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Charania NA, Tonumaipe'a D, Barbarich-Unasa TW, Iusitini L, Davis G, Pacheco G, Wilson D. Exploring the impact of the COVID-19 pandemic on perceptions of national scheduled childhood vaccines among Māori and Pacific caregivers, whānau, and healthcare professionals in Aotearoa New Zealand. Hum Vaccin Immunother 2024; 20:2301626. [PMID: 38205779 DOI: 10.1080/21645515.2023.2301626] [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: 09/28/2023] [Accepted: 12/30/2023] [Indexed: 01/12/2024] Open
Abstract
In Aotearoa New Zealand, there has been a marked decrease in the uptake of routine childhood vaccinations since the onset of the COVID-19 pandemic, particularly among Māori and Pacific children. This Māori and Pacific-centered research used an interpretive description methodology. We undertook culturally informed interviews and discussions with Māori and Pacific caregivers (n = 24) and healthcare professionals (n = 13) to understand their perceptions of routine childhood vaccines. Data were analyzed using reflexive thematic analysis and privileged respective Māori and Pacific worldviews. Four themes were constructed. "We go with the norm" reflected how social norms, health personnel and institutions promoted (and sometimes coerced) participants' acceptance of routine vaccines before the pandemic. "Everything became difficult" explains how the pandemic added challenges to the daily struggles of whānau (extended family networks) and healthcare professionals. Participants noted how information sources influenced disease and vaccine perceptions and health behaviors. "It needed to have an ethnic-specific approach" highlighted the inappropriateness of Western-centric strategies that dominated during the initial pandemic response that did not meet the needs of Māori and Pacific communities. Participants advocated for whānau-centric vaccination efforts. "People are now finding their voice" expressed renewed agency among whānau about vaccination following the immense pressure to receive COVID-19 vaccines. The pandemic created an opportune time to support informed parental vaccine decision-making in a manner that enhances the mana (authority, control) of whānau. Māori and Pacific-led vaccination strategies should be embedded in immunization service delivery to improve uptake and immunization experiences for whānau.
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Affiliation(s)
- Nadia A Charania
- Department of Public Health, Auckland University of Technology, Auckland, New Zealand
| | - Daysha Tonumaipe'a
- New Zealand Work Research Institute, Auckland University of Technology, Auckland, New Zealand
| | - Te Wai Barbarich-Unasa
- Taupua Waiora Centre for Māori Health Research, Auckland University of Technology, Auckland, New Zealand
| | - Leon Iusitini
- New Zealand Work Research Institute, Auckland University of Technology, Auckland, New Zealand
| | - Georgina Davis
- Taupua Waiora Centre for Māori Health Research, Auckland University of Technology, Auckland, New Zealand
| | - Gail Pacheco
- New Zealand Work Research Institute, Auckland University of Technology, Auckland, New Zealand
| | - Denise Wilson
- Taupua Waiora Centre for Māori Health Research, Auckland University of Technology, Auckland, New Zealand
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Chow EHY, Tiwari A. Perceptions of abused Chinese women on community-based participatory approach programme in addressing their needs. Int J Qual Stud Health Well-being 2024; 19:2331107. [PMID: 38564773 PMCID: PMC10989199 DOI: 10.1080/17482631.2024.2331107] [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: 12/14/2023] [Accepted: 03/12/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND The community-based participatory approach (CBPA) has gained increasing recognition worldwide for enhancing the effectiveness of intervention. It is relatively new in Chinese societies and participants' perceptions are underexplored. This study aims to explore abused Chinese women's perceptions on the CBPA programme in addressing their needs. METHODS A total of 11 abused Chinese women were recruited for a focus group and individual interviews. A semi-structured interview guide was used. All interviews were audio-recorded and data were transcribed verbatim. Conventional content analysis was used for analysis. RESULTS Four themes were identified regarding the women's perceptions and experiences of the community-based participatory approach programme: (1) Women's perceived acceptability of the CBPA programme; (2) Women's perceived usefulness of the CBPA programme; (3) Women's perceived feasibility of the CBPA programme; and (4) Empowering the women through participating in CBPA. CONCLUSIONS Abused Chinese women had high perceived acceptance and positive experiences towards the community-based participatory approach. Women benefited from their robust participation throughout the process. The findings confirm the potential of using the community-based participatory approach in designing interventions for future programme planning and intervention to address the needs of abused Chinese women.
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Affiliation(s)
| | - Agnes Tiwari
- School of Nursing, Hong Kong Sanatorium & Hospital Limited, Hong Kong, China
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Maricar N, Khan B, David T, Hyrich KL, Barton A. Factors facilitating and hindering South Asian immigrant adults from engaging in exercise and physical activity - a qualitative systematic review. BMC Public Health 2024; 24:1342. [PMID: 38762730 PMCID: PMC11102233 DOI: 10.1186/s12889-024-18288-1] [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: 10/17/2023] [Accepted: 03/05/2024] [Indexed: 05/20/2024] Open
Abstract
BACKGROUND Exercise and physical activity are key components of management in patients with rheumatic musculoskeletal diseases (RMD), but people of the South Asian communities have a lower level of engagement with these activities compared to their Caucasian counterparts. The aim of this qualitative systematic review was to determine the barriers and facilitators of exercise and physical activity in South Asian communities who have migrated and live in western countries, particularly in those who have RMD. METHODS Qualitative studies, published in English between 1999 and 2021 and including evaluation of barriers and/or facilitators to exercise or physical activity behaviour in people of South Asian adult communities who have migrated and/or lived in western countries were identified from Embase, MEDLINE, CINAHL, PsycINFO, Google Scholar and manual searches. The studies were appraised using the CASP checklist. Inductive thematic synthesis was used to identify common and global themes. RESULTS A total of 32 studies that discussed barriers and facilitators of physical activity in South Asian communities who have migrated and lived in western countries were used for this review but there were no studies identified that focussed specifically on those with RMD. Following appraisal of the reporting of the studies, 30 studies were included in the pooling of the results. The facilitators and barriers to physical activities were broadly categorized into 'extrinsic' and 'intrinsic' factors. Extrinsic factors such as 'opportunity' included environmental factors such as weather and safety; socioeconomic factors such as education, language and literacy, and support in the form of social, psychological and resources. Intrinsic factors included cultural factors, such as life stages and family influence, beliefs and knowledge, which impacted attitudes and skills. CONCLUSIONS This review has synthesised evidence of barriers or facilitators and identified potentially modifiable factors influencing physical activity and exercise engagement, which could form the basis of evidence-based interventions to promote participation in healthy behaviour change. Provision of a safe, comfortable and culturally acceptable environment together with culturally-aligned cognitive strategies to facilitate acquisition of exercise-efficacy skills could help engagement. REGISTRATION The systematic review was registered on PROSPERO, registration no. 289,235.
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Affiliation(s)
- Nasimah Maricar
- Northern Care Alliance NHS Foundation Trust, Salford Royal NHS Foundation Trust, Manchester, UK.
- Centre for Epidemiology Versus Arthritis, Centre for Musculoskeletal Research, Division of Musculoskeletal and Dermatological Sciences, University of Manchester, Manchester, UK.
- Department of Health Professions, Manchester Metropolitan University, Manchester, UK.
| | - Behram Khan
- The Kellgren Centre for Rheumatology, Manchester University NHS Foundation Trust, Manchester, UK
| | - Trixy David
- The Kellgren Centre for Rheumatology, Manchester University NHS Foundation Trust, Manchester, UK
| | - Kimme L Hyrich
- Centre for Epidemiology Versus Arthritis, Centre for Musculoskeletal Research, Division of Musculoskeletal and Dermatological Sciences, University of Manchester, Manchester, UK
- The Kellgren Centre for Rheumatology, Manchester University NHS Foundation Trust, Manchester, UK
- NIHR Manchester Biomedical Research Centre, Manchester Foundation NHS Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Anne Barton
- The Kellgren Centre for Rheumatology, Manchester University NHS Foundation Trust, Manchester, UK
- NIHR Manchester Biomedical Research Centre, Manchester Foundation NHS Trust, Manchester Academic Health Science Centre, Manchester, UK
- Centre for Genetics and Genomics Versus Arthritis, Centre for Musculoskeletal Research, Division of Musculoskeletal and Dermatological Sciences, University of Manchester, Manchester, UK
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Dopelt K, Krispel E, Davidovitch N. Role of Grassroots Public Health Leadership in Bedouin Society in Israel in Reducing Health Disparities. J Healthc Leadersh 2024; 16:177-192. [PMID: 38595328 PMCID: PMC11003427 DOI: 10.2147/jhl.s447950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 03/22/2024] [Indexed: 04/11/2024] Open
Abstract
Introduction Negev Bedouin settlements suffer from poor infrastructure, and the population's health status is low across all indicators. While it is difficult for Bedouin citizens of Israel to integrate into the Israeli employment market, integrating this population into the health system is far-reaching. The aim of this study is to analyze the barriers and motivational factors experienced by Bedouin doctors to promote public health in the Bedouin community in southern Israel and to examine the perceptions these doctors have around the concept of leadership in a public health setting. Methods We conducted semi-structured interviews with Bedouin doctors from the Negev Bedouin community and analyzed them using thematic analysis. Results Most interviewees saw themselves as leaders whose role was to improve public health in their community. They stressed the need for health leadership in Negev Bedouin society, and their desire to lead change in the community from within. All interviewees had grown used to a different way of life and a higher standard of living, and as a result, had difficulty returning home. Interviewees presented that trust in the health system is a critical factor for the success of health promotion programs. However, they noted the evolving trends of general mistrust in the government and its institutions that form the infrastructure for mistrust in the health system. Lack of time and workload were barriers to exercising leadership. Interviewees reported their perception of how socioeconomic status, the standard of living, and lack of infrastructure, education, and training affect health outcomes and collaboration potential. Discussion This study presents a unique perspective on the views of doctors from the Negev Bedouin population on their involvement with grassroots leadership as a strategy to reduce health disparities in this community.
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Affiliation(s)
- Keren Dopelt
- School of Public Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
- Department of Public Health, Ashkelon Academic College, Ashkelon, Israel
| | - Einat Krispel
- School of Public Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Nadav Davidovitch
- School of Public Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
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Maricar N, Yeowell G, David T, Khan B, Barton A, Hyrich KL, Hartley SE. Barriers and enablers to engagement in exercise and physical activity in non-English speaking South Asian people with chronic musculoskeletal disease. BMC Rheumatol 2024; 8:12. [PMID: 38462630 PMCID: PMC10926668 DOI: 10.1186/s41927-024-00372-z] [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: 02/01/2023] [Accepted: 01/08/2024] [Indexed: 03/12/2024] Open
Abstract
BACKGROUND Exercise and physical activity (EPA) are recommended for people with chronic musculoskeletal disease; however, lower levels of engagement with EPA has been consistently reported in people from the South Asian community across a range of diseases. As language can pose a significant barrier in healthcare, this study aimed to understand the enablers and barriers to the acceptance of EPA among non-English speaking South Asian people who attended rheumatology clinics. METHODS 12 non-English speaking individuals from the South Asian community who had chronic musculoskeletal disease with significant pain scores were interviewed via telephone or face-to-face in their spoken languages. The audio recordings of the interviews were translated into English and transcribed verbatim. Data was analysed using thematic analysis implemented in the NVivo 12 Pro software program. RESULTS The mean age was 52 years (9 women and 2 men). One main theme was identified: 'Enablers and barriers to exercise and physical activity'. Enablers to EPA were having knowledge about the benefits of EPA, being given resources in a language that they understood, and supportive environments such as having access to community facilities for those who could not undertake EPA in their houses. Barriers included physical health such as pain and fatigue, lack of time, difficulties with transportation to exercise venues, dislike of group exercises and lack of understanding of what and how to do exercise and be physically active. Participants' beliefs about EPA and whether they impacted their physical health seemed to influence whether they were undertaken or not. There was a perception that their culture shaped their compatriots' beliefs about EPA, and it was not normal practice for people from their country of birth to engage in it. CONCLUSIONS This is the first qualitative study to explore the barriers and enablers to engagement in EPA in non-English speaking South Asian people with chronic musculoskeletal disease. Modifiable factors such as addressing the level of knowledge on the benefits of EPA in the management of chronic joint and muscle pain; aiding the development of the skills required to exercise safely and confidently despite chronic pain and providing information and services in the native language could promote the EPA engagement of non-English speaking South Asian individuals with chronic musculoskeletal disease. The findings may inform improvements within clinical services to promote the benefits, impact and self-efficacy of engagement with EPA as part of chronic musculoskeletal disease management. ETHICS APPROVAL The West Midlands-Edgbaston Research Ethics Committee (reference:20/WM/0305).
