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Miguéns DGM, Cachafeiro MZ, Mallón SN, Coego IL, Pérez NV, Fernández AR. Knowledge, attitudes, and perceptions of student nurses regarding community activities in primary care: A cross-sectional study. Public Health Nurs 2024. [PMID: 39054621 DOI: 10.1111/phn.13385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 06/03/2024] [Accepted: 07/10/2024] [Indexed: 07/27/2024]
Abstract
OBJECTIVE To ascertain student nurses' degree of knowledge, attitudes, and perceptions regarding the implementation of community activities (CA) in primary care. DESIGN Questionnaire-based cross-sectional study. SAMPLE The study was conducted with 152 students seeking a nursing degree at the University of Santiago de Compostela (North Spain) in the 2022/2023 academic year. MEASUREMENTS We distributed a self-administered online questionnaire on CA, which are actions undertaken in collaboration with the local community and targeted at groups of people with common needs, in order to improve the health and wellbeing of the population. RESULTS Only 15.1% of the sample was able to identify CA correctly. However, 93.4% considered these an effective approach for the control of chronic diseases. Special mention should be made of the positive attitude shown by students toward the implementation of these types of activities. CONCLUSION Nurses play a key role in preventing chronic diseases, and it is therefore necessary to ensure that they are trained in the implementation of CA aimed at reducing the incidence of such diseases. Future training plans for nurses should emphasize the community perspective in order to improve the skills of future professionals in this field and to increase the success of these interventions.
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Affiliation(s)
- Diego Gabriel Mosteiro Miguéns
- Galician Public Healthcare Service, Healthcare Centre of Concepción Arenal, Rúa de Santiago León de Caracas, Santiago de Compostela, Spain
- Department of Psiquiatry, Radiology, Public Health, Nursing and Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Maruxa Zapata Cachafeiro
- Department of Psiquiatry, Radiology, Public Health, Nursing and Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER of Epidemiology and Public Health, CIBERESP) Instituto de Salud Carlos III, Madrid, Spain
- Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Silvia Novío Mallón
- Department of Psiquiatry, Radiology, Public Health, Nursing and Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Iria Lareu Coego
- Galician Public Healthcare Service, University Hospital Complex of Santiago de Compostela (CHUS), Santiago de Compostela, Spain
| | - Natalia Vieito Pérez
- Galician Public Healthcare Service, University Hospital Complex of Santiago de Compostela (CHUS), Santiago de Compostela, Spain
| | - Almudena Rodríguez Fernández
- Department of Psiquiatry, Radiology, Public Health, Nursing and Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER of Epidemiology and Public Health, CIBERESP) Instituto de Salud Carlos III, Madrid, Spain
- Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
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Zuniga JM, Prachniak C, Policek N, Magula N, Gandhi A, Anderson J, Diallo DD, Lima VD, Ravishankar S, Acharya S, Achrekar A, Adeleke M, Aïna É, Baptiste S, Barrow G, Begovac J, Bukusi E, Castel A, Castellanos E, Cestou J, Chirambo G, Crowley J, Dedes N, Ditiu L, Doherty M, Duncombe C, Durán A, Futterman D, Hader S, Kounkeu C, Lawless F, Lazarus JV, Lex S, Lobos C, Mayer K, Mejia M, Moheno HR, d'Arminio Monforte A, Morán-Arribas M, Nagel D, Ndugwa R, Ngunu C, Poonkasetwattana M, Prins M, Quesada A, Rudnieva O, Ruth S, Saavedra J, Toma L, Wanjiku Njenga L, Williams B. IAPAC-Lancet HIV Commission on the future of urban HIV responses. Lancet HIV 2024:S2352-3018(24)00124-3. [PMID: 39043198 DOI: 10.1016/s2352-3018(24)00124-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 04/26/2024] [Accepted: 05/02/2024] [Indexed: 07/25/2024]
Affiliation(s)
- José M Zuniga
- International Association of Providers of AIDS Care, Washington, DC, USA; Fast-Track Cities Institute, Washington, DC, USA.
| | | | | | | | - Anisha Gandhi
- New York City Department of Health and Mental Hygiene, New York, NY, USA
| | | | | | | | | | | | | | | | | | - Solange Baptiste
- International Treatment Preparedness Coalition, Johannesburg, South Africa
| | | | | | - Elizabeth Bukusi
- Kenya Medical Research Institute, Nairobi, Kenya; University of Nairobi, Nairobi, Kenya
| | | | | | - Jorge Cestou
- Chicago Department of Public Health, Chicago, IL, USA
| | | | | | | | | | - Meg Doherty
- World Health Organization, Geneva, Switzerland
| | - Chris Duncombe
- International Association of Providers of AIDS Care, Washington, DC, USA
| | - Adriana Durán
- Ministry of Health, City of Buenos Aires, Buenos Aires, Argentina
| | | | | | - Chyrol Kounkeu
- Cameroonian Association for the Development and Empowerment of Vulnerable People, Yaoundé, Cameroon
| | - Fran Lawless
- Mayor's Office of Health Policy, New Orleans, LA, USA
| | - Jeffrey V Lazarus
- University of Barcelona, Barcelona, Spain; CUNY Graduate School of Public Health and Policy, New York, NY, USA
| | | | | | - Kenneth Mayer
- Fenway Institute, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | | | | | | | | | | | | | - Carol Ngunu
- Nairobi City County Department of Health, Nairobi, Kenya
| | | | - Maria Prins
- Academic Medical Center, Amsterdam, Netherlands
| | - Amara Quesada
- Action for Health Initiatives, Quezon City, Philippines
| | | | - Simon Ruth
- Thorne Harbour Health, Melbourne, VIC, Australia
| | | | - Lance Toma
- San Francisco Community Health Center, San Francisco, CA, USA
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Krishnan N, Sunder P, Lalachan N, Mohan M, Venkateswaran C, John D. Participatory research in mental health care services in low- and middle-income countries: a scoping review protocol. JBI Evid Synth 2024:02174543-990000000-00327. [PMID: 38956969 DOI: 10.11124/jbies-23-00491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/04/2024]
Abstract
OBJECTIVE The objective of this scoping review will be to identify and map the characteristics of participatory research approaches in mental health care services conducted in low- and middle-income countries (LMICs). INTRODUCTION Developing countries have a treatment gap of 76% to 85% for mental disorders. Participatory research can help understand community perspectives, which, in turn, helps develop sustainable, contextually specific services. Although participatory research appears promising, especially in the context of LMICs, the field is heterogenous in terms of the methods used; the various stakeholders; the design, implementation, and evaluation of services; and outcome measures. INCLUSION CRITERIA This review will include all studies on participatory research in mental health care services in LMICs. All types of participants (ie, children/adolescent/adults, gender, rural/urban, etc.) and settings will be considered. METHODS The proposed review will follow the JBI methodology for scoping reviews. Published and unpublished studies will be searched for in MEDLINE (PubMed), Embase (Ovid), PsycINFO (EBSCOhost), CINAHL (EBSCOhost), and Google Scholar (first 10 pages). We will also search for gray literature and screen reference lists of relevant reviews. Two independent reviewers will screen the titles and abstracts of the studies, followed by full-text screening. Data will be extracted using a predefined form. The findings will be descriptively presented with supporting tables and diagrams, accompanied by a narrative summary. REVIEW REGISTRATION Details of the review can be found in Open Science Framework https://osf.io/cn54r.
