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Safa F, McClellan N, Bonato S, Rueda S, O’Brien KK. The Role of the Social Determinants of Health on Engagement in Physical Activity or Exercise among Adults Living with HIV: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13528. [PMID: 36294111 PMCID: PMC9602835 DOI: 10.3390/ijerph192013528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 09/30/2022] [Accepted: 10/11/2022] [Indexed: 06/16/2023]
Abstract
Physical activity (PA) and exercise are an effective rehabilitation strategy to improve health outcomes among people living with HIV (PLWH). However, engagement in exercise among PLWH can vary. Our aim was to characterize the literature on the role of social determinants of health (SDOH) on engagement in PA or exercise among adults living with HIV. We conducted a scoping review using the Arksey and O'Malley Framework. We searched databases between 1996 and 2021. We included articles that examined PA or exercise among adults with HIV and addressed at least one SDOH from the Public Health Agency of Canada Framework. We extracted data from included articles onto a data extraction charting form, and collated results using content analytical techniques. Of the 11,060 citations, we included 41 articles, with 35 studies involving primary data collection 23 (66%) quantitative, 8 (23%) qualitative, and four (11%) mixed methods. Of the 14,835 participants, 6398 (43%) were women. Gender (n = 24 articles), social support (n = 15), and income and social status (n = 14) were the most commonly reported SDOH in the literature with the majority of studies addressing only one SDOH. Future research should consider the intersection between multiple SDOH to better understand their combined impact on engagement in PA or exercise among PLWH.
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Affiliation(s)
- Farhana Safa
- Institute for Mental Health Policy Research (IMHPR), Centre for Addiction and Mental Health (CAMH), Toronto, ON M5S 2S1, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health (CAMH), Toronto, ON M5S 2S1, Canada
| | - Natalia McClellan
- AIDS Community Care Montreal, SIDA Bénévoles Montréal, Montreal, QC H2L 2Y4, Canada
| | - Sarah Bonato
- Library Services, Centre for Addiction and Mental Health (CAMH), Toronto, ON M5S 2S1, Canada
| | - Sergio Rueda
- Institute for Mental Health Policy Research (IMHPR), Centre for Addiction and Mental Health (CAMH), Toronto, ON M5S 2S1, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health (CAMH), Toronto, ON M5S 2S1, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5T 1R8, Canada
- Institute of Health Policy, Management and Evaluation (IHPME), Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada
| | - Kelly K. O’Brien
- Institute of Health Policy, Management and Evaluation (IHPME), Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5G 1V7, Canada
- Rehabilitation Sciences Institute (RSI), University of Toronto, Toronto, ON M5G 1V7, Canada
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2
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Gupta SD, Pisolkar V, Alhassan JAK, Judge A, Engler-Stringer R, Gauvin L, Muhajarine N. Employing the equity lens to understand multisectoral partnerships: lessons learned from a mixed-method study in Canada. Int J Equity Health 2022; 21:141. [PMID: 36163031 PMCID: PMC9512985 DOI: 10.1186/s12939-022-01746-w] [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: 03/18/2022] [Accepted: 08/15/2022] [Indexed: 11/24/2022] Open
Abstract
Background Multisectoral approaches to health are collaborations between stakeholders across multiple sectors, usually formed to address issues that affect health but go beyond the purview of one particular sector. The significance of multisectoral partnerships to attain health equity has been widely acknowledged. However, the extent which equity can be attained depends upon the perceptions of various stakeholders. We examine how multisectoral partnerships promoting healthy eating and active living conceptualized and employed an equity lens in their work. Method This study is part of a larger pan-Canadian mixed-method research and knowledge sharing program entitled MUSE (Multisectoral Urban Systems for health and Equity in Canadian cities). Data collected from both quantitative and qualitative sources for two sites of the MUSE project-Saskatoon and Toronto were analyzed. In the qualitative part, 30 semi-structured key informant interviews were conducted with key stakeholders from six different multisectoral partnerships based in Saskatoon and Toronto. Data were analyzed in an inductive way. In the quantitative part, a survey with 37 representatives of stakeholder organizations was carried out. Simple descriptive statistics (means and percentages) were used to observe the distribution of data and to complement the qualitative analysis. Results Equity was not a central component in program design although participants addressing equity, did so by discussing accessibility. How much consideration was given to equity varied as a function of the type of partnership. Most participants emphasized geographical accessibility but a few mentioned financial accessibility. Collaborative leadership style facilitated a participatory decision-making process, and thereby upholding equity in the partnership decision-making process. Communication, networking, and negotiation skills were found to be core competencies of a leader that contributed in upholding equity in partnership dynamics. The study also showed some challenges to embed equity in partnership works, such as the lack of comprehensive understanding of population health and its equity tenet. Conclusions Findings indicate that multisectoral partnerships aimed at promoting healthy eating and physical activity experience several challenges to attain equity within the partnership as well as in the partnership-based works aimed at reducing health equity in populations. Factors identified can support decision makers commit to and work to attaining equity within their partnerships as well as in the partnership-based work in the community and beyond.
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Affiliation(s)
- Suvadra Datta Gupta
- Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Canada.,Saskatchewan Population Health Evaluation and Research Unit (SPHERU), University of Saskatchewan, Saskatoon, Canada
| | - Vaidehi Pisolkar
- Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Canada.,Saskatchewan Population Health Evaluation and Research Unit (SPHERU), University of Saskatchewan, Saskatoon, Canada
| | - Jacob Albin Korem Alhassan
- Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Canada.,Saskatchewan Population Health Evaluation and Research Unit (SPHERU), University of Saskatchewan, Saskatoon, Canada
| | - Allap Judge
- Saskatchewan Population Health Evaluation and Research Unit (SPHERU), University of Saskatchewan, Saskatoon, Canada
| | - Rachel Engler-Stringer
- Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Canada.,Saskatchewan Population Health Evaluation and Research Unit (SPHERU), University of Saskatchewan, Saskatoon, Canada
| | - Lise Gauvin
- Department of Social and Preventive Medicine, Université de Montréal, & Centre de Recherche du Centre Hospitalier de L'Université de Montréal, Montréal, Québec, Canada
| | - Nazeem Muhajarine
- Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Canada. .,Saskatchewan Population Health Evaluation and Research Unit (SPHERU), University of Saskatchewan, Saskatoon, Canada.
