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Moore A. From education to empowerment: Redesigning the role of students in college health promotion. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:984-987. [PMID: 34197276 DOI: 10.1080/07448481.2021.1920603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 02/05/2021] [Accepted: 04/18/2021] [Indexed: 05/31/2023]
Abstract
College health promotion departments frequently employ peer health educators to disseminate relevant education and conduct outreach to their student body. While there are certainly benefits to these programs, this approach is outdated and does little to empower students or engage them in the process of health promotion. In this viewpoint article, I describe the Community Health Organizer model, which expands students' role in peer engagement and advocacy beyond the traditional peer educator or peer counseling programs. Finally, I provide recommendations for college health practitioners interested in implementing a similar model on their campuses.
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Affiliation(s)
- Andrea Moore
- Office for Health Promotion Strategy, Student Health, University of Southern California, Los Angeles, California, USA
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Derksen ME, Jaspers MWM, Kunst AE, Fransen MP. Usage of digital, social and goal-setting functionalities to support health behavior change: A mixed methods study among disadvantaged women during or after pregnancy and their healthcare professionals. Int J Med Inform 2023; 170:104981. [PMID: 36603389 DOI: 10.1016/j.ijmedinf.2022.104981] [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: 08/22/2022] [Revised: 11/26/2022] [Accepted: 12/28/2022] [Indexed: 01/02/2023]
Abstract
OBJECTIVE We aimed to gain insight into how and to what extent social (i.e. private/group chat) and goal-setting (e.g. rewards) functionalities in digital interventions for health behavior change were used by clients and nurses in a preventive care program for disadvantaged women during or after pregnancy, and which factors influenced usage. METHODS We collected quantitative and qualitative data on usage of these functionalities in 'Kindle', a mHealth intervention to prepare for health behavior change. RESULTS We found that nurses (n = 5) and clients (n = 20) scarcely used both functionalities. They sent 862 messages in the social functionality whose security they appreciated, but habitually used WhatsApp likewise. Moreover, nurses were hesitant to let their clients interact in the group chat. Clients formulated 59 personal goals, which they found difficult to do. Nurses rewarded 846 points for clients' progress on goal attainment, but found it hard to determine how many points to reward. Clients and nurses indicated that the functionality made it more fun and easy to discuss clients' personal goals. CONCLUSIONS To conclude, digital, social and goal-setting functionalities were used to a limited extent by nurses and clients, and need optimization before implementation to support disadvantaged groups to change their health behavior.
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Affiliation(s)
- M E Derksen
- Amsterdam UMC, University of Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Meibergdreef 9, 1105 AZ Amsterdam, Netherlands.
| | - M W M Jaspers
- Amsterdam UMC, University of Amsterdam, Department of Medical Informatics, Amsterdam Public Health Research Institute, Meibergdreef 9, 1105 AZ Amsterdam, Netherlands
| | - A E Kunst
- Amsterdam UMC, University of Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Meibergdreef 9, 1105 AZ Amsterdam, Netherlands
| | - M P Fransen
- Amsterdam UMC, University of Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Meibergdreef 9, 1105 AZ Amsterdam, Netherlands
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Lee CN, Matthew RA, Orpinas P. Design, implementation, and evaluation of community health worker training programs in Latinx communities: A scoping review. JOURNAL OF COMMUNITY PSYCHOLOGY 2023; 51:382-405. [PMID: 35716392 PMCID: PMC10084025 DOI: 10.1002/jcop.22910] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 05/04/2022] [Accepted: 06/01/2022] [Indexed: 06/15/2023]
Abstract
This review examines the current reporting trends of program design, implementation, and evaluation of training programs for Latinx community health workers. Five scholarly databases were searched using a scoping review methodology to identify articles describing training programs for Latinx community health workers. The timeframe was 2009 to 2021. We identified 273 articles, with 59 meeting inclusion criteria. Researchers thematically coded the articles to identify reporting strategies related to program design, implementation, and evaluation. Findings suggest a lack of consensus in reporting elements critical to program resources, instructor qualifications, frequency and length of training implementation, theoretical background, and pedagogical tools associated with the training program. We offer detailed reporting recommendations of community health worker training programs to support the consistent dissemination of promising practices and facilitate the initiation of new programs for Latinx community health workers.
