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Smith A, Arena R, Bacon SL, Faghy MA, Grazzi G, Raisi A, Vermeesch AL, Ong'wen M, Popovic D, Pronk NP. Recommendations on the use of artificial intelligence in health promotion. Prog Cardiovasc Dis 2024:S0033-0620(24)00127-0. [PMID: 39389332 DOI: 10.1016/j.pcad.2024.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2024] [Accepted: 10/06/2024] [Indexed: 10/12/2024]
Abstract
The purpose of this perspective is to provide recommendations on the use of Artificial Intelligence (AI) in health promotion. To arrive at these recommendations, we followed a 6-step process. The first step was to recruit an international authorship team from the Healthy Living for Pandemic Event Protection (HL- PIVOT) network. This enabled us to achieve an international perspective with insights from Canada, Great Britain, Kenya, Italy, and the US. A philosophical inquiry was conducted addressing 5 questions. What should the relationship be between humans and AI in health promotion? How can the public and professionals trust AI? How can we ensure AI is aligned with our values? How can we ensure the ethical use of data by AI? How can we control AI? 4 hypothetical scenarios were also developed to provide perspectives on: i) Artificial 'Versus' Human Intelligence; ii) AI Empowerment in Self-Care; iii) Could AI Improve Patient Provider Relationship; and iii) The Kenyan Cancer Patient at the Height of a Pandemic. Based on the philosophical inquiry and the scenarios 11 recommendations are made by the HL-PIVOT on the use of AI in health promotion. The golden thread running through these recommendations is a human centric approach. The recommendations begin by suggesting that workforce planning should take account of AI. They conclude with the statement that any serious incidents involving an AI in Health Promotion should be reported to the relevant regulatory authority.
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Affiliation(s)
- Andy Smith
- Independent Sport and Exercise Scientist, United Kingdom; Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL, USA
| | - Ross Arena
- Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL, USA). Department of Physical Therapy, University of Illinois at Chicago, Chicago, USA
| | - Simon L Bacon
- Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montreal, Canada; Montreal Behavioural Medicine Centre, Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal (CIUSSS-NIM), Montreal, Canada
| | - Mark A Faghy
- Biomedical and Clinical Exercise Science Research Centre, University of Derby, HL-Pivot Network Member.Otieno Martin Ong'wen OMT NPT (Afyafrica Orthopedic Services), Derby, UK.
| | - Giovanni Grazzi
- Center for Exercise Science and Sport, Department of Neuroscience and Rehabilitation, University of Ferrara, Italy; Healthy Living for Pandemic Event Protection (HL-PIVOT) Network, Chicago, IL, USA; Public Health Department, AUSL, Ferrara, Italy
| | - Andrea Raisi
- Program in Environmental Sustainability and Wellbeing, Department of Humanities, University of Ferrara, Ferrara, Italy
| | - Amber L Vermeesch
- Advanced Nursing Education Department, University of North Carolina Greensboro School of Nursing, HL-PIVOT Network Member, Greensboro, NC, USA
| | | | - Dejana Popovic
- Department of Cardiology, University Clinical Center of Serbia, Belgrade, Serbia; Mayo Clinic, Rochester, MN, USA; Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia
| | - Nicolaas P Pronk
- HealthPartners Institute, Minneapolis, MN, USA; University of Minnesota, Dept. of Health Policy and Management, Minneapolis, MN, USA
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Dadi AF, Ahmed KY, Berhane Y, Bizuayehu HM, Tesema GA, Hassen TA, Kibret GD, Ketema DB, Bore MG, Belachew SA, Amsalu E, Nhassengo S, Shifti DM, Seid A, Mesfin YM, Tegegne TK, Odo DB, Kassa ZY, Thapa S, Kidane EG, Desyibelew HD, Misganaw A, Zeleke BM, Bolarinwa OA, Ross AG. Intimate partner violence and childhood health outcomes in 37 sub-Saharan African countries: an analysis of demographic health survey data from 2011 to 2022. Lancet Glob Health 2024:S2214-109X(24)00313-9. [PMID: 39332421 DOI: 10.1016/s2214-109x(24)00313-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 06/14/2024] [Accepted: 07/12/2024] [Indexed: 09/29/2024]
Abstract
BACKGROUND Understanding the contribution of intimate partner violence (IPV) to childhood health outcomes (eg, morbidity and mortality) is crucial for improving child survival in sub-Saharan Africa. This comprehensive study aimed to explore the associations between maternal exposure to physical, sexual, or emotional violence and adverse childhood health outcomes in sub-Saharan Africa. METHODS We analysed Demographic Health Survey datasets from 37 sub-Saharan African countries from 2011 to 2022. A generalised linear mixed model was used to examine the associations between maternal physical violence, sexual violence, or emotional violence, and early childhood health outcomes (eg, acute respiratory infection, diarrhoea, undernutrition, and child mortality). A random effects meta-analysis was used to calculate pooled odds ratios (ORs) for adverse childhood health outcomes. The odds of undernutrition and mortality were 55% and 58% higher among children younger than 5 years born to mothers who were exposed to physical and sexual violence, respectively. FINDINGS 238 060 children younger than 5 years were included. Children whose mothers experienced physical violence (adjusted OR 1·33, 95% CI 1·29-1·42), sexual violence (1·47, 1·34-1·62), emotional violence (1·39, 1·32-1·47), or a combination of emotional and sexual violence (1·64, 1·20-2·22), or a combination of all the three forms of violence (1·88, 1·62-2·18) were associated with an increased odds of developing diarrhoeal disease. Similarly, children whose mothers experienced physical violence (1·43, 1·28-1·59), sexual violence (1·47, 1·34-1·62), emotional violence (1·39, 1·32-1·47), or a combination of emotional and sexual violence (1·48, 1·16-1·89), or a combination of all three forms of violence (1·66, 1·47-1·88) were positively associated with symptoms of acute respiratory infection. INTERPRETATION We found a strong link between maternal exposure to IPV and health outcomes for children younger than 5 years in sub-Saharan Africa, with minor variations across countries. To address childhood morbidity and mortality attributed to IPV, interventions need to be tailored for specific countries. Burkina Faso, Burundi, Chad, Comoros, Gabon, Liberia, Nigeria, Sierra Leone, South Africa, and Uganda should be priority nations. FUNDING None.
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Affiliation(s)
- Abel F Dadi
- Menzies School of Health Research, Charles Darwin University, Casuarina, NT, Australia; Addis Continental Institute of Public Health, Addis Ababa, Ethiopia.