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Affiliation(s)
- Naveen Krishnan
- Department of Medical Research, Believers Church Medical College Hospital, Thiruvalla, Kerala, India
| | | | - Nithin Lalachan
- Department of Medical Research, Believers Church Medical College Hospital, Thiruvalla, Kerala, India
| | - Monisha Mohan
- Department of Medical Research, Believers Church Medical College Hospital, Thiruvalla, Kerala, India
| | - Chitra Venkateswaran
- Mehac Foundation, Kochi, Kerala, India
- Department of Psychiatry, Believers Church Medical College Hospital, Thiruvalla, Kerala, India
| | - Denny John
- Evidence Synthesis and Implementation for Indigenous Health: A JBI Affiliated Group, Centre for Public Health Research (CPHR), Manbhum Ananda Ashram Nityananda Trust (MANT), Kolkata, India
- Faculty of Life and Allied Health Sciences, MS Ramaiah University of Applied Sciences, Bengaluru, India
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Darvish S, Mahoney SA, Venkatasubramanian R, Rossman MJ, Clayton ZS, Murray KO. Socioeconomic status as a potential mediator of arterial aging in marginalized ethnic and racial groups: current understandings and future directions. J Appl Physiol (1985) 2024; 137:194-222. [PMID: 38813611 DOI: 10.1152/japplphysiol.00188.2024] [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: 03/13/2024] [Revised: 05/28/2024] [Accepted: 05/28/2024] [Indexed: 05/31/2024] Open
Abstract
Cardiovascular diseases (CVDs) are the leading cause of death in the United States. However, disparities in CVD-related morbidity and mortality exist as marginalized racial and ethnic groups are generally at higher risk for CVDs (Black Americans, Indigenous People, South and Southeast Asians, Native Hawaiians, and Pacific Islanders) and/or development of traditional CVD risk factors (groups above plus Hispanics/Latinos) relative to non-Hispanic Whites (NHW). In this comprehensive review, we outline emerging evidence suggesting these groups experience accelerated arterial dysfunction, including vascular endothelial dysfunction and large elastic artery stiffening, a nontraditional CVD risk factor that may predict risk of CVDs in these groups with advancing age. Adverse exposures to social determinants of health (SDOH), specifically lower socioeconomic status (SES), are exacerbated in most of these groups (except South Asians-higher SES) and may be a potential mediator of accelerated arterial aging. SES negatively influences the ability of marginalized racial and ethnic groups to meet aerobic exercise guidelines, the first-line strategy to improve arterial function, due to increased barriers, such as time and financial constraints, lack of motivation, facility access, and health education, to performing conventional aerobic exercise. Thus, identifying alternative interventions to conventional aerobic exercise that 1) overcome these common barriers and 2) target the biological mechanisms of aging to improve arterial function may be an effective, alternative method to aerobic exercise to ameliorate accelerated arterial aging and reduce CVD risk. Importantly, dedicated efforts are needed to assess these strategies in randomized-controlled clinical trials in these marginalized racial and ethnic groups.
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Affiliation(s)
- Sanna Darvish
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, United States
| | - Sophia A Mahoney
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, United States
| | | | - Matthew J Rossman
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, United States
| | - Zachary S Clayton
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, United States
| | - Kevin O Murray
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, United States
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Suarez-Herrera JC, Diaz-Castro L, Ramirez-Rojas MG, Pelcastre-Villafuerte BE. Unpacking participation in healthcare governance: Lessons from two local health councils in Brazil and Spain. Int J Health Plann Manage 2024; 39:1097-1112. [PMID: 38373041 DOI: 10.1002/hpm.3781] [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: 09/01/2023] [Revised: 12/14/2023] [Accepted: 01/30/2024] [Indexed: 02/20/2024] Open
Abstract
This paper describes and compares the integration of cross-sector actors' participation into the governance of two local health councils, one located in Salvador de Bahia (Brazil) and the other in the Canary Islands (Spain). Based on the cross-national comparative research conducted as part of a doctoral thesis, a qualitative design based on secondary data analysis was proposed on the three stages of the organisational integration process of participation. We used information from individual semi-structured interviews (n = 70), situational observation, focus groups, literature review, and field notes to understand participatory processes of networking between multiple cross-sector actors and to show how such processes might be associated with innovative practices. For these innovations to be successfully implemented, stakeholders need to acquire adequate competencies in cross-sector collaboration, enabling them to learn about new organisational practices and to adapt the network of actors to the often unpredictable influences of contextual factors.
