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Gharacheh L, Amini-Rarani M, Torabipour A, Karimi S. A Scoping Review of Possible Solutions for Decreasing Socioeconomic Inequalities in Type 2 Diabetes Mellitus. Int J Prev Med 2024; 15:5. [PMID: 38487697 PMCID: PMC10935579 DOI: 10.4103/ijpvm.ijpvm_374_22] [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] [Received: 11/12/2022] [Accepted: 05/17/2023] [Indexed: 03/17/2024] Open
Abstract
Background As socioeconomic inequalities are key factors in access and utilization of type 2 diabetes (T2D) services, the purpose of this scoping review was to identify solutions for decreasing socioeconomic inequalities in T2D. Methods A scoping review of scientific articles from 2000 and later was conducted using PubMed, Web of Science (WOS), Scopus, Embase, and ProQuest databases. Using the Arksey and O'Malley framework for scoping review, articles were extracted, meticulously read, and thematically analyzed. Results A total of 7204 articles were identified from the reviewed databases. After removing duplicate and nonrelevant articles, 117 articles were finally included and analyzed. A number of solutions and passways were extracted from the final articles. Solutions for decreasing socioeconomic inequalities in T2D were categorized into 12 main solutions and 63 passways. Conclusions Applying identified solutions in diabetes policies and interventions would be recommended for decreasing socioeconomic inequalities in T2D. Also, the passways could be addressed as entry points to help better implementation of diabetic policies.
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Affiliation(s)
- Laleh Gharacheh
- Student Research Committee, School of Management and Medical Information Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mostafa Amini-Rarani
- Social Determinants of Health Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Amin Torabipour
- Social Determinants of Health Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Saeed Karimi
- Health Management and Economics Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Aagaard-Hansen J, Bloch P. Settings, populations, and time: a conceptual framework for public health interventions. Front Public Health 2023; 11:1297019. [PMID: 38169651 PMCID: PMC10758471 DOI: 10.3389/fpubh.2023.1297019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 11/22/2023] [Indexed: 01/05/2024] Open
Abstract
This paper presents a conceptual framework displaying how combinations of settings and populations seen in a long-term perspective may guide public health and health promotion planning and research. The notion of settings constitutes a key element of health promotion as stipulated by the Ottawa Charter from 1986. The setting approach highlights the individual, social and structural dimensions of health promotion. Likewise, the notion of populations and how they are selected forms a center pillar of public health. By joining the two perspectives, four combinations of intervention strategies appear by addressing: (1) a single population segment within a single setting, (2) multiple population segments within a single setting, (3) a single population segment within multiple settings or (4) multiple population segments within multiple settings. Furthermore, the addition of a time dimension inspired by the life-course perspective illustrates how trajectories of individuals and projects change settings and population segments as time goes by. The conceptual framework displays how systematic awareness of long-term, multi-setting, multi-population trajectories allow health promotion planners and researchers to systematically develop, plan and analyze their projects.
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Affiliation(s)
- Jens Aagaard-Hansen
- Diabetes Prevention Research, Department for Prevention, Health Promotion and Society, Steno Diabetes Center Copenhagen, Herlev, Denmark
- SA MRC Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Paul Bloch
- Diabetes Prevention Research, Department for Prevention, Health Promotion and Society, Steno Diabetes Center Copenhagen, Herlev, Denmark
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Litchfield I, Barrett T, Hamilton-Shield J, Moore T, Narendran P, Redwood S, Searle A, Uday S, Wheeler J, Greenfield S. Current evidence for designing self-management support for underserved populations: an integrative review using the example of diabetes. Int J Equity Health 2023; 22:188. [PMID: 37697302 PMCID: PMC10496394 DOI: 10.1186/s12939-023-01976-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 07/26/2023] [Indexed: 09/13/2023] Open
Abstract
AIMS With numerous and continuing attempts at adapting diabetes self-management support programmes to better account for underserved populations, its important that the lessons being learned are understood and shared. The work we present here reviews the latest evidence and best practice in designing and embedding culturally and socially sensitive, self-management support programmes. METHODS We explored the literature with regard to four key design considerations of diabetes self-management support programmes: Composition - the design and content of written materials and digital tools and interfaces; Structure - the combination of individual and group sessions, their frequency, and the overall duration of programmes; Facilitators - the combination of individuals used to deliver the programme; and Context - the influence and mitigation of a range of individual, socio-cultural, and environmental factors. RESULTS We found useful and recent examples of design innovation within a variety of countries and models of health care delivery including Brazil, Mexico, Netherlands, Spain, United Kingdom, and United States of America. Within Composition we confirmed the importance of retaining best practice in creating readily understood written information and intuitive digital interfaces; Structure the need to offer group, individual, and remote learning options in programmes of flexible duration and frequency; Facilitators where the benefits of using culturally concordant peers and community-based providers were described; and finally in Context the need to integrate self-management support programmes within existing health systems, and tailor their various constituent elements according to the language, resources, and beliefs of individuals and their communities. CONCLUSIONS A number of design principles across the four design considerations were identified that together offer a promising means of creating the next generation of self-management support programme more readily accessible for underserved communities. Ultimately, we recommend that the precise configuration should be co-produced by all relevant service and patient stakeholders and its delivery embedded in local health systems.
