The exchange and use of cultural and social capital among community health workers in the United States

The Pre-Implementation Phase of a Project Seeking to Deliver a Community-Based CVD Prevention Intervention (SPICES-Sussex): A Qualitative Study Exploring Views and Experience Relating to Intervention Development

BACKGROUND.

Community-led health care interventions may be an effective way to tackle cardiovascular disease (CVD) risk factors, especially in materially deprived communities where health care resources are stretched and engagement with institutions is often low. To do so effectively and equitably, interventions might be developed alongside community members through community engagement.

OBJECTIVES.

The aim of this project was to carry out stakeholder mapping and partnership identification and to understand the views, needs, experiences of community members who would be involved in later stages of a community-based CVD prevention intervention's development and implementation.

METHODS.

Stakeholder mapping was carried out to identify research participants in three communities in Sussex, United Kingdom. A qualitative descriptive approach was taken during the analysis of focus groups and interviews with 47 participants.

FINDINGS.

Three themes were highlighted related to intervention design (a) Management: the suitability of the intervention for the community, management of volunteers, and communication; (b) Logistics: the structure and design of the intervention; and (c) Sociocultural issues, the social and cultural expectations/experiences of participants and implementers.

CONCLUSIONS.

Study participants were open and willing to engage in the planned community-based intervention, particularly in elements of co-design and community-led delivery. They also highlighted the importance of sociocultural factors. Based on the findings, we developed recommendations for intervention design which included (but were not limited to): (a) a focus on a bottom-up approach to intervention design, (b) the recruitment of skilled local volunteers, and (c) the importance of fun and simplicity.

Community Health Workers as Puentes/Bridges to Increase COVID-19 Health Equity in Latinx Communities of the Southwest U.S

This study documents the pivotal role that Community Health Workers (CHW) played while supporting underserved Latinx communities affected by COVID-19-related health inequities. With the support of CHWs' agencies historically serving three Latinx-dense counties in Arizona, we recruited CHWs who participated in a state-wide COVID-19 testing project. Using phenomenology and narrative qualitative research methods, five focus groups were facilitated in Spanish between August and November 2021. Bilingual research team members conducted the analysis of the Spanish verbatim transcripts and CHWs reviewed the results for validity. Three interconnected themes reflected the CHWs experiences: (1) CHWs as puentes/bridges with deep community embeddedness through shared experiences and social/cultural context, (2) CHWs as communication brokers and transformational agents, playing a pivotal role in responding to the health and socioeconomic challenges posed by the COVID-19 pandemic, (3) CHWs satisfaction and frustration due to their dual role as committed community members but unrecognized and undervalued frontline public health workers. These findings emphasize the CHWs' commitment towards supporting their communities, even amidst the stressors of the pandemic. It is important to continue to integrate the role of CHWs into the larger healthcare system as opposed to relegating them to short term engagements as was the case during the COVID-19 pandemic. This article provides a set of practice, policy, and future research recommendations, emphasizing the need to allocate greater budgetary and training resources in support of CHWs.

Conditions for the success and the feasibility of health mediation for healthcare use by underserved populations: a scoping review

OBJECTIVE

This article aims to analyse the conditions under which health mediation for healthcare use is successful and feasible for underserved populations.

METHOD

We conducted a scoping review on the conditions for effective health mediation according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews standards. We searched for articles in the following databases: PubMed, PsychINFO, Scopus and Cairn published between 1 January 2015 and 18 December 2020. We selected the articles concerning health mediation interventions or similar, implemented in high-income countries and conducted among underserved populations, along with articles that questioned their effectiveness conditions. We created a two-dimensional analysis grid of the data collected: a descriptive dimension of the intervention and an analytical dimension of the conditions for the success and feasability of health mediation.

RESULTS

22 articles were selected and analysed. The scoping review underlines many health mediation characteristics that articulate education and healthcare system navigation actions, along with mobilisation, engagement, and collaboration of local actors among themselves and with the populations. The conditions for the success and the feasability were grouped in a conceptual framework of health mediation.

CONCLUSION

The scoping review allows us to establish an initial framework for analysing the conditions for the success and the feasability of health mediation and to question the consistency of the health mediation approach regarding cross-cutting tensions and occasionally divergent logic.

The Genetic Structure and East-West Population Admixture in Northwest China Inferred From Genome-Wide Array Genotyping

Northwest China is a contacting region for East and West Eurasia and an important center for investigating the migration and admixture history of human populations. However, the comprehensive genetic structure and admixture history of the Altaic speaking populations and Hui group in Northwest China were still not fully characterized due to insufficient sampling and the lack of genome-wide data. Thus, We genotyped genome-wide SNPs for 140 individuals from five Chinese Mongolic, Turkic speaking groups including Dongxiang, Bonan, Yugur, and Salar, as well as the Hui group. Analysis based on allele-sharing and haplotype-sharing were used to elucidate the population history of Northwest Chinese populations, including PCA, ADMIXTURE, pairwise Fst genetic distance, f-statistics, qpWave/qpAdm and ALDER, fineSTRUCTURE and GLOBETROTTER. We observed Dongxiang, Bonan, Yugur, Salar, and Hui people were admixed populations deriving ancestry from both East and West Eurasians, with the proportions of West Eurasian related contributions ranging from 9 to 15%. The genetic admixture was probably driven by male-biased migration- showing a higher frequency of West Eurasian related Y chromosomal lineages than that of mtDNA detected in Northwest China. ALDER-based admixture and haplotype-based GLOBETROTTER showed this observed West Eurasian admixture signal was introduced into East Eurasia approximately 700 ∼1,000 years ago. Generally, our findings provided supporting evidence that the flourish transcontinental communication between East and West Eurasia played a vital role in the genetic formation of northwest Chinese populations.