| | - Kedir Y Ahmed
- Rural Health Research Institute, Charles Sturt University, Orange, NSW, Australia
| | - Yemane Berhane
- Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| | - Habtamu Mellie Bizuayehu
- First Nations Cancer and Wellbeing Research Program, The University of Queensland, Brisbane, QLD, Australia
| | - Getayeneh Antehunegn Tesema
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia; Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tahir A Hassen
- Center for Women's Health Research, College of Health, Medicine, and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia
| | - Getiye Dejenu Kibret
- School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia; Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Faculty of Medicine, Health, and Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - Daniel Bekele Ketema
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia; College of Medicine and Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Meless G Bore
- School of Nursing and Midwifery, University of Technology Sydney, Ultimo, NSW, Australia; School of Nursing, Hawassa University, Hawassa, Ethiopia
| | | | - Erkihun Amsalu
- Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia; St Paul Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Sergio Nhassengo
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden
| | | | - Abdulbasit Seid
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Yonatan M Mesfin
- Asia-Pacific Health, Infection, Immunity, and Global Health, MCRI, Parkville, VIC, Australia
| | - Teketo Kassaw Tegegne
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
| | - Daniel Bogale Odo
- National Centre for Aboriginal and Torres Strait Islander Wellbeing Research, National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT, Australia
| | - Zemenu Yohannes Kassa
- School of Nursing and Midwifery, University of Technology Sydney, Ultimo, NSW, Australia; College of Medicine and Health Science, Hawassa University, Hawassa, Ethiopia
| | - Subash Thapa
- Rural Health Research Institute, Charles Sturt University, Orange, NSW, Australia
| | | | | | - Awoke Misganaw
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA; National Data Management Center for Health, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Berihun M Zeleke
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Obasanjo Afolabi Bolarinwa
- Department of Public Health, York St John University, London, UK; Department of Demography and Population Studies, University of the Witwatersrand, Johannesburgh, South Africa
| | - Allen G Ross
- Rural Health Research Institute, Charles Sturt University, Orange, NSW, Australia
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Chen CX, Rogers SK, Li R, Hinrichs RJ, Fortenberry JD, Carpenter JS. Social Determinants of Health and Dysmenorrhea: A Systematic Review. THE JOURNAL OF PAIN 2024; 25:104574. [PMID: 38788887 PMCID: PMC11347097 DOI: 10.1016/j.jpain.2024.104574] [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: 12/21/2023] [Revised: 05/14/2024] [Accepted: 05/16/2024] [Indexed: 05/26/2024]
Abstract
Social determinants of health play a key role in health disparities. Dysmenorrhea is a highly prevalent and impactful public health problem affecting reproductive-age females. Systematically examining social determinants of health (SDoH) in dysmenorrhea is important for identifying gaps in the literature and informing research, policy, and clinical practice to reduce the public health burden associated with dysmenorrhea. The purpose of this systematic review was to synthesize the literature on SDoH and dysmenorrhea. The review protocol was prospectively registered. We searched Medline, EMBASE, CINAHL, PsycINFO, Scopus, and Google Scholar through February 2024 using search strategies informed by the literature. Screening of the articles, data extraction, and risk-of-bias (RoB) assessment were conducted independently by at least 2 reviewers on the Covidence platform. Among 2,594 unique records screened, 166 met eligibility criteria and were included for data extraction and RoB assessment. Evidence suggests traumatic experiences, toxic environmental exposures, female genital mutilation, job-related stress, lack of menstrual education, and low social support were associated with worse dysmenorrhea outcomes. However, evidence was equivocal regarding the relationships between dysmenorrhea outcomes and SDoH factors, including socioeconomic status, geographical location, race/ethnicity, employment, and religion. Nearly all articles (99.4%) had a high or very high overall RoB. The relationships between SDoH and dysmenorrhea outcomes were often inconsistent and complicated by heterogeneous study populations and methodologies. More rigorous research examining SDoH in dysmenorrhea is needed to inform policy and clinical practice. PERSPECTIVE: This systematic review synthesizes evidence linking SDoH and dysmenorrhea. The relationships between SDoH and dysmenorrhea were often equivocal and complicated by heterogeneous study populations and methodologies. We identify directions for future research and SDoH factors that could be addressed clinically (eg, trauma, menstrual education, and occupational stress).
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Affiliation(s)
- Chen X Chen
- Indiana University School of Nursing, Indianapolis, Indiana.
| | - Sarah K Rogers
- Department of Psychology, School of Science, Indiana University Purdue University-Indianapolis, Indianapolis, Indiana
| | - Rui Li
- Seattle Children's Research Institute, Seattle, Washington; Department of Anesthesiology and Pain Medicine, School of Medicine, University of Washington, Seattle, Washington
| | - Rachel J Hinrichs
- Indiana University Indianapolis, University Library, Indianapolis, Indiana
| | - J Dennis Fortenberry
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana
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Callegari S, Romain G, Cleman J, Scierka L, Peri-Okonny PA, Spertus J, Labrosciano C, Beltrame JF, Abbott JD, Fitridge R, Mena-Hurtado C, Smolderen KG. Association of social support and health status outcomes in peripheral artery disease. J Vasc Surg 2024:S0741-5214(24)01706-3. [PMID: 39151740 DOI: 10.1016/j.jvs.2024.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 07/10/2024] [Accepted: 08/04/2024] [Indexed: 08/19/2024]
Abstract
OBJECTIVE A critical goal in the care of patients with peripheral artery disease (PAD) is to optimize their health status; that is, their symptoms, function, and quality of life. Social support has been proposed to be a predictor of disease-specific health status in patients with PAD. However, the prevalence of low perceived social support, the association with health status outcomes, and the interaction with other biopsychosocial variables, is unknown. Our aim was to assess the association of baseline perceived social support with health status at 12 months in patients with PAD. METHODS The Patient-Centered Outcomes Related Treatment Practices in Peripheral Arterial Disease: Investigating Trajectories (PORTRAIT) registry, which enrolled patients with PAD in the United States, the Netherlands, and Australia from 2011 to 2015, was used. Perceived social support was assessed at baseline with the Enhancing Recovery in Coronary Heart Disease Patients (ENRICHD) Social Support Inventory (ESSI), and disease-specific (Peripheral Artery Disease Questionnaire [PAQ]) and generic health status (Euro-Quality of Life Visual Analog Scale [VAS] and EQ-5D-3L Index) questionnaires were assessed at baseline and 12 months. Low social support was defined as a score of ≤3 on two items and an ESSI score of ≤18. A hierarchical mixed level linear regression model adjusting for biopsychosocial variables was used to assess the association between low perceived social support and the ESSI score with health status at 12 months. RESULTS A total of 949 patients were included (mean age, 67.64 ± 9.32 years; 37.9% female), with low social support being present in 18.2%. Patients with low social support were more likely to not be married or to be living alone (50.0% vs 77.5%; P < .001); have more financial constraints; have more depressive, stress, and anxiety symptoms; and have lower disease-specific and generic health status at baseline and at 12 months. In the unadjusted model, low social support was associated with a -7.02 (95% confidence interval [CI], -10.97 to -3.07) point reduction in the PAQ, -7.43 (95% CI, -10.33 to -4.54) in the VAS, and -0.06 (95% CI, -0.09 to -0.03) in the EQ-5D-3L Index. Adjusting for biopsychosocial factors minimally attenuated these associations (PAQ: -6.52; 95% CI, -10.55 to -2.49; P = .002; VAS: -5.39; 95% CI, 8.36 to -2.42; P < .001; EQ-5D-3L Index: -0.04; 95% CI, -0.07 to 0.01; P = .022). The ESSI per-point score was associated with a decrease of 0.51 (95% CI, 0.18-0.85; P = .003) in PAQ and 0.46 (95% CI, 0.12-0.61; P = .004) in the VAS. CONCLUSIONS Among patients with PAD, low social support was frequent and associated with a lower health status at 1 year independent of other biopsychosocial variables. Improving social support could improve health status and outcomes in PAD.
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Affiliation(s)
- Santiago Callegari
- Vascular Medicine Outcomes Program (VAMOS), Division of Cardiology, Department of Medicine, Yale School of Medicine, New Haven, CT
| | - Gaëlle Romain
- Vascular Medicine Outcomes Program (VAMOS), Division of Cardiology, Department of Medicine, Yale School of Medicine, New Haven, CT
| | - Jacob Cleman
- Vascular Medicine Outcomes Program (VAMOS), Division of Cardiology, Department of Medicine, Yale School of Medicine, New Haven, CT
| | - Lindsey Scierka
- Vascular Medicine Outcomes Program (VAMOS), Division of Cardiology, Department of Medicine, Yale School of Medicine, New Haven, CT
| | - Poghni A Peri-Okonny
- Vascular Medicine Outcomes Program (VAMOS), Division of Cardiology, Department of Medicine, Yale School of Medicine, New Haven, CT
| | - John Spertus
- Cardiovascular Research Saint Luke's Mid America Heart Institute Kansas City, Kansas City, MO; Department of Biomedical and Health Informatics of Medicine University of Missouri-Kansas City, Kansas City, MO
| | - Clementine Labrosciano
- The Queen Elizabeth Hospital, Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - John F Beltrame
- School of Medicine, Faculty of Health Sciences, The University of Adelaide, Adelaide, Australia
| | - J Dawn Abbott
- Lifespan Cardiovascular Institute and Division of Cardiology, Department of Medicine, Alpert Medical School of Brown University, Providence, RI
| | - Robert Fitridge
- School of Medicine, Faculty of Health Sciences, The University of Adelaide, Adelaide, Australia
| | - Carlos Mena-Hurtado
- Vascular Medicine Outcomes Program (VAMOS), Division of Cardiology, Department of Medicine, Yale School of Medicine, New Haven, CT
| | - Kim G Smolderen
- Vascular Medicine Outcomes Program (VAMOS), Division of Cardiology, Department of Medicine, Yale School of Medicine, New Haven, CT; Department of Psychiatry, Yale School of Medicine, New Haven, CT.
