1
|
Alonge O, Homsi M, Rizvi MS, Malykh R, Geffert K, Kasymova N, Tilenbaeva N, Isakova L, Kushubakova M, Mavlyanova D, Mamyrbaeva T, Duishenkulova M, Pinedo A, Andreeva O, Wickramasinghe K. Design and Implementation of Brief Interventions to Address Noncommunicable Diseases in Uzbekistan. GLOBAL HEALTH, SCIENCE AND PRACTICE 2024; 12:GHSP-D-23-00443. [PMID: 38986583 PMCID: PMC11349505 DOI: 10.9745/ghsp-d-23-00443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 06/04/2024] [Indexed: 07/12/2024]
Abstract
In Uzbekistan, NCDs, including cardiovascular diseases, cancer, and diabetes, accounted for over 80% of mortality in 2019. In 2021, national stakeholders, in conjunction with the World Health Organization, identified brief interventions (BIs) to implement in primary health care settings to change unhealthy behaviors and reduce the burden of NCDs in the country. BIs consist of a validated set of questions to identify and measure NCD behavioral risk factors and a short conversation with patients/clients about their behavior, as well as the provision of a referral opportunity for further in-depth counseling or treatment if needed. We used a multimethod approach of document review, participatory workshops, and key informant interviews to describe how BIs were designed and implemented in Uzbekistan and generated a theory of change for its large-scale implementation. BIs in Uzbekistan targeted 4 risk factors (alcohol use, tobacco use, unhealthy diet, and physical inactivity) and entailed training clinicians on how to conduct behavioral change counseling using the 5As and 5Rs toolkit, conducting supportive supervision, and using feedback to improve service delivery. The program was collaboratively designed by multiple stakeholders across sectors, including the Ministries of Health, Higher Education, Science, and Innovations, with buy-in from key political leaders. The potential impact of the program (i.e., reducing the incidence of NCDs) was mediated by several intermediate and implementation outcomes at the individual, primary care, and community levels operating along multiple pathways. Significant health system challenges remain to the program, such as limited human resources, lack of incentives for clinicians, outdated systems and data collection processes for performance monitoring, and coordination among different relevant sectors. These and other challenges will need to be addressed to ensure the effective large-scale implementation of BIs in Uzbekistan and similar LMICs.
Collapse
Affiliation(s)
| | - Maysam Homsi
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Regina Malykh
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Karin Geffert
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | | | | | - Lola Isakova
- Research Institute of Sanitation, Hygiene and Occupational Diseases, Ministry of Health of the Republic of Uzbekistan, Tashkent, Uzbekistan
| | - Maria Kushubakova
- Department of Disease Prevention and State Epidemiological Surveillance, Ministry of Health of Kyrgyzstan, Bishkek, Kyrgyzstan
| | | | | | - Marina Duishenkulova
- Republican Center of Health Promotion and Mass Communication under Ministry of Health, Bishkek, Kyrgyzstan
| | - Adriana Pinedo
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Olga Andreeva
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | | |
Collapse
|
2
|
Patel J, Ibrahim S, Bhawra J, Khadilkar A, Katapally TR. Association between yoga and related contextual factors with moderate-to-vigorous physical activity among children and youth aged 5 to 17 years across five Indian states. PeerJ 2024; 12:e17369. [PMID: 38832045 PMCID: PMC11146328 DOI: 10.7717/peerj.17369] [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: 08/10/2023] [Accepted: 04/18/2024] [Indexed: 06/05/2024] Open
Abstract
Physical inactivity is one of the four key preventable risk factors, along with unhealthy diet, tobacco use, and alcohol consumption, underlying most noncommunicable diseases. Promoting physical activity is particularly important among children and youth, whose active living behaviours often track into adulthood. Incorporating yoga, an ancient practice that originated in India, can be a culturally-appropriate strategy to promote physical activity in India. However, there is little evidence on whether yoga practice is associated with moderate-to-vigorous physical activity (MVPA) accumulation. Thus, this study aims to understand how yoga practice is associated with MVPA among children and youth in India. Data for this study were obtained during the coronavirus disease lockdown in 2021. Online surveys capturing MVPA, yoga practice, contextual factors, and sociodemographic characteristics, were completed by 5 to 17-year-old children and youth in partnership with 41 schools across 28 urban and rural locations in five states. Linear regression analyses were conducted to assess the association between yoga practice and MVPA. After controlling for age, gender, and location, yoga practice was significantly associated with MVPA among children and youth (β = 0.634, p < 0.000). These findings highlight the value of culturally-appropriate activities such as yoga, to promote physical activity among children and youth. Yoga practice might have a particularly positive impact on physical activity among children and youth across the world, owing to its growing global prevalence.