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D’Silva C, Hafleen N, Mansfield E, Martel S, Fierheller D, Banerjee A, Malhotra G, Mutta B, Dhillon P, Hasan Z, Parikh A, Nooraie RY, Chaze F, Zenlea I. Service provider perspectives on exploring social determinants of health impacting type 2 diabetes management for South Asian adults in Peel region, Canada. Can J Diabetes 2022; 46:611-619.e1. [DOI: 10.1016/j.jcjd.2022.05.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 04/29/2022] [Accepted: 05/25/2022] [Indexed: 11/28/2022]
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Raffoul A, Gibbons B, Boluk K, Neiterman E, Hammond D, Kirkpatrick SI. "Maybe a little bit of guilt isn't so bad for the overall health of an individual": a mixed-methods exploration of young adults' experiences with calorie labelling. BMC Public Health 2022; 22:938. [PMID: 35538462 PMCID: PMC9092873 DOI: 10.1186/s12889-022-13364-w] [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: 10/27/2021] [Accepted: 04/28/2022] [Indexed: 11/24/2022] Open
Abstract
Background Menu labelling, and more specifically calorie labelling, has been posited as an intervention to improve nutrition literacy and the healthfulness of consumers’ food purchases. However, there is some concern calorie labelling may unintentionally trigger or exacerbate disordered eating among vulnerable persons. The purpose of this research was to explore young adults’ experiences with labelling, with a focus on its implications for their relationships with food. Methods Individual semi-structured interviews were conducted with participants from a campus-based menu labelling study. Interview data were inductively coded using thematic analysis and supported by survey data assessing disordered eating, body esteem, and related constructs. Results The sample consisted of 13 participants (10 women, 3 men), most of whom perceived themselves as “about the right weight” (62%). Four key themes included: (1) participants’ support of and skepticism about labelling interventions, (2) the identification of knowledge and autonomy as mechanisms of labelling interventions, (3) the role of the individual’s and others’ relationships with food in experiences with labelling, and (4) disordered eating and dieting as lenses that shape experiences with interventions. Participants’ perceptions of and experiences with calorie labels were shaped by gender, body esteem, and disordered eating risk. Conclusions The results provide insight into the complexity of young adults’ interactions with labelling interventions and context for future research exploring the unintended consequences of public health nutrition interventions. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13364-w.
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Affiliation(s)
- Amanda Raffoul
- School of Public Health Sciences, University of Waterloo, 200 University Ave W, Waterloo, ON, N2L 3G1, Canada. .,Present address: Division of Adolescent/Young Adult Medicine, Department of Pediatrics, Boston Children's Hospital, 333 Longwood Avenue, Boston, MA, 02115, USA.
| | - Brooke Gibbons
- Department of Recreation and Leisure Studies, University of Waterloo, 200 University Ave W, Waterloo, ON, N2L 3G1, Canada
| | - Karla Boluk
- Department of Recreation and Leisure Studies, University of Waterloo, 200 University Ave W, Waterloo, ON, N2L 3G1, Canada
| | - Elena Neiterman
- School of Public Health Sciences, University of Waterloo, 200 University Ave W, Waterloo, ON, N2L 3G1, Canada
| | - David Hammond
- School of Public Health Sciences, University of Waterloo, 200 University Ave W, Waterloo, ON, N2L 3G1, Canada
| | - Sharon I Kirkpatrick
- School of Public Health Sciences, University of Waterloo, 200 University Ave W, Waterloo, ON, N2L 3G1, Canada
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Plamondon K, Neufeld V. Are we there yet? Principles in advancing equity though global public health research. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2022; 113:178-183. [PMID: 35290654 PMCID: PMC8975980 DOI: 10.17269/s41997-022-00624-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Canadian engagement in global and public health includes a long history of centering issues of equity in practice, policy, and research. In 2015, through a series of deliberative dialogues about what ethical standards should guide how people engage in global health research, the Canadian Coalition for Global Health Research (CCGHR) released a set of six equity-centred principles and critically reflective questions. These principles offered a platform for identifying equity implications and choices about theories, methods, approaches, partnerships, or practices in global and public health. In 2022, as questions of how to unsettle systems of power and move beyond rhetorical efforts to advance equity action continue to grow, Canada's global public health research community is turning a critically reflexive gaze at our own practices and ways of working, recognizing excellence as necessarily integrating equity in research pursuits, processes, and outcomes. In this commentary, we reflect on the contexts that led to the evolution of the CCGHR Principles for Global Health Research and highlight their current reach and impact, including their integration in the Canadian Institutes Framework for Action on Global Health Research. We invite others to embrace a lifelong commitment to equity work as an act of solidarity and investment in our collective futures.
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Affiliation(s)
- Katrina Plamondon
- School of Nursing, University of British Columbia, Kelowna, BC, Canada.
| | - Vic Neufeld
- Centre for Global Studies, University of Victoria, Victoria, BC, Canada
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Zalani GS, Shokri A, Mirbahaeddin E, Kashkalani T, Khalilnezhad R, Bayat M. Projection of Health Sector Workforce Requirement: Vision 2025. IRANIAN JOURNAL OF PUBLIC HEALTH 2021; 50:1463-1473. [PMID: 34568186 PMCID: PMC8426765 DOI: 10.18502/ijph.v50i7.6637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 07/15/2020] [Indexed: 02/03/2023]
Abstract
Background: This study was conducted with a long-term vision (2014–2025) targeted workforce requirement projection by occupational groups in Iran’s health sector. Methods: The “modified & combined model” used including Hall Model and Australian health workforce estimation model. It was a need-based approach with three components of estimation; requirements, supply with current growth and net required workforce. Requirement estimated by three assumptions: active workforce calculation; the growth of health service delivery resources and facilities; and daily individual working hours, created eight different scenarios. Economic feasibility of each scenario determined. To forecast the supply, used accurate numbers of the existing pool of practicing workforce in addition to inflows, minus losses from the profession. To calculate total recruits required, base year stock deducted from projected requirement and by adding Net flow, recruits required calculated. Results: The health sector will need 781,887 workforces to realize service’s needs. Workforce supply with the existing trend in the target year was 799,347. Therefore, workforce balance would be 17,460 surpluses. Moreover, to estimate required workforce and substitution number for the exited ones during the study periods till the target year, 547,136 individuals should be recruited mostly nurses and physicians. Conclusion: Limiting the workforce required to economic feasibility challenge workforce accessibility in the future as it is sensed in present tense as well. Therefore, in addition augmenting GDP and health funds, it is necessary alternative policies such as increasing share of health sector from GDP, prioritization of workforce needs or moving towards other proper policies.
