights the community-based participatory research (CBPR) process and expands on the applicability of these principles to Latino communities. METHODS We review steps taken and describe lessons learned in using a participatory approach to broadly assess and address the health of urban-dwelling Latinos in Baltimore, Maryland, through the adaptation of CBPR principles. FINDINGS We identified health priorities, access barriers, and community resources (eg, Latin American trained nurses who were not currently working in the health field, immigrant networks) using a participatory approach. Suggestions for improving trust, research participation, and access to care ranged from not collecting data on legal status, and regular attendance and presentations of ongoing research at community provider meetings, to referral to free or low-cost health care services at screening events. CONCLUSION Despite growing interest in CBPR, limited guidance exists on how to apply CBPR principles to conduct health research among Latinos. Incorporating a participatory process can help address Latino community concerns, enrich quality and relevance of research, and empower community members.
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Affiliation(s)
- Iveris Luz Martinez
- Department of Humanities, Health & Society, Florida Internationa University, Herbert Wertheim College of Medicine, Miami, FL 33199, USA.
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Williams Q, Ochsner M, Marshall E, Kimmel L, Martino C. The impact of a peer-led participatory health and safety training program for Latino day laborers in construction. JOURNAL OF SAFETY RESEARCH 2010; 41:253-261. [PMID: 20630277 DOI: 10.1016/j.jsr.2010.02.009] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2009] [Revised: 02/23/2010] [Accepted: 02/23/2010] [Indexed: 05/29/2023]
Abstract
BACKGROUND Immigrant Latino day laborers working in residential construction are at particularly high risk of fatal and non-fatal traumatic injury and benefit from targeted training. OBJECTIVE To understand the impact of a participatory, peer-facilitated health and safety awareness training customized to the needs of Latino day laborers. METHODS Baseline surveys exploring exposures, PPE use, attitudes, work practices and work-related injuries were collected from more than 300 New Jersey Latino day laborers in construction prior to their participation in a one day (minimum of six hour) Spanish language health and safety training class. The classes, led by trained worker trainers, engaged participants in a series of tasks requiring teamwork and active problem solving focused on applying safe practices to situations they encounter at their worksites. Follow-up surveys were difficult to obtain among mobile day laborers, and were collected from 70 men (22% response rate) 2-6 months following training. Chi-square analysis was used to compare pre- and post-intervention PPE use, self protective actions, and self-reported injury rates. Focus groups and in-depth interviews addressing similar issues provided a context for discussing the survey findings. RESULTS At baseline, the majority of day laborers who participated in this study reported great concern about the hazards of their work and were receptive to learning about health and safety despite limited influence over employers. Changes from baseline to follow-up revealed statistically significant differences in the use of certain types of PPE (hard hats, work boots with steel toes, safety harnesses, and visible safety vests), and in the frequency of self-protective work practices (e.g., trying to find out more about job hazards on your own). There was also a suggestive decrease in self-reported injuries (receiving an injury at work serious enough that you had to stop working for the rest of the day) post-training based on small numbers. Sixty-six percent of workers surveyed post-training reported sharing information from their safety workbook with friends and co-workers. Focus groups and interview results generally confirmed the quantitative findings. CONCLUSIONS Participatory, peer led training tailored to the needs of construction day laborers may have a positive effect on Latino immigrant workers' attitudes, work practices, and self reported injury rates, but major changes would require employer engagement. IMPACT ON INDUSTRY Health and safety researchers have identified reducing the number of traumatic injuries among the immigrant construction workforce as an increasingly important priority. This project provides one model for collaboration between university-based researchers, a union, and a community-based organization. The specific elements of this project-participatory curriculum customized to the needs of day laborers in residential construction, training day laborers to facilitate training classes, and involving peer leaders in outreach and research-could be adapted by other organizations. The findings of this study suggest that the Latino day laborers have a strong interest in and some ability to act on health and safety information. Widespread implementation of this type of training, especially if supported with cooperation from residential contractors, could lead to reduced rates of traumatic injury in the residential construction industry.
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Affiliation(s)
- Quintin Williams
- Environmental and Occupational Health Sciences, University of Illinois, School of Public Health (MC 922), 2121 West Taylor Street, Chicago, IL 60612-7260, USA.
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