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Affiliation(s)
- Nasimah Maricar
- Northern Care Alliance NHS Foundation Trust, Salford Royal NHS Foundation Trust, Manchester, UK.
- Centre for Epidemiology Versus Arthritis, Centre for Musculoskeletal Research, Division of Musculoskeletal and Dermatological Sciences, University of Manchester, Manchester, UK.
- Department of Health Professions, Manchester Metropolitan University, Manchester, UK.
| | - Gillian Yeowell
- Department of Health Professions, Manchester Metropolitan University, Manchester, UK
| | - Trixy David
- The Kellgren Centre for Rheumatology, Manchester University NHS Foundation Trust, Manchester, UK
| | - Behram Khan
- The Kellgren Centre for Rheumatology, Manchester University NHS Foundation Trust, Manchester, UK
| | - Anne Barton
- The Kellgren Centre for Rheumatology, Manchester University NHS Foundation Trust, Manchester, UK
- Centre for Genetics and Genomics Versus Arthritis, Centre for Musculoskeletal Research, Division of Musculoskeletal and Dermatological Sciences, University of Manchester, Manchester, UK
- NIHR Manchester Biomedical Research Centre, Manchester Foundation NHS Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Kimme L Hyrich
- Centre for Epidemiology Versus Arthritis, Centre for Musculoskeletal Research, Division of Musculoskeletal and Dermatological Sciences, University of Manchester, Manchester, UK
- The Kellgren Centre for Rheumatology, Manchester University NHS Foundation Trust, Manchester, UK
- NIHR Manchester Biomedical Research Centre, Manchester Foundation NHS Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Sandra E Hartley
- Department of Health Professions, Manchester Metropolitan University, Manchester, UK
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Tsuji SRJ, Zuk AM, Solomon A, Edwards-Wheesk R, Ahmed F, Tsuji LJS. What Is Wellbeing, and What Is Important for Wellbeing? Indigenous Voices from across Canada. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6656. [PMID: 37681798 PMCID: PMC10487260 DOI: 10.3390/ijerph20176656] [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: 05/31/2023] [Revised: 08/15/2023] [Accepted: 08/19/2023] [Indexed: 09/09/2023]
Abstract
Indigenous peoples' perceptions of wellbeing differ from non-Indigenous constructs. Thus, it is imperative to recognize that Indigenous peoples will conceptualize wellbeing from their perspectives and set their own wellbeing priorities. In keeping with this viewpoint, the aims of the present study were to conceptualize wellbeing and determine what was (and is) important for wellbeing from Canadian Indigenous peoples' perspectives. In this paper, we take a partnership approach based on the elements of respect, equity, and empowerment. One primary data source and two existing data sources were examined and analyzed thematically utilizing a combination approach of deductive and inductive coding. Indigenous leadership and organizations viewed wellbeing holistically and conceptualized wellbeing multidimensionally. From across Canada, wellbeing was communicated as physical, economic, political, social, and cultural. The scaling of wellbeing represented a collectivist perspective, and land was the connecting thread between all types of wellbeing, being a place to practice cultural traditions, reassert one's Indigenous identity, find solace, and pass on Indigenous knowledge and languages. Although wellbeing was discussed in the context of the individual, family, community, and nation, wellbeing was most often discussed at the cultural level by regional and national Indigenous leadership and organizations. Even in acknowledging the great cultural diversity among Canadian Indigenous nations, four concordant themes were identified regionally and nationally, with respect to what was important for cultural wellbeing: land and water, sustainability, and inherent obligations; being on the land, and indigenous languages and knowledge systems; sustainable development; and meaningful involvement in decision-making, and free, prior, and informed consent. Taking into account these themes is foundational for any interaction with Indigenous peoples, especially in the context of land, culture, and development. There needs to be a new beginning on the journey to reconciliation with land and cultural wellbeing at the forefront.
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Affiliation(s)
- Stephen R. J. Tsuji
- Department of Physical and Environmental Sciences, University of Toronto, Toronto, ON M1C 1A4, Canada; (A.M.Z.); (F.A.); (L.J.S.T.)
- School of Environmental Studies, Queen’s University, Kingston, ON K7L 3N6, Canada
| | - Aleksandra M. Zuk
- Department of Physical and Environmental Sciences, University of Toronto, Toronto, ON M1C 1A4, Canada; (A.M.Z.); (F.A.); (L.J.S.T.)
- School of Nursing, Queen’s University, Kingston, ON K7L 3N6, Canada
| | - Andrew Solomon
- Fort Albany First Nation, Fort Albany, ON P0L 1H0, Canada
| | | | - Fatima Ahmed
- Department of Physical and Environmental Sciences, University of Toronto, Toronto, ON M1C 1A4, Canada; (A.M.Z.); (F.A.); (L.J.S.T.)
| | - Leonard J. S. Tsuji
- Department of Physical and Environmental Sciences, University of Toronto, Toronto, ON M1C 1A4, Canada; (A.M.Z.); (F.A.); (L.J.S.T.)
- Department of Health and Society, University of Toronto, Toronto, ON M1C 1A4, Canada
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Sullivan P, Starr V, Dubois E, Starr A, Acharibasam JB, McIlduff C. Where past meets present: Indigenous vaccine hesitancy in Saskatchewan. MEDICAL HUMANITIES 2023; 49:321-331. [PMID: 36604166 PMCID: PMC10439261 DOI: 10.1136/medhum-2022-012501] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/07/2022] [Indexed: 06/17/2023]
Abstract
In Canada, colonisation, both historic and ongoing, increases Indigenous vaccine hesitancy and the threat posed by infectious diseases. This research investigated Indigenous vaccine hesitancy in a First Nation community in Saskatchewan, ways it can be overcome, and the influence of a colonial history as well as modernity. Research followed Indigenous research methodologies, a community-based participatory research design, and used mixed methods. Social media posts (interventions) were piloted on a community Facebook page in January and February (2022). These interventions tested different messaging techniques in a search for effective strategies. The analysis that followed compared the number of likes and views of the different techniques to each other, a control post, and community-developed posts implemented by the community's pandemic response team. At the end of the research, a sharing circle occurred and was followed by culturally appropriate data analysis (Nanâtawihowin Âcimowina Kika-Môsahkinikêhk Papiskîci-Itascikêwin Astâcikowina procedure). Results demonstrated the importance of exploring an Indigenous community's self-determined solution, at the very least, alongside the exploration of external solutions. Further, some sources of vaccine hesitancy, such as cultural barriers, can also be used to promote vaccine confidence. When attempting to overcome barriers, empathy is crucial as vaccine fears exist, and antivaccine groups are prepared to take advantage of empathetic failures. Additionally, the wider community has a powerful influence on vaccine confidence. Messaging, therefore, should avoid polarising vaccine-confident and vaccine-hesitant people to the point where the benefits of community influence are limited. Finally, you need to understand people and their beliefs to understand how to overcome hesitancy. To gain this understanding, there is no substitute for listening.
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Affiliation(s)
- Patrick Sullivan
- College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Victor Starr
- Kihew Kawaskasit Health Services, Star Blanket Cree Nation, Saskatchewan, Canada
| | - Ethel Dubois
- Star Blanket Cree Nation, Star Blanket Cree Nation, Saskatchewan, Canada
| | - Alyssa Starr
- College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | | | - Cari McIlduff
- College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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Jones-Konneh TEC, Kaikai AI, Bah IB, Nonaka D, Takeuchi R, Kobayashi J. Impact of health systems reform on COVID-19 control in Sierra Leone: a case study. Trop Med Health 2023; 51:28. [PMID: 37198669 PMCID: PMC10189713 DOI: 10.1186/s41182-023-00521-z] [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: 12/03/2022] [Accepted: 05/05/2023] [Indexed: 05/19/2023] Open
Abstract
BACKGROUND There are various impacts of COVID-19 on health systems of the world. The health systems of low- and middle-income countries are less developed. Therefore, they have greater tendencies to experience challenges and vulnerabilities in COVID-19 control compared to high-income countries. It is important to contain the spread of the virus, and likewise strengthen the capacity of health systems in order for the response to be effective and swift. The experience from 2014 to 2016 Ebola outbreak in Sierra Leone served as preparation for COVID-19 outbreak. The aim of this study is to determine how control of COVID-19 outbreak in Sierra Leone was enhanced by the lessons learned from 2014 to 2016 Ebola outbreak, and health systems reform. METHODS We used data from a qualitative case study conducted in four districts in Sierra Leone through key informant interviews, focus group discussions, document, and archive record reviews. A total of 32 key informant interviews and 14 focus group discussions were conducted. A thematic analysis was used to analyze the data, and all transcripts were coded and analyzed with the aid of ATLAS.ti 9 software program. RESULTS The six themes obtained were composed of categories that connect with each other and with codes to form networks. The analysis of the responses demonstrated that "Multisectoral Leadership and Cooperation", "Government Collaboration among International Partners", and "Awareness in the Community" were among the key interventions used during the control of 2014-2016 Ebola virus disease outbreak, which were applied in the control of COVID-19. An infectious disease outbreak control model was proposed based on the results obtained from the analysis of the lessons learned during the Ebola virus disease outbreak, and health systems reform. CONCLUSIONS "Multisectoral Leadership and Cooperation", "Government Collaboration among International Partners" and "Awareness in the Community" are key strategies that enhanced the control of the COVID-19 outbreak in Sierra Leone. It is recommended that they are implemented in controlling COVID-19 pandemic or any other infectious disease outbreak. The proposed model can be used in controlling infectious disease outbreaks, especially in low- and middle-income countries. Further research is needed to validate the usefulness of these interventions in overcoming an infectious disease outbreak.
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Affiliation(s)
- Tracey Elizabeth Claire Jones-Konneh
- Department of Global Health, Graduate School of Health Sciences, University of the Ryukyus, 207 Uehara, Nishihara-Cho, Nakagami-Gun, Okinawa, 903-0215, Japan.
- Pharmaceutical Society, Freetown, Sierra Leone.
- Ministry of Health and Sanitation, Freetown, Sierra Leone.
| | - Angella Isata Kaikai
- Pharmaceutical Society, Freetown, Sierra Leone
- Ministry of Health and Sanitation, Freetown, Sierra Leone
- Sierra Leone Psychiatric Hospital, University of Sierra Leone Teaching Hospital Complex, Freetown, Sierra Leone
| | - Ibrahim Borbor Bah
- Pharmaceutical Society, Freetown, Sierra Leone
- Ministry of Health and Sanitation, Freetown, Sierra Leone
- District Health Management Team, Pujehun, Sierra Leone
| | - Daisuke Nonaka
- Department of Global Health, Graduate School of Health Sciences, University of the Ryukyus, 207 Uehara, Nishihara-Cho, Nakagami-Gun, Okinawa, 903-0215, Japan
| | - Rie Takeuchi
- Department of Global Health, Graduate School of Health Sciences, University of the Ryukyus, 207 Uehara, Nishihara-Cho, Nakagami-Gun, Okinawa, 903-0215, Japan
- Graduate School of Public Health, International University of Health and Welfare 4-3, Koudunomori, Narita, Chiba, 286-8686, Japan
| | - Jun Kobayashi
- Department of Global Health, Graduate School of Health Sciences, University of the Ryukyus, 207 Uehara, Nishihara-Cho, Nakagami-Gun, Okinawa, 903-0215, Japan
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Jackson SF, Morgan GT, Gloger A, Luca S, Cerda E, Poland B. Relationships are everything: The underpinnings of grassroots community action in the COVID-19 pandemic in Toronto. CITIES (LONDON, ENGLAND) 2023; 134:104163. [PMID: 36593904 PMCID: PMC9797416 DOI: 10.1016/j.cities.2022.104163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 12/15/2022] [Accepted: 12/17/2022] [Indexed: 06/17/2023]
Abstract
Most government emergency/pandemic response plans feature top-down decision making and communication strategies and a focus on 'hard' (physical) infrastructure. There is nothing about the importance of the ideas and communications originating from communities, the social infrastructure that supports their impact locally and their contribution to the central administration. In this study, we found that the 'soft' (social) infrastructure within communities and between communities and formal institutions is key to an inclusive and more equitable response to large-scale crises like the COVID-19 pandemic. Grassroots leaders in six Toronto neighbourhoods were interviewed between the first and second waves of the COVID-19 pandemic in Toronto about what helped or hindered community action. Three themes emerged: (1) Grassroots leaders and community organizations were able to act as key connection points in a two-way flow of information and resources with residents and service providers; (2) Grassroots leaders and groups were challenged to engage in this work in a sustained capacity without adequate resourcing; and (3) there was a disconnect between community-centred grassroots approaches and the City's emergency response. We conclude that there needs to be pre-disaster investment in community level planning and preparation that fosters two-way connections between all municipal emergency/disaster and pandemic preparedness plans and community-centred organizations and grassroots leaders working in marginalized communities.