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Affiliation(s)
| | - Azad Shokri
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | | | - Tahereh Kashkalani
- Center for Health Human Resources Research & Studies, Ministry of Health and Medical Education, Tehran, Iran
| | - Roghayeh Khalilnezhad
- Center for Health Human Resources Research & Studies, Ministry of Health and Medical Education, Tehran, Iran.,Health Management and Economics Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Mahboubeh Bayat
- Center for Health Human Resources Research & Studies, Ministry of Health and Medical Education, Tehran, Iran
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Pauly B, Revai T, Marcellus L, Martin W, Easton K, MacDonald M. "The health equity curse": ethical tensions in promoting health equity. BMC Public Health 2021; 21:1567. [PMID: 34407781 PMCID: PMC8375114 DOI: 10.1186/s12889-021-11594-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 08/04/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Public health (PH) practitioners have a strong moral commitment to health equity and social justice. However, PH values often do not align with health systems values, making it challenging for PH practitioners to promote health equity. In spite of a growing range of PH ethics frameworks and theories, little is known about ethical concerns related to promotion of health equity in PH practice. The purpose of this paper is to examine the ethical concerns of PH practitioners in promoting health equity in the context of mental health promotion and prevention of harms of substance use. METHODS As part of a broader program of public health systems and services research, we interviewed 32 PH practitioners. RESULTS Using constant comparative analysis, we identified four systemic ethical tensions: [1] biomedical versus social determinants of health agenda; [2] systems driven agendas versus situational care; [3] stigma and discrimination versus respect for persons; and [4] trust and autonomy versus surveillance and social control. CONCLUSIONS Naming these tensions provides insights into the daily ethical challenges of PH practitioners and an opportunity to reflect on the relevance of PH frameworks. These findings highlight the value of relational ethics as a promising approach for developing ethical frameworks for PH practice.
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Affiliation(s)
- Bernie Pauly
- School of Nursing and Canadian Institute for Substance Use Research, University of Victoria, Box 1700 STN CSC, Victoria, BC, V8W 2Y2, Canada
| | - Tina Revai
- Equity Lens in Public Health Project, University of Victoria, Box 1700 STN CSC, Victoria, BC, V8W 2Y2, Canada
| | - Lenora Marcellus
- School of Nursing, University of Victoria, PO Box 1700 STN CSC, Victoria, BC, V8W 2Y2, Canada
| | - Wanda Martin
- College of Nursing, University of Saskatchewan, Health Science Building-1A10, Box 6, 107 Wiggins Road, Saskatoon, SK, S7N 5E5, Canada.
| | - Kathy Easton
- Island Health, 345 Wale Rd, Victoria, BC, V9B 6X2, Canada
| | - Marjorie MacDonald
- School of Nursing and Canadian Institute for Substance Use Research, University of Victoria, Box 1700 STN CSC, Victoria, BC, V8W 2Y2, Canada
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Ndumbe-Eyoh S. What would it take for health promotion to take structural racism seriously? Glob Health Promot 2020; 27:3-5. [PMID: 33331227 DOI: 10.1177/1757975920972259] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Sume Ndumbe-Eyoh
- Senior Knowledge Translation Specialist, National Collaborating Centre for Determinants of Health, Antigonish, NS Canada
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Ndumbe-Eyoh S. ¿Qué se necesita para que la promoción de la salud tome en serio al racismo estructural? Glob Health Promot 2020. [DOI: 10.1177/1757975920972622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Sume Ndumbe-Eyoh
- Senior Knowledge Translation Specialist, National Collaborating Centre for Determinants of Health, Antigonish, NS, Canada
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10
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Ndumbe-Eyoh S. Que faudrait-il pour que la promotion de la santé prenne au sérieux le racisme structurel ? Glob Health Promot 2020. [DOI: 10.1177/1757975920972621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Sume Ndumbe-Eyoh
- Senior Knowledge Translation Specialist, National Collaborating Centre for Determinants of Health, Antigonish, Nova Scotia, Canada
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11
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Fagbamigbe AF, Desai R, Sewpaul R, Kandala NB, Sekgala D, Reddy P. Age at the onset of tobacco smoking in South Africa: a discrete-time survival analysis of the prognostic factors. ACTA ACUST UNITED AC 2020; 78:128. [PMID: 33292586 PMCID: PMC7709430 DOI: 10.1186/s13690-020-00503-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 11/05/2020] [Indexed: 11/18/2022]
Abstract
Background While knowledge of onset of smoking tobacco, and associated risk factors can aid the formulation of evidence-based policy and interventions, such information is scarce in South Africa. We assessed age at onset of tobacco smoking in South Africa and identified its risk factors. Methods We analysed data of 15,316 respondents aged 15–98 years from the 2012 South African National Health and Nutrition Examination Survey. Descriptive statistics and survival analysis techniques were used alongside weighted percentages. Results Overall lifetime prevalence of smoking was 20.5%. Among the 3360 ever-smoked respondents, the overall median age at smoking onset was 18 years (Inter-quartile range (IQR) =5) with 2% starting before age 10 while 60% had smoked before age 20. Likelihood of tobacco smoking was higher among adolescents (<=20 years) and those aged 20–29 years than those aged > = 60 years, thrice higher among males, 29% higher among urban dwellers and thrice higher in Western Cape and Free State than in North West Province. The onset of tobacco smoking was earlier among males, wealthier and “coloured” people from Northern and Eastern Capes. Conclusion The onset of tobacco smoking peaked at 15–22 years and varied by province, sex, location, race and other characteristics. The age restrictions on smoking in South Africa has changed over time, coupled with the recent open and electronic advertisement of tobacco, and social media could have influenced the earlier onset of tobacco smoking in South Africa. Stricter regulations on tobacco-related advertisement and sales should be implemented.
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Affiliation(s)
- Adeniyi Francis Fagbamigbe
- Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria. .,Division of Population and Behavioural Sciences, School of Medicine, St Andrews University, Fife, UK. .,Division of Health Sciences, Populations, Evidence and Technologies Group, University of Warwick, Coventry, UK.