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Affiliation(s)
| | - Lina Diaz-Castro
- National Institute of Psychiatry Ramón de la Fuente Muñiz, Direction of Epidemiological and Psychosocial Research, Mexico City, Mexico
| | - Maria Guadalupe Ramirez-Rojas
- Department of Social and Environmental Processes and Health, National Council of Humanities, Sciences and Technologies (CONAHCYT), Center for Research and Higher Studies in Social Anthropology (CIESAS) Southeast Unit, San Cristóbal de las Casas, Chiapas, Mexico
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Martin S, Dill J, Demeritte D, Geressu H, Dahal R, Kirkland C, Hunt S, Parikh R. A Scoping Review of Health Equity Interventions in Governmental Public Health. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2024; 30:479-489. [PMID: 38830006 DOI: 10.1097/phh.0000000000001947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2024]
Abstract
CONTEXT Despite major efforts in research, practice, and policy, racial and ethnic disparities in health and health care persist in the United States. Interventions in collaboration with governmental public health may provide ways to address these persistent racial and ethnic health and health care disparities and improve health outcomes. OBJECTIVE To conduct a comprehensive review of health equity interventions performed in collaboration with public health agencies. DESIGN This scoping review includes intervention studies from Ovid MEDLINE, PsycINFO, and Academic Search Premier, published between 2017 and 2023. The search strategy used terminology focused on 4 concepts: race/ethnicity, equity, health departments, and epidemiologic studies. ELIGIBILITY CRITERIA The following inclusion criteria were determined a priori: (1) intervention tailored to reduce racial/ethnic health disparities, (2) public health department involvement, (3) health outcome measures, (4) use of epidemiologic study methods, (5) written in English, (6) implemented in the United States, (7) original data (not a commentary), and (8) published between January 2017 and January 2023. MAIN OUTCOME MEASURES This review focused primarily on 4 dimensions of racial health equity interventions including intervention components, intervention settings, intervention delivery agents, and intervention outcomes. RESULTS This review indicated that health equity interventions involving public health agencies focused on the following categories: (1) access to care, (2) health behavior, (3) infectious disease testing, (4) preventing transmission, and (5) cancer screening. Critical strategies included in interventions for reaching racial/ethnic minoritized people included using community settings, mobile clinics, social media/social networks, phone-based interventions, community-based workers, health education, active public health department involvement, and structural/policy change. CONCLUSIONS This scoping review aims to provide an evidence map to inform public health agencies, researchers, and funding agencies on gaps in knowledge and priority areas for future research and to identify existing health equity interventions that could be considered for implementation by public health leaders.
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Affiliation(s)
- Skky Martin
- Author Affiliations: Center for Public Health Systems, University of Minnesota School of Public Health, Minneapolis, Minnesota
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Obi C, Ojiakor I, Etiaba E, Onwujekwe O. Collaborations and Networks Within Communities for Improved Utilization of Primary Healthcare Centers: On the Road to Universal Health Coverage. Int J Public Health 2024; 69:1606810. [PMID: 38887723 PMCID: PMC11180759 DOI: 10.3389/ijph.2024.1606810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 05/20/2024] [Indexed: 06/20/2024] Open
Abstract
Objectives Community involvement depends on the level of linked and targeted activities for health by community members. This study examines the collaborations employed within communities to ensure sustainable access and improved use of healthcare in the community. Methods This study was conducted in rural and urban local government areas in Anambra, Kano, and Akwa-Ibom, Nigeria. About 90 in-depth interviews and 12 focus group discussions were conducted with community stakeholders and service users. The findings were transcribed and coded via thematic analysis, guided by the Expanded Health Systems framework. Results Various horizontal collaborations in communities foster increased use of PHC services; promoting community health. Major horizontal collaborations in these communities were community-led, primary health facility-led, and Individual-led collaborations. Their actions revolved around advocacy, building and renovating PHC centers, equipping facilities, and sensitization to educate community members on the need to utilize services at PHC centers. Conclusion Strategic involvements and collaborations of local actors within communities give rise to improvements in the utilization of primary healthcare centres, reportedly resulting in improved access to PHC healthcare services for community members.
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Affiliation(s)
- Chinelo Obi
- Health Policy Research Group, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Nigeria
| | - Iheomimichineke Ojiakor
- Health Policy Research Group, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Nigeria
| | - Enyi Etiaba
- Health Policy Research Group, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Nigeria
- Department of Health Administration and Management, Faculty of Health Science and Technology, University of Nigeria, Enugu, Nigeria
| | - Obinna Onwujekwe
- Health Policy Research Group, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Nigeria
- Department of Health Administration and Management, Faculty of Health Science and Technology, University of Nigeria, Enugu, Nigeria
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Park M, Bui LK, Kim J, Kim J, Jung J, Shin O, Na J, Guk H, Jang JS, Oh S, Kim DS. Developing an Online Health Community Platform for Facilitating Empowerment in Chronic Disease Prevention and Health Promotion. Comput Inform Nurs 2024; 42:421-429. [PMID: 38453463 DOI: 10.1097/cin.0000000000001070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
This study aimed to develop an online health community platform for facilitating the empowerment of people with chronic diseases dwelling in the community regarding disease prevention and health promotion. The user-centered design approach included four main steps: (1) identifying the health problems and needs of target users, (2) developing the content of the platform, (3) constructing the platform, and (4) pilot testing, refinement, and finalization. An online health community platform available both in a mobile application and a Web-enabled application has been launched to facilitate empowerment and self-management by people with chronic conditions. The main components of the application comprised (1) screening for chronic diseases and health problems, (2) setting personal goals for health promotion and action planning to achieve the goals themselves, (3) offering an online health community with shared group goals that help users engage with their peers to attain their goals, and (4) creating one's own online health community and inviting others to participate. The platform has the potential to encourage people with chronic conditions to proactively engage in their own health promotion. Future studies are needed to determine the impact of the application on self-management and empowerment for its users.