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Affiliation(s)
- Suzanne F Jackson
- Dalla Lana School of Public Health, University of Toronto, 155 College St. 5th Floor, Toronto, Ontario M5T 3M7, Canada
| | - Garrett T Morgan
- Department of Geography and Planning, University of Toronto, 100 St. George Street, Room 5047, Toronto, Ontario M5S 3G3, Canada
| | - Anne Gloger
- Centre for Connected Communities (C3), 832 College St., Suite 301, Toronto, Ontario M6G 1C8, Canada
| | - Sarah Luca
- Centre for Connected Communities, 832 College St., Suite 301, Toronto, Ontario M6G 1C8, Canada
| | - Ewa Cerda
- Centre for Connected Communities, 832 College St., Suite 301, Toronto, Ontario M6G 1C8, Canada
| | - Blake Poland
- Dalla Lana School of Public Health, University of Toronto, 155 College St. 5th Floor, Toronto, Ontario M5T 3M7, Canada
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Ramirez CC, Farmer Y, Bouthillier ME. Public voices on tie-breaking criteria and underlying values in COVID-19 triage protocols to access critical care: a scoping review. DISCOVER HEALTH SYSTEMS 2023; 2:16. [PMID: 37206881 PMCID: PMC10169297 DOI: 10.1007/s44250-023-00027-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 03/14/2023] [Indexed: 05/21/2023]
Abstract
Background To reduce the arbitrariness in the allocation of rare resources in intensive care units (ICU) in the context of the pandemic, tiebreakers were considered in some COVID-19 triage algorithms. They were also contemplated to facilitate the tragic decisions of healthcare workers when faced with two patients with similar prognosis and only one ICU bed available. Little is known about the public's perspective on tiebreakers. Objectives To consolidate the available scientific literature on public consultations, particularly on tiebreakers and their underlying values. Also, to obtain an overview of the key arguments presented by the participating public and to identify potential gaps related to this topic. Methods The steps described by Arksey and O'Malley was the preferred method to our approach. Seven electronic databases were searched from January 2020 to April 2022, using keywords for each database: PubMed, Medline, EMBASE, Web of Science, PsycINFO, EBM reviews, CINAHL complete. We also searched in Google and Google Scholar, and in the references of the articles found. Our analysis was mainly qualitative. A thematic analysis was performed to consider the public's perspectives on tiebreakers and their underlying values, according to these studies. Results Of 477 publications found, 20 were selected. They carried out public consultations through various methods: surveys (80%), interviews (20%), deliberative processes (15%) and others (5%) in various countries: Australia, Brazil, Canada, China, France, Germany, India, Iran, Italy, Japan, Korea, Netherlands, Portugal, Spain, Switzerland, Thailand, United Kingdom, and United States. Five themes emerged from our analysis. The public favored the life cycle (50%) and absolute age (45%) as a tiebreaker. Other values considered important were reciprocity, solidarity, equality, instrumental value, patient merit, efficiency, and stewardship. Among the new findings were a preference for patient nationality and those affected by COVID-19. Conclusions There is a preference for favoring younger patients over older patients when there is a tie between similar patients, with a slight tendency to favor intergenerational equity. Variability was found in the public's perspectives on tiebreakers and their values. This variability was related to socio-cultural and religious factors. More studies are needed to understand the public's perspective on tiebreakers. Supplementary Information The online version contains supplementary material available at 10.1007/s44250-023-00027-9.
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Affiliation(s)
- Claudia Calderon Ramirez
- Biomedical Sciences Program, Clinical Ethics, Faculty of Medicine, Université de Montréal, 2900 Bd Édouard-Montpetit, Montréal, Québec H3T 1J4 Canada
| | - Yanick Farmer
- Department of Social and Public Communication, Faculty of Communication, Université du Québec à Montréal, C.P 8888, Succursale Centre-Ville, Montréal, Québec H3C 3P8 Canada
| | - Marie-Eve Bouthillier
- Department of Family and Emergency Medicine and Office of Clinical Ethics, Faculty of Medicine, Université de Montréal, 2900 Bd Édouard-Montpetit, Montréal, Québec H3T 1J4 Canada
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11
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Gailloux C, Furness WW, Myles CC, Wiley DS, Collins K. Fieldwork without the field: Navigating qualitative research in pandemic times. FRONTIERS IN SUSTAINABLE FOOD SYSTEMS 2022. [DOI: 10.3389/fsufs.2022.750409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
More than ever before, the COVID-19 pandemic has required qualitative researchers to develop open-ended, flexible, and creative approaches to continuing their work. This reality includes the adoption of open-ended research goals, a willingness to continually adapt to unpredictable and changing (viral) circumstances, and a commitment to opening toward and adhering to participants' preferences. This ethos is entrenched in a web of moral responsibility and a future anteriorized ethics. We reflect on pandemic-era ethical and methodological considerations in light of Fortun's studies of toxic contamination, research conducted in conflict settings, and researcher experiences during the early stages of COVID-19. Drawing from our own experiences and bearing in mind our own entangled web(s) of moral responsibility, we explore the future anteriorized ethics and methodological landscape of the “new normal” pandemic (potentially endemic) era. We reflect on what data we are able to gather and what data we dare to gather in the context of COVID-19, ultimately asking how qualitative researchers can maintain a safe and ethical environment for conducting research. To this end, we emphasize a recognition of our obligations to our research partners and ourselves in order to reduce risk by turning doubts and concerns into opportunities during project development and fieldwork and transforming participants into collaborators in spaces of uncertainty. Through targeted reflections on our processes of adaptation in research, we examine how scholars can perform relatedness, knowledge, reasonableness, and care in the midst of a risky, compromised research context.
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12
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Kemper S, Kupper F, Kengne Kamga S, Brabers A, De Jong J, Bongers M, Timen A. Public engagement in decision-making regarding the management of the COVID-19 epidemic: Views and expectations of the 'publics'. Health Expect 2022; 25:2807-2817. [PMID: 36148630 PMCID: PMC9538976 DOI: 10.1111/hex.13583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 06/23/2022] [Accepted: 08/07/2022] [Indexed: 11/28/2022] Open
Abstract
Background In the management of epidemics, like COVID‐19, trade‐offs have to be made between reducing mortality and morbidity and minimizing socioeconomic and political consequences. Traditionally, epidemic management (EM) has been guided and executed attentively by experts and policymakers. It can, however, still be controversial in the public sphere. In the last decades, public engagement (PE) has been successfully applied in various aspects of healthcare. This leads to the question if PE could be implemented in EM decision‐making. Methods From June to October 2020, seven deliberative discussion focus groups were executed with 35 Dutch citizens between 19 and 84 years old. Their views on PE in COVID‐19 management were explored. The deliberative approach allows for the education of participants on the topic before the discussion. The benefits, barriers, timing and possible forms of PE in EM were discussed. Results Almost all participants supported PE in EM, as they thought that integrating their experiences and ideas would benefit the quality of EM, and increase awareness and acceptance of measures. A fitting mode for PE was consultation, as it was deemed important to provide the public with possibilities to share ideas and feedback; however, final authority remained with experts. The publics could particularly provide input about communication campaigns and control measures. PE could be executed after the first acute phase of the epidemic and during evaluations. Conclusions This paper describes the construction of an empirically informed framework about the values and conditions for PE in EM from the perspective of the public. Participants expressed support to engage certain population groups and considered it valuable for the quality and effectiveness of EM; however, they expressed doubts about the feasibility of PE and the capabilities of citizens. In future studies, these results should be confirmed by a broader audience. Patient or Public Contribution No patients or members of the public were involved in the construction and execution of this study. This study was very exploratory, to gain a first insight into the views of the public in the Netherlands, and will be used to develop engagement practices accordingly. At this stage, the involvement of the public was not yet appropriate.
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Affiliation(s)
- Sophie Kemper
- National Coordination Centre for Communicable Disease Control, The National Institute for Public Health and the Environment, Bilthoven, The Netherlands.,Athena Institute, Faculty of Science, VU University Amsterdam, Amsterdam, 1081 HV, The Netherlands
| | - Frank Kupper
- Athena Institute, Faculty of Science, VU University Amsterdam, Amsterdam, 1081 HV, The Netherlands
| | - Sandra Kengne Kamga
- National Coordination Centre for Communicable Disease Control, The National Institute for Public Health and the Environment, Bilthoven, The Netherlands.,Athena Institute, Faculty of Science, VU University Amsterdam, Amsterdam, 1081 HV, The Netherlands
| | - Anne Brabers
- NIVEL, The Netherlands Institute for Health Services Research, Utrecht, 3513 CR, The Netherlands
| | - Judith De Jong
- NIVEL, The Netherlands Institute for Health Services Research, Utrecht, 3513 CR, The Netherlands.,Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Marloes Bongers
- National Coordination Centre for Communicable Disease Control, The National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Aura Timen
- National Coordination Centre for Communicable Disease Control, The National Institute for Public Health and the Environment, Bilthoven, The Netherlands.,Athena Institute, Faculty of Science, VU University Amsterdam, Amsterdam, 1081 HV, The Netherlands.,Department of Primary and Community Care, Radboud University Medical Centre, Nijmegen, The Netherlands
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13
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Fitzpatrick K, Sehgal A, Montesanti S, Pianarosa E, Barnabe C, Heyd A, Kleissen T, Crowshoe L. Examining the role of Indigenous primary healthcare across the globe in supporting populations during public health crises. Glob Public Health 2022; 18:2049845. [PMID: 35343868 DOI: 10.1080/17441692.2022.2049845] [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: 11/04/2022]
Abstract
When health systems are overwhelmed during a public health crisis regular care is often delayed and deaths result from lapses in routine care. Indigenous primary healthcare (PHC) can include a range of programmes that incorporate treatment and management, prevention and health promotion, as well as addressing the social determinants of health (SDoH) and a focus on redressing health inequities. We examined how Indigenous PHC mobilises and innovates during a public health crisis to address patient needs and the broader SDoH. A rapid review methodology conducted from January 2021 - March 2021 was purposefully chosen given the urgency with COVID-19, to understand the role of Indigenous PHC during a public health crisis. Our review identified five main themes that highlight the role of Indigenous PHC during a public health crisis: (1) development of culturally appropriate communication and education materials about vaccinations, infection prevention, and safety; (2) Indigenous-led approaches for the prevention of infection and promotion of health; (3) strengthening intergovernmental and interagency collaboration; (4) maintaining care continuity; and (5) addressing the SDoH. The findings highlight important considerations for mobilising Indigenous PHC services to meet the needs of Indigenous patients during a public health crisis such as the COVID-19 pandemic.