| | - Rachana Desai
- SAMRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Ronel Sewpaul
- Health & Wellbeing, Human and Social Capabilities Division, Human Sciences Research Council (HSRC), 116 - 118 Merchant House, Buitengracht Street, Cape Town, 8001, South Africa
| | - Ngianga-Bakwin Kandala
- Division of Epidemiology and Biostatistics, University of the Witwatersrand, School of Public Health, Johannesburg, South Africa
| | - Derrick Sekgala
- Health & Wellbeing, Human and Social Capabilities Division, Human Sciences Research Council (HSRC), 116 - 118 Merchant House, Buitengracht Street, Cape Town, 8001, South Africa
| | - Priscilla Reddy
- Health & Wellbeing, Human and Social Capabilities Division, Human Sciences Research Council (HSRC), 116 - 118 Merchant House, Buitengracht Street, Cape Town, 8001, South Africa.,Nelson Mandela University, Port Elizabeth, South Africa
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Williams O, Sarre S, Papoulias SC, Knowles S, Robert G, Beresford P, Rose D, Carr S, Kaur M, Palmer VJ. Lost in the shadows: reflections on the dark side of co-production. Health Res Policy Syst 2020; 18:43. [PMID: 32380998 PMCID: PMC7204208 DOI: 10.1186/s12961-020-00558-0] [Citation(s) in RCA: 92] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 04/02/2020] [Indexed: 11/30/2022] Open
Abstract
This article is a response to Oliver et al.'s Commentary 'The dark side of coproduction: do the costs outweigh the benefits for health research?' recently published in Health Research Policy and Systems (2019, 17:33). The original commentary raises some important questions about how and when to co-produce health research, including highlighting various professional costs to those involved. However, we identify four related limitations in their inquiry, as follows: (1) the adoption of a problematically expansive definition of co-production that fails to acknowledge key features that distinguish co-production from broader collaboration; (2) a strong focus on technocratic rationales for co-producing research and a relative neglect of democratic rationales; (3) the transposition of legitimate concerns relating to collaboration between researchers and practitioners onto work with patients, service users and marginalised citizens; and (4) the presentation of bad practice as an inherent flaw, or indeed 'dark side', of co-production without attending to the corrupting influence of contextual factors within academic research that facilitate and even promote such malpractice. The Commentary's limitations can be seen to reflect the contemporary use of the term 'co-production' more broadly. We describe this phenomenon as 'cobiquity' - an apparent appetite for participatory research practice and increased emphasis on partnership working, in combination with the related emergence of a plethora of 'co' words, promoting a conflation of meanings and practices from different collaborative traditions. This phenomenon commonly leads to a misappropriation of the term 'co-production'. Our main motivation is to address this imprecision and the detrimental impact it has on efforts to enable co-production with marginalised and disadvantaged groups. We conclude that Oliver et al. stray too close to 'the problem' of 'co-production' seeing only the dark side rather than what is casting the shadows. We warn against such a restricted view and argue for greater scrutiny of the structural factors that largely explain academia's failure to accommodate and promote the egalitarian and utilitarian potential of co-produced research.
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Affiliation(s)
- Oli Williams
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, 4th Floor, James Clerk Maxwell Building, 57 Waterloo Road, London, SE1 8WA, United Kingdom.
- THIS Institute, Cambridge, United Kingdom.
| | - Sophie Sarre
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, 4th Floor, James Clerk Maxwell Building, 57 Waterloo Road, London, SE1 8WA, United Kingdom
| | | | | | - Glenn Robert
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, 4th Floor, James Clerk Maxwell Building, 57 Waterloo Road, London, SE1 8WA, United Kingdom
| | | | - Diana Rose
- Service User Research Enterprise, King's College London, London, United Kingdom
| | - Sarah Carr
- University of Birmingham, Birmingham, United Kingdom
| | - Meerat Kaur
- NIHR ARC Northwest London, London, United Kingdom
| | - Victoria J Palmer
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, 4th Floor, James Clerk Maxwell Building, 57 Waterloo Road, London, SE1 8WA, United Kingdom
- The University of Melbourne, Melbourne, Australia
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13
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Plamondon KM, Caxaj CS, Graham ID, Bottorff JL. Connecting knowledge with action for health equity: a critical interpretive synthesis of promising practices. Int J Equity Health 2019; 18:202. [PMID: 31878940 PMCID: PMC6933619 DOI: 10.1186/s12939-019-1108-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 12/10/2019] [Indexed: 11/12/2022] Open
Abstract
Connecting knowledge with action (KWA) for health equity involves interventions that can redistribute power and resources at local, national, and global levels. Although there is ample and compelling evidence on the nature, distribution, and impact of health inequities, advancing health equity is inhibited by policy arenas shaped by colonial legacies and neoliberal ideology. Effective progress toward health equity requires attention to evidence that can promote the kind of socio-political restructuring needed to address root causes of health inequities. In this critical interpretive synthesis, results of a recent scoping review were broadened to identify evidence-informed promising practices for KWA for health equity. Following screening procedures, 10 literature reviews and 22 research studies were included in the synthesis. Analysis involved repeated readings of these 32 articles to extract descriptive data, assess clarity and quality, and identify promising practices. Four distinct kinds of promising practices for connecting KWA for health equity were identified and included: ways of structuring systems, ways of working together, and ways of doing research and ways of doing knowledge translation. Our synthesis reveals that advancing health equity requires greater awareness, dialogue, and action that aligns with the what is known about the causes of health inequities. By critically reflecting on dominant discourses and assumptions, and mobilizing political will from a more informed and transparent democratic exercise, knowledge to action for health equity can be achieved.
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Affiliation(s)
- Katrina M Plamondon
- School of Nursing, The University of British Columbia, 1147 Research Rd., ART 360, Kelowna, BC, V1V 1V7, Canada.
| | | | - Ian D Graham
- School of Epidemiology & Public Health, University of Ottawa, Ottawa, Canada
| | - Joan L Bottorff
- School of Nursing, The University of British Columbia, 1147 Research Rd., ART 360, Kelowna, BC, V1V 1V7, Canada
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Yii V, Palermo C, Kleve S. Population-based interventions addressing food insecurity in Australia: A systematic scoping review. Nutr Diet 2019; 77:6-18. [PMID: 31593624 DOI: 10.1111/1747-0080.12580] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 07/09/2019] [Accepted: 07/19/2019] [Indexed: 01/07/2023]
Abstract
AIM Food insecurity (FI) is a critical public health issue in Australia. Population-based interventions aiming to address the socio-ecological determinants of FI are critical for relieving and preventing it. This review aimed to map and summarise the characteristics of population-based interventions addressing household and/or community FI in Australia. METHODS A systematic scoping review was undertaken. Five databases, selected for range and relevance to FI in Australia ("CINAHL plus", "Ovid MEDLINE", "Sociological Abstracts", "Australian Public Affairs Information Service", and "Rural and Remote Health") were searched in May 2018 using the terms and relevant synonyms "FI" and "interventions". In addition a systematic grey literature search using multiple Google searches was undertaken. Data synthesis included categorisation and counting intervention type. Interventions were defined and charted by influence of at least one dimension of food security and impact on the socioeconomic, cultural and environmental conditions. RESULTS A total of 3565 published and grey literature records were identified, with the final 60 records describing 98 interventions. Few national interventions were identified, with approaches predominantly in Victoria, Northern Territory and Tasmania. Determinants related to living and working environments, food availability and food utilisation were most frequently addressed. Interventions addressing the key determinant of FI economic access were limited. A number of interventions did not appear to be associated with rigorous evaluation. CONCLUSIONS While there is evidence of population responses to FI in Australia, the effectiveness of these remains limited. Importantly there is a lack of coordinated and coherent national responses that address the range of FI determinants.