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Pratama R, Suhanda R, Aini Z, Nurjannah N, Geumpana TA. Application of artificial intelligence technology in monitoring students' health: Preliminary results of Syiah Kuala Integrated Medical Monitoring (SKIMM). NARRA J 2024; 4:e644. [PMID: 39280283 PMCID: PMC11391959 DOI: 10.52225/narra.v4i2.644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 04/04/2024] [Indexed: 09/18/2024]
Abstract
Health promoting university is a holistic approach to health that uses higher education settings to create a learning environment that improves the health and well-being of the campus community in a sustainable manner. The utilization of technology such as artificial intelligence (AI) could be one of the main success factors in the implementation of health-promoting universities to increase the effectiveness and efficiency of all stages of activities carried out in health promotion and prevention efforts. Integrated monitoring with the utilization of AI in this program is conducted to evaluate the health status of the students. The Syiah Kuala Integrated Medical Monitoring (SKIMM) has three components of continuous health status evaluation: vital signs, nutritional status, and burnout status. Health status monitoring was conducted continuously for three months among medical students at the Faculty of Medicine Universitas Syiah Kuala, Banda Aceh, Indonesia. This system uses the WhatsApp application as a platform to monitor health status. Student health monitoring in this program consists of two main activities: the health measurement phase and the health monitoring phase. The use of the SKIMM system to monitor students' vital signs, nutritional status and burnout status through the use of AI significantly raises students' awareness to conduct timely self-examination and enables sustainable healthy lifestyle behavior change. The adoption of AI technology allows for continuous health promotion to the entire academic community, including students in implementing the health promoting university.
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Affiliation(s)
- Rovy Pratama
- Department of Public Health and Community Medicine, Faculty of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia
| | - Rachmad Suhanda
- Department of Public Health and Community Medicine, Faculty of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia
| | - Zahratul Aini
- Department of Family Medicine, Faculty of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia
| | - Nurjannah Nurjannah
- Department of Public Health and Community Medicine, Faculty of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia
| | - Teuku A Geumpana
- School of Information and Physical Science, University of Newcastle, Newcastle, Australia
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Zhang Z, Xue D, Bian Y. Association Between Socioeconomic Inequalities in Pain and All-Cause Mortality in the China Health and Retirement Longitudinal Study: Longitudinal Cohort Study. JMIR Public Health Surveill 2024; 10:e54309. [PMID: 38872381 PMCID: PMC11282390 DOI: 10.2196/54309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 05/04/2024] [Accepted: 06/13/2024] [Indexed: 06/15/2024] Open
Abstract
BACKGROUND Few studies focus on the equality of pain, and the relationship between pain and death is inconclusive. Investigating the distribution of pain and potential mortality risks is crucial for ameliorating painful conditions and devising targeted intervention measures. OBJECTIVE Our study aimed to investigate the association between inequalities in pain and all-cause mortality in China. METHODS Longitudinal cohort data from waves 1 and 2 of the China Health and Retirement Longitudinal Study (2011-2013) were used in this study. Pain was self-reported at baseline, and death information was obtained from the 2013 follow-up survey. The concentration index and its decomposition were used to explain the inequality of pain, and the association between pain and death was analyzed with a Cox proportional risk model. RESULTS A total of 16,747 participants were included, with an average age of 59.57 (SD 9.82) years. The prevalence of pain was 32.54% (8196/16,747). Among participants with pain, the main pain type was moderate pain (1973/5426, 36.36%), and the common pain locations were the waist (3232/16,747, 19.3%), legs (2476/16,747, 14.78%) and head (2250/16,747, 13.44%). We found that the prevalence of pain was concentrated in participants with low economic status (concentration index -0.066, 95% CI -0.078 to -0.054). Educational level (36.49%), location (36.87%), and economic status (25.05%) contributed significantly to the inequality of pain. In addition, Cox regression showed that pain was associated with an increased risk of all-cause mortality (hazard ratio 1.30, 95% CI 1.06-1.61). CONCLUSIONS The prevalence of pain in Chinese adults is concentrated among participants with low economic status, and pain increases the risk of all-cause death. Our results highlight the importance of socioeconomic factors in reducing deaths due to pain inequalities by implementing targeted interventions.
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Affiliation(s)
- Zhuo Zhang
- Institute of Chinese Medical Sciences, State Key Laboratory of Quality Research in Chinese Medicine, University of Macau, Taipa, Macao
| | - Dongmei Xue
- Institute of Chinese Medical Sciences, State Key Laboratory of Quality Research in Chinese Medicine, University of Macau, Taipa, Macao
| | - Ying Bian
- Institute of Chinese Medical Sciences, State Key Laboratory of Quality Research in Chinese Medicine, University of Macau, Taipa, Macao
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Khosravi M, Azar G, Izadi R. Principles and elements of patient-centredness in mental health services: a thematic analysis of a systematic review of reviews. BMJ Open Qual 2024; 13:e002719. [PMID: 38960446 PMCID: PMC11227821 DOI: 10.1136/bmjoq-2023-002719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 06/23/2024] [Indexed: 07/05/2024] Open
Abstract
INTRODUCTION Mental health disorders, particularly depression and anxiety, are widespread globally and necessitate effective solutions. The patient-centred approach has been identified as a viable and effective method for addressing these challenges. This paper synthesised the principles of patient-centred mental health services and provides a comprehensive review of the existing literature. MATERIALS AND METHODS This is a qualitative content analysis study conducted in a systematic review framework in 2022. PubMed, Scopus, ProQuest and Cochrane databases were systematically searched, and by screening the titles, abstracts, and the texts of studies related to the purpose of the research, the data were extracted. Evaluation of the quality of the studies was done using the CASP checklist for qualitative studies. After selecting the final studies based on the entry and exit criteria, subsequently, a thematic analysis of findings was conducted on the data obtained from the systematic review. RESULTS The database search produced 6649 references. After screening, 11 studies met the inclusion criteria. The quality scores indicated the studies were of high level of quality with acceptable risk of bias. The thematic analysis identified six major principles of patient-centredness in mental health services: education, involvement and cooperation, access, effectiveness and safety, health and well-being, and ethics. CONCLUSIONS Patient-centredness is a complex approach in mental health services. The principles and elements of patient-centredness foster positive patient outcomes, enhance healthcare quality and ensure compassionate and effective care. Upholding these principles is crucial for delivering patient-centred, ethical and effective mental health services. Furthermore, the study found that patient education can boost adherence and satisfaction, and decrease unnecessary hospitalisations. Patient involvement in decision-making is influenced by their age and the relationship with their psychologists. And, effective leadership and resource management can enhance clinical processes and patient-centredness in mental health services.
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Affiliation(s)
- Mohsen Khosravi
- Department of Healthcare Management, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ghazaleh Azar
- Department of Consultation and Mental Health, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Reyhane Izadi
- Department of Healthcare Management, Shiraz University of Medical Sciences, Shiraz, Iran
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Cook BL, Rastegar J, Patel N. Social Risk Factors and Racial and Ethnic Disparities in Health Care Resource Utilization Among Medicare Advantage Beneficiaries With Psychiatric Disorders. Med Care Res Rev 2024; 81:209-222. [PMID: 38235576 PMCID: PMC11168608 DOI: 10.1177/10775587231222583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
The intersection of social risk and race and ethnicity on mental health care utilization is understudied. This study examined disparities in health care treatment, adjusting for clinical need, among 25,780 Medicare Advantage beneficiaries with a diagnosis of a psychiatric disorder. We assessed contributions to disparities from racial and ethnic differences in the composition and returns of social risk variables. Black and Hispanic beneficiaries had lower rates of mental health outpatient visits than Whites. Assessing composition, Black and Hispanic beneficiaries experienced greater financial, food, and housing insecurity than White beneficiaries, factors associated with greater mental health treatment. Assessing returns, food insecurity was associated with an exacerbation of Hispanic-White disparities. Health care systems need to address the financial, food and housing insecurity of racial and ethnic minority groups with psychiatric disorder. Accounting for racial and ethnic differences in social risk adjustment-based payment reforms has significant implications for provider reimbursement and outcomes.