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Affiliation(s)
- Myonghwa Park
- Author Affiliations: Chungnam National University Community Care Center, College of Nursing (Dr Park, Ms Bui, Mr Kim, Ms Kim, Dr Jung) and Nursing Science Research Institute (Ms Shin), Chungnam National University; Mindle Health Welfare Social Cooperative (Dr Na, Mss Guk, Oh, and Kim); and Majubom Cooperative (Mr Jang), Daejeon, South Korea; and Hanoi Medical University, Faculty of Nursing and Midwifery, Hanoi, Vietnam (Ms Bui)
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Bapuji SB, Hansen A, Marembo MH, Olivier P, Yap MBH. Modifiable parental factors associated with the mental health of youth from immigrant families in high-income countries: A systematic review and meta-analysis. Clin Psychol Rev 2024; 110:102429. [PMID: 38643664 DOI: 10.1016/j.cpr.2024.102429] [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: 06/23/2023] [Revised: 02/06/2024] [Accepted: 04/04/2024] [Indexed: 04/23/2024]
Abstract
Parental factors play a major role in youth mental health and many youth in high-income countries have at least one overseas-born parent. It is, hence, important to understand how immigrant parenting is associated with youth mental health in high-income countries. Following PRISMA guidelines, this review sought to identify modifiable parental factors to inform parenting interventions to prevent mental health problems in youth aged 0-18 years whose parents migrated voluntarily for economic reasons from low and middle-income countries to high-income countries. Sixteen parental factors were identified from 56 studies that were associated with five outcomes - youth self-esteem (k = 17), general stress (k = 4), acculturative stress (k = 4), anxiety symptoms (k = 9), and depressive symptoms (k = 41). A sound evidence base was found for one or more of these outcomes associated with protective factors - caring and supportive parenting and parental monitoring; and risk factors - parent-youth acculturative and general conflict, parental withdrawal, interparental conflict, and parent mental health problems. This systematic review and meta-analysis identified immigrant parental factors that have robust associations with youth mental health outcomes. These findings can be used to inform parenting interventions and support immigrant parents in preventing youth mental health problems.
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Affiliation(s)
- Sunita Bayyavarapu Bapuji
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, 18 Innovation Walk, Clayton campus, VIC 3800, Australia
| | - Ashlyn Hansen
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, 18 Innovation Walk, Clayton campus, VIC 3800, Australia
| | - Miriam H Marembo
- Department of Econometrics & Business Statistics, Monash University, 20 Chancellor's Walk, Clayton Campus, Wellington Road, Clayton, VIC 3800, Australia
| | - Patrick Olivier
- Action Lab, Department of Human-Centred Computing, Faculty of Information Technology, Monash University, Australia
| | - Marie Bee Hui Yap
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, 18 Innovation Walk, Clayton campus, VIC 3800, Australia.
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Molete MM, Malele-Kolisa Y, Thekiso M, Lang AY, Kong A, George A. The role of community health workers in promoting oral health at school settings: A scoping review. J Public Health Dent 2024; 84:175-186. [PMID: 38558304 DOI: 10.1111/jphd.12612] [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: 06/27/2023] [Revised: 01/15/2024] [Accepted: 01/16/2024] [Indexed: 04/04/2024]
Abstract
OBJECTIVES The scoping review aimed to examine the literature on the role of Community Health Workers (CHW) in oral health interventions within school settings. The objectives were to identify the characteristics of school oral health interventions where CHWs played a role; and to assess the outcomes derived from CHW participation in school oral health. METHODS The scoping review was guided by the Levac et al (2010) framework. Articles selected for this review included all forms of study designs and gray literature. The search strategy included CHW and other non-dental personnel providing oral health activities within schools and the outcomes of these interventions from 1995. Databases included Pubmed, ProQuest, Scopus and EBSCO Host. RESULTS There were eleven (n = 11) peer reviewed articles included. Only one study in this review related to CHW involvement in school oral health settings. The remaining involved teachers (n = 4), peer learners (n = 3) or a combination of both (n = 3). Characteristics of the interventions ranged from oral health screenings, education, supervised brushing, and community engagements. Three outcomes emerged; widening access to oral health services, acceptability of non-oral health personnel and learners in promoting oral health and improvement of oral health self-care. CONCLUSIONS The review brought to light the benefits of utilizing non-dental personnel such as teachers and peer learners in augmenting staff capacity for school oral health interventions. In addition, the findings highlighted the need to further research on the feasibility and acceptability of integrating CHW in school oral health settings.
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Affiliation(s)
- Mpho Matlakale Molete
- Department of Oral Biological Sciences, University of the Witwatersrand, School of Oral Health Sciences, Johannesburg, South Africa
- Australian Centre for Integration of Oral Health (ACIOH), School of Nursing and Midwifery, Western Sydney University, Penrith, Australia
| | - Yolanda Malele-Kolisa
- Department of Community Dentistry, University of the Witwatersrand, School of Oral Health Sciences, Johannesburg, South Africa
| | - Maphefo Thekiso
- Department of Community Dentistry, University of the Witwatersrand, School of Oral Health Sciences, Johannesburg, South Africa
| | | | - Ariana Kong
- Australian Centre for Integration of Oral Health (ACIOH), School of Nursing and Midwifery, Western Sydney University, Penrith, Australia
| | - Ajesh George
- Australian Centre for Integration of Oral Health (ACIOH), School of Nursing and Midwifery, Western Sydney University, Penrith, Australia
- School of Dentistry, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia
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Raj A, Dey A, Rao N, Yore J, McDougal L, Bhan N, Silverman JG, Hay K, Thomas EE, Fotso JC, Lundgren R. The EMERGE framework to measure empowerment for health and development. Soc Sci Med 2024; 351 Suppl 1:116879. [PMID: 38825382 DOI: 10.1016/j.socscimed.2024.116879] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 01/24/2024] [Accepted: 04/09/2024] [Indexed: 06/04/2024]
Abstract
RATIONALE Women's empowerment is a UN Sustainable Development Goal and a focus of global health and development but survey measures and data on gender empowerment remain weak. Existing indicators are often disconnected from theory; stronger operationalization is needed. OBJECTIVE We present the EMERGE Framework to Measure Empowerment, a framework to strengthen empowerment measures for global health and development. METHOD We initiated development of this framework in 2016 as part of EMERGE - an initiative designed to build the science of survey research and availability of high-quality survey measures and data on gender empowerment. The framework is guided by existing theories of empowerment, evidence, and expert input. We apply this framework to understand women's empowerment in family planning (FP) via review of state of the field measures. RESULTS Our framework offers concrete measurable constructs to assess critical consciousness and choice, agency and backlash, and goal achievement as the empowerment process, recognizing its operation at multiple levels-from the individual to the collective. Internal attributes, social norms, and external contexts and resources create facilitators or barriers to the empowerment process. Review of best evidence FP measures assessing empowerment constructs, social norms, and key influencers (e.g., partners and providers) show a strong landscape of measures, including those with women, partners, and providers, but they are limited in assessing translation of choice to agency to achievement of women's self-determined fertility or contraceptive goals, instead relying on assumption of contraceptive use as the goal. We see no measures on collective empowerment toward women's reproductive choice and rights. CONCLUSION The EMERGE Framework can guide development and analysis of survey measures on empowerment and is needed as the current state of the field shows limited coverage of empowerment constructs even in areas which have received more study, such as family planning.