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Affiliation(s)
- Vivien Yii
- Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Notting Hill, Victoria, Australia
| | - Claire Palermo
- Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Notting Hill, Victoria, Australia
| | - Sue Kleve
- Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Notting Hill, Victoria, Australia
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Dixon S. Intersectionality of Cultural Identities in Health Psychology: Key Recommendations for Working With African-Caribbean Immigrant Women. FRONTIERS IN SOCIOLOGY 2019; 4:51. [PMID: 33869374 PMCID: PMC8022647 DOI: 10.3389/fsoc.2019.00051] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 06/03/2019] [Indexed: 06/12/2023]
Abstract
While the field of health psychology has progressed over the years, much work still needs to be done when considering immigrants' health care and well-being. Particularly, for African-Caribbean immigrants, the intersectionality of their cultural identities in the health care system require much attention moving forward. Therefore, this article is particularly relevant for Canada's multicultural society; it describes cultural identity reconstruction within health psychology as a common issue for diverse groups, particularly African-Caribbean immigrant women. The article speaks to the holistic worldview that is required in a paradigm shift which engages a pluralistic society that is Canada. The author presents a key cultural identity model and assessment tool that should be integrated into the health care system to ensure culturally-sensitive and inclusive care for immigrants, especially women. As is argued in the article, contemporary research, advocacy, and social movements speak to invoking alternative ways to complement the prevailing downstream approach to health psychology. In a growing multicultural society that should strive on honoring and respecting the pluralistic cultural worldviews of all people in the health care system, many immigrant women struggle to cope with the social determinants of health post-migration. Their concerns are often pushed to the margins of health care services, with several individuals relying on their faith for coping strategies. This article concludes with culturally-informed and socially-just recommendations for health care professionals working with immigrant populations, particularly African Caribbean immigrant women.
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Affiliation(s)
- Sandra Dixon
- Faculty of Education, University of Lethbridge, Lethbridge, AB, Canada
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Plamondon KM, Pemberton J. Blending integrated knowledge translation with global health governance: an approach for advancing action on a wicked problem. Health Res Policy Syst 2019; 17:24. [PMID: 30832660 PMCID: PMC6399857 DOI: 10.1186/s12961-019-0424-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Accepted: 02/06/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The persistence of health inequities is a wicked problem for which there is strong evidence of causal roots in the maldistribution of power, resources and money within and between countries. Though the evidence is clear, the solutions are far from straightforward. Integrated knowledge translation (IKT) ought to be well suited for designing evidence-informed solutions, yet current frameworks are limited in their capacity to navigate complexity. Global health governance (GHG) also ought to be well suited to advance action, but a lack of accountability, inclusion and integration of evidence gives rise to politically driven action. Recognising a persistent struggle for meaningful action, we invite contemplation about how blending IKT with GHG could leverage the strengths of both processes to advance health equity. DISCUSSION Action on root causes of health inequities implicates disruption of structures and systems that shape how society is organised. This infinitely complex work demands sophisticated examination of drivers and disrupters of inequities and a vast imagination for who (and what) should be engaged. Yet, underlying tendencies toward reductionism seem to drive superficial responses. Where IKT models lack consideration of issues of power and provide little direction for how to support cohesive efforts toward a common goal, recent calls from the field of GHG may provide insight into these issues. Additionally, though GHG is criticised for its lack of attention to using evidence, IKT offers approaches and strategies for collaborative processes of generating and refining knowledge. Contemplating the inclusion of governance in IKT requires re-examining roles, responsibilities, power and voice in processes of connecting knowledge with action. We argue for expanding IKT models to include GHG as a means of considering the complexity of issues and opening new possibilities for evidence-informed action on wicked problems. CONCLUSION Integrated learning between these two fields, adopting principles of GHG alongside the strategies of IKT, is a promising opportunity to strengthen leadership for health equity action.
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Affiliation(s)
- Katrina Marie Plamondon
- University of British Columbia, 3333 University Way, Kelowna, BC Canada
- Interior Health, 505 Doyle Avenue, Kelowna, BC Canada
| | - Julia Pemberton
- McMaster University, 1280 Main Street West, Hamilton, ON Canada
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Al-Hazzaa HM, AlMarzooqi MA. Descriptive Analysis of Physical Activity Initiatives for Health Promotion in Saudi Arabia. Front Public Health 2018; 6:329. [PMID: 30488032 PMCID: PMC6246731 DOI: 10.3389/fpubh.2018.00329] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 10/26/2018] [Indexed: 01/10/2023] Open
Abstract
Background: Although the benefits of physical activity are well acknowledged, a high percentage of Saudi population, especially females, remain essentially physically inactive. Getting inactive people to start participating in physical activity and to keep exercising remains a great challenge. Physical activity initiatives in the country have not been previously documented. Therefore, the aim of this article was to provide a narrative review of the physical activity initiatives and discusses influencing factors. Methods: Publically-available physical activity initiatives conducted before June 2018 were searched through the web or they were obtained straight from the organization themselves. The search focus was on any initiative aimed to promote physical activity and mass sports participation and encourage people to adopt active living habit. Results: Numerous initiatives aimed at promoting physical activity existed in Saudi Arabia. However, a common attribute of these initiatives is that they were fragmented, short term attempts, and lacked a coordinating body. The majority of the physical activity initiatives also lacked objective evaluations of their outcomes. It was clear that more physical activity opportunity must be provided for Saudi girls, women, and elderly. There is a need for establishing a national policy encouraging active living and discouraging sedentary lifestyle with contributions from all involved parties. Conclusions: Based on the available evidences, more intensified efforts toward promoting physical activity and reducing sedentary behaviors among Saudi population are needed in order to reduce the risks of NCD's.