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Affiliation(s)
- Benjamin Lê Cook
- Harvard Medical School, Boston, MA, USA
- Cambridge Health Alliance, Cambridge, MA, USA
| | | | - Nikesh Patel
- Regeneron Pharmaceuticals Inc, Tarrytown, NY, USA
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Jain S, Bey GS, Forrester SN, Rahman-Filipiak A, Thompson Gonzalez N, Petrovsky DV, Kritchevsky SB, Brinkley TE. Aging, Race, and Health Disparities: Recommendations From the Research Centers Collaborative Network. J Gerontol B Psychol Sci Soc Sci 2024; 79:gbae028. [PMID: 38442186 PMCID: PMC11101762 DOI: 10.1093/geronb/gbae028] [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: 06/03/2023] [Indexed: 03/07/2024] Open
Abstract
Racial disparities in adverse health outcomes with aging have been well described. Yet, much of the research focuses on racial comparisons, with relatively less attention to the identification of underlying mechanisms. To address these gaps, the Research Centers Collaborative Network held a workshop on aging, race, and health disparities to identify research priorities and inform the investigation, implementation, and dissemination of strategies to mitigate disparities in healthy aging. This article provides a summary of the key recommendations and highlights the need for research that builds a strong evidence base with both clinical and policy implications. Successful execution of these recommendations will require a concerted effort to increase participation of underrepresented groups in research through community engagement and partnerships. In addition, resources to support and promote the training and development of health disparities researchers will be critical in making health equity a shared responsibility for all major stakeholders.
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Affiliation(s)
- Snigdha Jain
- Section of Pulmonary, Critical Care, and Sleep Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Ganga S Bey
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Sarah N Forrester
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Annalise Rahman-Filipiak
- Department of Psychiatry—Neuropsychology Section, University of Michigan, Ann Arbor, Michigan, USA
| | - Nicole Thompson Gonzalez
- Department of Integrative Anthropological Sciences, University of California Santa Barbara, Santa Barbara, California, USA
| | - Darina V Petrovsky
- School of Nursing, Institute for Health, Health Care Policy, and Aging Research, Rutgers University, New Brunswick, New Jersey, USA
| | - Stephen B Kritchevsky
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Tina E Brinkley
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
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10
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Mondal T, Hernandez-Romero B, Wood N, Adler D, Abar B. Evaluating follow-up rates in cancer screening interventions among emergency department patients. Acad Emerg Med 2024. [PMID: 38742269 DOI: 10.1111/acem.14938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 04/24/2024] [Accepted: 04/25/2024] [Indexed: 05/16/2024]
Affiliation(s)
- Trisha Mondal
- Department of Emergency Medicine, Psychiatry, and Public Health Sciences, University of Rochester Medical Center, Rochester, New York, USA
| | - Brenda Hernandez-Romero
- Department of Emergency Medicine, Psychiatry, and Public Health Sciences, University of Rochester Medical Center, Rochester, New York, USA
| | - Nancy Wood
- Department of Emergency Medicine, Psychiatry, and Public Health Sciences, University of Rochester Medical Center, Rochester, New York, USA
| | - David Adler
- Department of Emergency Medicine, Psychiatry, and Public Health Sciences, University of Rochester Medical Center, Rochester, New York, USA
| | - Beau Abar
- Department of Emergency Medicine, Psychiatry, and Public Health Sciences, University of Rochester Medical Center, Rochester, New York, USA
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Ingram BM, DeFreese JD, Kerr ZY, Oyesanya TO, Picha KJ, Register-Mihalik JK. Applying the National Institute on Minority Health and Health Disparities Research Framework to Social Determinants of Health in the Context of Sport-Related Concussion: A Clinical Commentary. J Athl Train 2024; 59:447-457. [PMID: 38446622 PMCID: PMC11127672 DOI: 10.4085/1062-6050-0370.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2024]
Abstract
Sport-related concussion (SRC) is a prevalent injury. Significant disparities in SRC outcomes exist across racial and ethnic groups. These disparities may be attributed to the unequal distribution of political power (or influence) and resource allocation in various communities, shaping individuals' social determinants of health (SDOH). However, the influence of SDOH on SRC outcomes remains understudied. In this clinical commentary, we use the National Institute on Minority Health and Health Disparities Research Framework and describe how its application can help address gaps in our understanding of SDOH and SRC. This framework provides a comprehensive approach to investigating and addressing health disparities by considering SDOH along multiple levels and domains of influence. Using this framework, athletic trainers can identify areas requiring intervention and better understand how SDOH influence SRC outcomes. This understanding can help athletic trainers develop tailored interventions to promote equitable care for patients with SRC.
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Affiliation(s)
- Brittany M. Ingram
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill
| | - J. D. DeFreese
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill
| | - Zachary Yukio Kerr
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill
| | | | - Kelsey J. Picha
- Department of Interdisciplinary Health Sciences, A.T. Still University, Mesa, AZ
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12
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Ennis K, Brown-DeVeaux D. How Can Organizations Support a Culture of Care? Nurs Clin North Am 2024; 59:131-139. [PMID: 38272579 DOI: 10.1016/j.cnur.2023.11.014] [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: 01/27/2024]
Abstract
Providing care is central to the operations of health care organizations. This article discusses how organizations can create a culture of care. It also identifies key elements that health care organizations can implement to build a culture that nurtures both patients and employees. Additionally, the article examines the benefits of implementing practices that demonstrate compassion toward both employees and patients. This article explores the significance of creating and supporting a culture of care for both patients and employees in health care organizations. Finally, the article identifies prevalent practices that contribute to a culture of care.
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Affiliation(s)
- Kimberley Ennis
- Department of Nursing NYU Langone Health, Site Lead for Nursing and Patient Care Services, NYU Langone Othopedic Hospital, 301 East 17th Street, New York, NY 10010, USA.
| | - Dewi Brown-DeVeaux
- Department of Nursing NYU Langone Health A, 10514 Flatlands 10th Street, Brooklyn NY 11236, USA
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Abed V, Kapp S, Bradley T, Homen DT, Landy DC, Dasa V, Conley C, Stone AV. Orthopaedic Sports Medicine Randomized Controlled Trials Infrequently Report on the Social Determinants of Health Factors of Their Patient Cohorts. Arthroscopy 2024; 40:922-927. [PMID: 37879516 DOI: 10.1016/j.arthro.2023.10.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 09/30/2023] [Accepted: 10/10/2023] [Indexed: 10/27/2023]
Abstract
PURPOSE To describe the prevalence of randomized controlled trials (RCTs) in orthopaedic sports medicine-related journals reporting on the social determinants of health (SDOH) of their patient cohorts, including factors receiving less attention, such as education level, employment status, insurance status, and socioeconomic status. METHODS The PubMed/MEDLINE database was used to search for RCTs between 2020 and 2022 from 3 high-impact orthopaedic sports medicine-related journals: American Journal of Sports Medicine, Arthroscopy, and Journal of Shoulder and Elbow Surgery. The following information was extracted from each article: age, sex/gender, body mass index, year published, corresponding author country, and self-reported SDOH factors (race, ethnicity, education level, employment status, insurance status, and socioeconomic status). RESULTS A total of 189 articles were analyzed. Articles originated from 34 different countries, with the United States (n = 66) producing the greatest number of articles. Overall, age (n = 186; 98.4%) and sex/gender (n = 184; 97.4%) were the factors most commonly reported, followed by body mass index (n = 112; 59.3%), race (n = 17; 9.0%), ethnicity (n = 10; 5.3%), employment status (n = 9; 4.8%), insurance status (n = 7; 3.7%), and education level (n = 5; 2.6%). Socioeconomic status was not reported in any of the articles analyzed. Articles from the United States report on SDOH factors more frequently than international articles, most notably race (24.2% vs 0.8%, respectively) and ethnicity (15.2% and 0%, respectively). CONCLUSIONS RCTs from 3 high-impact orthopaedic sports medicine journals infrequently report on SDOH. CLINICAL RELEVANCE Better understanding patient SDOH factors in RCTs is important to help orthopaedic surgeons and other practitioners best apply study results to their patients, as well as help researchers and our field ensure that research is being done transparently with relevance to as many patients as possible.