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Affiliation(s)
- Anita Raj
- Newcomb Institute, Tulane University, 43 Newcomb Place, Suite 301, New Orleans, LA, 70118, USA; Tulane School of Public Health and Tropical Medicine, 1440 Canal Street, Suite 2460 #8329, New Orleans, LA, 70112, USA; Center on Gender Equity and Health, University of California, San Diego, 9500 Gilman Drive, Mail Code 0507, La Jolla, CA, 92093, USA.
| | - Arnab Dey
- Center on Gender Equity and Health, University of California, San Diego, 9500 Gilman Drive, Mail Code 0507, La Jolla, CA, 92093, USA
| | - Namratha Rao
- Newcomb Institute, Tulane University, 43 Newcomb Place, Suite 301, New Orleans, LA, 70118, USA
| | - Jennifer Yore
- Center on Gender Equity and Health, University of California, San Diego, 9500 Gilman Drive, Mail Code 0507, La Jolla, CA, 92093, USA
| | - Lotus McDougal
- Center on Gender Equity and Health, University of California, San Diego, 9500 Gilman Drive, Mail Code 0507, La Jolla, CA, 92093, USA
| | - Nandita Bhan
- O.P. Jindal Global University, Sonipat Narela Road, Near Jagdishpur Village, Sonipat, Haryana, 131001, India
| | - Jay G Silverman
- Tulane School of Public Health and Tropical Medicine, 1440 Canal Street, Suite 2460 #8329, New Orleans, LA, 70112, USA
| | - Katherine Hay
- Center on Gender Equity and Health, University of California, San Diego, 9500 Gilman Drive, Mail Code 0507, La Jolla, CA, 92093, USA
| | - Edwin E Thomas
- Newcomb Institute, Tulane University, 43 Newcomb Place, Suite 301, New Orleans, LA, 70118, USA
| | | | - Rebecka Lundgren
- Center on Gender Equity and Health, University of California, San Diego, 9500 Gilman Drive, Mail Code 0507, La Jolla, CA, 92093, USA
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Amanyi-Enegela JA, Badaki JA, Alege GO, Okunade F, Kumbur J, Ishaya R, Ashikeni D, Qureshi MB, Sankar G. Community Feedback on Mass Medicines Administration for Neglected Tropical Diseases in Federal Capital Territory, Abuja, Nigeria. Trop Med Infect Dis 2024; 9:126. [PMID: 38922038 PMCID: PMC11209482 DOI: 10.3390/tropicalmed9060126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 05/27/2024] [Accepted: 05/27/2024] [Indexed: 06/27/2024] Open
Abstract
The World Health Organization (WHO) recommends the use of annual mass drug administration (MDA) as the strategy for controlling and eliminating the five preventive chemotherapy neglected tropical diseases (PC-NTDs). The success of MDAs hinges on community acceptance, active participation, and compliance. This study aimed to explore the experiences and perceptions of community members, to obtain a more thorough understanding of their openness and willingness to participate in MDA and other NTD elimination activities. A mixed-methods approach was employed, utilizing qualitative and quantitative methods for comprehensive data collection. Eighteen key informant interviews (KIIs) and sixteen focus group discussions (FGDs) were conducted to explore community engagement, participation, medication utilization, and programme perception. Triangulation of findings from interviews and discussions with household survey results was performed to gain a deeper understanding of emerging themes. The household survey involved interviewing 1220 individuals (Abaji: 687; Bwari: 533). Audio tapes recorded KIIs and FGDs, with interview transcripts coded using Nvivo 12.0 software based on predefined themes. Descriptive analysis using SPSS version 21 was applied to quantitative data. Results indicated high awareness of mass drug administration (MDA) campaigns in both area councils (Abaji: 84.9%; Bwari: 82.9%), with a small percentage claiming ignorance (15.1%), attributed to lack of information or absence during health campaigns. Respondents primarily participated by taking medication (82.5%), with minimal involvement in other MDA campaigns. Perception of medicines was generally positive, with a significant association between participation level and performance rating (p < 0.05). The study recommends leveraging high awareness and community responsiveness to enhance engagement in various MDA activities, ensuring sustainability and ownership of the programme.
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Affiliation(s)
- Juliana Ajuma Amanyi-Enegela
- Inclusive Eye Health and Neglected Tropical Diseases Initiative, CBM Christoffel-Blindenmission Christian Blind Mission e.V., Wellington House, East Road, Cambridge CB1 1BH, UK
| | | | | | - Faizah Okunade
- CBM Christoffel-Blindenmission Christian Blind Mission e.V Nigeria Country Office, 13 Okemesi Crescent, Garki 2, Federal Capital Territory, Abuja 900103, Nigeria
| | - Joseph Kumbur
- CBM Christoffel-Blindenmission Christian Blind Mission e.V Nigeria Country Office, 13 Okemesi Crescent, Garki 2, Federal Capital Territory, Abuja 900103, Nigeria
| | - Rinpan Ishaya
- HANDS, 5A Naomi Jugu Drive, Rayfield, Jos, Nigeria (D.A.)