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Affiliation(s)
- Christina N. Lee
- Department of Anthropology, Franklin College of Arts and ScienceUniversity of GeorgiaAthensGeorgiaUSA
| | | | - Pamela Orpinas
- Department of Health Promotion and Behavior, College of Public HealthUniversity of GeorgiaAthensGeorgiaUSA
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Tarver WL, Haggstrom DA. The Use of Cancer-Specific Patient-Centered Technologies Among Underserved Populations in the United States: Systematic Review. J Med Internet Res 2019; 21:e10256. [PMID: 31012855 PMCID: PMC6658273 DOI: 10.2196/10256] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 08/31/2018] [Accepted: 09/14/2018] [Indexed: 12/11/2022] Open
Abstract
Background In the United States, more than 1.6 million new cases of cancer are estimated to be diagnosed each year. However, the burden of cancer among the US population is not shared equally, with racial and ethnic minorities and lower-income populations having a higher cancer burden compared with their counterparts. For example, African Americans have the highest mortality rates and shortest survival rates for most cancers compared with other racial or ethnic groups in the United States. A wide range of technologies (eg, internet-based [electronic health, eHealth] technologies, mobile [mobile health, mHealth] apps, and telemedicine) available to patients are designed to improve their access to care and empower them to participate actively in their care, providing a means to reduce health care disparities; however, little is known of their use among underserved populations. Objective The aim of this study was to systematically review the current evidence on the use of cancer-specific patient-centered technologies among various underserved populations. Methods Computer-based search was conducted in the following academic databases: (1) PubMed (cancer subset), (2) MEDLINE, (3) PsycINFO, and (4) CINAHL. We included studies that were peer-reviewed, published in the English language, and conducted in the United States. Each study was individually assessed for relevance, with any disagreements being reconciled by consensus. We used a 3-step inclusion process in which we examined study titles, abstracts, and full-text papers for assessment of inclusion criteria. We systematically extracted information from each paper meeting our inclusion criteria. Results This review includes 71 papers that use patient-centered technologies that primarily targeted African Americans (n=31), rural populations (n=14), and Hispanics (n=12). A majority of studies used eHealth technologies (n=41) finding them to be leading sources of cancer-related health information and significantly improving outcomes such as screening among nonadherent individuals and increasing knowledge about cancer and cancer screening. Studies on mHealth found that participants reported overall favorable responses to receiving health information via short message service (SMS) text message; however, challenges were experienced with respect to lack of knowledge of how to text among some participants. More complex mobile technologies (eg, a tablet-based risk assessment tool) were also found favorable to use and acceptable among underserved populations; however, they also resulted in more significant barriers, for example, participants expressed concerns regarding security and unfamiliarity with the technology and preferred further instruction and assistance in its use. Conclusions There is a growing body of literature exploring patient-centered technology and its influence on care of underserved populations. In this review, we find that these technologies seem to be effective, especially when tailored, in improving patient and care-related outcomes. Despite the potential of patient-centered technologies and the receptivity of underserved populations, challenges still exist with respect to their effective use and usability.
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Affiliation(s)
- Will L Tarver
- VA Health Services Research and Development, Center for Health Information & Communication, Richard L Roudebush VA Medical Center, Indianapolis, IN, United States.,Department of Health Policy & Management, Fairbanks School of Public Health, Indiana University, Indianapolis, IN, United States
| | - David A Haggstrom
- VA Health Services Research and Development, Center for Health Information & Communication, Richard L Roudebush VA Medical Center, Indianapolis, IN, United States.,Division of General Internal Medicine and Geriatrics, School of Medicine, Indiana University, Indianapolis, IN, United States.,Center for Health Services Research, Regenstrief Institute, Indianapolis, IN, United States
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Logan RI. Not a duty but an opportunity: exploring the lived experiences of community health workers in Indiana through photovoice. QUALITATIVE RESEARCH IN MEDICINE & HEALTHCARE 2018. [DOI: 10.4081/qrmh.2018.7816] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Few studies have conducted photovoice projects to explore themes related to the lived experiences of community health workers (CHWs). As a relatively unknown segment of the health care workforce in the United States, CHWs are typically members of the communities they work within and fulfill unique and complementary roles through health education, health prevention, community outreach, and advocacy. This article documents a photovoice project that assessed the strengths, challenges, impacts, and what it means to be a CHW in Indiana. In this project, CHWs participated in the method of photovoice in two formal meetings – one to introduce the method and another to analyze the photographs. Participants displayed photographs, interpreted these images, and co-constructed their lived experiences. Several key themes emerged from discussion of the photographs including: participant descriptions of building individual and character traits, conceptualizations of this position, and how participants connect disparate resources for their clients. Themes and findings from this research can be utilized to reach out to potential employers and policy makers regarding the integration of CHWs into the workforce. Overall, this project documents the lived experiences of CHWs and highlights their voices as they become an accepted member within the broader workforce.
