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Kabbes N, Bugra A, Wissanji H, Osmanlliu E. Telehealth for Indigenous Children Worldwide: A Scoping Review. J Pediatr Surg 2024; 59:908-917. [PMID: 38413263 DOI: 10.1016/j.jpedsurg.2024.01.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 01/22/2024] [Indexed: 02/29/2024]
Abstract
PURPOSE Indigenous children worldwide face healthcare disparities due, in part, to resource scarcity in remote settings which may be mitigated with technology. This study aims to determine the use of telehealth for this population, with respect to feasibility, acceptability, and the degree of patient/family involvement in reported interventions. We focused on the use of telehealth to support perioperative care. METHODS To identify relevant studies, five databases were searched to find articles that focused on the role of telehealth in caring for Indigenous populations worldwide, with an emphasis on the pediatric population. Studies that lacked insight into those themes, as well as protocols and review articles, were excluded. Analysis was done according to the non-adoption, abandonment, scale-up, spread, and sustainability (NASSS) framework, the Montreal Model (patient involvement), and the theoretical framework of acceptability (TFA). RESULTS Of the 1690 articles screened, 34 met the eligibility criteria. The most frequent uses of telehealth for Indigenous children were in ENT and psychiatry. Most of those had a low degree of complexity across the NASSS framework domains, suggesting greater feasibility. In 13 articles, the patient involvement was limited to information (lowest level of involvement in the Montreal Model). Only 11 articles directly assessed patient/family-perceived acceptability. Finally, two articles addressed telehealth in the surgical context. CONCLUSIONS The relative simplicity of the proposed telehealth applications may support their sustained impact and use in other settings such as for perioperative care. Early and longitudinal involvement of communities is essential for responsible telehealth development that addresses local needs. LEVEL OF EVIDENCE Level V.
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Affiliation(s)
- Nour Kabbes
- McGill Faculty of Medicine, Montreal, QC, Canada
| | - Adalet Bugra
- McGill Faculty of Medicine, Montreal, QC, Canada
| | - Hussein Wissanji
- Division of Pediatric General and Thoracic Surgery, Montreal Children's Hospital, McGill University Health Centre, Montreal, QC, Canada.
| | - Esli Osmanlliu
- Research Institute of the McGill University Health Centre, Montreal, QC, Canada; Division of Pediatric Emergency Medicine, Department of Pediatrics, Montreal Children's Hospital, McGill University Health Centre, Montreal, QC, Canada
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Hicks LJ, Toombs E, Lund J, Kowatch KR, Hopkins C, Mushquash CJ. Expanding our understanding of digital mental health interventions for Indigenous youth: An updated systematic review. J Telemed Telecare 2024:1357633X241239715. [PMID: 38584397 DOI: 10.1177/1357633x241239715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
Past research has examined available literature on electronic mental health interventions for Indigenous youth with mental health concerns. However, as there have recently been increases in both the number of studies examining electronic mental health interventions and the need for such interventions (i.e. during periods of pandemic isolation), the present systematic review aims to provide an updated summary of the available peer-reviewed and grey literature on electronic mental health interventions applicable to Indigenous youth. The purpose of this review is to better understand the processes used for electronic mental health intervention development. Among the 48 studies discussed, smoking cessation and suicide were the most commonly targeted mental health concerns in interventions. Text message and smartphone application (app) interventions were the most frequently used delivery methods. Qualitative, quantitative, and/or mixed outcomes were presented in several studies, while other studies outlined intervention development processes or study protocols, indicating high activity in future electronic mental health intervention research. Among the findings, common facilitators included the use of community-based participatory research approaches, representation of culture, and various methods of motivating participant engagement. Meanwhile, common barriers included the lack of necessary resources and limits on the amount of support that online interventions can provide. Considerations regarding the standards and criteria for the development of future electronic mental health interventions for Indigenous youth are offered and future research directions are discussed.