Collapse
Affiliation(s)
- Jamin Patel
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
- Faculty of Health Sciences, Western University, DEPtH Lab, London, Ontario, Canada
| | - Sheriff Ibrahim
- Faculty of Health Sciences, Western University, DEPtH Lab, London, Ontario, Canada
| | - Jasmin Bhawra
- Hirabai Cowasji Jehangir Medical Research Institute, Pune, Maharashtra, India
- School of Occupational and Public Health, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Anuradha Khadilkar
- Hirabai Cowasji Jehangir Medical Research Institute, Pune, Maharashtra, India
| | - Tarun Reddy Katapally
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
- Faculty of Health Sciences, Western University, DEPtH Lab, London, Ontario, Canada
- Hirabai Cowasji Jehangir Medical Research Institute, Pune, Maharashtra, India
- Lawson Health Research Institute, Children’s Health Research Institute, London, Ontario, Canada
| |
Collapse
|
3
|
Harrison R, Iqbal MP, Chitkara U, Adams C, Chauhan A, Mitchell R, Manias E, Alston M, Hadley AM. Approaches for enhancing patient-reported experience measurement with ethnically diverse communities: a rapid evidence synthesis. Int J Equity Health 2024; 23:26. [PMID: 38342909 PMCID: PMC10860321 DOI: 10.1186/s12939-024-02107-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 01/13/2024] [Indexed: 02/13/2024] Open
Abstract
BACKGROUND Patient-reported experience measures (PREMs) are used to drive and evaluate unit and organisational-level healthcare improvement, but also at a population level, these measures can be key indicators of healthcare quality. Current evidence indicates that ethnically diverse communities frequently experience poorer care quality and outcomes, with PREMs data required from this population to direct service improvement efforts. This review synthesises evidence of the methods and approaches used to promote participation in PREMs among ethnically diverse populations. METHODS A rapid evidence appraisal (REA) methodology was utilised to identify the disparate literature on this topic. A search strategy was developed and applied to three major electronic databases in July 2022 (Medline; PsycINFO and CINAHL), in addition to websites of health agencies in Organisation for Economic Co-operation and Development countries via grey literature searches. A narrative evidence synthesis was undertaken to address the review question. RESULTS The review resulted in 97 included studies, comprised 86 articles from electronic database searches and 11 articles from the grey literature. Data extraction and synthesis identified five strategies used in PREM instruments and processes to enhance participation among ethnically diverse communities. Strategies applied sought to better inform communities about PREMs, to create accessible PREMs instruments, to support PREMs completion and to include culturally relevant topics. Several methods were used, predominantly drawing upon bicultural workers, translation, and community outreach to access and support communities at one or more stages of design or administration of PREMs. Limited evidence was available of the effectiveness of the identified methods and strategies. PREMs topics of trust, cultural responsiveness, care navigation and coordination were identified as pertinent to and frequently explored with this population. CONCLUSIONS The findings provide a basis for a maturity model that may guide change to increase participation of ethnically diverse communities in PREMs. In the short-medium term, health systems and services must be able to recognise and respond to cultural and linguistic diversity in the population when applying existing PREMs. In the longer-term, by working in collaboration with ethnically diverse communities, systems and services may co-create adapted or novel PREMs that tackle the factors that currently inhibit uptake and completion among ethnically diverse communities.