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Affiliation(s)
- Ian Litchfield
- Institute of Applied Health Research, University of Birmingham, Birmingham, B15 2TT, UK.
| | - Tim Barrett
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, B15 2TT, UK
- Diabetes and Endocrinology, Birmingham Women's and Children's Hospital, Birmingham, B4 6NH, UK
| | - Julian Hamilton-Shield
- Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS1 2NT, UK
- The Royal Hospital for Children in Bristol, Bristol, BS2 8BJ, UK
- NIHR Bristol BRC Nutrition Theme, University Hospitals Bristol and Weston Foundation Trust, Bristol, B52 8AE, UK
| | - Theresa Moore
- The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS1 1TH, B52 8EA, UK
| | - Parth Narendran
- Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, B15 2TT, UK
- Queen Elizabeth Hospital, Birmingham, B15 2GW, UK
| | - Sabi Redwood
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS1 1TH, B52 8EA, UK
| | - Aidan Searle
- NIHR Bristol BRC Nutrition Theme, University Hospitals Bristol and Weston Foundation Trust, Bristol, B52 8AE, UK
| | - Suma Uday
- Diabetes and Endocrinology, Birmingham Women's and Children's Hospital, Birmingham, B4 6NH, UK
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, B15 2TT, UK
| | - Jess Wheeler
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS1 1TH, B52 8EA, UK
| | - Sheila Greenfield
- Institute of Applied Health Research, University of Birmingham, Birmingham, B15 2TT, UK
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Termansen T, Bloch P, Tørslev MK, Vardinghus-Nielsen H. Spaces of participation: Exploring the characteristics of conducive environments for citizen participation in a community-based health promotion initiative in a disadvantaged neighborhood. Health Place 2023; 80:102996. [PMID: 36857895 DOI: 10.1016/j.healthplace.2023.102996] [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: 09/02/2022] [Revised: 02/08/2023] [Accepted: 02/15/2023] [Indexed: 03/02/2023]
Abstract
Research has shown that community participation in health programmes is vital to ensure positive health outcomes and sustainable solutions. This is often challenged by difficulties to engage socially disadvantaged population groups. Through ethnographic fieldwork in a community initiative in a disadvantaged neighbourhood in Copenhagen, Denmark, we explored which factors contributed to a conducive environment for participation. Data material consists of observation notes taken during fieldwork in a community hub from January 2020 until August 2021 and 19 semi-structured interviews with professional stakeholders and participants. We applied the analytical concept of space to elucidate how the organizational, social, and physical environments played important roles in ensuring possibilities for participation. We termed these environments Spaces of Participation. Our results highlight the importance of ensuring spaces that are flexible, informal, and responsive when engaging those who are hard to reach.
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Affiliation(s)
- Tina Termansen
- Steno Diabetes Center Copenhagen, Department of Health Promotion Research, Borgmester Ib Juuls Vej 83, 2730, Herlev, Denmark; Aalborg University, Department of Health Sciences and Technology, Frederik Bayers Vej 7D, 9220, Aalborg, Denmark.
| | - Paul Bloch
- Steno Diabetes Center Copenhagen, Department of Health Promotion Research, Borgmester Ib Juuls Vej 83, 2730, Herlev, Denmark.
| | - Mette Kirstine Tørslev
- Steno Diabetes Center Copenhagen, Department of Health Promotion Research, Borgmester Ib Juuls Vej 83, 2730, Herlev, Denmark.
| | - Henrik Vardinghus-Nielsen
- Aalborg University, Department of Health Sciences and Technology, Frederik Bayers Vej 7D, 9220, Aalborg, Denmark.