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Affiliation(s)
- Lydia J Hicks
- Department of Psychology, Lakehead University - Thunder Bay Campus, ON, Canada
| | - Elaine Toombs
- Department of Psychology, Lakehead University - Thunder Bay Campus, ON, Canada
- Dilico Anishinabek Family Care, Fort William First Nation, Canada
| | - Jessie Lund
- Department of Psychology, Lakehead University - Thunder Bay Campus, ON, Canada
| | - Kristy R Kowatch
- Department of Psychology, Lakehead University - Thunder Bay Campus, ON, Canada
| | - Carol Hopkins
- Thunderbird Partnership Foundation, Bothwell, ON, Canada
| | - Christopher J Mushquash
- Department of Psychology, Lakehead University - Thunder Bay Campus, ON, Canada
- Dilico Anishinabek Family Care, Fort William First Nation, Canada
- Thunder Bay Regional Health Sciences Centre, ON, Canada
- Thunder Bay Regional Health Research Institute, ON, Canada
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Tuitt NR, Wexler LM, Kaufman CE, Whitesell NR, Rink E, Anastario M, Ivanich JD, Belone L, Moore RS, Huh D, Campbell TE, Allen J. Unsettling Settler Colonialism in Research: Strategies Centering Native American Experience and Expertise in Responding to Substance Misuse and Co-occurring Sexual Risk-Taking, Alcohol-Exposed Pregnancy, and Suicide Prevention Among Young People. ADVERSITY AND RESILIENCE SCIENCE 2023; 4:389-400. [PMID: 38045956 PMCID: PMC10688593 DOI: 10.1007/s42844-023-00100-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/07/2023] [Indexed: 12/05/2023]
Abstract
Native American (NA) populations in the USA (i.e., those native to the USA which include Alaska Natives, American Indians, and Native Hawaiians) have confronted unique historical, sociopolitical, and environmental stressors born of settler colonialism. Contexts with persistent social and economic disadvantage are critical determinants of substance misuse and co-occurring sexual risk-taking and suicide outcomes, as well as alcohol exposed pregnancy among NA young people (i.e., adolescents and young adults). Despite intergenerational transmission of resistance and resiliencies, NA young people face continued disparities in substance misuse and co-occurring outcomes when compared to other racial and ethnic groups in the USA. The failure in progress to address these inequities is the result of a complex set of factors; many of which are structural and rooted in settler colonialism. One of these structural factors includes barriers evident in health equity research intended to guide solutions to address these disparities yet involving maintenance of a research status quo that has proven ineffective to developing these solutions. Explicitly or implicitly biased values, perspectives, and practices are deeply rooted in current research design, methodology, analysis, and dissemination and implementation efforts. This status quo has been supported, intentionally and unintentionally, by researchers and research institutions with limited experience or knowledge in the historical, social, and cultural contexts of NA communities. We present a conceptual framework illustrating the impact of settler colonialism on current research methods and opportunities to unsettle its influence. Moreover, our framework illustrates opportunities to resist settler colonialism in research. We then focus on case examples of studies from the Intervention Research to Improve Native American Health program, funded by the NIH, that impact substance use and co-occurring health conditions among NA young people.
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Affiliation(s)
- Nicole R. Tuitt
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Lisa M. Wexler
- School of Social Work, University of Michigan, Ann Arbor, MI, USA
| | - Carol E. Kaufman
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Nancy Rumbaugh Whitesell
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Elizabeth Rink
- Center for American Indian and Rural Health Equity, College of Education, Health, and Human Resources, Montana State University, Bozeman, MT, USA
| | - Michael Anastario
- Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
| | - Jerreed D. Ivanich
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Lorenda Belone
- Center for Participatory Research, Department of Health, Exercise, and Sports Science, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | - Roland S. Moore
- Pacific Institute for Research and Evaluation, Albuquerque, NM, USA
| | - David Huh
- School of Social Work, University of Washington, Seattle, WA, USA
| | | | - James Allen