| | | | - Mohammad Babar Qureshi
- Inclusive Eye Health and Neglected Tropical Diseases Initiative, CBM Christoffel-Blindenmission Christian Blind Mission e.V., Wellington House, East Road, Cambridge CB1 1BH, UK
| | - Girija Sankar
- Inclusive Eye Health and Neglected Tropical Diseases Initiative, CBM Christoffel-Blindenmission Christian Blind Mission e.V., Wellington House, East Road, Cambridge CB1 1BH, UK
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Mesic A, Stewart B, Opoku I, Wagenaar BH, Andoh Mohammed B, Abdul Matinue S, Jmaileh M, Damsere-Derry J, Gyedu A, Mock C, Kitali A, Hardy Wuaku D, Owusu Afram M, Feldacker C. "We are pleading for the government to do more": Road user perspectives on the magnitude, contributing factors, and potential solutions to road traffic injuries and deaths in Ghana. PLoS One 2024; 19:e0300458. [PMID: 38787863 PMCID: PMC11125548 DOI: 10.1371/journal.pone.0300458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 02/27/2024] [Indexed: 05/26/2024] Open
Abstract
Road traffic collisions disproportionately impact Ghana and other low- and middle-income countries. This study explored road user perspectives regarding the magnitude, contributing factors, and potential solutions to road traffic collisions, injuries, and deaths. We designed a qualitative study of 24 in-depth interviews with 14 vulnerable road users (pedestrians, occupants of powered 2- and 3-wheelers, cyclists) and ten non-vulnerable road users in four high-risk areas in November 2022. We used a mixed deductive (direct content analysis) and inductive (interpretive phenomenological analysis) approach. In the direct content analysis, a priori categories based on Haddon's Matrix covered human, vehicle, socioeconomic environment, and physical environment factors influencing road traffic collisions, along with corresponding solutions. We used inductive analysis to identify emerging themes. Participants described frequent and distressing experiences with collisions, and most often reported contributing factors, implementation gaps, and potential solutions within the human (road user) level domain of Haddon's Matrix. Implementation challenges included sporadic enforcement, reliance on road users' adherence to safety laws, and the low quality of the existing infrastructure. Participants expressed that they felt neglected and ignored by road safety decision-makers. This research emphasizes the need for community input for successful road safety policies in Ghana and other low- and middle-income countries, calling for greater governmental support an action to address this public health crisis. We recommend the government collaborates with communities to adapt existing interventions including speed calming, footbridges, and police enforcement, and introduces new measures that meet local needs.
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Affiliation(s)
- Aldina Mesic
- Department of Global Health, University of Washington, Seattle, Washington, United States of America
| | - Barclay Stewart
- Department of Surgery, University of Washington, Seattle, Washington, United States of America
- Harborview Injury Prevention and Research Center, Seattle, Washington, United States of America
| | - Irene Opoku
- Building and Road Research Institute, Kumasi, Ghana
| | - Bradley H. Wagenaar
- Department of Global Health, University of Washington, Seattle, Washington, United States of America
- Department of Epidemiology, University of Washington, Seattle, Washington, United States of America
| | - Bilal Andoh Mohammed
- Department of Surgery, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Sulemana Abdul Matinue
- Department of Global Health, University of Washington, Seattle, Washington, United States of America
| | - Manal Jmaileh
- Department of Global Health, University of Washington, Seattle, Washington, United States of America
| | - James Damsere-Derry
- Department of Surgery, University of Washington, Seattle, Washington, United States of America
| | - Adam Gyedu
- Department of Surgery, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Charles Mock
- Department of Global Health, University of Washington, Seattle, Washington, United States of America
- Department of Surgery, University of Washington, Seattle, Washington, United States of America
- Harborview Injury Prevention and Research Center, Seattle, Washington, United States of America
- Department of Epidemiology, University of Washington, Seattle, Washington, United States of America
- Department of Surgery, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Angela Kitali
- Civil Engineering Program, University of Washington, Tacoma, Washington, United States of America
| | | | | | - Caryl Feldacker
- Department of Global Health, University of Washington, Seattle, Washington, United States of America
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Chatio ST, Duah E, Ababio LO, Lister N, Egbujo O, Marfo K, Aborigo R, Ansah P, Odame I. Barriers and facilitators to community acceptability of integrating point-of-care testing to screen for sickle cell disease in children in primary healthcare settings in rural Upper East Region of Northern Ghana. PLoS One 2024; 19:e0303520. [PMID: 38768171 PMCID: PMC11104616 DOI: 10.1371/journal.pone.0303520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 04/25/2024] [Indexed: 05/22/2024] Open
Abstract
INTRODUCTION Sickle cell disease (SCD) remains a public health problem especially in sub-Saharan Africa including Ghana. While pilot initiatives in Africa have demonstrated that neonatal screening coupled with early intervention reduces SCD-related morbidity and mortality, only 50-70% of screen-positive babies have been successfully retrieved to benefit from these interventions. Point-of-care testing (POCT) with high specificity and sensitivity for SCD screening can be integrated into existing immunization programs in Africa to improve retrieval rates. This study explored community acceptability of integrating POCT to screen for SCD in children under 5 years of age in primary healthcare facilities in Northern Ghana. METHOD This was an exploratory study using qualitative research approach where 10 focus group discussions and 20 in-depth interviews were conducted with community members and health workers between April and June 2022. The recorded interviews were transcribed verbatim after repeatedly listening to the recordings. Data was coded into themes using QSR Nvivo 12 software before thematic analysis. RESULTS Most participants (70.9%) described SCD as serious and potentially life-threatening condition affecting children in the area. Of 148 community members and health workers, 141 (95.2%) said the screening exercise could facilitate diagnosis of SCD in children for early management. However, discrimination, fear of being tested positive, stigmatization, negative health worker attitude linked with issues of maintaining confidentiality were reported by participants as key factors that could affect uptake of the SCD screening exercise. Most participants suggested that intensive health education (78.3%), positive attitude of health workers (69.5%), and screening health workers not being biased (58.8%) could promote community acceptability. CONCLUSION A large majority of participants viewed screening of SCD in children as very important. However, opinions expressed by most participants suggest that health education and professionalism of health workers in keeping patients' information confidential could improve the uptake of the exercise.
