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Paulus K, Bass SB, Kelly PJA, Pilla J, Otor A, Scialanca M, Arroyo A, Faison N. Using health belief model constructs to understand the role of perceived disease threat and resilience in responding to COVID-19 among people who use drugs: a cluster analysis. ADVANCES IN DRUG AND ALCOHOL RESEARCH 2024; 4:12197. [PMID: 39040943 PMCID: PMC11261343 DOI: 10.3389/adar.2024.12197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 06/26/2024] [Indexed: 07/24/2024]
Abstract
Introduction The Health Belief Model (HBM) has been successfully applied to understanding adherence to COVID-19 prevention practices. It has not, however, been used to understand behavior in people who use drugs (PWUD). The aim of this study was to use the HBM to better understand COVID-19 perceptions among PWUD and understand how resiliency affects those perceptions. Materials and methods A cross-sectional survey was completed from September to December 2021 with PWUD (n = 75) who utilize services at a large harm reduction organization in Philadelphia. Segmentation analysis was done using a k-means clustering approach. Two clusters emerged based on perceived COVID-19 personal impact and resiliency (Less COVID impact/High resilience (NoCOV/HR) and High COVID impact/Low resilience (COV/LR). Differences in responses by cluster to perceptions of COVID-19 and individual pandemic response grouped by HBM constructs were assessed using Student's t-test and chi squares. Results Significant differences in HBM constructs were seen between clusters. Those in the COV/LR cluster were more likely to think they were susceptible to getting COVID-19 and less likely to believe they knew how to protect themselves. The NoCOV/HR cluster believed they were able to protect themselves from COVID-19 and that they were able to easily understand messages about protecting themselves. Conclusion Understanding how PWUD conceptualize disease threat and using HBM can better inform interventions to improve future pandemic response. Findings suggest that resilience is key to protecting PWUD from future infectious disease outbreaks. Interventions aimed at increasing resiliency among PWUD may improve preventative behavior and decrease disease burden in this vulnerable population.
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Affiliation(s)
- Kirsten Paulus
- Department of Social and Behavioral Sciences, Temple University College of Public Health, Philadelphia, PA, United States
- Risk Communication Laboratory, Temple University College of Public Health, Philadelphia, PA, United States
| | - Sarah Bauerle Bass
- Department of Social and Behavioral Sciences, Temple University College of Public Health, Philadelphia, PA, United States
- Risk Communication Laboratory, Temple University College of Public Health, Philadelphia, PA, United States
| | - Patrick J. A. Kelly
- Risk Communication Laboratory, Temple University College of Public Health, Philadelphia, PA, United States
| | - Jenine Pilla
- Department of Social and Behavioral Sciences, Temple University College of Public Health, Philadelphia, PA, United States
- Risk Communication Laboratory, Temple University College of Public Health, Philadelphia, PA, United States
| | - AnnaMarie Otor
- Department of Social and Behavioral Sciences, Temple University College of Public Health, Philadelphia, PA, United States
- Risk Communication Laboratory, Temple University College of Public Health, Philadelphia, PA, United States
| | - Madison Scialanca
- Department of Social and Behavioral Sciences, Temple University College of Public Health, Philadelphia, PA, United States
- Risk Communication Laboratory, Temple University College of Public Health, Philadelphia, PA, United States
| | - Anamarys Arroyo
- Department of Social and Behavioral Sciences, Temple University College of Public Health, Philadelphia, PA, United States
- Risk Communication Laboratory, Temple University College of Public Health, Philadelphia, PA, United States
| | - Namaijah Faison
- Department of Social and Behavioral Sciences, Temple University College of Public Health, Philadelphia, PA, United States
- Risk Communication Laboratory, Temple University College of Public Health, Philadelphia, PA, United States
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Lichtveld M, Covert H, El-Dahr J, Grimsley LF, Cohn R, Watson CH, Thornton E, Kennedy S. A Community-Based Participatory Research Approach to Hurricane Katrina: When Disasters, Environmental Health Threats, and Disparities Collide. Am J Public Health 2020; 110:1485-1489. [PMID: 32816539 DOI: 10.2105/ajph.2020.305759] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
In 2005, Hurricane Katrina resulted in long-term flooding of 80% of New Orleans, Louisiana. Mold-infested homes gave rise to concerns about increased childhood asthma. To address these concerns, a diverse community-academic partnership used a community-based participatory research (CBPR) approach to implement the Head-off Environmental Asthma in Louisiana (HEAL) study in 2007.The study examined the relationship between post-Katrina mold and other environmental exposures and asthma morbidity, while testing an asthma counselor (AC) intervention. Both the AC intervention and the CBPR approach were effectively implemented in the postdisaster setting. However, homes had lower levels of mold and other allergens than expected, possibly because of the timing of environmental sampling. Also, HEAL illustrated the vulnerability of the study community, especially to the interconnected threats of health disparities, environmental health stressors, and disasters.We examine the implications of these threats for public health science, policy, and practice, not only through the lens of Hurricane Katrina but also for future disasters faced by communities in the Gulf Coast and nationally.