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Affiliation(s)
- Hazzaa M Al-Hazzaa
- Lifestyle and Health Research, Health Science Research Center, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Mezna A AlMarzooqi
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
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18
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Heilbrunn-Lang AY, Carpenter LM, Powell SM, Kearney SL, Cole D, de Silva AM. Reviewing public policy for promoting population oral health in Victoria, Australia (2007-12). AUST HEALTH REV 2016. [PMID: 26210775 DOI: 10.1071/ah15013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Government policy and planning set the direction for community decisions related to resource allocation, infrastructure, services, programs, workforce and social environments. The aim ofthe present study was to examine the policy and planning context for oral health promotion in Victoria, Australia, over the period 2007-12. METHODS Key Victorian policies and plans related to oral health promotion in place during the 2007-12 planning cycle were identified through online searching, and content analysis was performed. Inclusion of oral health (and oral health-related) promotion initiatives was assessed within the goals, objectives and strategies sections of each plan. RESULTS Six of the 223 public health plans analysed (3%) included oral health 'goals' (including one plan representing nine agencies). Oral health was an 'objective' in 10 documents. Fifty-six plan objectives, and 70 plan strategies related to oral health or healthy eating for young children. Oral health was included in municipal plans (44%) more frequently than the other plans examined. CONCLUSION There is a policy opportunity to address oral health at a community level, and to implement population approaches aligned with the Ottawa Charter that address the social determinants of health.
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Affiliation(s)
| | - Lauren M Carpenter
- University of Melbourne, Centre for Health Equity, The Melbourne School of Population and Global Health, Level 4, 207 Bouverie Street, Carlton, Vic. 3053, Australia. Email
| | - Seona M Powell
- Dental Health Services Victoria, 720 Swanston Street, Carlton, Vic. 3053, Australia. ;
| | - Susan L Kearney
- Dental Health Services Victoria, 720 Swanston Street, Carlton, Vic. 3053, Australia. ;
| | - Deborah Cole
- Dental Health Services Victoria, 720 Swanston Street, Carlton, Vic. 3053, Australia. ;
| | - Andrea M de Silva
- Dental Health Services Victoria, 720 Swanston Street, Carlton, Vic. 3053, Australia. ;
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Langeveld K, Stronks K, Harting J. Use of a knowledge broker to establish healthy public policies in a city district: a developmental evaluation. BMC Public Health 2016; 16:271. [PMID: 26979063 PMCID: PMC4793512 DOI: 10.1186/s12889-016-2832-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Accepted: 02/04/2016] [Indexed: 11/17/2022] Open
Abstract
Background Public health is to a large extent determined by non-health-sector policies. One approach to address this apparent paradox is to establish healthy public policies. This requires policy makers in non-health sectors to become more aware of the health impacts of their policies, and more willing to adopt evidence-informed policy measures to improve health. We employed a knowledge broker to set the agenda for health and to specify health-promoting policy alternatives. This study aimed at gaining in-depth understanding of how this knowledge broker approach works. Methods In the context of a long-term partnership between the two universities in Amsterdam and the municipal public health service, we employed a knowledge broker who worked part-time at a university and part-time for an Amsterdam city district. When setting an agenda and specifying evidence-informed policy alternatives, we considered three individual policy portfolios as well as the policy organization of the city district. We evaluated and developed the knowledge broker approach through action research using participant observation. Results Our knowledge brokering strategy led to the adoption of several policy alternatives in individual policy portfolios, and was especially successful in agenda-setting for health. More specifically, health became an issue on the formal policy agenda as evidenced by its uptake in the city district’s mid-term review and the appointment of a policy analyst for health. Our study corroborated the importance of process factors such as building trust, clearly distinguishing the knowledge broker role, and adequate management support. We also saw the benefits of multilevel agenda-setting and specifying policy alternatives at appropriate policy levels. Sector-specific responsibilities hampered the adoption of cross-sectoral policy alternatives, while thematically designed policy documents offered opportunities for including them. Further interpretation revealed three additional themes in knowledge brokering: boundary spanning, a ripple effect, and participant observation. Conclusions The employment of a knowledge broker who works simultaneously on both agenda-setting for health as well as the specification of health-promoting policy alternatives seems to be a promising first step in establishing local healthy public policies. Future studies are needed to explore the usefulness of our approach in further policy development and policy implementation.
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Affiliation(s)
- Kirsten Langeveld
- Department of Public Health, Academic Medical Center, University of Amsterdam, P.O. Box 22700, Amsterdam, 1100 DE, The Netherlands.
| | - Karien Stronks
- Department of Public Health, Academic Medical Center, University of Amsterdam, P.O. Box 22700, Amsterdam, 1100 DE, The Netherlands
| | - Janneke Harting
- Department of Public Health, Academic Medical Center, University of Amsterdam, P.O. Box 22700, Amsterdam, 1100 DE, The Netherlands
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The Social Determinants of Health in Military Forces of Iran: A Qualitative Study. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2015; 2015:524341. [PMID: 26379716 PMCID: PMC4561324 DOI: 10.1155/2015/524341] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Accepted: 08/04/2015] [Indexed: 11/28/2022]
Abstract
Providing effective health interventions and achieving equity in health need to apply the community-based approaches such as social determinants of health. In the military organizations, these determinants have received less attention from the military health researchers and policymakers. Therefore, this study aimed to identify and explain the social determinants affecting the health of military forces in Iran. This was a qualitative study which was conducted in 2014. The required data were collected through semistructured interviews and analyzed through Conventional Content Analysis. The studied sample consisted of 22 military health experts, policymakers, and senior managers selected using purposeful sampling method with maximum variation sampling. MAXQDA.2007 was used to analyze the collected data. After analyzing the collected data, two main contents, that is, “general social determinants of health” and “military social determinants of health,” with 22 themes and 90 subthemes were identified as the social determinants of military forces' health. Main themes were religious rule, spirituality promotion policies, international military factors, military command, and so forth. Given the role and importance of social factors determining the military forces' health, it can be recommended that the military organizations should pay more attention to these determinants in making policies and creating social, economic, and cultural structures for their forces.
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BAHADORI M, SANAEINASAB H, GHANEI M, MEHRABI TAVANA A, RAVANGARD R, KARAMALI M. The Social Determinants of Health (SDH) in Iran: A Systematic Review Article. IRANIAN JOURNAL OF PUBLIC HEALTH 2015; 44:728-41. [PMID: 26258086 PMCID: PMC4524298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Accepted: 03/10/2015] [Indexed: 12/03/2022]
Abstract
BACKGROUND Many studies have been conducted in Iran in order to investigate the status of social determinants of health (SDH) and their associations with health indicators. This study aimed to review the Iranian studies conducted on SDH. METHODS A systematic review of all Iranian Persian and English languages articles published between 2005 and 2014 on the SDH was conducted using the search of SID, Iran Medex, Iran Doc, Medline, Embase, Scopus, and Google Scholar databases. The eligibility criteria were studies describing SDH status, designed based on the WHO conceptual framework of SDH, published in Persian or English languages, and full text articles. The structured narrative approach was used to synthesize the data. RESULTS The entire review process led to the selection of 21 papers. Most of studies had been conducted on the intermediary (38%) and structural (33%) components and determinants in Iran, 4 studies (19%) on the study of all components affecting the health and health inequality and, finally, the minimum number of studies (10%) on the context components and determinants. The focus of 43% of selected studies was on the WHO conceptual framework of SDH and had evaluated this model as an appropriate conceptual framework. CONCLUSION In order to fill the gap in the scientific evidence of SDH and make appropriate policies and plans in Iran, it is needed to conduct studies on all SDH according to the WHO conceptual framework.