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Affiliation(s)
| | - Enyonam Duah
- Navrongo Health Research Center, Navrongo, Ghana
| | | | - Nicola Lister
- Global Health & Sustainability, Novartis Pharma AG, Basel, Switzerland
| | - Olufolake Egbujo
- Global Health & Sustainability, Novartis Pharma AG, Basel, Switzerland
| | - Kwaku Marfo
- Global Health & Sustainability, Novartis Pharma AG, Basel, Switzerland
| | | | | | - Isaac Odame
- Hemoglobinopathy Program, The Hospital For Sick Children, University of Toronto, Toronto, ON, Canada
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Grice-Jackson T, Rogers I, Ford E, Dickinson R, Frere-Smith K, Goddard K, Silver L, Topham C, Nahar P, Musinguzi G, Bastiaens H, Van Marwijk H. A community health worker led approach to cardiovascular disease prevention in the UK-SPICES-Sussex (scaling-up packages of interventions for cardiovascular disease prevention in selected sites in Europe and Sub-saharan Africa): an implementation research project. FRONTIERS IN HEALTH SERVICES 2024; 4:1152410. [PMID: 38784704 PMCID: PMC11113076 DOI: 10.3389/frhs.2024.1152410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 03/20/2024] [Indexed: 05/25/2024]
Abstract
Background This paper describes a UK-based study, SPICES-Sussex, which aimed to co-produce and implement a community-based cardiovascular disease (CVD) risk assessment and reduction intervention to support under-served populations at moderate risk of CVD. The objectives were to enhance stakeholder engagement; to implement the intervention in four research sites and to evaluate the use of Voluntary and Community and Social Enterprises (VCSE) and Community Health Worker (CHW) partnerships in health interventions. Methods A type three hybrid implementation study design was used with mixed methods data. This paper represents the process evaluation of the implementation of the SPICES-Sussex Project. The evaluation was conducted using the RE-AIM framework. Results Reach: 381 individuals took part in the risk profiling questionnaire and forty-one women, and five men participated in the coaching intervention. Effectiveness: quantitative results from intervention participants showed significant improvements in CVD behavioural risk factors across several measures. Qualitative data indicated high acceptability, with the holistic, personalised, and person-centred approach being valued by participants. Adoption: 50% of VCSEs approached took part in the SPICES programme, The CHWs felt empowered to deliver high-quality and mutually beneficial coaching within a strong project infrastructure that made use of VCSE partnerships. Implementation: Co-design meetings resulted in local adaptations being made to the intervention. 29 (63%) of participants completed the intervention. Practical issues concerned how to embed CHWs in a health service context, how to keep engaging participants, and tensions between research integrity and the needs and expectations of those in the voluntary sector. Maintenance: Several VCSEs expressed an interest in continuing the intervention after the end of the SPICES programme. Conclusion Community-engagement approaches have the potential to have positively impact the health and wellbeing of certain groups. Furthermore, VCSEs and CHWs represent a significant untapped resource in the UK. However, more work needs to be done to understand how links between the sectors can be bridged to deliver evidence-based effective alternative preventative healthcare. Reaching vulnerable populations remains a challenge despite partnerships with VCSEs which are embedded in the community. By showing what went well and what did not, this project can guide future work in community engagement for health.
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Affiliation(s)
- Thomas Grice-Jackson
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, United Kingdom
| | - Imogen Rogers
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, United Kingdom
| | - Elizabeth Ford
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, United Kingdom
| | - Robert Dickinson
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, United Kingdom
| | - Kat Frere-Smith
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, United Kingdom
| | - Katie Goddard
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, United Kingdom
| | - Linda Silver
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, United Kingdom
| | - Catherine Topham
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, United Kingdom
| | - Papreen Nahar
- Department of Global Health Infection, Brighton and Sussex Medical School, University of Sussex, Brighton, United Kingdom
| | - Geofrey Musinguzi
- Department of Disease Control and Environmental Health, Makerere University, Kampala, Central Region, Uganda
| | - Hilde Bastiaens
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Harm Van Marwijk
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, United Kingdom
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Li S, Gulley J, Booty M, Firchow B, McGladrey ML. Using Photovoice to Improve Engagement in Community Health Assessments Addressing Behavioral Health. J Behav Health Serv Res 2024:10.1007/s11414-024-09885-4. [PMID: 38710979 DOI: 10.1007/s11414-024-09885-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2024] [Indexed: 05/08/2024]
Abstract
Behavioral health disorders are well-known to have close links with the social determinants of health, yet little is known about how impacted communities perceive these links. Qualitative participatory methods can not only provide insight into how communities conceptualize these relationships but also empower those with lived experience to contextualize their perspectives and formulate calls to action. This study used Photovoice as a participatory method to supplement the Clark County Health Department Community Health Assessment and determine priority facilitators and barriers contributing to the behavioral health of Clark County, KY, residents. A secondary aim was to gain a greater understanding of how the Photovoice methodology impacts community engagement efforts in Community Health Assessments. Twenty-three Clark County residents participated in four Photovoice groups involving five weekly sessions, which included photograph "show and tell," critical group dialogue, participatory analysis, and planning for dissemination. Secondary analysis of Photovoice focus group discussions revealed behavioral health facilitators and barriers were most influenced by (1) public sector unresponsiveness, (2) strong partnerships formed between community and grassroots organizations, and (3) the siloed division of responsibility between agencies and across sectors. The authors also found the Photovoice method successfully enhanced engagement and empowered those with lived experience to frame their perspectives of the behavioral health landscape. This project has implications for enhancing community engagement and empowerment in behavioral health-focused public health assessments and shaping policy to promote multi-sector collaboration.
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Affiliation(s)
- Stacey Li
- School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, 70118, USA.
| | | | - Marisa Booty
- University of Kentucky College of Arts and Sciences, Lexington, KY, 40506, USA
| | - Bradley Firchow
- University of Kentucky College of Medicine, Lexington, KY, 40506, USA
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Brydges HT, Laspro M, Verzella AN, Alcon A, Schechter J, Cassidy MF, Chaya BF, Iturrate E, Flores RL. Contemporary Prevalence of Oral Clefts in the US: Geographic and Socioeconomic Considerations. J Clin Med 2024; 13:2570. [PMID: 38731101 PMCID: PMC11084882 DOI: 10.3390/jcm13092570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Revised: 04/20/2024] [Accepted: 04/24/2024] [Indexed: 05/13/2024] Open
Abstract
Background: Socio-economic status, living environments, and race have been implicated in the development of different congenital abnormalities. As orofacial clefting is the most common anomaly affecting the face, an understanding of its prevalence in the United States and its relationship with different determinants of health is paramount. Therefore, the purpose of this study is to determine the modern prevalence of oral-facial clefting in the United States and its association with different social determinants of health. Methods: Utilizing Epic Cosmos, data from approximately 180 US institutions were queried. Patients born between November 2012 and November 2022 were included. Eight orofacial clefting (OC) cohorts were identified. The Social Vulnerability Index (SVI) was used to assess social determinants of health. Results: Of the 15,697,366 patients identified, 31,216 were diagnosed with OC, resulting in a prevalence of 19.9 (95% CI: 19.7-20.1) per 10,000 live births. OC prevalence was highest among Asian (27.5 CI: 26.2-28.8) and Native American (32.8 CI: 30.4-35.2) patients and lowest among Black patients (12.96 CI: 12.5-13.4). Male and Hispanic patients exhibited higher OC prevalence than female and non-Hispanic patients. No significant differences were found among metropolitan (20.23/10,000), micropolitan (20.18/10,000), and rural populations (20.02/10,000). SVI data demonstrated that OC prevalence was positively associated with the percentage of the population below the poverty line and negatively associated with the proportion of minority language speakers. Conclusions: This study examined the largest US cohort of OC patients to date to define contemporary US prevalence, reporting a marginally higher rate than previous estimates. Multiple social determinants of health were found to be associated with OC prevalence, underscoring the importance of holistic prenatal care. These data may inform clinicians about screening and counseling of expectant families based on socio-economic factors and direct future research as it identifies potential risk factors and provides prevalence data, both of which are useful in addressing common questions related to screening and counseling.