Collapse
Affiliation(s)
- Reema Harrison
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences- Macquarie University, Level 6, 75 Talavera Road, Sydney, NSW, 2109, Australia.
| | - Maha Pervaz Iqbal
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences- Macquarie University, Level 6, 75 Talavera Road, Sydney, NSW, 2109, Australia
| | - Upma Chitkara
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences- Macquarie University, Level 6, 75 Talavera Road, Sydney, NSW, 2109, Australia
| | - Corey Adams
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences- Macquarie University, Level 6, 75 Talavera Road, Sydney, NSW, 2109, Australia
| | - Ashfaq Chauhan
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences- Macquarie University, Level 6, 75 Talavera Road, Sydney, NSW, 2109, Australia
| | - Rebecca Mitchell
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences Macquarie University, Level 6, 75 Talavera Road, Sydney, NSW, 2109, Australia
| | - Elizabeth Manias
- School of Nursing and Midwifery, Monash University, Melbourne, VIC, 3800, Australia
| | - Megan Alston
- Elevating the Human Experience Program, NSW Ministry of Health, Sydney, NSW, 2065, Australia
| | - Anne Marie Hadley
- Elevating the Human Experience Program, NSW Ministry of Health, Sydney, NSW, 2065, Australia
| |
Collapse
|
4
|
Short E, Council SK, Bennett Milburn A, Ammerman A, Callaghan-Koru J, Mendoza Kabua P, Ayers BL. Assessing the acceptability and implementation feasibility of a culturally adapted parenting intervention for Marshallese mothers: A study protocol. Contemp Clin Trials Commun 2024; 37:101240. [PMID: 38261960 PMCID: PMC10796808 DOI: 10.1016/j.conctc.2023.101240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 11/21/2023] [Accepted: 12/02/2023] [Indexed: 01/25/2024] Open
Abstract
Background Pacific Islanders, including the Marshallese, face higher rates of obesity and obesity-related chronic conditions. Early-life interventions targeting eating patterns during the first 1000 days of life are essential to promote proper nutrition and growth. Marshallese mothers and caregivers are important decision-makers for feeding practices that could affect childhood obesity rates in Marshallese children. However, little is known about dietary patterns and practices of Marshallese families from birth to 12 months. Culturally-adapted approaches using community-based assets and Pacific Islander cultural values/practices have demonstrated effectiveness in reducing obesity but have not been developed for children. Methods This article describes the protocol for a study to culturally adapt the Centering Parenting intervention for Marshallese mothers in Arkansas. Conclusion This will be the first study to culturally adapt and implement Centering Parenting with Marshallese women in the United States. This study will be an important first step to assess the feasibility and acceptability of an abbreviated parenting intervention to reduce childhood obesity in Marshallese communities.