- Department of Family Medicine and Biobehavioral Health, University of Minnesota, Minneapolis, MN, USA
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4
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Povey J, Raphiphatthana B, Torok M, Nagel T, Mills PPJR, Sells JRH, Shand F, Sweet M, Lowell A, Dingwall K. An emerging framework for digital mental health design with Indigenous young people: a scoping review of the involvement of Indigenous young people in the design and evaluation of digital mental health interventions. Syst Rev 2023; 12:108. [PMID: 37393283 PMCID: PMC10314399 DOI: 10.1186/s13643-023-02262-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 05/30/2023] [Indexed: 07/03/2023] Open
Abstract
BACKGROUND Indigenous young people worldwide possess unique protective factors that support wellbeing. However, they experience mental illness at higher rates than their non-indigenous counterparts. Digital mental health (dMH) resources can increase access to structured, timely, and culturally tailored mental health interventions by reducing structural and attitudinal barriers to accessing treatment. The involvement of Indigenous young people in dMH resource development is recommended, however, no guidelines exist on how this can best be facilitated. METHODS A scoping review examining processes to involve Indigenous young people in developing or evaluating dMH interventions was conducted. Studies reported between 1990 and 2023 involving Indigenous young people aged 12-24 years, originating from Canada, the USA, New Zealand, and Australia, in the development or evaluation of dMH interventions were eligible for inclusion. Following a three-step search process, four electronic databases were searched. Data were extracted, synthesized, and described under three categories: dMH intervention attributes, study design, and alignment with research best practice. Best practice recommendations for Indigenous research and participatory design principles derived from the literature were identified and synthesised. Included studies were assessed against these recommendations. Consultation with two Senior Indigenous Research Officers ensured Indigenous worldviews informed analysis. RESULTS Twenty-four studies describing eleven dMH interventions met inclusion criteria. Studies included formative, design, pilot, and efficacy studies. Overall, most included studies demonstrated a high degree of Indigenous governance, capacity building, and community benefit. All studies adapted their research processes to ensure that local community protocols were followed and most aligned these within an Indigenous research paradigm. Formal agreements regarding existing and created intellectual property and implementation evaluations were rare. Outcomes were the primary focus of reporting, with limited detailed descriptions of governance and decision-making processes or strategies for managing predictable tensions between co-design stakeholders. CONCLUSIONS This study identified recommendations for undertaking participatory design with Indigenous young people and evaluated the current literature against these criteria. Common gaps were evident in the reporting of study processes. Consistent, in-depth reporting is needed to allow assessment of approaches for this hard-to-reach population. An emergent framework, informed by our findings, for guiding the involvement of Indigenous young people in the design and evaluation of dMH tools is presented. TRIAL REGISTRATION Available via osf.io/2nkc6.
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Affiliation(s)
- Josie Povey
- Menzies School of Health Research, Charles Darwin University, Casuarina Campus, Ellengowan Drive, Casuarina, NT 0810 Australia
| | - Buaphrao Raphiphatthana
- Menzies School of Health Research, Charles Darwin University, Casuarina Campus, Ellengowan Drive, Casuarina, NT 0810 Australia
| | - Michelle Torok
- Black Dog Institute, University of New South Wales, Sydney, NSW 2052 Australia
| | - Tricia Nagel
- Menzies School of Health Research, Charles Darwin University, Casuarina Campus, Ellengowan Drive, Casuarina, NT 0810 Australia
| | - Patj Patj Janama Robert Mills
- Menzies School of Health Research, Charles Darwin University, Casuarina Campus, Ellengowan Drive, Casuarina, NT 0810 Australia
| | - Joshua Russell Howard Sells
- Menzies School of Health Research, Charles Darwin University, Casuarina Campus, Ellengowan Drive, Casuarina, NT 0810 Australia
| | - Fiona Shand
- Black Dog Institute, University of New South Wales, Sydney, NSW 2052 Australia
| | - Michelle Sweet
- Menzies School of Health Research, Charles Darwin University, Casuarina Campus, Ellengowan Drive, Casuarina, NT 0810 Australia