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Affiliation(s)
- Kayla Fitzpatrick
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Anika Sehgal
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | | | - Emilie Pianarosa
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Cheryl Barnabe
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.,Department of Family Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Amber Heyd
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Tessa Kleissen
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Lynden Crowshoe
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
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14
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Casillas A, Rosas LG, Carson SL, Orechwa A, North G, AuYoung M, Kim G, Guereca JA, Ramers CB, Burke NJ, Corchado CG, Aguilar-Gaxiola S, Cheney A, Rabin BA, Stadnick NA, Oswald W, Cabrera A, Sorkin DH, Zaldivar F, Wong W, Yerraguntala AS, Vassar SD, Wright AL, Washington DL, Norris KC, Brown AF. STOP COVID-19 CA: Community engagement to address the disparate impacts of the COVID-19 pandemic in California. FRONTIERS IN HEALTH SERVICES 2022; 2:935297. [PMID: 36925779 PMCID: PMC10012632 DOI: 10.3389/frhs.2022.935297] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 10/10/2022] [Indexed: 12/03/2022]
Abstract
Objective To describe the early activities and lessons of the Share, Trust, Organize, Partner COVID-19 California Alliance (STOP COVID-19 CA), the California awardee of the NIH-funded multi-state Community Engagement Alliance (CEAL) against COVID-19. The Alliance was established to ensure equity in Coronavirus-19 disease (COVID-19) research, clinical practice, and public health for communities most impacted by the COVID-19 pandemic. Study setting The STOP COVID-19 CA Alliance network of 11 universities and affiliated partner community-based organizations (CBOs) across California. Study design Mixed methods evaluation consisting of an analysis of activity (August 2020 to December 2021) detailed in reports submitted by community-academic teams and a survey (August 2021) of academic investigators and affiliated community-based organization (CBO) partners. Data collection We summarized activities from the 11 community-academic teams' progress reports and described results from an online survey of academic investigators and CBO partners in the California Alliance. Principal findings A review of progress reports (n = 256) showed that teams fielded surveys to 11,000 Californians, conducted 133 focus groups, partnered with 29 vaccine/therapeutics clinical trials, and led more than 300 town halls and vaccine events that reached Californians from communities disproportionately impacted by COVID-19. Survey responses from academic investigators and CBO partners emphasized the importance of learning from the successes and challenges of the California Alliance teams' COVID-19 initiatives. Both academic and CBO respondents highlighted the need for streamlined federal and institutional administrative policies, and fiscal practices to promote more effective and timely operations of teams in their efforts to address the numerous underlying health and social disparities that predispose their communities to higher rates of, and poor outcomes from, COVID-19. Conclusions STOP COVID-19 CA represents a new and potentially sustainable statewide community engagement model for addressing health disparities in multiethnic/multicultural and geographically dispersed communities.
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Affiliation(s)
- Alejandra Casillas
- Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, UCLA, Los Angeles, CA, United States
| | - Lisa G Rosas
- Department of Epidemiology and Population Health, Stanford School of Medicine, Stanford, CA, United States.,Division of Primary Care and Population Health, Department of Medicine, Stanford School of Medicine, Stanford, CA, United States
| | - Savanna L Carson
- Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, UCLA, Los Angeles, CA, United States
| | - Allison Orechwa
- Southern California Clinical and Translational Science Institute, University of Southern California, Los Angeles, CA, United States
| | - Gemma North
- Southern California Clinical and Translational Science Institute, University of Southern California, Los Angeles, CA, United States
| | | | - Gloria Kim
- Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, UCLA, Los Angeles, CA, United States
| | - Jesus A Guereca
- Laura Rodriguez Research Institute Family Health Centers of San Diego, San Diego, CA, United States
| | - Christian B Ramers
- Division of Infectious Diseases, Department of Medicine, University of California San Diego, La Jolla, CA, United States
| | - Nancy J Burke
- Public Health Department, University of California, Merced, Merced, CA, United States
| | | | - Sergio Aguilar-Gaxiola
- Center for Reducing Health Disparities and Community Engagement Program of the Clinical and Translational Science Center, Department of Internal Medicine, University of California, Davis, Sacramento, CA, United States
| | - Ann Cheney
- Department of Social Medicine Population and Public Health, School of Medicine, University of California, Riverside, Riverside, CA, United States
| | - Borsika A Rabin
- UC San Diego Altman Clinical Translational Research Institute Dissemination and Implementation Science Center, University of California San Diego, La Jolla, CA, United States.,Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, United States
| | - Nicole A Stadnick
- UC San Diego Altman Clinical Translational Research Institute Dissemination and Implementation Science Center, University of California San Diego, La Jolla, CA, United States.,Department of Psychiatry, School of Medicine, University of California San Diego, La Jolla, CA, United States.,Child and Adolescent Services Research Center, San Diego, CA, United States
| | - William Oswald
- The Global Action Research Center, San Diego, CA, United States
| | - Abby Cabrera
- Center for Excellence in Primary Care, Department of Family and Community Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Dara H Sorkin
- Department of Medicine, Institute for Clinical and Translational Science, University of California, Irvine, Irvine, CA, United States
| | - Frank Zaldivar
- Department of Pediatrics, Susan and Henry Samueli College of Health Sciences, University of California, Irvine, Irvine, CA, United States
| | - Wennie Wong
- Southern California Clinical and Translational Science Institute, University of Southern California, Los Angeles, CA, United States
| | - Anusha S Yerraguntala
- Southern California Clinical and Translational Science Institute, University of Southern California, Los Angeles, CA, United States
| | - Stefanie D Vassar
- Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, UCLA, Los Angeles, CA, United States
| | - Aziza Lucas Wright
- Department of Preventive and Social Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, United States.,South Central Prevention Coalition, Los Angeles, CA, United States
| | - Donna L Washington
- Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, UCLA, Los Angeles, CA, United States.,VA Greater Los Angeles Healthcare System, Los Angeles, CA, United States
| | - Keith C Norris
- Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, UCLA, Los Angeles, CA, United States
| | - Arleen F Brown
- Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, UCLA, Los Angeles, CA, United States.,Olive View Medical Center, Los Angeles County Department of Health Services, Sylmar, CA, United States
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15
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Hayes T, Baskin L, Funchess T, Lowe S, Mayfield-Johnson S. Engaging African American Pastors in COVID-19 Research During a Pandemic: Lessons Learned. THE JOURNAL OF PASTORAL CARE & COUNSELING : JPCC 2021; 75:241-250. [PMID: 34851223 DOI: 10.1177/15423050211062547] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
African American pastors are recognized as trusted information sources for their communities. The pastors willing to address health-related concerns such as preventing the spread of the coronavirus are invaluable for leading their congregation through relevant health programs. Underlining the importance of religion, spirituality, and faith-based leaders in addressing and furthering health promotion research, the article discusses lessons learned during the study implementation and the recommendations for engaging minority pastors in research during a global health pandemic.
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Affiliation(s)
- Traci Hayes
- School of Health Professions (Department of Public Health), 5104University of Southern Mississippi, Hattiesburg, Mississippi, USA
| | - LaWanda Baskin
- School of Leadership and Advanced Nursing Practice (Department of Nursing), 5104University of Southern Mississippi, Hattiesburg, Mississippi, USA
| | - Tanya Funchess
- School of Health Professions (Department of Public Health), 5104University of Southern Mississippi, Hattiesburg, Mississippi, USA
| | - Samaria Lowe
- School of Health Professions (Department of Public Health), 5104University of Southern Mississippi, Hattiesburg, Mississippi, USA
| | - Susan Mayfield-Johnson
- School of Health Professions (Department of Public Health), 5104University of Southern Mississippi, Hattiesburg, Mississippi, USA
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16
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Kemper S, Bongers M, Slok E, Schoonmade LJ, Kupper J, Timen A. Patient and public engagement in decision-making regarding infectious disease outbreak management: an integrative review. BMJ Glob Health 2021; 6:bmjgh-2021-007340. [PMID: 34824137 PMCID: PMC8627369 DOI: 10.1136/bmjgh-2021-007340] [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: 08/31/2021] [Accepted: 11/09/2021] [Indexed: 11/26/2022] Open
Abstract
Introduction Worldwide, people experience the effects of infectious disease outbreaks on a regular basis. These effects vary from direct impact of the virus on health, to indirect impact of control measures on day-to-day life. Yet, incorporating the experiences, views and ideas of patients and the public in decision-making in managing outbreaks does not take place on a structural basis. However, this might be beneficial. We examined the current incorporation of patient and public engagement (PPE) in decision-making regarding outbreak management (OM). Methods A systematic search was executed in PubMed, Embase, APA PsycInfo, Web of Science, Scopus and other literature sources. Papers describing PPE in decision-making regarding OM on a collective level (group-level) were included. Relevant information about study characteristics, methods, impact and embedment of PPE in decision-making in OM was collected. Results The search yielded 4186 papers of which 13 were included. The papers varied in study context and design. Remarkably, no substantial patient engagement was identified. Overall, public engagement (PE) in decision-making regarding OM was mostly executed by a mix of methods, for example, workshops, interviews and surveys. Knowledge and idea sharing between the public and experts was deemed beneficial for establishing well-informed discussions. The efforts resulted in either direct implications for practice or recommendations in policy papers. Most papers described their efforts as a first step. No structural embedment of collective PE in decision-making regarding OM was identified. Furthermore, the quality of most papers was low to moderate due to insufficient description. Conclusion Overall, various practices for PE can be potentially valuable, but structural embedment in OM decision-making on a collective level was low. Before PPE can be permanently embedded in OM, more evidence on its impact needs to be collected. Furthermore, reporting on the engagement process and used terminology needs to be harmonised to ensure reproducibility and transparency.
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Affiliation(s)
- Sophie Kemper
- National Coordination Centre for Communicable Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands .,Athena Institute, VU University Amsterdam, Amsterdam, The Netherlands
| | - Mej Bongers
- National Coordination Centre for Communicable Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Ene Slok
- National Coordination Centre for Communicable Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - L J Schoonmade
- Medical Library, VU University Amsterdam, Amsterdam, The Netherlands
| | - Jfh Kupper
- Athena Institute, VU University Amsterdam, Amsterdam, The Netherlands
| | - A Timen
- National Coordination Centre for Communicable Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands.,Athena Institute, VU University Amsterdam, Amsterdam, The Netherlands
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17
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Green Energy—Green for Whom? A Case Study of the Kabinakagami River Waterpower Project in Northern Canada. SUSTAINABILITY 2021. [DOI: 10.3390/su13169445] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Green energy has become a term that heralds efforts of environmental conservation and protection worldwide; however, much of it is marred with questions of what it means to be green. More precisely, it has become a question of Green for whom? While many of the impacts of supposed green energy projects are local in their reach, some may be more regional in their scope, such as hydroelectric power. Hydroelectric power generation negatively impacts the environment and people who rely on the environment for sustenance, such as, Indigenous peoples of northern Canada. Taking into account their position with respect to the areas impacted by these green projects, many Indigenous peoples have voiced their concerns and doubts concerning green energy, which is purported to be a mode of energy production that champions the environment. The Kabinakagami River Waterpower Project serves as a case study for both the potential effects of the project and the different views associated with these endeavors. If nothing else, the accounts and testimonies found within shall stand as a testament to the hubris of calling an energy project green without properly assessing and considering the impacts. While these statements relate to the case presented, they also carry significance in the wider world due to the numerous Indigenous communities around the world that are having their spaces slowly being encroached upon in the name of sustainable growth, or green energy. This will especially be true in the post-COVID-19 period where green energy and a green economy are being touted as a way towards state and worldwide recovery.
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18
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Khorram-Manesh A, Dulebenets MA, Goniewicz K. Implementing Public Health Strategies-The Need for Educational Initiatives: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:5888. [PMID: 34070882 PMCID: PMC8198884 DOI: 10.3390/ijerph18115888] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 05/23/2021] [Accepted: 05/28/2021] [Indexed: 12/11/2022]
Abstract
In the absence of a specific treatment or vaccines, public health strategies are the main measures to use in the initial stages of a pandemic to allow surveillance of infectious diseases. During the ongoing global pandemic of coronavirus disease 2019 (COVID-19), several countries initiated various public health strategies, such as contact tracing and quarantine. The present study aims to conduct a systematic literature review to identify the presence of educational initiatives that promote the implementation of public health strategies before public health emergencies, with a special focus on contact tracing applications. Using Science Direct, PubMed, Scopus, and Gothenburg University search engines, all published scientific articles were included, while conference, reports, and non-scientific papers were excluded. The outcomes of the reviewed studies indicate that the effective implementation of public health strategies depends on the peoples' willingness to participate and collaborate with local authorities. Several factors may influence such willingness, of which ethical, psychological, and practical factors seem to be the most important and frequently discussed. Moreover, individual willingness and readiness of a community may also vary based on the acquired level of knowledge about the incident and its cause and available management options. Educational initiatives, proper communication, and timely information at the community level were found to be the necessary steps to counteract misinformation and to promote a successful implementation of public health strategies and attenuate the effects of a pandemic. The systematic review conducted as a part of this study would benefit the relevant stakeholders and policy makers and assist with effective designing and implementation.