Collapse
Affiliation(s)
- Eliza Short
- University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St., Springdale, AR, 72762, USA
| | - Sarah K. Council
- University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St., Springdale, AR, 72762, USA
| | | | - Alice Ammerman
- University of North Carolina at Chapel Hill, 1700 MLK, Chapel Hill, NC, 27599, USA
| | - Jennifer Callaghan-Koru
- University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St., Springdale, AR, 72762, USA
| | - Philmar Mendoza Kabua
- University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St., Springdale, AR, 72762, USA
| | - Britni L. Ayers
- University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St., Springdale, AR, 72762, USA
| |
Collapse
|
5
|
McCann NC, McMahan VM, Smith R, Majeski A, Johns SL, Kosakowski S, Wolfe S, Brennan S, Robinson M, Coffin PO, Walley AY. Feasibility and acceptability of a timeline follow-back method to assess opioid use, non-fatal overdose, and substance use disorder treatment. Addict Behav 2024; 148:107873. [PMID: 37801804 PMCID: PMC10618957 DOI: 10.1016/j.addbeh.2023.107873] [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: 05/15/2023] [Revised: 08/11/2023] [Accepted: 09/28/2023] [Indexed: 10/08/2023]
Abstract
BACKGROUND Non-fatal overdoses are underreported and there is no accepted and feasible self-report research measure of non-fatal opioid overdose. Timeline follow-back (TLFB) calendar-based questionnaires assess self-reported risk behaviors. We assessed feasibility and acceptability of a new TLFB research measure for opioid use, non-fatal opioid overdose, and substance use disorder treatment among opioid overdose survivors. METHODS For the Repeated-dose Behavioral Intervention to Reduce Opioid Overdose Trial (REBOOT) study among opioid overdose survivors, we developed a TLFB questionnaire to assess daily non-prescribed opioid use, opioid overdose, facility stays, medications/behavioral treatment for opioid use disorder, and COVID-19 history during the previous 120 days. Staff assessors administered TLFB at four-monthly visits over the 16-month study participation period. To measure feasibility, we estimated TLFB completion time using an electronic timestamp tool. To measure acceptability, we administered a satisfaction survey to 103 participants who completed REBOOT. RESULTS Among 525 TLFB assessments conducted in 174 participants from January 2021-January 2023, opioid use was reported in 510 assessments, medication for opioid use disorder (MOUD) in 331 assessments, and ≥ 1 overdose in 107 assessments. Median TLFB completion time was 11 (IQR: 6-17) minutes for sections administered to all participants; detailed overdose questions administered to those reporting overdose took an additional 3 (IQR: 2-6) minutes. Report of ≥ 1 overdose and MOUD use were significantly associated with increased TLFB completion time. 88 % of participants reported that TLFB was very/somewhat acceptable. CONCLUSIONS Among opioid overdose survivors, REBOOT TLFB was a feasible and acceptable research measure, with similar completion time as other TLFB assessments of substance use.
Collapse
Affiliation(s)
- Nicole C McCann
- Boston University School of Public Health, Department of Health Law, Policy, and Management, Boston, MA.
| | - Vanessa M McMahan
- Center on Substance Use and Health, San Francisco Department of Public Health, San Francisco, CA
| | - Rachel Smith
- Boston University Chobanian & Avedisian School of Medicine, Boston MA
| | - Adam Majeski
- Grayken Center for Addiction and Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine, Boston Medical Center, Boston MA
| | - Sarah L Johns
- Grayken Center for Addiction and Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine, Boston Medical Center, Boston MA
| | - Sarah Kosakowski
- Grayken Center for Addiction and Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine, Boston Medical Center, Boston MA
| | - Shae Wolfe
- Grayken Center for Addiction and Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine, Boston Medical Center, Boston MA
| | - Sarah Brennan
- Center on Substance Use and Health, San Francisco Department of Public Health, San Francisco, CA
| | - Mackenzie Robinson
- Center on Substance Use and Health, San Francisco Department of Public Health, San Francisco, CA
| | - Phillip O Coffin
- Center on Substance Use and Health, San Francisco Department of Public Health, San Francisco, CA; University of California San Francisco, San Francisco CA
| | - Alexander Y Walley
- Boston University Chobanian & Avedisian School of Medicine, Boston MA; Grayken Center for Addiction and Clinical Addiction Research and Education (CARE) Unit, Section of General Internal Medicine, Boston Medical Center, Boston MA
| |
Collapse
|
6
|
Carson M, Fernandez A, Martin M. A Review of Community Health Worker Interventions for Latinx/o/a Individuals With Unhealthy Alcohol Use. J Addict Med 2023; 17:717-721. [PMID: 37934543 DOI: 10.1097/adm.0000000000001209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/18/2023]
Abstract
ABSTRACT Unhealthy alcohol use (UAU) affects nearly 1 in 4 Latinx/o/a individuals in the United States (US). Compared with White individuals, Latinx/o/a individuals with UAU face increased morbidity, decreased access to addiction treatment, and higher rates of incarceration. Community health workers (CHWs), also known as promotores, provide culturally and linguistically informed services while augmenting social and health care interventions. Although there is extensive literature evaluating the role of CHW interventions for chronic conditions including hypertension and diabetes, less is known about CHW interventions for UAU in the US. To better understand how CHWs can address UAU in the Latinx/o/a community in the US, we performed a scoping review of the literature for CHW interventions for UAU in the Latinx/o/a population. We reviewed publications up to March 8, 2022, which described CHW interventions for UAU in Latinx/o/a individuals in the US and identified 6 publications that met inclusion criteria after full-text review. These publications included 3 randomized controlled trials, 2 follow-up feasibility and acceptability assessments within the randomized controlled trial intervention group, and a pre-post noncontrolled feasibility study. All interventions were brief, with low-intensity touchpoints between CHWs and patients. None included medications for alcohol use disorder. We found few publications related to CHW-delivered interventions for UAU within the Latinx/o/a population. Given the acceptance and success of CHW-delivered interventions other conditions, as well as the increasing use of CHWs in the US, we need to invest in research that examines the efficacy of the CHWs in UAU.