| | - Anne Lowell
- Northern Institute, Charles Darwin University, Casuarina Campus, Casuarina, NT 0810 Australia
| | - Kylie Dingwall
- Northern Institute, Charles Darwin University, Casuarina Campus, Casuarina, NT 0810 Australia
- Menzies School of Health Research, Charles Darwin University, 10 Grevillia Drive, Alice Springs Campus, NT Australia
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Kaufman CE, Asdigian NL, Reed ND, Shrestha U, Bull S, Begay RL, Shangreau C, Howley CT, Vossberg RL, Sarche M. A virtual randomized controlled trial of an alcohol-exposed pregnancy prevention mobile app with urban American Indian and Alaska Native young women: Native WYSE CHOICES rationale, design, and methods. Contemp Clin Trials 2023; 128:107167. [PMID: 37001855 PMCID: PMC10290431 DOI: 10.1016/j.cct.2023.107167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 03/13/2023] [Accepted: 03/22/2023] [Indexed: 03/31/2023]
Abstract
BACKGROUND Fetal Alcohol Spectrum Disorders (FASD) result in lifelong disability and are a leading cause of preventable birth defects in the US, including for American Indian and Alaska Natives (AIANs). Prevention of alcohol exposed pregnancies (AEPs), which can cause FASD, is typically aimed at adult women who are risky drinkers and have unprotected sex. Among AIANs, AEP prevention research has been primarily conducted in reservation communities, even though over 70% of AIANs live in urban areas. Culturally appropriate AEP prevention for urban AIAN young women, regardless of current drinking or sexual behaviors, may maximize the potential for primary prevention at the beginning of the reproductive years for this underserved population. METHODS We developed a virtual randomized controlled trial (RCT) - fully implemented through technology - to evaluate Native WYSE CHOICES, a culturally tailored mobile app, with urban AIAN young women ages 16-20 nationally. While virtual RCTs are not new, this is the first engaging a solely urban AIAN population, historically excluded from research. Participants are recruited on a rolling basis through the project social media community, organizational partnerships, and in-person events. Eligible participants complete a baseline survey and are randomized to either the app's intervention or comparison arm - each of which provide about 3 h of content. Follow-up data are collected at 1-, 6-, and 12-months post-baseline. RESULTS Our study offers a template for building trust and extending reach to this underserved population while also providing important lessons and insights on advances in virtual or hybrid research approaches.
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Affiliation(s)
- Carol E Kaufman
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado-Anschutz Medical Campus, Mail Stop F800, 13055 East 17(th) Avenue, Aurora, CO 80045, United States of America.
| | - Nancy L Asdigian
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado-Anschutz Medical Campus, Mail Stop F800, 13055 East 17(th) Avenue, Aurora, CO 80045, United States of America.
| | - Nicole D Reed
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado-Anschutz Medical Campus, Mail Stop F800, 13055 East 17(th) Avenue, Aurora, CO 80045, United States of America.
| | - Umit Shrestha
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado-Anschutz Medical Campus, Mail Stop F800, 13055 East 17(th) Avenue, Aurora, CO 80045, United States of America.
| | - Sheana Bull
- mHealth Impact Lab, Department of Community and Behavioral Health, Colorado School of Public Health, Mail Stop F802, 13055 East 17(th) Avenue, Aurora, CO 80045, United States of America.
| | - Rene L Begay
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado-Anschutz Medical Campus, Mail Stop F800, 13055 East 17(th) Avenue, Aurora, CO 80045, United States of America.
| | - Carly Shangreau
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado-Anschutz Medical Campus, Mail Stop F800, 13055 East 17(th) Avenue, Aurora, CO 80045, United States of America.
| | - Caitlin Trucksess Howley
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado-Anschutz Medical Campus, Mail Stop F800, 13055 East 17(th) Avenue, Aurora, CO 80045, United States of America.
| | - Raeann L Vossberg
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado-Anschutz Medical Campus, Mail Stop F800, 13055 East 17(th) Avenue, Aurora, CO 80045, United States of America.
| | - Michelle Sarche
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado-Anschutz Medical Campus, Mail Stop F800, 13055 East 17(th) Avenue, Aurora, CO 80045, United States of America.