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Affiliation(s)
- Amir Khorram-Manesh
- Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, 413 45 Gothenburg, Sweden
- Department of Development and Research, Armed Forces Center for Defense Medicine, Gothenburg, 426 76 Västra Frölunda, Sweden
| | - Maxim A. Dulebenets
- Department of Civil & Environmental Engineering, College of Engineering, Florida A&M University-Florida State University (FAMU-FSU), 2525 Pottsdamer Street, Building A, Suite A124, Tallahassee, FL 32310-6046, USA;
| | - Krzysztof Goniewicz
- Department of Aviation Security, Military University of Aviation, 08521 Deblin, Poland;
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19
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Chiam AL, Cheng NWI, Larson H. Community engagement for outbreak preparedness and response in high-income settings: A systematic review. Glob Public Health 2021; 17:1113-1135. [PMID: 33938368 DOI: 10.1080/17441692.2021.1919734] [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: 10/21/2022]
Abstract
BACKGROUND This review aims to (i) identify and critique existing methods of community engagement for outbreak preparedness and response in high-income settings, and (ii) understand community members' experiences of community engagement, and their views and concerns towards pandemic planning/response. METHODS Following the PRISMA guidelines, a systematic review was conducted by searching Medline, Embase, PubMed, Global Health, CINAHL Plus and Scopus for publications from 2004 to June 2019. Potential literature was screened using explicit inclusion and exclusion criteria. Included studies were appraised using the Critical Appraisal Skills Programme Qualitative Research checklist. Those using deliberative approaches were appraised using additional criteria for judging deliberation quality. Thematic synthesis was then conducted. RESULTS Primary studies employed participatory research approaches, deliberative forums, interviews/focus groups to engage community members on pandemic planning/response with varying degrees of involvement and methodological rigour. This review indicates such endeavours must take into account instrumental and relational considerations: socioeconomic pressures; agency and capacity; diversity and divergent views; educate, communicate and engage; trust and transparency. CONCLUSION Community engagement for pandemic planning/response requires clear methods, processes and who 'community' constitutes. Instrumental and relational considerations must be addressed concurrently in pandemic planning/response to enhance preparedness for public health emergencies.
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Affiliation(s)
| | | | - Heidi Larson
- London School of Hygiene & Tropical Medicine, London, UK
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20
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Abstract
The purpose of this article was to demonstrate the difference between a pandemic plan’s textual prescription and its effective processing using graphical notation. Before creating a case study of the Business Process Model and Notation (BPMN) of the Czech Republic’s pandemic plan, we conducted a systematic review of the process approach in pandemic planning and a document analysis of relevant public documents. The authors emphasized the opacity of hundreds of pages of text records in an explanatory case study and demonstrated the effectiveness of the process approach in reengineering and improving the response to such a critical situation. A potential extension to the automation and involvement of SMART technologies or process optimization through process mining techniques is presented as a future research topic.
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21
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Nelson H, Hubbard Murdoch N, Norman K. The Role of Uncertainty in the Experiences of Nurses During the Covid-19 Pandemic: A Phenomenological Study. Can J Nurs Res 2021; 53:124-133. [PMID: 33541124 DOI: 10.1177/0844562121992202] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The novel coronavirus (Covid-19) has spread quickly to all corners of the globe and caused high rates of morbidity and mortality. Nurses have been at the centre of this experience managing the outbreak through direct bedside care, managing hospital units, providing Covid-19 testing, and contact tracing. PURPOSE The aim of this article is to examine the role that nurses played in the early stages of the Covid-19 pandemic through the voices of the participants. METHODS Using a phenomenological methodology thirty-one interviews were completed via phone and thematic analysis was completed. RESULTS The major themes that emerged from this phenomenological study were: emotional challenges, uncertainty, and protective factors. Emotional challenges included, stress, anxiety, exhaustion, frustration, guilt, and loneliness. These challenges were magnified by uncertainty through leadership and communication challenges, needs of the pandemic versus needs of the patient, and Covid-19 and best practice. In this study, emotional challenges were mitigated by the protective factors of: education, ability to contribute, team cohesiveness, and community support. CONCLUSIONS Nurses are challenged during this time but by limiting uncertainty and providing protective factors, nurses can be less affected by emotional challenges and able to provide nursing care and manage the outbreak effectively.
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Affiliation(s)
- Heather Nelson
- Centre for Health Research, Improvement and Scholarship, Saskatchewan Polytechnic, Regina, Canada
| | - Natasha Hubbard Murdoch
- Centre for Health Research, Improvement and Scholarship, Saskatchewan Polytechnic, Regina, Canada
| | - Kasandra Norman
- Centre for Health Research, Improvement and Scholarship, Saskatchewan Polytechnic, Saskatoon, Canada
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22
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Harrison ME, Wijedasa LS, Cole LE, Cheyne SM, Choiruzzad SAB, Chua L, Dargie GC, Ewango CE, Honorio Coronado EN, Ifo SA, Imron MA, Kopansky D, Lestarisa T, O’Reilly PJ, Van Offelen J, Refisch J, Roucoux K, Sugardjito J, Thornton SA, Upton C, Page S. Tropical peatlands and their conservation are important in the context of COVID-19 and potential future (zoonotic) disease pandemics. PeerJ 2020; 8:e10283. [PMID: 33240628 PMCID: PMC7678489 DOI: 10.7717/peerj.10283] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 10/09/2020] [Indexed: 12/14/2022] Open
Abstract
The COVID-19 pandemic has caused global disruption, with the emergence of this and other pandemics having been linked to habitat encroachment and/or wildlife exploitation. High impacts of COVID-19 are apparent in some countries with large tropical peatland areas, some of which are relatively poorly resourced to tackle disease pandemics. Despite this, no previous investigation has considered tropical peatlands in the context of emerging infectious diseases (EIDs). Here, we review: (i) the potential for future EIDs arising from tropical peatlands; (ii) potential threats to tropical peatland conservation and local communities from COVID-19; and (iii) potential steps to help mitigate these risks. We find that high biodiversity in tropical peat-swamp forests, including presence of many potential vertebrate and invertebrate vectors, combined, in places, with high levels of habitat disruption and wildlife harvesting represent suitable conditions for potential zoonotic EID (re-)emergence. Although impossible to predict precisely, we identify numerous potential threats to tropical peatland conservation and local communities from the COVID-19 pandemic. This includes impacts on public health, with the potential for haze pollution from peatland fires to increase COVID-19 susceptibility a noted concern; and on local economies, livelihoods and food security, where impacts will likely be greater in remote communities with limited/no medical facilities that depend heavily on external trade. Research, training, education, conservation and restoration activities are also being affected, particularly those involving physical groupings and international travel, some of which may result in increased habitat encroachment, wildlife harvesting or fire, and may therefore precipitate longer-term negative impacts, including those relating to disease pandemics. We conclude that sustainable management of tropical peatlands and their wildlife is important for mitigating impacts of the COVID-19 pandemic, and reducing the potential for future zoonotic EID emergence and severity, thus strengthening arguments for their conservation and restoration. To support this, we list seven specific recommendations relating to sustainable management of tropical peatlands in the context of COVID-19/disease pandemics, plus mitigating the current impacts of COVID-19 and reducing potential future zoonotic EID risk in these localities. Our discussion and many of the issues raised should also be relevant for non-tropical peatland areas and in relation to other (pandemic-related) sudden socio-economic shocks that may occur in future.
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Affiliation(s)
- Mark E. Harrison
- Centre for Ecology and Conservation, College of Life and Environmental Sciences, University of Exeter, Penryn, UK
- Borneo Nature Foundation International, Penryn, UK
- School of Geography, Geology and the Environment, University of Leicester, Leicester, UK
| | - Lahiru S. Wijedasa
- Integrated Tropical Peatland Research Program (INTPREP), Environmental Research Institute, National University of Singapore, Singapore, Singapore
- ConservationLinks Pvt Ltd, Singapore, Singapore
| | - Lydia E.S. Cole
- School of Geography and Sustainable Development, University of St. Andrews, St. Andrews, UK
| | - Susan M. Cheyne
- Borneo Nature Foundation International, Penryn, UK
- Humanities and Social Sciences, Oxford Brookes University, Oxford, UK
- IUCN SSC PSG Section on Small Apes, Oxford, UK
| | - Shofwan Al Banna Choiruzzad
- Department of International Relations, Universitas Indonesia, Depok, Indonesia
- ASEAN Studies Center, Universitas Indonesia, Depok, Indonesia
| | - Liana Chua
- Department of Social and Political Sciences, Brunel University, London, UK
| | | | - Corneille E.N. Ewango
- Faculty of Renewable Natural Resources Management/Faculty of Sciences, University of Kisangani, Kisangani, DR Congo
| | | | - Suspense A. Ifo
- Laboratoire de Géomatique et d’Ecologie Tropicale Appliquée, Département des Sciences et Vie de la Terre, Ecole Normale Supérieure, Université Marien Ngouabi, Brazzaville, Republic of Congo
| | | | - Dianna Kopansky
- Global Peatlands Initiative, Ecosystems Division, United Nations Environment Programme, Nairobi, Kenya
| | - Trilianty Lestarisa
- Faculty of Medicine, Palangka Raya University, Palangka Raya, Kalteng, Indonesia
- Doctoral Program of Public Health, Airlangga University, Surabaya, Indonesia
| | - Patrick J. O’Reilly
- School of Geography, Geology and the Environment, University of Leicester, Leicester, UK
| | | | - Johannes Refisch
- Great Apes Survival Partnership, United Nations Environment Programme, Nairobi, Kenya
| | - Katherine Roucoux
- School of Geography and Sustainable Development, University of St. Andrews, St. Andrews, UK
| | - Jito Sugardjito
- Centre for Sustainable Energy and Resources Management, Universitas Nasional, Jakarta, Indonesia
- Faculty of Biology, Universitas Nasional, Jakarta, Indonesia
| | - Sara A. Thornton
- Borneo Nature Foundation International, Penryn, UK
- School of Geography, Geology and the Environment, University of Leicester, Leicester, UK
| | - Caroline Upton
- School of Geography, Geology and the Environment, University of Leicester, Leicester, UK
| | - Susan Page
- Borneo Nature Foundation International, Penryn, UK
- School of Geography, Geology and the Environment, University of Leicester, Leicester, UK
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23
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Graffigna G, Bosio C, Savarese M, Barello M, Barello S. "#I-Am-Engaged": Conceptualization and First Implementation of a Multi-Actor Participatory, Co-designed Social Media Campaign to Raise Italians Citizens' Engagement in Preventing the Spread of COVID-19 Virus. Front Psychol 2020; 11:567101. [PMID: 33250811 PMCID: PMC7674954 DOI: 10.3389/fpsyg.2020.567101] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 08/25/2020] [Indexed: 01/29/2023] Open
Abstract
The COVID-19 pandemic forced health authorities around the world to introduce public health measures to contain the risks of contagion. This greatly impacted on citizens' quality of life, often raising concerns and reactance. There is an ongoing urgent need to promote and sustain behavioral changes and adherence to preventive measures. Based on the theoretical framework of the Patient Health Engagement Model and a participatory co-design process, a social media campaign aimed at improving citizens' health engagement toward behavioral change for preventing the spread of COVID-19 was promoted in Italy in the early months of the pandemic. In this paper, we describe the methodological process adopted to develop the campaign, its characteristics, and the first results-in terms of audience reach and engagement in its early implementation. The discussion of this grounded-up and citizen-centered approach to social campaign development highlights key ways of promoting learning, engaging citizens, and supporting their participation in the co-production of educational interventions for behavioral change toward preventive actions.