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Affiliation(s)
- Maureen Lichtveld
- Maureen Lichtveld and Hannah Covert are with the Department of Environmental Health Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA. Jane El-Dahr is with the Department of Pediatrics, School of Medicine, Tulane University. L. Faye Grimsley is with the Department of Public Health Sciences, Xavier University of Louisiana, New Orleans. Richard Cohn is an independent consultant in Chapel Hill, NC. Claire Hayes Watson and Eleanor Thornton are with Visionary Consulting Partners LLC, Fairfax, VA. Suzanne Kennedy is with the Children's Research Institute, Department of Pediatrics, NC Children's Hospital, University of North Carolina, Chapel Hill
| | - Hannah Covert
- Maureen Lichtveld and Hannah Covert are with the Department of Environmental Health Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA. Jane El-Dahr is with the Department of Pediatrics, School of Medicine, Tulane University. L. Faye Grimsley is with the Department of Public Health Sciences, Xavier University of Louisiana, New Orleans. Richard Cohn is an independent consultant in Chapel Hill, NC. Claire Hayes Watson and Eleanor Thornton are with Visionary Consulting Partners LLC, Fairfax, VA. Suzanne Kennedy is with the Children's Research Institute, Department of Pediatrics, NC Children's Hospital, University of North Carolina, Chapel Hill
| | - Jane El-Dahr
- Maureen Lichtveld and Hannah Covert are with the Department of Environmental Health Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA. Jane El-Dahr is with the Department of Pediatrics, School of Medicine, Tulane University. L. Faye Grimsley is with the Department of Public Health Sciences, Xavier University of Louisiana, New Orleans. Richard Cohn is an independent consultant in Chapel Hill, NC. Claire Hayes Watson and Eleanor Thornton are with Visionary Consulting Partners LLC, Fairfax, VA. Suzanne Kennedy is with the Children's Research Institute, Department of Pediatrics, NC Children's Hospital, University of North Carolina, Chapel Hill
| | - L Faye Grimsley
- Maureen Lichtveld and Hannah Covert are with the Department of Environmental Health Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA. Jane El-Dahr is with the Department of Pediatrics, School of Medicine, Tulane University. L. Faye Grimsley is with the Department of Public Health Sciences, Xavier University of Louisiana, New Orleans. Richard Cohn is an independent consultant in Chapel Hill, NC. Claire Hayes Watson and Eleanor Thornton are with Visionary Consulting Partners LLC, Fairfax, VA. Suzanne Kennedy is with the Children's Research Institute, Department of Pediatrics, NC Children's Hospital, University of North Carolina, Chapel Hill
| | - Richard Cohn
- Maureen Lichtveld and Hannah Covert are with the Department of Environmental Health Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA. Jane El-Dahr is with the Department of Pediatrics, School of Medicine, Tulane University. L. Faye Grimsley is with the Department of Public Health Sciences, Xavier University of Louisiana, New Orleans. Richard Cohn is an independent consultant in Chapel Hill, NC. Claire Hayes Watson and Eleanor Thornton are with Visionary Consulting Partners LLC, Fairfax, VA. Suzanne Kennedy is with the Children's Research Institute, Department of Pediatrics, NC Children's Hospital, University of North Carolina, Chapel Hill
| | - Claire Hayes Watson
- Maureen Lichtveld and Hannah Covert are with the Department of Environmental Health Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA. Jane El-Dahr is with the Department of Pediatrics, School of Medicine, Tulane University. L. Faye Grimsley is with the Department of Public Health Sciences, Xavier University of Louisiana, New Orleans. Richard Cohn is an independent consultant in Chapel Hill, NC. Claire Hayes Watson and Eleanor Thornton are with Visionary Consulting Partners LLC, Fairfax, VA. Suzanne Kennedy is with the Children's Research Institute, Department of Pediatrics, NC Children's Hospital, University of North Carolina, Chapel Hill