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Krishnasamy C, Ong SY, Yock Y, Lim I, Rees R, Car J. Factors influencing the implementation, adoption, use, sustainability and scalability of mLearning for medical and nursing education: a systematic review protocol. Syst Rev 2016; 5:178. [PMID: 27756442 PMCID: PMC5069977 DOI: 10.1186/s13643-016-0354-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Accepted: 09/29/2016] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND mLearning is increasingly presented as an attractive novel educational strategy for medical and nursing education. Yet, evidence base for its effectiveness or factors which influence use, success, implementation or adoption are not clear. We aim to synthesise findings from qualitative studies to provide insight into the factors (barriers and facilitators) influencing adoption, implementation and use of mobile devices for learning in medical and nursing education. The review also aims to identify factors or actions which are considered to optimise the experience and satisfaction of educators and learners in using mobile technologies for medical and nursing education and to identify strategies for improving mLearning interventions for medical and nursing education. METHODS A systematic search will be conducted across a range of databases for studies describing or evaluating the experiences, barriers, facilitators and factors pertaining to the use of mLearning for medical and nursing education. The framework synthesis approach will be used to organise and bring different components of the results together. The confidence in the qualitative review findings will be assessed using the CERQual approach. DISCUSSION This study will contribute to the planning and design of effective mLearning and the development of mLearning guidelines for medical and nursing education. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42016035411.
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Affiliation(s)
- Charmaine Krishnasamy
- HOMER, Education Development Office, National Healthcare Group, Tan Tock Seng Hospital, 7 Jalan Tan Tock Seng, Annex 2 (Level 3, West Wing), Singapore, 308440, Singapore
| | - Sik Yin Ong
- HOMER, Education Development Office, National Healthcare Group, Tan Tock Seng Hospital, 7 Jalan Tan Tock Seng, Annex 2 (Level 3, West Wing), Singapore, 308440, Singapore
| | - Yvonne Yock
- HOMER, Education Development Office, National Healthcare Group, Tan Tock Seng Hospital, 7 Jalan Tan Tock Seng, Annex 2 (Level 3, West Wing), Singapore, 308440, Singapore
| | - Issac Lim
- HOMER, Education Development Office, National Healthcare Group, Tan Tock Seng Hospital, 7 Jalan Tan Tock Seng, Annex 2 (Level 3, West Wing), Singapore, 308440, Singapore
| | - Rebecca Rees
- Evidence for Policy and Practice Information and Co-ordinating Centre (EPPI-Centre), Social Science Research Unit, Department of Social Science, UCL Institute of Education, University College London, 18 Woburn Square, London, WC1H0NR, UK
| | - Josip Car
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, 3 Fusionopolis Link, #06-13, Nexus@One-North, South Tower, Singapore, 138543, Singapore. .,Global eHealth Unit, Department of Primary Care and Public Health, Imperial College London, London, UK.
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Awareness, Interest, and Preferences of Primary Care Providers in Using Point-of-Care Cancer Screening Technology. PLoS One 2016; 11:e0145215. [PMID: 26771309 PMCID: PMC4714834 DOI: 10.1371/journal.pone.0145215] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Accepted: 12/01/2015] [Indexed: 11/19/2022] Open
Abstract
Well-developed point-of-care (POC) cancer screening tools have the potential to provide better cancer care to patients in both developed and developing countries. However, new medical technology will not be adopted by medical providers unless it addresses a population’s existing needs and end-users’ preferences. The goals of our study were to assess primary care providers’ level of awareness, interest, and preferences in using POC cancer screening technology in their practice and to provide guidelines to biomedical engineers for future POC technology development. A total of 350 primary care providers completed a one-time self-administered online survey, which took approximately 10 minutes to complete. A $50 Amazon gift card was given as an honorarium for the first 100 respondents to encourage participation. The description of POC cancer screening technology was provided in the beginning of the survey to ensure all participants had a basic understanding of what constitutes POC technology. More than half of the participants (57%) stated that they heard of the term “POC technology” for the first time when they took the survey. However, almost all of the participants (97%) stated they were either “very interested” (68%) or “somewhat interested” (29%) in using POC cancer screening technology in their practice. Demographic characteristics such as the length of being in the practice of medicine, the percentage of patients on Medicaid, and the average number of patients per day were not shown to be associated with the level of interest in using POC. These data show that there is a great interest in POC cancer screening technology utilization among this population of primary care providers and vast room for future investigations to further understand the interest and preferences in using POC cancer technology in practice. Ensuring that the benefits of new technology outweigh the costs will maximize the likelihood it will be used by medical providers and patients.