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Affiliation(s)
- Guendalina Graffigna
- EngageMinds HUB – Consumer, Food and Health Engagement Research Center, Università Cattolica del Sacro Cuore, Milan, Italy
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
- Faculty of Agricultural, Nutrition and Environmental Sciences, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Caterina Bosio
- EngageMinds HUB – Consumer, Food and Health Engagement Research Center, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Mariarosaria Savarese
- EngageMinds HUB – Consumer, Food and Health Engagement Research Center, Università Cattolica del Sacro Cuore, Milan, Italy
- Faculty of Agricultural, Nutrition and Environmental Sciences, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Marina Barello
- EngageMinds HUB – Consumer, Food and Health Engagement Research Center, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Serena Barello
- EngageMinds HUB – Consumer, Food and Health Engagement Research Center, Università Cattolica del Sacro Cuore, Milan, Italy
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
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24
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Tsuji LJS, Tsuji SRJ, Zuk AM, Davey R, Liberda EN. Harvest Programs in First Nations of Subarctic Canada: The Benefits Go Beyond Addressing Food Security and Environmental Sustainability Issues. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8113. [PMID: 33153153 PMCID: PMC7663715 DOI: 10.3390/ijerph17218113] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 10/26/2020] [Accepted: 10/30/2020] [Indexed: 12/04/2022]
Abstract
By breaking down barriers that impacted the ability of subarctic First Nations people to harvest waterfowl, the Sharing-the-Harvest program provided a safe, nutritious, and culturally appropriate food (i.e., geese) to James Bay Cree communities while also helping to protect the environment by harvesting overabundant geese. However, the impacts extend beyond those described above. Thus, the objectives of the present paper are twofold: to document the food sharing networks of the Sharing-the-Harvest program; and to examine the benefits associated with the harvest program beyond food security and environmental sustainability issues, as revealed through semi-directed interviews. In the regional initiative, harvested geese were shared with all James Bay communities; sharing is an important part of Cree culture. Where detailed information was collected, the goose-sharing network reached 76% of the homes in one of the communities. Likewise, in the local initiative, the goose-sharing network had a 76% coverage rate of the homes in the community. Although decreasing food insecurity was an important focus of the harvest-sharing programs, there were other benefits, from an Indigenous perspective, of being on the land, as identified by the Cree harvesters through semi-directed interviews (e.g., the transmission of Indigenous knowledge, the strengthening of social networks, and the feeling of wellness while out on-the-land). Thus, by participating in the on-the-land harvest programs, the Cree gained benefits beyond those solely related to strengthening food security and contributing in part to environmental sustainability. The Sharing-the-Harvest protocol has the potential to be adapted and employed by other Indigenous (or marginalized) groups worldwide, to help improve health and wellness, while, also protecting the environment from overabundant and/or invasive species.
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Affiliation(s)
- Leonard J. S. Tsuji
- Department of Physical and Environmental Sciences, University of Toronto, Toronto, ON M1C 1A4, Canada;
| | - Stephen R. J. Tsuji
- School of Environmental Studies, Queen’s University, Kingston, ON K7L 3N6, Canada;
| | - Aleksandra M. Zuk
- Department of Physical and Environmental Sciences, University of Toronto, Toronto, ON M1C 1A4, Canada;
- School of Nursing, Faculty of Health Sciences, Queen’s University, Kingston, ON K7L 3N6, Canada
| | - Roger Davey
- Fort Albany First Nation, Fort Albany, ON P0L 1H0, Canada;
| | - Eric N. Liberda
- School of Occupational and Public Health, Ryerson University, Toronto, ON M5B 2K3, Canada;
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25
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Gilmore B, Ndejjo R, Tchetchia A, de Claro V, Mago E, Diallo AA, Lopes C, Bhattacharyya S. Community engagement for COVID-19 prevention and control: a rapid evidence synthesis. BMJ Glob Health 2020. [PMID: 33051285 DOI: 10.1136/bmjgh‐2020‐003188] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
INTRODUCTION Community engagement has been considered a fundamental component of past outbreaks, such as Ebola. However, there is concern over the lack of involvement of communities and 'bottom-up' approaches used within COVID-19 responses thus far. Identifying how community engagement approaches have been used in past epidemics may support more robust implementation within the COVID-19 response. METHODOLOGY A rapid evidence review was conducted to identify how community engagement is used for infectious disease prevention and control during epidemics. Three databases were searched in addition to extensive snowballing for grey literature. Previous epidemics were limited to Ebola, Zika, SARS, Middle East respiratory syndromeand H1N1 since 2000. No restrictions were applied to study design or language. RESULTS From 1112 references identified, 32 articles met our inclusion criteria, which detail 37 initiatives. Six main community engagement actors were identified: local leaders, community and faith-based organisations, community groups, health facility committees, individuals and key stakeholders. These worked on different functions: designing and planning, community entry and trust building, social and behaviour change communication, risk communication, surveillance and tracing, and logistics and administration. CONCLUSION COVID-19's global presence and social transmission pathways require social and community responses. This may be particularly important to reach marginalised populations and to support equity-informed responses. Aligning previous community engagement experience with current COVID-19 community-based strategy recommendations highlights how communities can play important and active roles in prevention and control. Countries worldwide are encouraged to assess existing community engagement structures and use community engagement approaches to support contextually specific, acceptable and appropriate COVID-19 prevention and control measures.
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Affiliation(s)
- Brynne Gilmore
- UCD Centre for Interdisciplinary Research, Education and Innovation in Health Systems (UCD IRIS), School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - Rawlance Ndejjo
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Adalbert Tchetchia
- Expanded Programme on Immunization, Ministry of Health, Yaoundé, Cameroon
| | | | - Elizabeth Mago
- Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts, USA
| | - Alpha A Diallo
- République de Guinée Ministère de Santé, Conakry, Guinea
| | - Claudia Lopes
- United Nations University International Institute for Global Health, Kuala Lumpur, Kuala Lumpur, Malaysia
| | - Sanghita Bhattacharyya
- Public Health Foundation of India, Haryana, India.,Community Health-Community of Practice Collectivity, United Nations Children's Fund (UNICEF) Headquarters, New York City, New York, USA
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26
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Gilmore B, Ndejjo R, Tchetchia A, de Claro V, Mago E, Diallo AA, Lopes C, Bhattacharyya S. Community engagement for COVID-19 prevention and control: a rapid evidence synthesis. BMJ Glob Health 2020; 5:e003188. [PMID: 33051285 PMCID: PMC7554411 DOI: 10.1136/bmjgh-2020-003188] [Citation(s) in RCA: 164] [Impact Index Per Article: 41.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 08/24/2020] [Accepted: 08/25/2020] [Indexed: 01/15/2023] Open
Abstract
INTRODUCTION Community engagement has been considered a fundamental component of past outbreaks, such as Ebola. However, there is concern over the lack of involvement of communities and 'bottom-up' approaches used within COVID-19 responses thus far. Identifying how community engagement approaches have been used in past epidemics may support more robust implementation within the COVID-19 response. METHODOLOGY A rapid evidence review was conducted to identify how community engagement is used for infectious disease prevention and control during epidemics. Three databases were searched in addition to extensive snowballing for grey literature. Previous epidemics were limited to Ebola, Zika, SARS, Middle East respiratory syndromeand H1N1 since 2000. No restrictions were applied to study design or language. RESULTS From 1112 references identified, 32 articles met our inclusion criteria, which detail 37 initiatives. Six main community engagement actors were identified: local leaders, community and faith-based organisations, community groups, health facility committees, individuals and key stakeholders. These worked on different functions: designing and planning, community entry and trust building, social and behaviour change communication, risk communication, surveillance and tracing, and logistics and administration. CONCLUSION COVID-19's global presence and social transmission pathways require social and community responses. This may be particularly important to reach marginalised populations and to support equity-informed responses. Aligning previous community engagement experience with current COVID-19 community-based strategy recommendations highlights how communities can play important and active roles in prevention and control. Countries worldwide are encouraged to assess existing community engagement structures and use community engagement approaches to support contextually specific, acceptable and appropriate COVID-19 prevention and control measures.
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Affiliation(s)
- Brynne Gilmore
- UCD Centre for Interdisciplinary Research, Education and Innovation in Health Systems (UCD IRIS), School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - Rawlance Ndejjo
- Department of Disease Control and Environmental Health, School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Adalbert Tchetchia
- Expanded Programme on Immunization, Ministry of Health, Yaoundé, Cameroon
| | | | - Elizabeth Mago
- Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts, USA
| | - Alpha A Diallo
- République de Guinée Ministère de Santé, Conakry, Guinea
| | - Claudia Lopes
- United Nations University International Institute for Global Health, Kuala Lumpur, Kuala Lumpur, Malaysia
| | - Sanghita Bhattacharyya
- Public Health Foundation of India, Haryana, India
- Community Health-Community of Practice Collectivity, United Nations Children's Fund (UNICEF) Headquarters, New York City, New York, USA
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27
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O'Sullivan B, Leader J, Couch D, Purnell J. Rural Pandemic Preparedness: The Risk, Resilience and Response Required of Primary Healthcare. Risk Manag Healthc Policy 2020; 13:1187-1194. [PMID: 32904086 PMCID: PMC7450525 DOI: 10.2147/rmhp.s265610] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 07/24/2020] [Indexed: 11/23/2022] Open
Abstract
Pandemic situations present enormous risks to essential rural primary healthcare (PHC) teams and the communities they serve. Yet, the pandemic policy development for rural contexts remains poorly defined. This article draws on reflections of the rural PHC response during the COVID-19 pandemic around three elements: risk, resilience, and response. Rural communities have nuanced risks related to their mobility and interaction patterns coupled with heightened population needs, socio-economic disadvantage, and access and health service infrastructure challenges. This requires specific risk assessment and communication which addresses the local context. Pandemic resilience relies on qualified and stable PHC teams using flexible responses and resources to enable streams of pandemic-related healthcare alongside ongoing primary healthcare. This depends on problem solving within limited resources and using networks and collaborations to enable healthcare for populations spread over large geographic catchments. PHC teams must secure systems for patient retrieval and managing equipment and resources including providing for situations where supply chains may fail and staff need rest. Response consists of rural PHC teams adopting new preventative clinics, screening and ambulatory models to protect health workers from exposure whilst maximizing population screening and continuity of healthcare for vulnerable groups. Innovative models that emerge during pandemics, including telehealth clinics, may bear specific evaluation for informing ongoing rural health system capabilities and patient access. It is imperative that mainstream pandemic policies recognize the nuance of rural settings and address resourcing and support strategies to each level of rural risk, resilience, and response for a strong health system ready for surge events.
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Affiliation(s)
- Belinda O'Sullivan
- Rural Clinical School, University of Queensland, Toowoomba, Queensland, Australia
| | - Joelena Leader
- Edwards School of Business, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Danielle Couch
- School of Rural Health, Monash University, Bendigo, Victoria, Australia
| | - James Purnell
- Department of Academic Family Medicine Northern Medical Services, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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28
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de Vries DH, Kinsman J, Takacs J, Tsolova S, Ciotti M. Methodology for assessment of public health emergency preparedness and response synergies between institutional authorities and communities. BMC Health Serv Res 2020; 20:411. [PMID: 32393259 PMCID: PMC7212582 DOI: 10.1186/s12913-020-05298-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 05/06/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This paper describes a participatory methodology that supports investigation of the synergistic collaboration between communities affected by infectious disease outbreak events and relevant official institutions. The core principle underlying the methodology is the recognition that synergistic relationships, characterised by mutual trust and respect, between affected communities and official institutions provide the most effective means of addressing outbreak situations. METHODS The methodological approach and lessons learned were derived from four qualitative case studies including (i) two tick-borne disease events (Crimean-Congo haemorrhagic fever in Spain, 2016, and tick-borne encephalitis in the Netherlands, 2016); and (ii) two outbreaks of acute gastroenteritis (norovirus in Iceland, 2017, and verocytotoxin-producing Escherichia coli [VTEC] in Ireland, 2018). An after-event qualitative case study approach was taken using mixed methods. The studies were conducted in collaboration with the respective national public health authorities in the affected countries by the European Centre for Disease Prevention and Control (ECDC). The analysis focused on the specific actions undertaken by the participating countries' public health and other authorities in relation to community engagement, as well as the view from the perspective of affected communities. RESULTS Lessons highlight the critical importance of collaborating with ECDC National Focal Points during preparation and planning and with anthropological experts. Field work for each case study was conducted over one working week, which although limiting the number of individuals and institutions involved, still allowed for rich data collection due to the close collaboration with local authorities. The methodology enabled efficient extraction of synergies between authorities and communities. Implementing the methodology required a reflexivity among fieldworkers that ackowledges that different versions of reality can co-exist in the social domain. The method allowed for potential generalisability across studies. Issues of extra attention included insider-outsider perspectives, politically sensitivity of findings, and how to deal with ethical and language issues. CONCLUSIONS The overall objective of the assessment is to identify synergies between institutional decision-making bodies and community actors and networks before, during and after an outbreak response to a given public health emergency. The methodology is generic and could be applied to a range of public health emergencies, zoonotic or otherwise.