| | - Eleanor Thornton
- Maureen Lichtveld and Hannah Covert are with the Department of Environmental Health Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA. Jane El-Dahr is with the Department of Pediatrics, School of Medicine, Tulane University. L. Faye Grimsley is with the Department of Public Health Sciences, Xavier University of Louisiana, New Orleans. Richard Cohn is an independent consultant in Chapel Hill, NC. Claire Hayes Watson and Eleanor Thornton are with Visionary Consulting Partners LLC, Fairfax, VA. Suzanne Kennedy is with the Children's Research Institute, Department of Pediatrics, NC Children's Hospital, University of North Carolina, Chapel Hill
| | - Suzanne Kennedy
- Maureen Lichtveld and Hannah Covert are with the Department of Environmental Health Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA. Jane El-Dahr is with the Department of Pediatrics, School of Medicine, Tulane University. L. Faye Grimsley is with the Department of Public Health Sciences, Xavier University of Louisiana, New Orleans. Richard Cohn is an independent consultant in Chapel Hill, NC. Claire Hayes Watson and Eleanor Thornton are with Visionary Consulting Partners LLC, Fairfax, VA. Suzanne Kennedy is with the Children's Research Institute, Department of Pediatrics, NC Children's Hospital, University of North Carolina, Chapel Hill
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Community Health Workers as Organizational Actors in Community Health Centers in 4 Gulf Coast States. J Ambul Care Manage 2020; 42:252-261. [PMID: 31169564 DOI: 10.1097/jac.0000000000000275] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Community health workers (CHWs) are recognized for bridging communities and health care systems; yet, there is limited discussion of CHWs' roles as organizational actors within and outside clinics. Individual semistructured interviews (n = 21) were conducted in 4 Gulf Coast states with CHWs and supervisors to examine the bridging function of CHWs from a community health center's perspective. Results highlight that CHWs can function as gatekeepers and ambassadors who extend the clinics' reach in the community, enhance patient access to resources, and improve organizational efficiency. This study demonstrates the value that CHWs can bring for clients and clinics as organizational actors.
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Goldstein BD. Broadening the Mandate of the Incident Command System to Address Community Mental and Behavioral Health Effects as Part of the Federal Response to Disasters. Curr Environ Health Rep 2020; 7:282-291. [PMID: 32594324 DOI: 10.1007/s40572-020-00283-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW In the United States, the Federal Incident Command System (ICS) directs response to major oil spills. Its initial imperative is to prevent immediate impacts on human health and safety. Subsequently, the ICS primarily turns its attention to environmental concerns, including considering vulnerable ecosystems. There is a growing body of evidence that disasters such as major oil spills lead to adverse psychosocial effects; yet, preventing such effects has not been formally incorporated into ICS disaster mitigation considerations. RECENT FINDINGS Community mental and behavioral effects are increasingly recognized as a significant impact of disasters. Standardized ecosystem analytical frameworks are key to ICS responses to its mandate for environmental protection. Similar frameworks have only begun to be developed for mental and behavioral effects. Providing the ICS with a formal mandate would likely lead to the prevention of community mental and behavioral effects being more systematically incorporated into ICS disaster responses.
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Affiliation(s)
- Bernard D Goldstein
- Graduate School of Public Health, University of Pittsburgh, 166 N. Dithridge St Apt A5, Pittsburgh, PA, 15213, USA.