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6
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Moecke DP, Holyk T, Beckett M, Chopra S, Petlitsyna P, Girt M, Kirkham A, Kamurasi I, Turner J, Sneddon D, Friesen M, McDonald I, Denson-Camp N, Crosbie S, Camp PG. Scoping review of telehealth use by Indigenous populations from Australia, Canada, New Zealand, and the United States. J Telemed Telecare 2023:1357633X231158835. [PMID: 36911983 DOI: 10.1177/1357633x231158835] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
Abstract
INTRODUCTION Telehealth has the potential to address health disparities experienced by Indigenous people, especially in remote areas. This scoping review aims to map and characterize the existing evidence on telehealth use by Indigenous people and explore the key concepts for effective use, cultural safety, and building therapeutic relationships. METHODS A search for published and gray literature, written in English, and published between 2000 and 2022 was completed in 17 electronic databases. Two reviewers independently screened retrieved records for eligibility. For included articles, data were extracted, categorized, and analyzed. Synthesis of findings was performed narratively. RESULTS A total of 321 studies were included. The most popular type of telehealth used was mHealth (44%), and the most common health focuses of the telehealth interventions were mental health (26%) and diabetes/diabetic retinopathy (13%). Frequently described barriers to effective telehealth use included concerns about privacy/confidentiality and limited internet availability; meanwhile, telehealth-usage facilitators included cultural relevance and community engagement. Although working in collaboration with Indigenous communities was the most frequently reported way to achieve cultural safety, 40% of the studies did not report Indigenous involvement. Finally, difficulty to establish trusting therapeutic relationships was a major concern raised about telehealth, and evidence suggests that having the first visit-in-person is a potential way to address this issue. CONCLUSION This comprehensive review identified critical factors to guide the development of culturally-informed telehealth services to meet the needs of Indigenous people and to achieve equitable access and positive health outcomes.
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Affiliation(s)
- Débora Petry Moecke
- University of British Columbia (UBC), Vancouver, Canada.,Faculty of Medicine, 8166University of British Columbia, Vancouver, Canada
| | - Travis Holyk
- Carrier Sekani Family Services, Prince George, Canada
| | - Madelaine Beckett
- University of British Columbia (UBC), Vancouver, Canada.,Faculty of Medicine, 8166University of British Columbia, Vancouver, Canada
| | - Sunaina Chopra
- University of British Columbia (UBC), Vancouver, Canada.,Faculty of Medicine, 8166University of British Columbia, Vancouver, Canada
| | | | - Mirha Girt
- 1974Faculty of Medicine, University of Queensland, Brisbane, Australia
| | | | - Ivan Kamurasi
- University of British Columbia (UBC), Vancouver, Canada.,Faculty of Medicine, 8166University of British Columbia, Vancouver, Canada
| | - Justin Turner
- University of British Columbia (UBC), Vancouver, Canada.,Faculty of Medicine, 8166University of British Columbia, Vancouver, Canada
| | - Donovan Sneddon
- University of British Columbia (UBC), Vancouver, Canada.,Faculty of Medicine, 8166University of British Columbia, Vancouver, Canada
| | | | - Ian McDonald
- University of British Columbia (UBC), Vancouver, Canada
| | | | | | - Pat G Camp
- University of British Columbia (UBC), Vancouver, Canada.,Faculty of Medicine, 8166University of British Columbia, Vancouver, Canada
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Valdez RS, Rogers CC. Consumer Health Informatics for Racial and Ethnic Minoritized Communities: Minor Progress, Major Opportunities. Yearb Med Inform 2022; 31:167-172. [PMID: 36463875 PMCID: PMC9719777 DOI: 10.1055/s-0042-1742520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
OBJECTIVE By reducing barriers to accessing health services and by supporting health management, consumer health informatics has the potential to reduce health disparities. Yet, technologies are still being designed without considerations for racial and ethnic minoritized populations. This paper reviews consumer health informatics research within this population to assess for whom and how such technologies are being designed. METHODS We searched four databases from January 2020- December 2021 for literature focused on consumer health informatics and racial and ethnic minoritized populations. We extracted information about the study population, geographic location, stage of the design lifecycle, culturally tailored approaches, community engagement strategies, and considerations for the social determinants of health. RESULTS Twenty articles were included in the review. Most of the included literature were original research articles that tested health management interventions focused on one racial or ethnic minoritized population primarily within a confined geographic area within the United States. Seven studies described the extent to which an intervention was culturally tailored, including modifying the content, interface, functionality, and platform. Community engagement strategies varied, but few articles employed robust approaches. Lastly, seven studies detailed considerations for the social determinants of health, including providing hardware to access interventions and incorporating information about community-based resources within an intervention. CONCLUSIONS There has been moderate progress in consumer health informatics focused on racial and ethnic minoritized populations and many opportunities remain for these technologies to be used as an approach to address health disparities. Future research should utilize community engagement strategies to design interventions that are attune to multiple racial and ethnic minoritized populations across geographic regions in addition to numerous intersectional identities and multiple co-morbidities.