Collapse
Affiliation(s)
- Mariam Carson
- From the Department of Medicine, San Francisco General Hospital, University of California, San Francisco, San Francisco, CA
| | | | | |
Collapse
|
7
|
Sanprakhon P, Chusri O, Suriyawong W, Banharak S. Pilot testing of the strengthening caregiving activities program for Thai informal caregivers of dependent older people. Geriatr Nurs 2023; 51:176-181. [PMID: 37011489 DOI: 10.1016/j.gerinurse.2023.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 03/14/2023] [Accepted: 03/15/2023] [Indexed: 04/04/2023]
Abstract
This study sought to evaluate the feasibility and preliminary effect of the Strengthening Caregiving Activities Program on care partners' caregiver burden and activities of daily living (ADLs) ability. The program was used for the informal caregivers of dependent older people; 29 participants were recruited from a community center in Thailand. Caregiver burden and ADL changes were assessed for preliminary effects using the one-way repeated measure ANOVA at baseline, post-intervention, and follow-up. The six program sessions were implemented as intended, with 93.10% of participants reporting satisfaction with the program (M = 26.653; SD = 3.380). Caregiver burden statistically decreased after the intervention and follow-up (p < .05), but the care partners' ADLs did not. This program was feasible and showed promise for the reduction of caregiver burden. A randomized controlled trial should be conducted to test the effect of the Strengthening Caregiving Activities Program on large samples of caregivers.
Collapse
Affiliation(s)
- Panawat Sanprakhon
- Faculty of Nursing, Suan Dusit University, 295 Nakornrajasima Rd, Dusit, Bangkok 10300, Thailand
| | - Orranuch Chusri
- Faculty of Nursing, Suan Dusit University, 295 Nakornrajasima Rd, Dusit, Bangkok 10300, Thailand.