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Affiliation(s)
- Varag Abed
- Department of Orthopaedic Surgery and Sports Medicine, University of Kentucky, Lexington, Kentucky, U.S.A
| | - Sabryn Kapp
- Department of Orthopaedic Surgery and Sports Medicine, University of Kentucky, Lexington, Kentucky, U.S.A
| | - Taylor Bradley
- Department of Orthopaedic Surgery and Sports Medicine, University of Kentucky, Lexington, Kentucky, U.S.A
| | - Dylan T Homen
- Department of Orthopaedic Surgery and Sports Medicine, University of Kentucky, Lexington, Kentucky, U.S.A
| | - David C Landy
- Department of Orthopaedic Surgery and Sports Medicine, University of Kentucky, Lexington, Kentucky, U.S.A
| | - Vinod Dasa
- Department of Orthopaedic Surgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana, U.S.A
| | - Caitlin Conley
- Department of Orthopaedic Surgery and Sports Medicine, University of Kentucky, Lexington, Kentucky, U.S.A
| | - Austin V Stone
- Department of Orthopaedic Surgery and Sports Medicine, University of Kentucky, Lexington, Kentucky, U.S.A..
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Chevinsky J, Chirumamilla S, Caswell S, Nyoni LM, Studer K. Clinical Preventive Medicine, Integrative Medicine, and Lifestyle Medicine: Current State and Future Opportunities in the Development of Emerging Clinical Areas. AJPM FOCUS 2024; 3:100166. [PMID: 38283577 PMCID: PMC10820328 DOI: 10.1016/j.focus.2023.100166] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/30/2024]
Affiliation(s)
- Jennifer Chevinsky
- Riverside University Health System – Public Health, Riverside, California
| | - Siri Chirumamilla
- Emory University, School of Medicine, Department of Family and Preventive Medicine, Atlanta, Georgia
| | | | | | - Karen Studer
- Loma Linda University Health, Loma Linda, California
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15
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Cunha F, Pinto MDR, Riesch S, Lucas P, Almeida S, Vieira M. Translation, Adaptation, and Validation of the Portuguese Version of the Exercise of Self-Care Agency Scale. Healthcare (Basel) 2024; 12:159. [PMID: 38255048 PMCID: PMC10815554 DOI: 10.3390/healthcare12020159] [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: 12/03/2023] [Revised: 12/30/2023] [Accepted: 01/03/2024] [Indexed: 01/24/2024] Open
Abstract
Assessing a person's capacity to engage in self-care behaviours is another added value in identifying one's potential to care for oneself in the health domain that contributes to planning person-centred care. This study aimed to translate, adapt, and validate the Exercise of Self-Care Agency (ESCA) Scale by Kearney and Fleischer, revised by Riesch and Hauck for the Portuguese version, using a sample of 625 elderly people living at home in Portugal. A cross-cultural adaptation process follows the stages of translation, synthesis, back-translation, and consensual solution for the translation process and pretesting. Construct validity was tested using exploratory factor analysis, and factor structure was subjected to confirmatory factor analysis. Reliability was determined by analysing internal consistency, resorting to Cronbach's alpha coefficient. This resulted in an instrument formed of 29 items, keeping the factor structure conceptually aligned with the underlying theory. Cronbach's alpha coefficient values were 0.87 for the global scale and varied between 0.65 and 0.84 for the subscales. The final four-factor model showed an acceptable quality of fit. The Portuguese version of the ESCA shows appropriate validity and reliability for use in future research and health contexts.
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Affiliation(s)
- Fátima Cunha
- Interdisciplinary Research Center in Health (CIIS), 4169-005 Porto, Portugal; (S.A.); (M.V.)
- Life Quality Research Center (CIEQV), 2040-413 Rio Maior, Portugal
- Higher School of Health, Santarém Polytechnic University, 2005-075 Santarém, Portugal
| | - Maria do Rosário Pinto
- Health Sciences Research Unit: Nursing (UICISA-E), 3046-851 Coimbra, Portugal;
- Nursing Research, Innovation and Development Center in Lisbon (CIDNUR), Nursing School of Lisbon, 1600-190 Lisbon, Portugal;
| | - Susan Riesch
- School of Nursing, University of Wisconsin-Madison, Madison, WI 53705, USA;
| | - Pedro Lucas
- Nursing Research, Innovation and Development Center in Lisbon (CIDNUR), Nursing School of Lisbon, 1600-190 Lisbon, Portugal;
| | - Sofia Almeida
- Interdisciplinary Research Center in Health (CIIS), 4169-005 Porto, Portugal; (S.A.); (M.V.)
- Faculty of Health Sciences and Nursing (FCSE), Catholic University of Portugal, 4169-005 Porto, Portugal
| | - Margarida Vieira
- Interdisciplinary Research Center in Health (CIIS), 4169-005 Porto, Portugal; (S.A.); (M.V.)
- Faculty of Health Sciences and Nursing (FCSE), Catholic University of Portugal, 4169-005 Porto, Portugal
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Malika N, Herman PM, Whitley M, Coulter I, Maiers M, Chesney M, Rogers R. Qualitative Assessment CIH Institutions' Engagement With Underserved Communities to Enhance Healthcare Access and Utilization. GLOBAL ADVANCES IN INTEGRATIVE MEDICINE AND HEALTH 2024; 13:27536130241244759. [PMID: 38545335 PMCID: PMC10966973 DOI: 10.1177/27536130241244759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 03/07/2024] [Accepted: 03/13/2024] [Indexed: 05/26/2024]
Abstract
Background In North America, there is a notable underutilization of complementary and integrative health approaches (CIH) among non-White and marginalized communities. Objectives This study sought to understand how CIH educational instutitions are proactively working to redress this disparity in access and utilization among these communities. Methods We conducted interviews with 26 key informants, including presidents, clinicians, and research deans across 13 CIH educational institutions across the US and Canada. Thematic analysis included deductive codes based on the interview guide during interview scripts review. Results Six themes were identified: (1) CIH institutions often had a long and varied history of community engaged care through partnerships to increase access and utilization; (2) CIH institutions' long-standing community outreach had been intentionally designed; (3) CIH institutions provided an array of services to a wide range of demographics and communities; (4) addressing healthcare access and utilization through community partnerships had a strong positive impact; (5) funding, staffing and COVID-19 were significant challenges that impeded efforts to increase CIH access through community engaged work; (6) identified gaps in community partnerships and services to increase access and utilization were recognized. Conclusion These findings underscore significant efforts made to enhance healthcare access and utilization among marginalized, underserved, and racial and ethnic communities. However, barriers such as funding constraints, resource allocation, and the need for proper measurement and accountability hinder proactive initiatives aimed at redressing disparities in CIH utilization within these communities.
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Affiliation(s)
| | | | | | | | - Michele Maiers
- Northwestern Health Sciences University, Bloomington, MN, USA
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17
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Adzrago D, Williams F. Mediation analysis of mental health characteristics linking social needs to life satisfaction among immigrants. SSM Popul Health 2023; 24:101522. [PMID: 37822807 PMCID: PMC10563063 DOI: 10.1016/j.ssmph.2023.101522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 08/22/2023] [Accepted: 09/23/2023] [Indexed: 10/13/2023] Open
Abstract
Background Life satisfaction contributes to improved long and healthy lives, enhanced biological function, better mental health, and decreased mortality risks. Social needs (e.g., food security, employment, healthcare utilization) are important determinants of mental health and life satisfaction among immigrants. However, there is limited literature on how social needs influence mental health, which, in turn, affects life satisfaction among immigrants. We examined whether mental health influences the mechanisms of the relationship between social needs and life satisfaction among immigrants. Methods We used the 2021 cross-sectional National Health Interview Survey data on U.S. immigrants (n = 4320) aged ≥18 years. We conducted weighted mediation analyses with multiple linear regression. Life satisfaction (scores 0-10; ≥1 as higher life satisfaction) was the dependent variable; independent variables were food security, employment, and healthcare utilization; and the mediator, serious psychological distress (SPD: scores 0-24; ≥1 as higher SPD). Results The total effect (not accounting for SPD) of food insecurity (vs. secure) on life satisfaction was negative (β = -0.61, p < 0.001); the direct effect (after accounting for SPD) was not statistically significant (β = -0.21, p = 0.153), while the indirect effect (food insecurity's effect explained by SPD) was negative (β = -0.40, p < 0.001). The total (β = 0.32, p < 0.001), direct (β = 0.24, p = 0.004), and indirect (β = 0.09, p = 0.006) effects of being employed (vs. unemployed) on life satisfaction were positive. The total (β = -0.12, p = 0.116) and direct (β = -0.03, p = 0.683) effects of healthcare utilization within the past year (vs. more than a year) on life satisfaction were not statistically significant, whereas the indirect effect was negative (β = -0.09, p < 0.001). Conclusions SPD mediates the effect of food security, healthcare utilization, and employment on life satisfaction, suggesting the need to improve social needs and mental health among immigrants.