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Affiliation(s)
- Rupa S. Valdez
- University of Virginia, Charlottesville, VA, USA,Correspondence to: Rupa S. Valdez Department of Public Health Sciences, University of VirginiaP.O. Box 800717, Charlottesville, VA 22908USA+1 434 982 2510
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Smith L, Hilton A, Walker J, Alfred L, Ahankari A, Schölin L. Prevention of alcohol related harm though preconception care: A scoping review of barriers and enablers. DIALOGUES IN HEALTH 2022; 1:100040. [PMID: 38515881 PMCID: PMC10953971 DOI: 10.1016/j.dialog.2022.100040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 08/23/2022] [Accepted: 08/23/2022] [Indexed: 03/23/2024]
Abstract
Objective To understand the perspectives of healthcare practitioners and women of reproductive age regarding addressing prevention of an alcohol exposed pregnancy before conception. Methods A scoping review of mixed methods, qualitative and quantitative research was conducted. Medline, CINAHL, EMBASE and PsychInfo databases were searched for literature published by March 2022. Data were extracted and synthesized. Results Twenty-three studies were included. Views varied between healthcare practitioners and women about addressing alcohol with women before pregnancy. Healthcare practitioners agreed prevention was important but believed they were ill-prepared to provide support, and that it might be intrusive if women were not contemplating pregnancy. Whereas women would welcome advice from healthcare practitioners, particularly if offered during appointments or visits for services related to reproductive health. A knowledge deficit about pregnancy and fetal harms from alcohol was expressed by both healthcare practitioners and women. Conclusions Investment in alcohol education and skills training for healthcare professionals is required to ensure a coherent message is communicated across services, and that shared decision making about healthcare between service users and health professionals is facilitated. Future research should explore implementation of interventions to prevent alcohol exposed pregnancy in settings where women are seeking reproductive health support.
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Affiliation(s)
- Lesley Smith
- Institute of Clinical and Applied Health Research, University of Hull, Hull, UK
| | - Andrea Hilton
- Department of Paramedical, Perioperative and Advanced Practice, University of Hull, Hull, UK
| | - Jayne Walker
- Department of Paramedical, Perioperative and Advanced Practice, University of Hull, Hull, UK
| | - Lolita Alfred
- Department of Nursing, City, University of London, London, UK
| | - Anand Ahankari
- Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Lisa Schölin
- Centre for Pesticide Suicide Prevention, University of Edinburgh, Edinburgh, UK
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Kruse G, Lopez-Carmen VA, Jensen A, Hardie L, Sequist TD. The Indian Health Service and American Indian/Alaska Native Health Outcomes. Annu Rev Public Health 2022; 43:559-576. [PMID: 35081315 DOI: 10.1146/annurev-publhealth-052620-103633] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The Indian Health Service (IHS) has made huge strides in narrowing health disparities between American Indian and Alaska Native (AI/AN) populations and other racial and ethnic groups. Yet, health disparities experienced by AI/AN people persist, with deep historical roots combined with present-day challenges. Here we review the history of the IHS from colonization to the present-day system, highlight persistent disparities in AI/AN health and health care, and discuss six key present-day challenges: inadequate funding, limited human resources, challenges associated with transitioning services from federal to Tribal control through contracting and compacting, evolving federal and state programs, the need for culturally sensitive services, and the promise and challenges of health technology.