| | - Wachira Suriyawong
- Faculty of Nursing, Chiang Mai University, 110/406 Inthawaroros Rd, Suthep District, Chiang Mai 50200, Thailand
| | - Samoraphop Banharak
- Faculty of Nursing, Khon Kaen University, 123 Mittaparp Rd, Muang, Khon Kaen 40002, Thailand
| |
Collapse
|
8
|
Trebilcock M, Shrubsole K, Worrall L, Ryan B. A survey of speech pathologists' opinions about the prospective acceptability of an online implementation platform for aphasia services. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2023; 58:390-405. [PMID: 36417204 DOI: 10.1111/1460-6984.12796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 09/05/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Online knowledge translation (KT) approaches are becoming increasingly prevalent within healthcare due to their accessibility and facilitation of international support networks. Online platforms enable timely and far-reaching dissemination of current evidence and best-practice recommendations. Although there is potential to improve the uptake of rehabilitation guidelines, it is essential to consider the acceptability of online approaches to healthcare professionals to ensure their successful integration within everyday clinical settings. AIMS To establish the prospective acceptability of a theoretically informed online intervention for speech pathologists, Aphasia Nexus: Connecting Evidence to Practice, that aims to facilitate the implementation of aphasia best practice. METHODS & PROCEDURES A mixed-methods multinational electronic survey based on the Theoretical Framework of Acceptability (TFA) completed by aphasia researchers and clinicians. OUTCOMES & RESULTS A total of 43 participants completed the survey with 91% (n = 39) indicating that they would use Aphasia Nexus. Understanding the intervention and how it works (intervention coherence as per the TFA) was the key factor influencing the likelihood of integration within everyday clinical practice. Participants identified potential areas where the intervention could influence service change and also recommended further design and content changes to improve the intervention. CONCLUSIONS & IMPLICATIONS Aphasia Nexus is an acceptable platform for further feasibility testing in the form of a pilot trial within an Australian-based health service. The study progresses the theory of TFA as it was a valuable framework facilitating the identification of prominent factors influencing acceptability. The study also informs further intervention refinements in preparation for the next stage of research. WHAT THIS PAPER ADDS What is already known on the subject Online strategies have the potential to enhance KT and promote the uptake of rehabilitation guidelines. An online intervention, however, can only be effective if implemented well. For this reason, it is essential to establish the acceptability of online interventions to the intended recipients and therefore increase the likelihood of successful implementation. What this paper adds to existing knowledge This study used a theoretically based framework to establish the acceptability of an online implementation intervention, Aphasia Nexus, to multinational aphasia clinicians and researchers. It demonstrated the value in identifying the prominent factors influencing acceptability to inform further intervention refinements and warrant continuing research. What are the potential or actual clinical implications of this work? Speech pathologists should use online platforms to drive the implementation of best practice on an international scale. It is important for clinicians to have an in-depth understanding of online interventions and how they work to enhance their successful uptake into routine clinical practice. Aphasia Nexus is an acceptable online platform for implementing best practice in aphasia.
Collapse
Affiliation(s)
- Megan Trebilcock
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, QLD, Australia
- School of Allied Health, Australian Catholic University, North Sydney, NSW, Australia
| | - Kirstine Shrubsole
- School of Health and Human Sciences, Southern Cross University, Gold Coast, QLD, Australia
- The Queensland Aphasia Research Centre, The University of Queensland, Brisbane, QLD, Australia
| | - Linda Worrall
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, QLD, Australia
- The Queensland Aphasia Research Centre, The University of Queensland, Brisbane, QLD, Australia
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Australia
| | - Brooke Ryan
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, QLD, Australia
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Australia
- Discipline of Clinical Psychology, Graduate School of Health, University of Technology Sydney, Utimo, NSW, Australia
- Curtin School of Allied Health, Curtin University, Perth, WA, Australia
| |
Collapse
|
9
|
Carey CM, Williams EC, Torres VN, Ornelas IJ. Help-Seeking Patterns and Barriers to Care Among Latino Immigrant Men with Unhealthy Alcohol Use. J Racial Ethn Health Disparities 2022; 9:1003-1011. [PMID: 33834422 PMCID: PMC8497645 DOI: 10.1007/s40615-021-01039-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 03/31/2021] [Accepted: 04/01/2021] [Indexed: 01/29/2023]
Abstract
Latino immigrant men have high rates of unhealthy alcohol use, a wide range of behaviors, from drinking above the recommended limits to severe alcohol use disorder, yet have low levels of treatment-seeking. Little is known about their preferred sources of care and barriers to care. Using survey data from a community-based sample of Latino immigrant men (N=121) with unhealthy alcohol use (AUDIT≥6), we described help-seeking patterns and perceived barriers to care. The mean AUDIT score was 20 (SD 10; range 6-40), and 49% of men had severe levels of unhealthy alcohol use (AUDIT score ≥ 20). We observed low help-seeking rates and high levels of perceived internal and external barriers. Thirty percent reported having sought help for drinking. Most men reported wanting to solve their drinking problem on their own (65%). Our findings were consistent with previous research. Future studies should further describe barriers to treatment among low-income Latino immigrant men with unhealthy alcohol use and identify ways to increase access to low-cost, high-quality treatment options.