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Affiliation(s)
- David Adzrago
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA
| | - Faustine Williams
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA
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Balis LE, Houghtaling B. Matching barriers and facilitators to implementation strategies: recommendations for community settings. Implement Sci Commun 2023; 4:144. [PMID: 37990243 PMCID: PMC10664260 DOI: 10.1186/s43058-023-00532-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 11/13/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND Implementation science aims to improve the integration of evidence-based interventions in real-world settings. While its methods and models could potentially apply to any field with evidence-based interventions, most research thus far has originated in clinical settings. Community settings often have fewer resources, missions beyond health, and a lack of support and expertise to implement evidence-based interventions when compared to many clinical settings. Thus, selecting and tailoring implementation strategies in community settings is particularly challenging, as existing compilations are primarily operationalized through clinical setting terminology. In this debate, we (1) share the process of using an existing match tool to select implementation strategies to increase uptake of nutrition and physical activity policy, systems, and environment interventions in community settings and (2) discuss the challenges of this process to argue that selecting implementation strategies in community settings has limited transferability from clinical settings and may require a unique implementation strategy compilation and pragmatic matching tool. MATCHING BARRIERS TO IMPLEMENTATION STRATEGIES The impetus for this debate paper came from our work selecting implementation strategies to improve the implementation and eventual scaling of nutrition and physical activity policy, systems, and environment interventions in a community settings. We conducted focus groups with practitioners and used the Consolidated Framework for Implementation Research-Expert Recommendations for Implementing Change match tool to select potential implementation strategies to overcome prominent barriers. There was limited congruence between tool outputs and optimal strategies, which may in part be due to differences in context between clinical and community settings. Based on this, we outline needs and recommendations for developing a novel and pragmatic matching tool for researchers and practitioners in community settings. CONCLUSIONS More work is needed to refine the implementation barrier-strategy matching process to ensure it is relevant, rapid, and rigorous. As leading implementation strategy scholars note, as more researchers document contextual factors and strategies selected to address them, the knowledge base will increase, and refined mapping processes can emerge.
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Affiliation(s)
- Laura E Balis
- Gretchen Swanson Center for Nutrition, Omaha, NE, 68514, USA.
- Department of Human Nutrition, Virginia Tech, Foods, and Exercise, Blacksburg, VA, 24061, USA.
| | - Bailey Houghtaling
- Gretchen Swanson Center for Nutrition, Omaha, NE, 68514, USA
- Department of Human Nutrition, Virginia Tech, Foods, and Exercise, Blacksburg, VA, 24061, USA
- School of Nutrition and Food Sciences, Louisiana State University (LSU) & LSU Agricultural Center, Baton Rouge, LA, 70803, USA
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Wilandika A, Pandin MGR, Yusuf A. The roles of nurses in supporting health literacy: a scoping review. Front Public Health 2023; 11:1022803. [PMID: 37663836 PMCID: PMC10469320 DOI: 10.3389/fpubh.2023.1022803] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 04/10/2023] [Indexed: 09/05/2023] Open
Abstract
Introduction The importance of health literacy in achieving optimum health is highly significant, particularly in the nursing profession where it is an integral part of the roles and functions of nurses. Therefore, this scoping review aims to describe the roles of nurses in promoting patient health literacy and identify the determinant factors of health literacy in nursing practices. Methods An integrative search was conducted through four databases, namely, ScienceDirect, ProQuest, SAGE Journal, and PubMed, using various keyword combinations such as "health literacy," "health information," "patient health literacy," "patient literacy," and "nurses." Furthermore, the inclusion criteria employed were peer-reviewed articles focused on the nursing profession, explicitly discussing health literacy related to nursing, and including original studies, such as cross-sectional, quasi-experimental, and qualitative studies. The selected review articles were all published between 2017 and 2022. Results In total, 13 articles met the criteria and were applied in this scoping review. Most of these discuss health literacy related to nursing practice in clinical and community settings, as well as educational institutions. Health literacy is an essential aspect of professional nursing practice. Consequently, the supportive roles of nurses include acting as caregivers, facilitators, and educators to help patients overcome their literacy limitations and attain improved wellbeing. Conclusion Nurses can improve the health literacy skills of patients by making health information related to their illnesses easier to access, understand, evaluate, and use. They must also recognize various factors influencing health literacy and use the factors as opportunities to optimize health literacy improvement. A health literacy approach can be applied by nurses to solve health problems and improve the quality of care for patients.
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Affiliation(s)
- Angga Wilandika
- Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia
- Faculty of Health Sciences, Universitas Aisyiyah Bandung, Bandung, Indonesia
| | | | - Ah Yusuf
- Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia
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Abstract
Long-standing health disparities in maternal reproductive health, infant morbidity and mortality, and long-term developmental outcomes are rooted in a foundation of structural racism. Social determinants of health profoundly affect reproductive health outcomes of Black and Hispanic women disproportionately; they have higher rates of death during pregnancy and preterm birth. Their infants are also more likely to be cared for in poorer quality neonatal intensive care units (NICUs), receive poorer quality of NICU care, and are less likely to be referred to an appropriate high-risk NICU follow-up program. Interventions that mitigate the impact of racism will help to eliminate health disparities.
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Affiliation(s)
- Yvette R Johnson
- Texas Christian University, Burnett School of Medicine, Cook Children's Medical Center, N.E.S.T. Developmental Follow-up Clinic, 1500 Cooper Street, Fort Worth, TX 76104, USA.
| | - Charleta Guillory
- Baylor College of Medicine, Texas Children's Hospital, Section of Neonatology, 6621 Fannin, Houston, TX 77030, USA
| | - Sonia Imaizumi
- Newtown Square, MultiPlan.com, 18 Campus Boulevard, Suite 200, Newtown Square, PA 19073, USA
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21
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Hosokawa R, Ojima T, Myojin T, Aida J, Kondo K, Kondo N. Association between the Standardized Mortality Ratio and Healthy Life Expectancy in Japan. JMA J 2023; 6:27-35. [PMID: 36793525 PMCID: PMC9908415 DOI: 10.31662/jmaj.2022-0140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 08/23/2022] [Indexed: 01/12/2023] Open
Abstract
Introduction Healthy life expectancy (HLE) remains the principal target of various health plans. We aimed to identify the areas of priority and determinants of mortality to extend HLE across local governments in Japan. Methods HLE according to secondary medical areas was calculated using the Sullivan method. People requiring long-term care of level 2 or higher were considered unhealthy. Standardized mortality ratios (SMRs) for major causes of death were calculated using vital statistics data. The association between HLE and SMR was analyzed using simple and multiple regression analyses. Results The average (standard deviation) HLE values were 79.24 (0.85) and 83.76 (0.62) years for men and women, respectively. A comparison of HLE revealed regional health gaps of 4.46 (76.90-81.36) and 3.46 (81.99-85.45) years for men and women, respectively. The coefficients of determination for the SMR of malignant neoplasms with HLE were the highest and were 0.402 and 0.219 among men and women, respectively, followed by those of cerebrovascular diseases, suicide, and heart diseases among men and those of heart disease, pneumonia, and liver disease among women. When all major preventable causes of death were analyzed simultaneously in a regression model, the coefficients of determination were 0.738 and 0.425 among men and women, respectively. Conclusions Our findings suggest that local governments should prioritize preventing cancer deaths via cancer screening and smoking cessation measures in health plans, with a special focus on men.