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Termansen T, Bloch P, Tørslev MK, Vardinghus-Nielsen H. Tingbjerg Changing Diabetes: experiencing and navigating complexity in a community-based health promotion initiative in a disadvantaged neighbourhood in Copenhagen, Denmark. BMC Public Health 2023; 23:392. [PMID: 36841764 PMCID: PMC9958318 DOI: 10.1186/s12889-023-15291-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 02/20/2023] [Indexed: 02/27/2023] Open
Abstract
As a response to the complexity of reducing health inequity there has been a rise in community-based health promotion interventions adhering to the principles of complexity thinking. Such interventions often work with adaptive practice and constitute themselves in complex webs of collaborations between multiple stakeholders. However, few efforts have been made to articulate how complexity can be navigated and addressed by stakeholders in practice. This study explores how partners experience and navigate complexity in the partnership behind Tingbjerg Changing Diabetes (TCD), a community-based intervention addressing health and social development in the disadvantaged neighborhood of Tingbjerg in urban Copenhagen. The study provides important insights on the role of context and how it contributes complexity in community-based health promotion.The study is based on 18 months of ethnographic fieldwork in the local community including participant observations and 9 in-depth interviews with key partner representatives. Findings show that complexity in TCD can be characterized by unpredictability in actions and outcomes, undefined purpose and direction, and differing organizational logics. Factors that support partners' navigation in complexity include connectivity, embracing a flexible intervention framework, autonomy, and quick responsiveness. The study showcases the interdependency between the intervention and the context of the disadvantaged neighborhood of Tingbjerg and encourages stakeholders and researchers to embrace the messiness of complexity, and to pay attention to ways through which messiness and unpredictability can be handled.
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Affiliation(s)
- Tina Termansen
- Department of Health Promotion Research, Steno Diabetes Center Copenhagen, Borgmester Ib Juuls Vej 83, 2730, Herlev, Denmark. .,Department of Health Sciences and Technology, Aalborg University, Selma Lagerløfs Vej 249, 9260, Gistrup, Denmark.
| | - Paul Bloch
- Department of Health Promotion Research, Steno Diabetes Center Copenhagen, Borgmester Ib Juuls Vej 83, 2730, Herlev, Denmark
| | - Mette Kirstine Tørslev
- Department of Health Promotion Research, Steno Diabetes Center Copenhagen, Borgmester Ib Juuls Vej 83, 2730, Herlev, Denmark
| | - Henrik Vardinghus-Nielsen
- Department of Health Sciences and Technology, Aalborg University, Selma Lagerløfs Vej 249, 9260, Gistrup, Denmark
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Jenkins CL, Wills J, Sykes S. Settings for the development of health literacy: A conceptual review. Front Public Health 2023; 11:1105640. [PMID: 36875396 PMCID: PMC9978221 DOI: 10.3389/fpubh.2023.1105640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 01/31/2023] [Indexed: 02/18/2023] Open
Abstract
Advances in conceptualizing settings in health promotion include understanding settings as complex and interlinked systems with a core commitment to health and related outcomes such as health literacy. Traditional settings for the development of health literacy include health care environments and schools. There is a need to identify and conceptualize non-traditional and emerging settings of twenty-first-century everyday life. The aim of this conceptual review is to inform a conceptual model of a "non-traditional" setting for the development of health literacy. The model uses the example of the public library to propose four equity-focused antecedents required in a setting for the development of health literacy: the setting acknowledges the wider determinants of health, is open access, involves local communities in how it is run, and facilitates informed action for health. The review concludes that a settings approach to the development of health literacy can be conceptualized as part of a coordinated "supersetting approach," where multiple settings work in synergy with each other.
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Affiliation(s)
- Catherine L Jenkins
- Institute of Health and Social Care, London South Bank University, London, United Kingdom
| | - Jane Wills
- Institute of Health and Social Care, London South Bank University, London, United Kingdom
| | - Susie Sykes
- Institute of Health and Social Care, London South Bank University, London, United Kingdom
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