Collapse
Affiliation(s)
- Cathea M Carey
- Department of Health Services, School of Public Health, University of Washington, Seattle, WA, USA
| | - Emily C Williams
- Department of Health Services, School of Public Health, University of Washington, Seattle, WA, USA
- Health Services Research and Development (HSR&D) Seattle-Denver Center of Innovation (COIN), U.S. Department of Veteran Affairs (V.A.), Seattle, WA, USA
| | - Vanessa N Torres
- Department of Health Policy and Management, University of California, Los Angeles, CA, USA
- Department of Behavioral and Policy Sciences, RAND Corporation, Santa Monica, CA, USA
| | - India J Ornelas
- Department of Health Services, School of Public Health, University of Washington, Seattle, WA, USA.
| |
Collapse
|
10
|
Venner KL, Hernandez-Vallant A, Hirchak KA, Herron JL. A scoping review of cultural adaptations of substance use disorder treatments across Latinx communities: Guidance for future research and practice. J Subst Abuse Treat 2022; 137:108716. [PMID: 35148923 PMCID: PMC9086178 DOI: 10.1016/j.jsat.2021.108716] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 10/26/2021] [Accepted: 12/14/2021] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Much of the substance use disorder (SUD) treatment efficacy and effectiveness research is lacking consensus on which scientifically rigorous approach to employ for culturally adapting evidence-based treatments (EBTs) and evidence-based preventions (EBPs) for SUDs among Latinx communities. The aim of this paper is to provide a scoping review of the literature on cultural adaptations of SUD treatment for Latinx communities. METHODS We examined the justifications for cultural adaptations, processes of adaptations, cultural adaptations described, and efficacy and effectiveness of culturally adapted SUD interventions. The study followed Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA). Inclusion criteria consisted of whether the intervention had been culturally adapted based upon an existing EBT or EBP for SUD. Through the search of four databases, expert knowledge and reviewing the reference list of applicable articles, 30 articles met inclusion criteria, which included 14 treatment or prevention outcome articles, one single group pre-post study article, and 15 methods papers on cultural adaptations. Justifications for cultural adaptations centered on SUD health inequities among Latinx populations. RESULTS Four research groups employed adaptation models to culturally tailor evidence-based interventions and most often used elements of community-based participatory research (CBPR). Using Bernal, Bellido, & Bonilla's (1995) Ecological Validity Framework of eight dimensions, the most common cultural adaptations centered on language, context, content, and persons. Efficacy trials with Latinx populations are nascent though growing and reveal: (1) significant time effects for EBTs and most EBPs, (2) superior SUD outcomes for culturally adapted EBTs compared to standard EBTs or other comparison conditions by three research groups, (3) significant prevention intervention effects by three research groups, and (4) significant cultural or social moderators by two groups suggesting Latinx with higher cultural identity, parental familism, or baseline discrimination improve significantly more in the culturally adapted EBTs. CONCLUSION These findings suggest that the science of culturally adapting EBTs is improving in rigor with the use of models to guide the work and the conduct of clinical trials. Measurement of cultural and social variables allows for tests of moderation to understand for whom cultural adaptations are most effective. Future hybrid efficacy/effectiveness trials and implementation research should continue moving the science of cultural adaptation forward.
Collapse
Affiliation(s)
- Kamilla L Venner
- University of New Mexico, MSC03 2220, Albuquerque, NM 87131, United States.
| | | | - Katherine A Hirchak
- Washington State University, Elson S. Floyd College of Medicine, United States.
| | - Jalene L Herron
- University of New Mexico, MSC03 2220, Albuquerque, NM 87131, United States; University of New Mexico, Center on Alcohol, Substance Use, and Addictions, United States.
| |
Collapse
|