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Affiliation(s)
- Rikuya Hosokawa
- Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Toshiyuki Ojima
- Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Tomoya Myojin
- Department of Public Health, Health Management and Policy, Nara Medical University, Nara, Japan
| | - Jun Aida
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Katsunori Kondo
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan,Center for Well-being and Society, Nihon Fukushi University, Aichi, Japan,Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, Aichi, Japan
| | - Naoki Kondo
- School of Public Health and Graduate School of Medicine, Kyoto University, Kyoto, Japan
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22
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Westervelt K, Rose GL, Avery S, Celley A, Cho J, Donoghue R, Goodrich B. Employee Group Coaching Program for University and Hospital Employees During COVID-19: A Feasibility Study. GLOBAL ADVANCES IN INTEGRATIVE MEDICINE AND HEALTH 2023; 12:27536130231207856. [PMID: 37868691 PMCID: PMC10588399 DOI: 10.1177/27536130231207856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 09/18/2023] [Accepted: 09/26/2023] [Indexed: 10/24/2023]
Abstract
Background Workplace wellbeing programs can be beneficial but range widely in approach. A group coaching model offers numerous benefits. Objective To evaluate feasibility of group coaching for employees during COVID-19. Methods Employees (n = 29) at a university and university hospital underwent a 12-week group coaching program. Measurements of feasibility -- including enrollment, attendance at sessions goal attainment and satisfaction -- and exploratory outcomes including perceived physical and mental health and stress were administered at beginning, middle, and end of the program, plus 2 follow-ups. Results Twenty-six of the 29 program enrollees (96% women; 65% university employees) opted to complete surveys at 1 or more time points, and 9 individuals completed surveys at all 5 time points. Median attendance was 9 sessions. Participants opted to focus on movement, nutrition and mind/body goals and all participants reported making progress toward their goal during the program. Exploratory wellness outcomes showed meaningful improvements in perceived physical and mental health and reduced stress during the program, with return to near baseline 12 weeks after program completion. Perceptions of workplace wellness culture varied by employer. Conclusion Despite pandemic-related disruptions to life, work, and health, online group coaching is feasible and acceptable to participants. The program should be replicated to evaluate whether the improvements in exploratory wellness outcomes observed during the program are statistically significant. The apparent return to baseline levels by 24 weeks suggests that post-program maintenance support may be helpful.
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Affiliation(s)
- Karen Westervelt
- Osher Center for Integrative Health, University of Vermont, Burlington, VT, USA
- Department of Rehabilitation and Movement Science, University of Vermont, Burlington, VT, USA
| | - Gail L. Rose
- Osher Center for Integrative Health, University of Vermont, Burlington, VT, USA
- Department of Psychiatry, University of Vermont, Burlington, VT, USA
| | - Scott Avery
- Department of Rehabilitation and Movement Science, University of Vermont, Burlington, VT, USA
| | - Alisha Celley
- Department of Rehabilitation and Movement Science, University of Vermont, Burlington, VT, USA
| | - Josh Cho
- Department of Rehabilitation and Movement Science, University of Vermont, Burlington, VT, USA
| | - Rory Donoghue
- Department of Rehabilitation and Movement Science, University of Vermont, Burlington, VT, USA
| | - Brennan Goodrich
- Department of Rehabilitation and Movement Science, University of Vermont, Burlington, VT, USA
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Legese GL, Asres G, Alemu S, Yesuf T, Tesfaye YA, Amare T. Determinants of poor glycemic control among type 2 diabetes mellitus patients at University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia: Unmatched case-control study. Front Endocrinol (Lausanne) 2023; 14:1087437. [PMID: 36843610 PMCID: PMC9947343 DOI: 10.3389/fendo.2023.1087437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 01/30/2023] [Indexed: 02/11/2023] Open
Abstract
BACKGROUND Poor glycemic control is one of the most determinant factors for type 2 diabetes-related morbidity and mortality. The proportion of type 2 diabetes mellitus patients with poor glycemic control remains high. Yet evidence on factors contributing to poor glycemic control remains scarce. The aim of this study is to identify determinants of poor glycemic control among type 2 diabetes mellitus patients at a diabetes mellitus clinic in University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia Determinants of Poor Glycemic Control among Type 2 Diabetes mellitus Patients at University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia: Unmatched Case-Control Study. METHODS A hospital-based case-control study was conducted from June to September 2020. Using convenience sampling techniques, a total of 90 cases and 90 controls with type 2 diabetes were recruited. The data were entered into Epidata version 4.6.0.2 and analyzed by Stata version 14. A multivariable logistic regression analysis was performed to assess the association between independent variables and glycemic control. Both 95% CI and p-value<0.05 were used to determine the level and significance, respectively. RESULTS The mean age ( ± standard deviations) for the cases and controls were 57.55± 10.42 and 61.03± 8.93% respectively. The determinants of poor glycemic control were age (Adjusted odd ratio (AOR)= 0.08; 95% CI= 0.02-0.33), inadequate physical exercise (AOR = 5.05; 95% CI = 1.99-11.98), presence of comorbidities (AOR = 5.50; 95% CI = 2.06-14.66), non-adherence to anti-diabetes medications (AOR= 2.76; 95% CI= 1.19-6.40), persistent proteinuria (AOR=4.95; 95% CI=1.83-13.36) and high-density lipoprotein less than 40 mg/dl (AOR=3.08; 95% CI= 1.30-7.31). CONCLUSIONS Age less than 65 years, inadequate physical exercise, presence of comorbidities, non-adherence to anti-diabetes medications, persistent proteinuria, and high-density lipoprotein less than 40 mg/dl were the determinants of poor glycemic control. Therefore, targeted educational and behavioral modification programs on adequate exercise and medication adherence should be routinely practiced. Furthermore, early guideline-based screening and treatment of comorbidities and complications is required to effectively manage diabetes mellitus.
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Affiliation(s)
- Gebrehiwot Lema Legese
- Department of Internal Medicine, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- *Correspondence: Gebrehiwot Lema Legese,
| | - Getahun Asres
- Department of Internal Medicine, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Shitaye Alemu
- Department of Internal Medicine, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tesfaye Yesuf
- Department of Internal Medicine, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Yeabsira Aklilu Tesfaye
- Department of Internal Medicine, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tsegaw Amare
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Baxter SL, Nwanyanwu K, Legault G, Lee AY. Data Sources for Evaluating Health Disparities in Ophthalmology: Where We Are and Where We Need to Go. Ophthalmology 2022; 129:e146-e149. [PMID: 36058733 PMCID: PMC9509471 DOI: 10.1016/j.ophtha.2022.06.035] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 05/17/2022] [Accepted: 06/06/2022] [Indexed: 10/14/2022] Open
Abstract
Data provide an opportunity to discover disparities and inequities that may otherwise be unrecognized. Within the American Academy of Ophthalmology (AAO) Task Force on Disparities in Eye Care, the Leveraging Data Sub-task Force was charged with identifying data sources to study health disparities in eye care and to leverage data to advance health equity. We evaluated large data sources to determine their strengths, deficiencies, and relative accessibility in relation to the likelihood of identifying eye care disparities. We highlight the current challenges with these data sources and review key recommendations for improving future sources for studying health disparities in eye care.
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Affiliation(s)
- Sally L Baxter
- Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, California; Health Department of Biomedical Informatics, University of California San Diego, La Jolla, California
| | - Kristen Nwanyanwu
- Department of Ophthalmology and Visual Science, Yale University, New Haven, Connecticut
| | - Gary Legault
- Department of Ophthalmology, Brooke Army Medical Center, Fort Sam Houston, Texas
| | - Aaron Y Lee
- Department of Ophthalmology, University of Washington, Seattle, Washington.
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LeBlanc M, Radix A, Sava L, Harris AB, Asquith A, Pardee DJ, Reisner SL. "Focus more on what's right instead of what's wrong:" research priorities identified by a sample of transgender and gender diverse community health center patients. BMC Public Health 2022; 22:1741. [PMID: 36104812 PMCID: PMC9472366 DOI: 10.1186/s12889-022-14139-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 08/24/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Transgender and gender diverse (TGD) individuals disproportionately experience disparate health outcomes compared to their cisgender peers. This study aimed to collect qualitative data from a sample of TGD community health center patients on health research priorities to inform future TGD-centered research in the field of TGD health. METHODS Between September-November of 2018, four focus groups (two groups in Boston MA, two in New York NY; n = 28 individuals) were held to evaluate community-identified TGD health research priorities with a sample of patients from two community health centers. Thematic analyses were conducted and restricted to social factors impacting health. Findings were incorporated into the development of The LEGACY Project, a longitudinal cohort of TGD patients, assessing the impact of gender-affirming care on health outcomes. RESULTS Cross-cutting themes about TGD research priorities pertaining to social factors and health included: (1) Embodiment: understanding and investigating the complex and intersectional lived experiences of TGD individuals; (2) Social determinants of health: the impact of structural and interpersonal stigma on TGD health; and (3) Resiliency and health promoting factors: the need to expand public health research beyond disparities to assess resiliency and health promotion in TGD communities. CONCLUSIONS Participants identified investigating the impact of social influences on health as a research priority for TGD patients. Recalibrating field norms from individual researcher priorities to TGD population-driven research will help ensure investigators address topics that may otherwise be missed or overlooked and may optimize the reach and impact of research in TGD health.