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Affiliation(s)
- Daniel H de Vries
- Department of Anthropology, University of Amsterdam, Nieuwe Achtergracht 166, 1018, WV, Amsterdam, the Netherlands.
| | - John Kinsman
- European Centre for Disease Prevention and Control, Gustav III:s Boulevard 40, 169 73, Solna, Sweden
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Judit Takacs
- European Centre for Disease Prevention and Control, Gustav III:s Boulevard 40, 169 73, Solna, Sweden
- Centre for Social Sciences, Hungarian Academy of Sciences, Budapest, Hungary
| | - Svetla Tsolova
- European Centre for Disease Prevention and Control, Gustav III:s Boulevard 40, 169 73, Solna, Sweden
| | - Massimo Ciotti
- European Centre for Disease Prevention and Control, Gustav III:s Boulevard 40, 169 73, Solna, Sweden
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29
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Schoch-Spana M, Brunson EK, Gwon H, Regenberg A, Toner ES, Daugherty-Biddison EL. Influence of Community and Culture in the Ethical Allocation of Scarce Medical Resources in a Pandemic Situation: Deliberative Democracy Study. J Particip Med 2020; 12:e18272. [PMID: 33064107 PMCID: PMC7141421 DOI: 10.2196/18272] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 03/20/2020] [Accepted: 03/20/2020] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Stark gaps exist between projected health needs in a pandemic situation and the current capacity of health care and medical countermeasure systems. Existing pandemic ethics discussions have advocated to engage the public in scarcity dilemmas and attend the local contexts and cultural perspectives that shape responses to a global health threat. This public engagement study thus considers the role of community and culture in the ethical apportionment of scarce health resources, specifically ventilators, during an influenza pandemic. It builds upon a previous exploration of the values and preferences of Maryland residents regarding how a finite supply of mechanical ventilators ought to be allocated during a severe global outbreak of influenza. An important finding of this earlier research was that local history and place within the state engendered different ways of thinking about scarcity. OBJECTIVE Given the intrastate variation in the themes expressed by Maryland participants, the project team sought to examine interstate differences by implementing the same protocol elsewhere to answer the following questions. Does variation in ethical frames of reference exist within different regions of the United States? What practical implications does evidence of sameness and difference possess for pandemic planners and policymakers at local and national levels? METHODS Research using the same deliberative democracy process from the Maryland study was conducted in Central Texas in March 2018 among 30 diverse participants, half of whom identified as Hispanic or Latino. Deliberative democracy provides a moderated process through which community members can learn facts about a public policy matter from experts and explore their own and others' views. RESULTS Participants proposed that by evenly distributing supplies of ventilators and applying clear eligibility criteria consistently, health authorities could enable fair allocation of scarce lifesaving equipment. The strong identification, attachment, and obligation of persons toward their nuclear and extended families emerged as a distinctive regional and ethnic core value that has practical implications for the substance, administration, and communication of allocation frameworks. CONCLUSIONS Maryland and Central Texas residents expressed a common, overriding concern about the fairness of allocation decisions. Central Texas deliberants, however, more readily expounded upon family as a central consideration. In Central Texas, family is a principal, culturally inflected lens through which life and death matters are often viewed. Conveners of other pandemic-related public engagement exercises in the United States have advocated the benefits of transparency and inclusivity in developing an ethical allocation framework; this study demonstrates cultural competence as a further advantage.
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Affiliation(s)
- Monica Schoch-Spana
- Johns Hopkins Center for Health Security, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Emily K Brunson
- Department of Anthropology, Texas State University, San Marcos, TX, United States
| | - Howard Gwon
- Department of Environmental Sciences, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Alan Regenberg
- Johns Hopkins Berman Institute of Bioethics, Johns Hopkins University, Baltimore, MD, United States
| | - Eric S Toner
- Johns Hopkins Center for Health Security, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Elizabeth L Daugherty-Biddison
- Division of Pulmonary and Critical Care Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, United States
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30
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Dadich A, Moore L, Eapen V. What does it mean to conduct participatory research with Indigenous peoples? A lexical review. BMC Public Health 2019; 19:1388. [PMID: 31660911 PMCID: PMC6819462 DOI: 10.1186/s12889-019-7494-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Accepted: 08/14/2019] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND To better understand and promote public health, participatory research with Indigenous peoples represents recommended practice, worldwide. However, due to the different ways such research is referred to, described, and used, it is unclear what might (and might not) warrant the term when collaborating with Indigenous peoples. As such, this article expands conceptual understandings of participatory research with Indigenous peoples, across timelines and regions. METHOD Following a systematic search of 29 academic databases in April 2018, a lexical analysis of the methods sections was conducted, which were sourced from 161 publications across 107 journals. RESULTS The active involvement of Indigenous peoples in research that is expressly participatory is limited across all project phases. This might be because the ways in which Indigenous peoples were involved throughout were not reported - however, it might also be because Indigenous peoples were not involved in all project phases. Furthermore, descriptions differ by study location and publication timeframe - notably, studies in the region of the Americas chiefly refer to pandemics, surveyors, and art; and those published in the last two decades have given primacy to artifacts of interest. CONCLUSIONS Findings from this corpus of data suggest participatory research with Indigenous peoples is not always described across different project phases; furthermore, it differs according to study location and publication timeframe. This offers considerable opportunity to further this important research area via alternative methodologies that award primacy to Indigenous expertise and agency.
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Affiliation(s)
- Ann Dadich
- School of Business, Western Sydney University, 169 Macquarie Street, Parramatta, NSW, 2150, Australia. .,1797 Locked Bag, Western Sydney University, 1797 Locked Bag, Penrith, NSW, 2751, Australia.
| | - Loretta Moore
- Autism Spectrum Australia (Aspect), Building 1, Level 2, 14 Aquatic Drive, Frenchs Forest, NSW, 2086, Australia.,, Forestville, NSW, 2087, Australia
| | - Valsamma Eapen
- Academic Unit of Infant, Child, Adolescent Psychiatry South West Sydney, University of New South Wales, Sydney, Australia.,ICAMHS, L1 MHC, Liverpool Hospital, Elizabeth Street, Liverpool, NSW, 2170, Australia.,University of New South Wales Sydney, Sydney, NSW, 2052, Australia
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31
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Kovesi T. Respiratory medicine in Nunavut and Northern Canada. CANADIAN JOURNAL OF RESPIRATORY, CRITICAL CARE, AND SLEEP MEDICINE 2019. [DOI: 10.1080/24745332.2018.1483784] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Thomas Kovesi
- Department of Pediatrics, Children’s Hospital of Eastern Ontrio, Ottawa, Ontario, Canada
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Planning for and responding to pandemic influenza emergencies: it's time to listen to, prioritize and privilege Aboriginal perspectives. Western Pac Surveill Response J 2018; 9:5-7. [PMID: 31832246 PMCID: PMC6902653 DOI: 10.5365/wpsar.2018.9.5.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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McMahon SA, Ho LS, Scott K, Brown H, Miller L, Ratnayake R, Ansumana R. "We and the nurses are now working with one voice": How community leaders and health committee members describe their role in Sierra Leone's Ebola response. BMC Health Serv Res 2017; 17:495. [PMID: 28720090 PMCID: PMC5516346 DOI: 10.1186/s12913-017-2414-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 06/28/2017] [Indexed: 11/11/2022] Open
Abstract
Background Across low-income settings, community volunteers and health committee members support the formal health system - both routinely and amid emergencies - by engaging in health services such as referrals and health education. During the 2014–2015 Ebola epidemic, emerging reports suggest that community engagement was instrumental in interrupting transmission. Nevertheless, literature regarding community volunteers’ roles during emergencies generally, and Ebola specifically, is scarce. This research outlines what this cadre of the workforce did, how they coped, and the facilitators and barriers they faced to providing care in Sierra Leone. Methods Thirteen focus group discussions (FGD) were conducted with community members (including members of Health Management Committees (HMC)) near the height of the Ebola epidemic in two districts of Sierra Leone: Bo and Kenema. Conducted in either Krio or Mende, each FGD lasted an average of two hours and was led by a trained moderator who was accompanied by a note taker. All FGDs were audio recorded, transcribed, and translated into English by the data collection team. Analysis followed a modified framework approach, which entailed coding (both inductive and deductive), arrangement of codes into themes, and drafting, distribution and discussion of analytic summaries across the study team. Results Community volunteers and HMC members described engaging in labor-related tasks (e.g. building isolation structures, digging graves) and administrative/community-outreach tasks (e.g. screening, contact tracing, and encouraging care seeking within facilities). Through their dual orientation as community members and as individuals linked to the health system, respondents described building community trust and support for Ebola prevention and treatment, while also enabling formal health workers to better understand and address people’s fears and needs. Community volunteers’ main concerns included inadequate communication with - and a sense of being forgotten by - the health system, negative perceptions of their role within their communities, and concerns regarding the amount and nature of their compensation. Discussion & Conclusion Respondents described commitment to supporting their health system and their communities during the Ebola crisis. The health system could more effectively harness the potential of local responders by recognizing community strengths and weaknesses, as well as community volunteers’ motivations and limitations. Clarifying the roles, responsibilities, and remuneration of health volunteers to the recipients themselves, facility-based staff, and the wider community will enable organizations that partner with health committees to bolster trust, manage expectations, and reinforce collaboration.
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Affiliation(s)
- Shannon A McMahon
- Institute of Public Health, Heidelberg University, Heidelberg, Germany.,Associate in International Health, Johns Hopkins School of Public Health, Baltimore, MD, USA
| | - Lara S Ho
- Associate in International Health, Johns Hopkins School of Public Health, Baltimore, MD, USA.,The International Rescue Committee, New York, NY, USA
| | - Kerry Scott
- Associate in International Health, Johns Hopkins School of Public Health, Baltimore, MD, USA.,Global Health Consultant, Bangalore, India
| | - Hannah Brown
- Anthropology Department, Durham University, Durham, England, UK
| | - Laura Miller
- International Rescue Committee, Freetown, Sierra Leone
| | | | - Rashid Ansumana
- Department of Community Health and Clinical Studies, School of Community Health Sciences, Njala University; Mercy Hospital Research Laboratory, Bo, Sierra Leone.
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Renzaho AMN. Dissecting and customising the Childhood Obesity Prevention Advisory Council (COPAC): the development and application of a community engagement framework to improve childhood obesity prevention among migrant populations. Glob Health Action 2017; 10:1321822. [PMID: 28573912 PMCID: PMC5496055 DOI: 10.1080/16549716.2017.1321822] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background: Migrant communities in Australia bear a disproportionate childhood obesity burden. They also show poor engagement in obesity prevention initiatives which may contribute to widening obesity disparities. Community engagement has been shown to be effective in reducing health disparities by improving migrant communities’ participation in prevention programmes. Objective: This study aimed to develop a community engagement framework to improve childhood obesity prevention among migrants. Design: Based on the African Review Panel model and the Community-Based Participatory Research conceptual logic model, the Childhood Obesity Prevention Advisory Council (COPAC) framework was developed and established in four disadvantaged areas in Victoria, Australia. The COPAC included service providers and migrant community members from the same project’s site. Results: COPAC demonstrated several benefits including cross-organisational and multidisciplinary collaborations; understanding of the cultural barriers in childhood obesity prevention; enthusiasm from the COPAC members in addressing childhood obesity in their multicultural communities; equitable involvement, motivation, and empowerment of COPAC members in research development; and establishing organisational affiliations to foster long-term community involvement. This study also documented several challenges in community engagement including lack of prioritisation of migration-related childhood obesity disparities by the policymakers; staffing constraints among service providers leading to frequent disruptions in COPAC members’ contributions; and lack of adequate training and skill-building of bicultural workers. Conclusions: The COPAC model adopted a flexible and dynamic community engagement process to suit the ongoing needs of the migrant community which incorporated the existing talents and resources within the community. For effective community engagement of migrant communities, it is important for policymakers to develop the knowledge, capacity and skills of the bicultural migrant workforce. Integrating both service providers and migrant community members in the COPAC has demonstrated that a multifaceted community-led approach has the potential to reduce childhood obesity-related disparities in Australia.