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Affiliation(s)
- Mohammadkarim BAHADORI
- Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Hormoz SANAEINASAB
- Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Mostafa GHANEI
- Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Ali MEHRABI TAVANA
- Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Ramin RAVANGARD
- Dept. of Health Services Management, School of Management and Medical Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mazyar KARAMALI
- Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran,Corresponding Author:
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MacGregor JCD, Wathen N, Kothari A, Hundal PK, Naimi A. Strategies to promote uptake and use of intimate partner violence and child maltreatment knowledge: an integrative review. BMC Public Health 2014; 14:862. [PMID: 25146253 PMCID: PMC4152574 DOI: 10.1186/1471-2458-14-862] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Accepted: 07/24/2014] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Intimate partner violence (IPV) and child maltreatment (CM) are major social and public health problems. Knowledge translation (KT) of best available research evidence has been suggested as a strategy to improve the care of those exposed to violence, however research on how best to promote the uptake and use of IPV and CM evidence for policy and practice is limited. Our research asked: 1) What is the extent of IPV/CM-specific KT research? 2) What KT strategies effectively translate IPV/CM knowledge? and 3) What are the barriers and facilitators relevant to translating IPV/CM-specific knowledge? METHODS We conducted an integrative review to summarize and synthesize the available evidence regarding IPV/CM-specific KT research. We employed multiple search methods, including database searches of Embase, CINAHL, ERIC, PsycInfo, Sociological Abstracts, and Medline (through April, 2013). Eligibility and quality assessments for each article were conducted by at least two team members. Included articles were analyzed quantitatively using descriptive statistics and qualitatively using descriptive content analysis. RESULTS Of 1230 identified articles, 62 were included in the review, including 5 review articles. KT strategies were generally successful at improving various knowledge/attitude and behavioural/behavioural intention outcomes, but the heterogeneity among KT strategies, recipients, study designs and measured outcomes made it difficult to draw specific conclusions. Four key themes were identified: existing measurement tools and promising/effective KT strategies are underused, KT efforts are rarely linked to health-related outcomes for those exposed to violence, there is a lack of evidence regarding the long-term effectiveness of KT interventions, and authors' inferences about barriers, facilitators, and effective/ineffective KT strategies are often not supported by data. The emotional and sometimes contested nature of the knowledge appears to be an important barrier unique to IPV/CM KT. CONCLUSIONS To direct future KT in this area, we present a guiding framework that highlights the need for implementers to use/adapt promising KT strategies that carefully consider contextual factors, including the fact that content in IPV/CM may be more difficult to engage with than other health topics. The framework also provides guidance regarding use of measurement tools and designs to more effectively evaluate and report on KT efforts.
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Affiliation(s)
- Jennifer CD MacGregor
- />Faculty of Information & Media Studies, The University of Western Ontario, North Campus Building, Room 240, 1151 Richmond St., London, ON N6A 5B7 Canada
- />Lab for Knowledge Translation in Health, The University of Western Ontario, Arthur and Sonia Labatt Health Sciences Building, Room 403, 1151 Richmond St., London, ON N6A 5B9 Canada
| | - Nadine Wathen
- />Faculty of Information & Media Studies, The University of Western Ontario, North Campus Building, Room 240, 1151 Richmond St., London, ON N6A 5B7 Canada
- />Lab for Knowledge Translation in Health, The University of Western Ontario, Arthur and Sonia Labatt Health Sciences Building, Room 403, 1151 Richmond St., London, ON N6A 5B9 Canada
| | - Anita Kothari
- />Faculty of Health Sciences, The University of Western Ontario, Arthur and Sonia Labatt Health Sciences Building, Room 222, 1151 Richmond St., London, ON N6A 5B9 Canada
- />Schulich Interfaculty Program in Public Health, The University of Western Ontario, The Western Centre for Public Health and Family Medicine, 1465 Richmond St., 4th Floor, London, ON N6G 2M1 Canada
- />Lab for Knowledge Translation in Health, The University of Western Ontario, Arthur and Sonia Labatt Health Sciences Building, Room 403, 1151 Richmond St., London, ON N6A 5B9 Canada
| | - Prabhpreet K Hundal
- />Faculty of Health Sciences, The University of Western Ontario, Arthur and Sonia Labatt Health Sciences Building, Room 222, 1151 Richmond St., London, ON N6A 5B9 Canada
| | - Anthony Naimi
- />Faculty of Information & Media Studies, The University of Western Ontario, North Campus Building, Room 240, 1151 Richmond St., London, ON N6A 5B7 Canada
- />Lab for Knowledge Translation in Health, The University of Western Ontario, Arthur and Sonia Labatt Health Sciences Building, Room 403, 1151 Richmond St., London, ON N6A 5B9 Canada
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Hanusaik N, Contandriopoulos D, Kishchuk N, Maximova K, Paradis G, O'Loughlin JL. Chronicling changes to the chronic disease prevention landscape in Canada's public health system 2004-2010. Public Health 2014; 128:716-24. [PMID: 25132388 PMCID: PMC7111625 DOI: 10.1016/j.puhe.2014.05.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Revised: 05/22/2014] [Accepted: 05/28/2014] [Indexed: 11/05/2022]
Abstract
The collective impact of major shifts in public health infrastructure and numerous new chronic disease prevention (CDP) capacity-building initiatives that have taken place in Canada over the last decade is unknown. The objective of this study was to determine if CDP capacity (i.e., skills and resources) and involvement in CDP programming improved in public health organizations in Canada from 2004 to 2010. Data for this repeated cross-sectional study were drawn from two waves of a national census of organizations mandated to carry out primary prevention of chronic disease and/or promotion of healthy eating, physical activity and tobacco control. Medians for continuous variables and frequencies for categorical variables were compared across time. Neither resources nor level of priority for CDP increased over time. There was little difference in the proportion of organizations with high levels of skills and involvement in core CDP practices (i.e., needs assessment, identification of relevant practices, planning, evaluation). Skills and involvement in CDP risk factor programming showed some gains, some steady states and some losses. Specifically, skill and involvement in tobacco control programming declined markedly while the proportion of organizations involved in healthy eating and physical activity programming increased. Skills to address and involvement in programming related to social determinants of health remained low over time as did involvement in programming addressing multiple risk factors concurrently. The lack of marked improvement in CDP capacity between 2004 and 2010 against a backdrop of initiatives favourable to strengthening the preventive health system in Canada suggests that efforts may have fallen short.