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A randomized controlled trial of two interventions to increase colorectal cancer screening among Hispanics on the Texas-Mexico border. Cancer Causes Control 2014; 26:1-10. [PMID: 25466604 DOI: 10.1007/s10552-014-0472-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Accepted: 09/30/2014] [Indexed: 02/07/2023]
Abstract
BACKGROUND Colorectal cancer (CRC) is the second and third leading cause of cancer death for Hispanic men and women, respectively. CRC can be prevented if precursors are detected early and removed and can be successfully treated if discovered early. While one-on-one interventions for increasing CRC screening (CRCS) are recommended, few studies specifically assess the effectiveness of lay health worker (LHW) approaches using different educational materials. PURPOSE To develop and evaluate the effectiveness of two LHW-delivered CRCS interventions known as Vale la Pena (VLP; "It's Worth It!") on increasing CRCS among Hispanics. DESIGN The study design was a cluster randomized controlled trial with two treatment arms. SETTING/PARTICIPANTS Six hundred and sixty five Hispanics 50 years and older were recruited from 24 colonias (neighborhoods) in the Lower Rio Grande Valley of the Texas-Mexico border. INTERVENTION The interventions were a small media print intervention (SMPI) (including DVD and flipchart), and a tailored interactive multimedia intervention (TIMI) delivered on tablet computers. A no intervention group served as the comparison group. Data were collected between 2007 and 2009 and analyzed between 2009 and 2013. MAIN OUTCOME MEASURES Measures assessed CRCS behavior, self-efficacy, knowledge, and other psychosocial constructs related to CRCS and targeted through VLP. RESULTS Among participants reached for follow-up, 18.9 % in the SMPI group, 13.3 % in the TIMI group, and 11.9 % in the comparison group completed CRCS. Intent-to-treat analysis showed that 13.6 % in the SMPI group, 10.2 % in the TIMI group, and 10.8 % in the comparison group completed CRCS. These differences were not statistically significant. CONCLUSION Results indicated that there are no significant differences in CRCS uptake between groups.
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Wu Y, Samant D, Squibbs K, Chaet A, Morshedi B, Barnes LE. Design of Interactive Cancer Education Technology for Latina Farmworkers. PROCEEDINGS OF THE ... IEEE SYSTEMS AND INFORMATION ENGINEERING DESIGN SYMPOSIUM. IEEE SYSTEMS AND INFORMATION ENGINEERING DESIGN SYMPOSIUM 2014; 2014. [PMID: 29978858 DOI: 10.1109/sieds.2014.6829908] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Latinas in the United States experience higher levels of cervical cancer (CC) incidence and mortality rates than the general population, and many lack access to healthcare or face communication, literacy, and knowledge barriers preventing proper CC screening. Interactive technological interventions, like embodied conversational agents (ECA)/virtual agents, are currently used in other populations, settings, and for other health topics, however, no known initiative has used culturally- and literacy-appropriate technological interventions to deliver Spanish-language CC education. This study aims to create a culturally tailored Spanish-language Virtual Patient Educator (VPE) application to augment a patient navigator (PN) intervention for increasing CC screening rates among Hispanic women in a rural agricultural community. The VPE is a computer character that can simulate face-to-face conversation with an actual person and will embody the characteristics of a PN. Through iterative interviews with the target population, key cultural design factors were identified to inform the design and implementation of a prototype VPE. This paper discusses design and usability issues associated with development of the VPE for low-literacy users in addition to a framework methodology for development of similar tools and a cultural matrix of design factors. A VPE might help close the knowledge gap between Hispanic women and the general population regarding cervical cancer screening. Incorporation of culturally tailored features in technology aids in increasing overall understanding and trust of health information presented. An iterative approach that engages the patient population in design of technology is important to identify population-specific patient preferences.