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Sherman M, Covert H, Brown L, Langhinrichsen-Rohling J, Hansel T, Rehner T, Buckner A, Lichtveld M. Enterprise Evaluation: A New Opportunity for Public Health Policy. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2020; 25:479-489. [PMID: 31348163 PMCID: PMC6716577 DOI: 10.1097/phh.0000000000000862] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Standard evaluation practice in public health remains limited to evaluative measures linked to individual projects, even if multiple interrelated projects are working toward a common impact. Enterprise evaluation seeks to fill this policy gap by focusing on cross-sector coordination and ongoing reflection in evaluation. We provide an overview of the enterprise evaluation framework and its 3 stages: collective creation, individual data collection, and collective analysis. We illustrate the application of enterprise evaluation to the Gulf Region Health Outreach Program, 4 integrated projects that aimed to strengthen health care in Louisiana, Mississippi, Alabama, and the Florida Panhandle after the Deepwater Horizon oil spill. Shared commitment to sustainability and strong leadership were critical to Gulf Region Health Outreach Program's success in enterprise evaluation. Enterprise evaluation provides an important opportunity for funding agencies and public health initiatives to evaluate the impact of interrelated projects in a more holistic and multiscalar manner than traditional siloed approaches to evaluation.
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Affiliation(s)
- Mya Sherman
- Center for Gulf Coast Environmental Health Research, Leadership & Strategic Initiatives (Ms Sherman and Dr Covert) and Department of Global Environmental Health Sciences (Dr Lichtveld), School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana; Evaluation and Research, Louisiana Public Health Institute, New Orleans, Louisiana (Dr Brown); Gulf Coast Behavioral Health Resiliency Center, University of South Alabama, Mobile, Alabama (Dr Langhinrichsen-Rohling); Department of Psychiatry, Louisiana State University Health Sciences Center, New Orleans, Louisiana (Dr Hansel); School of Social Work, The University of Southern Mississippi, Hattiesburg, Mississippi (Dr Rehner); and Community Health Cooperative, Atlanta, Georgia (Dr Buckner)
| | - Hannah Covert
- Center for Gulf Coast Environmental Health Research, Leadership & Strategic Initiatives (Ms Sherman and Dr Covert) and Department of Global Environmental Health Sciences (Dr Lichtveld), School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana; Evaluation and Research, Louisiana Public Health Institute, New Orleans, Louisiana (Dr Brown); Gulf Coast Behavioral Health Resiliency Center, University of South Alabama, Mobile, Alabama (Dr Langhinrichsen-Rohling); Department of Psychiatry, Louisiana State University Health Sciences Center, New Orleans, Louisiana (Dr Hansel); School of Social Work, The University of Southern Mississippi, Hattiesburg, Mississippi (Dr Rehner); and Community Health Cooperative, Atlanta, Georgia (Dr Buckner)
| | - Lisanne Brown
- Center for Gulf Coast Environmental Health Research, Leadership & Strategic Initiatives (Ms Sherman and Dr Covert) and Department of Global Environmental Health Sciences (Dr Lichtveld), School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana; Evaluation and Research, Louisiana Public Health Institute, New Orleans, Louisiana (Dr Brown); Gulf Coast Behavioral Health Resiliency Center, University of South Alabama, Mobile, Alabama (Dr Langhinrichsen-Rohling); Department of Psychiatry, Louisiana State University Health Sciences Center, New Orleans, Louisiana (Dr Hansel); School of Social Work, The University of Southern Mississippi, Hattiesburg, Mississippi (Dr Rehner); and Community Health Cooperative, Atlanta, Georgia (Dr Buckner)
| | - Jennifer Langhinrichsen-Rohling
- Center for Gulf Coast Environmental Health Research, Leadership & Strategic Initiatives (Ms Sherman and Dr Covert) and Department of Global Environmental Health Sciences (Dr Lichtveld), School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana; Evaluation and Research, Louisiana Public Health Institute, New Orleans, Louisiana (Dr Brown); Gulf Coast Behavioral Health Resiliency Center, University of South Alabama, Mobile, Alabama (Dr Langhinrichsen-Rohling); Department of Psychiatry, Louisiana State University Health Sciences Center, New Orleans, Louisiana (Dr Hansel); School of Social Work, The University of Southern Mississippi, Hattiesburg, Mississippi (Dr Rehner); and Community Health Cooperative, Atlanta, Georgia (Dr Buckner)