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Affiliation(s)
- A M N Renzaho
- a Humanitarian and Development Studies, School of Social Sciences and Psychology , Western Sydney University , Penrith , NSW , Australia
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Outbreak of Salmonella Reading in persons of Eastern Mediterranean origin in Canada, 2014-2015. ACTA ACUST UNITED AC 2017; 43:14-20. [PMID: 29770042 DOI: 10.14745/ccdr.v43i01a03] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Background Salmonella Reading (S. Reading) is a rare serotype of Salmonella subspecies (spp.) in Canada with less than nine cases reported each year (2011-2013). An increase in S. Reading was identified in several Canadian provinces in early 2015, prompting the initiation of a national outbreak investigation. Objectives To describe a multi-provincial S. Reading outbreak in Canada that affected over 30 people. Methods Cases were defined as laboratory-confirmed S. Reading with related pulsed-field gel electrophoresis (PFGE) patterns. Onset dates were between November 2014 and September 2015.: Early in the investigation, investigators noted cases were predominantly of Eastern Mediterranean origin, mainly Afghan and Lebanese and many of those affected had consumed food items not typically captured on standard enteric outbreak hypothesis-generating questionnaires. An open-ended three day food consumption survey was conducted with a convenience sample of community informants to better understand food preferences of the affected ethnocultural populations. Results of the survey were used to design a focused questionnaire for case re-interviews and subsequent outbreak cases. Public health investigators obtained food samples from case homes and relevant food premises. Food safety authorities conducted traceback of suspected food items and collected food samples for laboratory testing. Results There were 31 confirmed cases (Ontario=23, Alberta=7, New Brunswick=1) and three probable (Ontario=2, Alberta=1) cases of S. Reading identified as part of the outbreak. The median age was 31 years (range less than one to 85 years) and 53% (18/34) of cases were female. Seven cases were hospitalized. No deaths were reported. Most cases were of Eastern Mediterranean origin (n=23) or had reported consuming Eastern Mediterranean foods (n=3). The predominant ethnic origins reported by cases were Afghan in Ontario (n=12) and Lebanese in Alberta (n=3). Genetic similarity of clinical isolates was further confirmed using whole genome sequencing.: Three ethnic bakeries were identified as possible common exposures for the cases; however, traceback of foods of interest from these bakeries did not identify a common supplier and the source of the illness was not identified. In total, 227 food samples from retail premises (n=142), restaurants (n=13) and case homes (n=72) were tested; two food samples, kalonji seeds and tahini, were positive for S. Ruiru and S. Meleagridis. These products were recalled from the marketplace. Conclusion Despite extensive epidemiological, microbiological and food traceback investigations, a common source was not identified for this S. Reading outbreak. Challenges included lack of familiarity with the food items consumed in affected ethnocultural groups, as well as a lack of background data on expected food exposures in the outbreak population. Engaging local partners helped build understanding of food preferences in affected communities. Given Canada's ethnic and cultural diversity, culturally competent approaches to enteric outbreak investigations and food consumption surveys may be useful.
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Bodewes AJ, Kunst AE. Involving hard-to-reach ethnic minorities in low-budget health research: lessons from a health survey among Moluccans in the Netherlands. BMC Res Notes 2016; 9:319. [PMID: 27328767 PMCID: PMC4915185 DOI: 10.1186/s13104-016-2124-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Accepted: 06/14/2016] [Indexed: 11/10/2022] Open
Abstract
Background There is little evidence on which strategies are effective in recruiting minority groups in low-budget health surveys. We evaluated different recruitment strategies for their impact on response rates in a hard-to-reach minority population in the Netherlands. Methods We conducted a health survey in 19 Moluccan districts (MDs). Each MD had its own set of recruitment strategies, such as information meetings, involving social or local media, involving community organizations, and door-to-door collection. The association between recruitment strategies and MD-specific response rates was assessed with logistic regression analysis. Results The overall response rate was 24 %, and varied from 9 to 58 %. Higher rates were obtained when the strategy included door-to-door collection (OR 1.57) and ‘active’ key informants (OR 1.68). No positive associations with response rates were observed of the other strategies. Conclusions The overall low response rate in this study may be due to high levels of distrust, segmentation within the community and high respect for privacy among Moluccans. Our study shows that in such communities, response may be increased by a highly personal recruitment approach and a strong commitment and participation of community key-figures.
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Affiliation(s)
- Adee J Bodewes
- Department of Public Health, Academic Medical Centre, PO Box 22660, 1100 DD, Amsterdam, The Netherlands.
| | - Anton E Kunst
- Department of Public Health, Academic Medical Centre, PO Box 22660, 1100 DD, Amsterdam, The Netherlands
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Cyril S, Smith BJ, Possamai-Inesedy A, Renzaho AMN. Exploring the role of community engagement in improving the health of disadvantaged populations: a systematic review. Glob Health Action 2015; 8:29842. [PMID: 26689460 PMCID: PMC4685976 DOI: 10.3402/gha.v8.29842] [Citation(s) in RCA: 215] [Impact Index Per Article: 23.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Revised: 11/02/2015] [Accepted: 11/20/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Although community engagement (CE) is widely used in health promotion, components of CE models associated with improved health are poorly understood. This study aimed to examine the magnitude of the impact of CE on health and health inequalities among disadvantaged populations, which methodological approaches maximise the effectiveness of CE, and components of CE that are acceptable, feasible, and effective when used among disadvantaged populations. DESIGN The systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We carried out methodological assessments of the included studies using rating scales. The analysis focussed on model synthesis to identify the key CE components linked to positive study outcomes and comparative analysis between positive study outcomes, processes, and quality indicators of CE. RESULTS Out of 24 studies that met our inclusion criteria, 21 (87.5%) had positively impacted health behaviours, public health planning, health service access, health literacy, and a range of health outcomes. More than half of the studies (58%) were of good quality, whereas 71% and 42% of studies showed good community involvement in research and achieved high levels of CE, respectively. Key CE components that affected health outcomes included real power-sharing, collaborative partnerships, bidirectional learning, incorporating the voice and agency of beneficiary communities in research protocol, and using bicultural health workers for intervention delivery. CONCLUSIONS The findings suggest that CE models can lead to improved health and health behaviours among disadvantaged populations if designed properly and implemented through effective community consultation and participation. We also found several gaps in the current measurement of CE in health intervention studies, which suggests the importance of developing innovative approaches to measure CE impact on health outcomes in a more rigorous way.
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Affiliation(s)
- Sheila Cyril
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- School of Social Sciences and Psychology, Western Sydney University, Penrith, NSW, Australia
| | - Ben J Smith
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Alphia Possamai-Inesedy
- Office of the Pro-Vice Chancellor Arts (Education), Western Sydney University, Bankstown, NSW, Australia
| | - Andre M N Renzaho
- Humanitarian and Development Studies, School of Social Sciences and Psychology, Western Sydney University, Penrith, NSW, Australia;
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Emerging infectious disease (EID) communication during the 2009 H1N1 influenza outbreak: literature review (2009-2013) of the methodology used for EID communication analysis. Disaster Med Public Health Prep 2015; 9:199-206. [PMID: 25882126 DOI: 10.1017/dmp.2014.126] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE This year alone has seen outbreaks of epidemics such as Ebola, Chikungunya, and many other emerging infectious diseases (EIDs). We must look to the responses of recent outbreaks to help guide our strategies in current and future outbreaks or we risk repeating the same mistakes. The objective of this paper was to conduct a systematic literature review of the methodology used by studies that examined EID communication during the 2009 H1N1 pandemic outbreak through different communication channels or by analyzing contents and strategies. METHODS This was a systematic review of the literature (n=61) studying risk communication strategies of H1N1 influenza, published between 2009 and 2013, and retrieved from searches of computerized databases, hand searches, and authoritative texts by use of specific search criteria. Searches were followed by review, categorization, and mixed qualitative and quantitative content analysis. RESULTS Of 41 articles that used quantitative methods, most used surveys (n=35); some employed content analyses (n=4) and controlled trials (n=2). The 16 articles that employed qualitative methods relied on content analyses (n=10), semi-structured interviews (n=2) and focus groups (n=4). Four more articles used mixed-methods or nonstandard methods. Seven different topic categories were found: risk perception and effects on behaviors, framing the risk in the media, public concerns, trust, optimistic bias, uncertainty, and evaluating risk communication. CONCLUSIONS Up until 2013, studies tended to be descriptive and quantitative rather than discursive and qualitative and to focus on the role of the media as representing information and not as a medium for actual communication with the public. Several studies from 2012, and increasingly more in 2013, addressed issues of discourse and framing and the complexity of risk communication with the public. Formative evaluations that use recommendations from past research when designing communication campaigns from the first stages of crises are recommended. Research should employ diverse triangulation processes based on representatives from different stakeholders. Further studies should address the potential offered by social media to create dialogue with individuals and the public at large.
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Driedger SM, Maier R, Furgal C, Jardine C. Factors influencing H1N1 vaccine behavior among Manitoba Metis in Canada: a qualitative study. BMC Public Health 2015; 15:128. [PMID: 25884562 PMCID: PMC4334920 DOI: 10.1186/s12889-015-1482-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Accepted: 01/27/2015] [Indexed: 11/11/2022] Open
Abstract
Background During the first wave of the H1N1 influenza pandemic in 2009, Aboriginal populations in Canada experienced disproportionate rates of infection, particularly in the province of Manitoba. To protect those thought to be most at-risk, health authorities in Manitoba listed all Aboriginal people, including Metis, among those able to receive priority access to the novel vaccine when it first became available. Currently, no studies exist that have investigated the attitudes, influences, and vaccine behaviors among Aboriginal communities in Canada. This paper is the first to systematically connect vaccine behavior with the attitudes and beliefs that influenced Metis study participants’ H1N1 vaccine decision-making. Methods Researchers held focus groups (n = 17) with Metis participants in urban, rural, and remote locations of Manitoba following the conclusion of the H1N1 pandemic. Participants were asked about their vaccination decisions and about the factors that influenced their decisions. Following data collection, responses were coded into the broad categories of a social-ecological model, nuanced by categories stemming from earlier research. Responses were then quantified to show the most influential factors in positively or negatively affecting the vaccine decision. Results Media reporting, the influence of peer groups, and prioritization all had positive and negative influential effects on decision making. Whether vaccinated or not, the most negatively influential factors cited by participants were a lack of knowledge about the vaccine and the pandemic as well as concerns about vaccine safety. Risk of contracting H1N1 influenza was the biggest factor in positively influencing a vaccine decision, which in many cases trumped any co-existing negative influencers. Conclusions Metis experiences of colonialism in Canada deeply affected their perceptions of the vaccine and pandemic, a context that health systems need to take into account when planning response activities in the future. Participants felt under-informed about most aspects of the vaccine and the pandemic, and many vaccine related misconceptions and fears existed. Recommendations include leveraging doctor-patient interactions as a site for sharing vaccine-related knowledge, as well as targeted, culturally-appropriate, and empowering public information strategies to supply reliable vaccine and pandemic information to potentially at-risk Aboriginal populations.
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Affiliation(s)
- S Michelle Driedger
- Department of Community Health Sciences, University of Manitoba, S113-750 Bannatyne Avenue, Winnipeg, Canada.
| | - Ryan Maier
- Department of Community Health Sciences, University of Manitoba, S113-750 Bannatyne Avenue, Winnipeg, Canada.
| | - Chris Furgal
- Indigenous Environment Studies Program, Trent University, 1600 West Bank Drive, Peterborough, Canada.
| | - Cindy Jardine
- School of Public Health, University of Alberta, 11405 - 87 Ave, Edmonton, Canada.
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Glik DC, Eisenman DP, Zhou Q, Tseng CH, Asch SM. Using the Precaution Adoption Process model to describe a disaster preparedness intervention among low-income Latinos. HEALTH EDUCATION RESEARCH 2014; 29:272-283. [PMID: 24399266 DOI: 10.1093/her/cyt109] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Only 40-50% of households in the United States are currently disaster prepared. In this intervention study, respondent-driven sampling was used to select a sample (n = 187) of low income, Latino residents of Los Angeles County, randomly assigned into two treatment conditions: (i) household preparedness education received through 'promotora' (community health worker) led small group meetings, and (ii) household preparedness education received through print media. Weinstein's Precaution Adoption Process, a stage model appropriate for risk communication guided the intervention. Outcomes are conceptualized as stages of decision making linked to having disaster supplies and creating a family communication plan. Quantitative results showed a significant shift over time from awareness to action and maintenance stages for disaster communication plans and supplies in both study arms; however, the shift in stage for a communication plan for those in the 'platica' study arm was (P < 0.0001) than for those in the media arm. For changes in stage linked to disaster supplies, people in both media and 'platica' study arms improved at the same rate. Simple media-based communications may be sufficient to encourage disadvantaged households to obtain disaster supplies; however, adoption of the more complex disaster family communication requires interpersonal education.
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Affiliation(s)
- Deborah C Glik
- Department of Community Health Sciences, UCLA Fielding School of Public Health, 650 South Charles E. Young Drive, PO Box 95-1772, Los Angeles, CA 90095-1772, USA, Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at UCLA, Los Angeles, California 90095-1736, USA, Department of Medicine, VA, Greater Los Angeles Health Care System, Los Angeles, CA 90073, USA
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