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Affiliation(s)
- Ying Wu
- University of Virginia, ysw3kz dms7tm, kls5dw, avc4ew, bm8wr
| | - Devan Samant
- University of Virginia, ysw3kz dms7tm, kls5dw, avc4ew, bm8wr
| | - Kristen Squibbs
- University of Virginia, ysw3kz dms7tm, kls5dw, avc4ew, bm8wr
| | - Alexis Chaet
- University of Virginia, ysw3kz dms7tm, kls5dw, avc4ew, bm8wr
| | - Bijan Morshedi
- University of Virginia, ysw3kz dms7tm, kls5dw, avc4ew, bm8wr
| | - Laura E Barnes
- University of Virginia, ysw3kz dms7tm, kls5dw, avc4ew, bm8wr
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Holt CL, Tagai EK, Scheirer MA, Santos SLZ, Bowie J, Haider M, Slade JL, Wang MQ, Whitehead T. Translating evidence-based interventions for implementation: Experiences from Project HEAL in African American churches. Implement Sci 2014; 9:66. [PMID: 24885069 PMCID: PMC4057552 DOI: 10.1186/1748-5908-9-66] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Accepted: 05/22/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Community-based approaches have been increasing in the effort to raise awareness and early detection for cancer and other chronic disease. However, many times, such interventions are tested in randomized trials, become evidence-based, and then fail to reach further use in the community. Project HEAL (Health through Early Awareness and Learning) is an implementation trial that aims to compare two strategies of implementing evidence-based cancer communication interventions in African American faith-based organizations. METHOD This article describes the community-engaged process of transforming three evidence-based cancer communication interventions into a coherent, branded strategy for training community health advisors with two delivery mechanisms. Peer community health advisors receive training through either a traditional classroom approach (with high technical assistance/support) or a web-based training portal (with low technical assistance/support). RESULTS We describe the process, outline the intervention components, report on the pilot test, and conclude with lessons learned from each of these phases. Though the pilot phase showed feasibility, it resulted in modifications to data collection protocols and team and community member roles and expectations. CONCLUSIONS Project HEAL offers a promising strategy to implement evidence-based interventions in community settings through the use of technology. There could be wider implications for chronic disease prevention and control.
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Affiliation(s)
- Cheryl L Holt
- Department of Behavioral and Community Health, University of Maryland, School of Public Health, 2369 School of Public Health (Building 255), College Park, MD 20742, USA
| | - Erin K Tagai
- Department of Behavioral and Community Health, University of Maryland, School of Public Health, 2369 School of Public Health (Building 255), College Park, MD 20742, USA
| | | | - Sherie Lou Z Santos
- Department of Behavioral and Community Health, University of Maryland, School of Public Health, 2369 School of Public Health (Building 255), College Park, MD 20742, USA
| | - Janice Bowie
- Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Muhiuddin Haider
- Maryland Institute for Applied Environmental Health, University of Maryland, School of Public Health, College Park, USA
| | - Jimmie L Slade
- Community Ministry of Prince George’s County, Upper Marlboro, USA
| | - Min Qi Wang
- Department of Behavioral and Community Health, University of Maryland, School of Public Health, 2369 School of Public Health (Building 255), College Park, MD 20742, USA
| | - Tony Whitehead
- Department of Anthropology, University of Maryland, College Park, USA
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Dumbauld J, Kalichman M, Bell Y, Dagnino C, Taras HL. Case study in designing a research fundamentals curriculum for community health workers: a university-community clinic collaboration. Health Promot Pract 2014; 15:79-85. [PMID: 24121537 DOI: 10.1177/1524839913504416] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Community health workers (CHWs) are increasingly incorporated into research teams. Training them in research methodology and ethics, while relating these themes to a community's characteristics, may help to better integrate these health promotion personnel into research teams. An interactive training course on research fundamentals for CHWs was designed and implemented jointly by a community agency serving a primarily Latino, rural population and an academic health center. A focus group of community members and input from community leaders comprised a community-based participatory research model to create three 3-hour interactive training sessions. The resulting curriculum was interactive and successfully stimulated dialogue between trainees and academic researchers. By choosing course activities that elicited community-specific responses into each session's discussion, researchers learned about the community as much as the training course educated CHWs about research. The approach is readily adaptable, making it useful to other communities where CHWs are part of the health system.