| | - Tonya Hansel
- Center for Gulf Coast Environmental Health Research, Leadership & Strategic Initiatives (Ms Sherman and Dr Covert) and Department of Global Environmental Health Sciences (Dr Lichtveld), School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana; Evaluation and Research, Louisiana Public Health Institute, New Orleans, Louisiana (Dr Brown); Gulf Coast Behavioral Health Resiliency Center, University of South Alabama, Mobile, Alabama (Dr Langhinrichsen-Rohling); Department of Psychiatry, Louisiana State University Health Sciences Center, New Orleans, Louisiana (Dr Hansel); School of Social Work, The University of Southern Mississippi, Hattiesburg, Mississippi (Dr Rehner); and Community Health Cooperative, Atlanta, Georgia (Dr Buckner)
| | - Timothy Rehner
- Center for Gulf Coast Environmental Health Research, Leadership & Strategic Initiatives (Ms Sherman and Dr Covert) and Department of Global Environmental Health Sciences (Dr Lichtveld), School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana; Evaluation and Research, Louisiana Public Health Institute, New Orleans, Louisiana (Dr Brown); Gulf Coast Behavioral Health Resiliency Center, University of South Alabama, Mobile, Alabama (Dr Langhinrichsen-Rohling); Department of Psychiatry, Louisiana State University Health Sciences Center, New Orleans, Louisiana (Dr Hansel); School of Social Work, The University of Southern Mississippi, Hattiesburg, Mississippi (Dr Rehner); and Community Health Cooperative, Atlanta, Georgia (Dr Buckner)
| | - Ayanna Buckner
- Center for Gulf Coast Environmental Health Research, Leadership & Strategic Initiatives (Ms Sherman and Dr Covert) and Department of Global Environmental Health Sciences (Dr Lichtveld), School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana; Evaluation and Research, Louisiana Public Health Institute, New Orleans, Louisiana (Dr Brown); Gulf Coast Behavioral Health Resiliency Center, University of South Alabama, Mobile, Alabama (Dr Langhinrichsen-Rohling); Department of Psychiatry, Louisiana State University Health Sciences Center, New Orleans, Louisiana (Dr Hansel); School of Social Work, The University of Southern Mississippi, Hattiesburg, Mississippi (Dr Rehner); and Community Health Cooperative, Atlanta, Georgia (Dr Buckner)
| | - Maureen Lichtveld
- Center for Gulf Coast Environmental Health Research, Leadership & Strategic Initiatives (Ms Sherman and Dr Covert) and Department of Global Environmental Health Sciences (Dr Lichtveld), School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana; Evaluation and Research, Louisiana Public Health Institute, New Orleans, Louisiana (Dr Brown); Gulf Coast Behavioral Health Resiliency Center, University of South Alabama, Mobile, Alabama (Dr Langhinrichsen-Rohling); Department of Psychiatry, Louisiana State University Health Sciences Center, New Orleans, Louisiana (Dr Hansel); School of Social Work, The University of Southern Mississippi, Hattiesburg, Mississippi (Dr Rehner); and Community Health Cooperative, Atlanta, Georgia (Dr Buckner)
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Avoiding Déjà vu All Over Again: Inserting Public Health, Mental/Behavioral Health, and Prevention Policy Into the Opiate Crisis Litigation. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2019; 25:211-213. [DOI: 10.1097/phh.0000000000000943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Instigating Public Health Set-Asides: Deepwater Horizon as a Model. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2019; 23 Suppl 6 Suppl, Gulf Region Health Outreach Program:S5-S7. [PMID: 28961645 DOI: 10.1097/phh.0000000000000616] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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The Gulf Region Health Outreach Program as a Model for Strengthening the Fragile Public Health Infrastructure. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2019; 23 Suppl 6 Suppl, Gulf Region Health Outreach Program:S8-S10. [PMID: 28961646 DOI: 10.1097/phh.0000000000000624] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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