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Affiliation(s)
- Gina Kruse
- Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA;
- Harvard Medical School, Boston, Massachusetts, USA
| | | | - Anpotowin Jensen
- School of Engineering, Stanford University, Stanford, California, USA
| | - Lakotah Hardie
- Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA;
| | - Thomas D Sequist
- Harvard Medical School, Boston, Massachusetts, USA
- Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Department of Quality and Patient Experience, Massachusetts General Brigham, Somerville, Massachusetts, USA
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10
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Perski O, Short CE. Acceptability of digital health interventions: embracing the complexity. Transl Behav Med 2021; 11:1473-1480. [PMID: 33963864 PMCID: PMC8320880 DOI: 10.1093/tbm/ibab048] [Citation(s) in RCA: 74] [Impact Index Per Article: 24.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Acceptability is a core concept in digital health. Available frameworks have not clearly articulated why and how researchers, practitioners and policy makers may wish to study the concept of acceptability. Here, we aim to discuss (i) the ways in which acceptability might differ from closely related concepts, including user engagement; (ii) the utility of the concept of acceptability in digital health research and practice; (iii) social and cultural norms that influence acceptability; and (iv) pragmatic means of measuring acceptability, within and beyond the research process. Our intention is not to offer solutions to these open questions but to initiate a debate within the digital health community. We conducted a narrative review of theoretical and empirical examples from the literature. First, we argue that acceptability may usefully be considered an emergent property of a complex, adaptive system of interacting components (e.g., affective attitude, beliefs), which in turn influences (and is influenced by) user engagement. Second, acceptability is important due to its ability to predict and explain key outcomes of interest, including user engagement and intervention effectiveness. Third, precisely what people find acceptable is deeply contextualized and interlinked with prevailing social and cultural norms. Understanding and designing for such norms (e.g., through drawing on principles of user centered design) is therefore key. Finally, there is a lack of standard acceptability measures and thresholds. Star ratings coupled with free-text responses may provide a pragmatic means of capturing acceptability. Acceptability is a multifaceted concept, which may usefully be studied with a complexity science lens.
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Affiliation(s)
- Olga Perski
- Department of Behavioural Science and Health, University College London, London, UK
| | - Camille E Short
- Melbourne Centre for Behaviour Change, Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia.,Melbourne School of Health Sciences, University of Melbourne, Melbourne, Australia
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Jacklin K, Pitawanakwat K, Blind M, Lemieux AM, Sobol A, Warry W. Peace of mind: A community-industry-academic partnership to adapt dementia technology for Anishinaabe communities on Manitoulin Island. J Rehabil Assist Technol Eng 2020; 7:2055668320958327. [PMID: 32999732 PMCID: PMC7509219 DOI: 10.1177/2055668320958327] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 08/24/2020] [Indexed: 11/17/2022] Open
Abstract
Introduction Aging Technologies for Indigenous Communities in Ontario (ATICON) explores the technology needs of Anishinaabe older adults in the Manitoulin region of Northern Ontario. Our program of research addresses inequitable access to supportive technologies that may allow Indigenous older adults to successfully age in place. Methods Using Indigenous research methodologies (IRM) and community-based participatory research (CBPR) we explored the acceptability of CareBand - a wearable location and activity monitoring device for people living with dementia using a LoRaWAN, a low-power wide-area network technology. We conducted key informant consultations and focus groups with Anishinaabe Elders, formal and informal caregivers, and health care providers (n = 29) in four geographically distinct regions. Results Overall, participants agreed that CareBand would improve caregivers' peace of mind. Our results suggest refinement of the technology is necessary to address the challenges of the rural geography and winter weather; to reconsider aesthetics; address privacy and access; and to consider the unique characteristics of Anishinaabe culture and reserve life. Conclusion All three partners in this research, including the Indigenous communities, industry partner, and academic researchers, benefited from the use of CBPR and IRM. As CareBand is further developed, community input will be crucial for shaping a useful and valued device.
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Affiliation(s)
- Kristen Jacklin
- Memory Keepers Medical Discovery Team, University of Minnesota Medical School - Duluth Campus, Duluth, USA
| | | | - Melissa Blind
- Memory Keepers Medical Discovery Team, University of Minnesota Medical School - Duluth Campus, Duluth, USA
| | - Andrine M Lemieux
- Memory Keepers Medical Discovery Team, University of Minnesota Medical School - Duluth Campus, Duluth, USA
| | | | - Wayne Warry
- Memory Keepers Medical Discovery Team, University of Minnesota Medical School - Duluth Campus, Duluth, USA
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