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Affiliation(s)
- N Hanusaik
- Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM), Montréal, Québec, Canada.
| | - D Contandriopoulos
- Université de Montréal, Faculté de sciences infirmières, Montréal, Québec, Canada; Institut de recherche en santé publique de l'Université de Montréal (IRSPUM), Montréal, Québec, Canada
| | - N Kishchuk
- Program Evaluation & Beyond Inc., Montréal, Québec, Canada; Université de Montréal, Département de médecine sociale et préventive, Montréal, Québec, Canada
| | - K Maximova
- University of Alberta, Department of Public Health Sciences, Edmonton, Alberta, Canada
| | - G Paradis
- McGill University, Department of Epidemiology, Biostatistics, and Occupational Health, Montréal, Québec, Canada; Institut national de santé publique du Québec (INSPQ), Montréal, Québec, Canada
| | - J L O'Loughlin
- Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM), Montréal, Québec, Canada; Université de Montréal, Département de médecine sociale et préventive, Montréal, Québec, Canada; Institut national de santé publique du Québec (INSPQ), Montréal, Québec, Canada
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Johnston LM, Matteson CL, Finegood DT. Systems science and obesity policy: a novel framework for analyzing and rethinking population-level planning. Am J Public Health 2014; 104:1270-8. [PMID: 24832406 PMCID: PMC4056198 DOI: 10.2105/ajph.2014.301884] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/10/2014] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We demonstrate the use of a systems-based framework to assess solutions to complex health problems such as obesity. METHODS We coded 12 documents published between 2004 and 2013 aimed at influencing obesity planning for complex systems design (9 reports from US and Canadian governmental or health authorities, 1 Cochrane review, and 2 Institute of Medicine reports). We sorted data using the intervention-level framework (ILF), a novel solutions-oriented approach to complex problems. An in-depth comparison of 3 documents provides further insight into complexity and systems design in obesity policy. RESULTS The majority of strategies focused mainly on changing the determinants of energy imbalance (food intake and physical activity). ILF analysis brings to the surface actions aimed at higher levels of system function and points to a need for more innovative policy design. CONCLUSIONS Although many policymakers acknowledge obesity as a complex problem, many strategies stem from the paradigm of individual choice and are limited in scope. The ILF provides a template to encourage natural systems thinking and more strategic policy design grounded in complexity science.
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Affiliation(s)
- Lee M Johnston
- Lee M. Johnston is with the Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada. Carrie L. Matteson and Diane T. Finegood are with the Chronic Disease Systems Modeling Laboratory, Department of Biomedical Physiology and Kinesiology, Simon Fraser University
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Affiliation(s)
- Andrea Bombak
- Andrea Bombak is a PhD candidate at the University of Manitoba studying health perceptions and lived experiences of obese individuals over time and differing weight trajectories
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Collins PA, Resendes SJ, Dunn JR. The untold story: examining Ontario's community health centres' initiatives to address upstream determinants of health. Healthc Policy 2014; 10:14-29. [PMID: 25410693 PMCID: PMC4253893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023] Open
Abstract
BACKGROUND Unlike traditional primary care centres, part of the Community Health Centre (CHC) mandate is to address upstream health determinants. In Ontario, CHCs refer to these activities as Community Initiatives (CIs); yet, little is known about how CIs operate. The objective of this study was to examine the scope, resource requirements, partnerships, successes and challenges among selected Ontario CIs. METHODS We conducted qualitative interviews with 10 CHC staff members representing 11 CIs across Ontario. CIs were identified through an online inventory, recruited by e-mail and interviewed between March and June 2011. RESULTS Most CIs aim to increase community participation, while addressing social isolation and poverty. They draw minimal financial resources from their CHC, and employ highly skilled staff to support implementation. Most enlist support from various partners, and use numerous methods for community engagement. Successes include improved community relations, increased opportunities for education and employment and rewarding partnerships, while insufficient funding was a commonly identified challenge. CONCLUSIONS Despite minimal attention from researchers and funders, our findings suggest that CIs play key capacity-building roles in vulnerable communities across Ontario, and warrant further investigation.
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Affiliation(s)
- Patricia A Collins
- Assistant Professor, School of Urban and Regional Planning, Queen's University, Kingston, ON
| | | | - James R Dunn
- Associate Professor, Department of Health, Aging & Society, McMaster University, Hamilton, ON
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Schrecker T. Beyond 'run, knit and relax': can health promotion in Canada advance the social determinants of health agenda? Healthc Policy 2013; 9:48-58. [PMID: 24289939 PMCID: PMC4750152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
Abstract
Can health promotion in Canada effectively respond to the challenge of reducing health inequities presented by the WHO Commission on Social Determinants of Health? Against a background of failure to take seriously issues of social structure, I focus in particular on treatments of stress and its effects on health, and on the destructive congruence of Canadian health promotion initiatives with the neoliberal "individualization" of responsibility for (ill) health. I suggest that the necessary reinvention of the health promotion enterprise is possible, but implausible.
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Affiliation(s)
- Ted Schrecker
- Adjunct Professor, Department of Epidemiology and Community Medicine, University of Ottawa, Canada, Professor of Global Health Policy, School of Medicine, Pharmacy and Health, Durham University, Stockton-on-Tees, UK
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Getting to the root of the problem: health promotion strategies to address the social determinants of health. Canadian Journal of Public Health 2013. [PMID: 23618119 DOI: 10.1007/bf03405654] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Although extensive research shows that the social determinants of health influence the distribution and course of chronic diseases, there is little programming in public health that addresses the social determinants as a disease prevention strategy. This paper discusses different types of health promotion initiatives and differentiates them based on whether they attempt to impact intermediate (environmental) determinants of health or structural determinants of health. We argue for the importance of programming targeted at the structural determinants as opposed to programming targeted solely at the immediate environment. Specifically, the former has more potential to create significant improvements in health, contribute to long-term social change and increase health equity. We urge public health leaders to take this distinction into consideration during public health program planning, and to build capacity in the public health workforce to tackle structural mechanisms that lead to poor health and health inequities.
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