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Affiliation(s)
- Jill Dumbauld
- 1University of California, San Diego, La Jolla, CA, USA
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Umstattd Meyer MR, Sharkey JR, Patterson MS, Dean WR. Understanding contextual barriers, supports, and opportunities for physical activity among Mexican-origin children in Texas border colonias: a descriptive study. BMC Public Health 2013; 13:14. [PMID: 23297793 PMCID: PMC3558355 DOI: 10.1186/1471-2458-13-14] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2012] [Accepted: 01/06/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The increasing numbers of colonias along the U.S.-Mexico border are characterized by disproportionately poor families of Mexican-origin, limited access to resources and health services, and heightened risk for obesity and diabetes. Despite consistent evidence supporting physical activity (PA) in prevention of chronic diseases, many individuals of Mexican-origin, including children, fail to meet PA recommendations. Environmental influences on PA, founded in ecological and social cognitive perspectives, have not been examined among children living in colonias. The purpose of this study was to identify and better understand (1) household and neighborhood environmental PA resources/supports, (2) perceived barriers to engaging in PA, and (3) PA offerings, locations, and transportation characteristics for Mexican-origin children living in colonias. METHODS Data for this study were collected by promotora-researchers (indigenous community health workers trained in research methods) using face-to-face interviews conducted in Spanish. The sample consists of 94 mother-child dyads from Texas border colonias in Hidalgo County. Interviews included questionnaire items addressing PA barriers, household and neighborhood environmental support assessments conducted with each dyad, and open-ended questions that were coded to identify availability and locations of PA opportunities and transportation options. Descriptive statistics were calculated and differences between genders, birth countries, and BMI categories of children were determined using chi-square tests. RESULTS All children were of Mexican-origin. The most frequently reported barriers were unleashed dogs in the street, heat, bad weather, traffic, no streetlights, and no place like a park to exercise. Prominent locations for current PA included schools, home, and parks. Common PA options for children were exercise equipment, running, playing, and sports. Environmental assessments identified exercise equipment (bicycles/tricycles, balls, etc.…), paved/good streets, yard/patio space, and social norms as the most frequent household or neighborhood resources within these colonias. Differences in PA barriers, options, and environmental resources for genders, birth countries, and BMI categories were detected. CONCLUSIONS This study suggests that PA environmental resources, barriers, and opportunities for colonias children are similar to previous studies and distinctively unique. As expected, built resources in these communities are limited and barriers exist; however, knowledge of PA opportunities and available PA resources within colonias households and neighborhoods offers insight to help guide future research, policy, and PA initiatives.
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Affiliation(s)
- M Renée Umstattd Meyer
- Baylor University, Department of Health, Human Performance, and Recreation, One Bear Place 97313, Waco, TX, 76798, USA
| | - Joseph R Sharkey
- Program for Research in Nutrition and Health Disparities, Department of Health Promotion and Community Health Sciences, Texas A&M School of Rural Public Health, TAMU, 1266, College Station, TX, 77843-1266, USA
| | - Megan S Patterson
- Baylor University, Department of Health, Human Performance, and Recreation, One Bear Place 97313, Waco, TX, 76798, USA
| | - Wesley R Dean
- Program for Research in Nutrition and Health Disparities, Department of Health Promotion and Community Health Sciences, Texas A&M School of Rural Public Health, TAMU, 1266, College Station, TX, 77843-1266, USA
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Arvey SR, Fernandez ME. Identifying the core elements of effective community health worker programs: a research agenda. Am J Public Health 2012; 102:1633-7. [PMID: 22813092 PMCID: PMC3415604 DOI: 10.2105/ajph.2012.300649] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2012] [Indexed: 11/04/2022]
Abstract
Community health workers (CHWs) are increasingly being incorporated into health programs because they are assumed to effectively deliver health messages in a culturally relevant manner to disenfranchised communities. Nevertheless, the role of CHWs-who they are, what they do, and how they do it-is tremendously varied. This variability presents a number of challenges for conducting research to determine the effectiveness of CHW programs, and translating research into practice. We discuss some of these challenges and provide examples from our experience working with CHWs. We call for future research to identify the "core elements" of effective CHW programs that improve the health and well-being of disenfranchised communities.
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Affiliation(s)
- Sarah R Arvey
- School of Public Health-Houston Health Science Center, University of Texas, Houston, TX, USA.
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