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Affiliation(s)
- Merrily LeBlanc
- The Fenway Institute, Fenway Health, 1340 Boylston Street, 8th Floor, Boston, MA, 02215, USA
| | - Asa Radix
- Callen-Lorde Community Health Center, New York, NY, USA
| | - Lauren Sava
- The Fenway Institute, Fenway Health, 1340 Boylston Street, 8th Floor, Boston, MA, 02215, USA
| | | | - Andrew Asquith
- The Fenway Institute, Fenway Health, 1340 Boylston Street, 8th Floor, Boston, MA, 02215, USA
| | - Dana J Pardee
- The Fenway Institute, Fenway Health, 1340 Boylston Street, 8th Floor, Boston, MA, 02215, USA
| | - Sari L Reisner
- The Fenway Institute, Fenway Health, 1340 Boylston Street, 8th Floor, Boston, MA, 02215, USA.
- Brigham and Women's Hospital, Boston, MA, USA.
- Harvard Medical School, Boston, MA, USA.
- Harvard School of Public Health, Boston, MA, USA.
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Terry PE. A Rose is a Rose is a Rose: Reviewing Definitions for and Reimbursement for Health Promotion, Lifestyle Medicine, Behavioral Medicine, Preventive Medicine and Population Health. Am J Health Promot 2022; 36:1077-1082. [PMID: 35658684 DOI: 10.1177/08901171221106666] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
How do the definitions between health promotion professions differ? Should the shift from using the term wellness to greater use of the well-being term challenge us to explain how our profession improves how people appraise their lives as a whole? After all, achieving well-being is a challenge as relevant to clergy, politicians, artists and entertainers as to health professionals. Successful organizations are keenly attentive to how they differentiate their services so as not to get lost in a sea of like competitors. The American College of Lifestyle Medicine has recently defined lifestyle medicine as a medical specialty delivered by certified clinicians. In contrast, the Society of Behavioral Medicine suggests that virtually any degree holder may be qualified to provide disease management and prevention services. If improved health is one of the surest ways to improve well-being, do we need to more clearly define the health promotion profession's value proposition? How should definitions about differences between professions influence reimbursement differences between professions?
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Affiliation(s)
- Paul E Terry
- Editor in Chief, The American Journal of Health Promotion, Senior Fellow, The Health Enhancement Research Organization (HERO)
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Terry PE. Do Faith Friendly Workplaces Increase Well-Being? Am J Health Promot 2022; 36:909-912. [DOI: 10.1177/08901171221098317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Many will draw distinctions between finding your purpose and tapping into spirituality. And many more are quick to point out that they are spiritual but not religious. This predictable definitional dynamic makes me doubtful that adoption of purpose finding strategies will be the gateway to unlocking the ambivalence and stigma related to sharing one’s faith in company settings. Drawing from tenets that drive social epidemics, wellness professionals and faith leaders travel in ‘closed circles’ and it will take ‘connectors’ with ties in both circles to spread the idea that workplace wellness and faith traditions can have positive synergies. Healthy People 2030 defines health and well-being as “how people think, feel, and function—at a personal and social level—and how they evaluate their lives as a whole.” This editorial describes components of faith friendly organizations and argues that employee resource groups and trends in diversity, equity and inclusion initiatives could be a catalyst for greater openness to including people’s faith traditions as a part of bringing their whole selves to work.
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Affiliation(s)
- Paul E. Terry
- Editor in Chief, American Journal of Health Promotion, Senior Fellow, The Health Enhancement Research Organization (HERO)
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Koh HK, Blakey C, Ochiai E. Flourishing After a Pandemic: Healthy People 2030. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2021; 27:S215-S217. [PMID: 34559737 PMCID: PMC8478293 DOI: 10.1097/phh.0000000000001415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Howard K. Koh
- Harvard T. H. Chan School of Public Health and Harvard Kennedy School, Boston, Massachusetts (Dr Koh); and Office of Disease Prevention and Health Promotion, US Department of Health and Human Services, Rockville, Maryland (Ms Blakey and Ms Ochiai)
| | - Carter Blakey
- Harvard T. H. Chan School of Public Health and Harvard Kennedy School, Boston, Massachusetts (Dr Koh); and Office of Disease Prevention and Health Promotion, US Department of Health and Human Services, Rockville, Maryland (Ms Blakey and Ms Ochiai)
| | - Emmeline Ochiai
- Harvard T. H. Chan School of Public Health and Harvard Kennedy School, Boston, Massachusetts (Dr Koh); and Office of Disease Prevention and Health Promotion, US Department of Health and Human Services, Rockville, Maryland (Ms Blakey and Ms Ochiai)
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Galvin AE, Friedman DB, Hébert JR. Focus on disability-free life expectancy: implications for health-related quality of life. Qual Life Res 2021; 30:2187-2195. [PMID: 33733432 PMCID: PMC7970769 DOI: 10.1007/s11136-021-02809-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2021] [Indexed: 10/31/2022]
Abstract
BACKGROUND Since the end of the industrial revolution, advances in public health and clinical medicine have contributed to dramatic decreases in infant and childhood mortality, improvements in health-related quality of life (HRQoL), increases in overall life expectancy (LE), and rectangularization of survival curves. OBJECTIVES In this article, we focus on disability that has occurred with the overall lengthening of LE in many populations and the implications this has for decreased HRQoL. METHODS We utilize the concept of rectangularization of population survival to depict the rising prevalence of disability associated with increased LE, especially among racial and ethnic minorities and people of low socioeconomic status (SES) and relate this to HRQoL. RESULTS Disability-free life expectancy (DFLE) and healthy life expectancy (HLE) are defined in terms of HRQoL. Specific attention is focused on disability experienced by disparate populations around the globe. By focusing on disparities in DFLE, and the need to expand LE to include HLE as a central component of HRQoL, this work provides an important counterpoint to the attention that has been paid to LE disparities according to race, gender, ethnicity, education, and SES. DISCUSSION By calling attention to those factors that appear to be the most important drivers of the differences in quality and length of DFLE between different groups (i.e., the components of the social gradient, exposure to chronic stress, systemic inflammation, and the psychological and biological mechanisms associated with the gut-brain axis) and, by logical extension, HRQoL, we hope to promote research in this arena with the ultimate goal of improving DFLE, HLE, and overall HRQoL, especially in disparate populations around the globe.
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Affiliation(s)
- Ashley E Galvin
- Statewide Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Suite 241-2, Columbia, SC, 29208, USA.,Pediatric Hematology-Oncology, Boston Children's Hospital, 300 Longwood Ave, Boston, MA, 02215, USA
| | - Daniela B Friedman
- Statewide Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Suite 241-2, Columbia, SC, 29208, USA.,Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC, 29208, USA.,Office for the Study of Aging, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC, 29208, USA
| | - James R Hébert
- Statewide Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Suite 241-2, Columbia, SC, 29208, USA. .,Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, 915 Greene St, Columbia, SC, 29208, USA.
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Pronk NP, Kleinman DV, Richmond TS. Healthy People 2030: Moving toward equitable health and well-being in the United States. EClinicalMedicine 2021; 33:100777. [PMID: 33733077 PMCID: PMC7941044 DOI: 10.1016/j.eclinm.2021.100777] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 02/11/2021] [Accepted: 02/12/2021] [Indexed: 11/30/2022] Open
Affiliation(s)
- Nicolaas P. Pronk
- HealthPartners Institute, Minneapolis, Minnesota; Department of Social and Behavioral Sciences, Harvard Chan School of Public Health, Boston Massachusetts; and Division of Health Policy and Management, University of Minnesota, Minneapolis, MN, United States
- Corresponding author at: HealthPartners Institute, Bloomington, Minneapolis, Minnesota, USA.
| | - Dushanka V. Kleinman
- Principal Associate Dean, University of Maryland (UMD) School of Public Health. Washington DC, United States
| | - Therese S. Richmond
- School of Nursing, Biobehavioral Health Sciences Department, Senior Fellow Leonard Davis Institute of Health Economics; University of Pennsylvania, Philadelphia, Pennsylvania, United States
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