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Affiliation(s)
- Hilliard T. Brydges
- Hansjörg Wyss Department of Plastic Surgery, NYU Grossman School of Medicine, New York, NY 10017, USA; (H.T.B.); (M.L.); (A.N.V.); (A.A.); (J.S.); (M.F.C.); (B.F.C.)
| | - Matteo Laspro
- Hansjörg Wyss Department of Plastic Surgery, NYU Grossman School of Medicine, New York, NY 10017, USA; (H.T.B.); (M.L.); (A.N.V.); (A.A.); (J.S.); (M.F.C.); (B.F.C.)
| | - Alexandra N. Verzella
- Hansjörg Wyss Department of Plastic Surgery, NYU Grossman School of Medicine, New York, NY 10017, USA; (H.T.B.); (M.L.); (A.N.V.); (A.A.); (J.S.); (M.F.C.); (B.F.C.)
| | - Andre Alcon
- Hansjörg Wyss Department of Plastic Surgery, NYU Grossman School of Medicine, New York, NY 10017, USA; (H.T.B.); (M.L.); (A.N.V.); (A.A.); (J.S.); (M.F.C.); (B.F.C.)
| | - Jill Schechter
- Hansjörg Wyss Department of Plastic Surgery, NYU Grossman School of Medicine, New York, NY 10017, USA; (H.T.B.); (M.L.); (A.N.V.); (A.A.); (J.S.); (M.F.C.); (B.F.C.)
| | - Michael F. Cassidy
- Hansjörg Wyss Department of Plastic Surgery, NYU Grossman School of Medicine, New York, NY 10017, USA; (H.T.B.); (M.L.); (A.N.V.); (A.A.); (J.S.); (M.F.C.); (B.F.C.)
| | - Bachar F. Chaya
- Hansjörg Wyss Department of Plastic Surgery, NYU Grossman School of Medicine, New York, NY 10017, USA; (H.T.B.); (M.L.); (A.N.V.); (A.A.); (J.S.); (M.F.C.); (B.F.C.)
| | - Eduardo Iturrate
- Department of Medicine, NYU Grossman School of Medicine, New York, NY 10017, USA;
| | - Roberto L. Flores
- Hansjörg Wyss Department of Plastic Surgery, NYU Grossman School of Medicine, New York, NY 10017, USA; (H.T.B.); (M.L.); (A.N.V.); (A.A.); (J.S.); (M.F.C.); (B.F.C.)
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Warkentin L, Hueber S, Kühlein T, Scherer M. Insights on the German College of General Practitioners and Family Physicians (DEGAM) guideline addressing medical overuse. BMJ Evid Based Med 2024:bmjebm-2023-112697. [PMID: 38395593 DOI: 10.1136/bmjebm-2023-112697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/12/2024] [Indexed: 02/25/2024]
Affiliation(s)
- Lisette Warkentin
- Institute of General Practice, Uniklinikum Erlangen, Erlangen, Germany
| | - Susann Hueber
- Institute of General Practice, Uniklinikum Erlangen, Erlangen, Germany
| | - Thomas Kühlein
- Institute of General Practice, Uniklinikum Erlangen, Erlangen, Germany
| | - Martin Scherer
- Institute and Polyclinic for Primary Care and Family Medicine, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
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Stover J, Avadhanula L, Sood S. A review of strategies and levels of community engagement in strengths-based and needs-based health communication interventions. Front Public Health 2024; 12:1231827. [PMID: 38655513 PMCID: PMC11035763 DOI: 10.3389/fpubh.2024.1231827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 03/14/2024] [Indexed: 04/26/2024] Open
Abstract
Background Community engagement is key in health communication interventions that seek to incorporate community voices in their planning and implementation. Understanding what approaches and strategies are currently being used can help tailor programs in different social and cultural contexts. This review explores needs-based and strengths-based approaches and consensus and conflict strategies in community-based global health communications programs. Our objective is to examine the current state of the field, outline lessons learned, and identify gaps in existing programming to help guide future interventions. Methods PubMed and Web of Science were searched for articles published between 2010 and 2023. Studies were included if they described a community-based health communication intervention and an ongoing or completed implementation. Interventions were coded then categorized according to their level of community engagement and as single, hybrid, or complex, depending upon the number of approaches and strategies used. Results The search yielded 678 results and 42 were included in the final review and analysis. A vast majority 34 (81.0%) interventions utilized a needs-based approach and 24 (57.1%) utilized a strengths-based approach. Consensus as a strategy was utilized in 38 (90.5%) of the manuscripts and 9 (21.4%) implemented a conflict strategy. Interventions that combined approaches and strategies were more likely to leverage a higher level of community engagement. Conclusion These results showcase the complicated nature of global health communication program planning and implementation. There is a lack of interventions that use conflict as a strategy to empower communities to act on their own behalf, even when at odds with existing power structures. Complex interventions that include all approaches and strategies demonstrate the potential for global health communication interventions to be at the cutting edge of public health practice.
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Affiliation(s)
- Jesse Stover
- Department of Community Health and Prevention, Drexel University Dornsife School of Public Health, Philadelphia, PA, United States
| | - Laxmisupriya Avadhanula
- Department of Community Health and Prevention, Drexel University Dornsife School of Public Health, Philadelphia, PA, United States
| | - Suruchi Sood
- Johns Hopkins Center for Communication Programs, Department of Health Behavior and Society, Bloomberg School of Public Health, Baltimore, MD, United States
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20
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Gray C, Crawford G, Roberts M, Vujcich D. 'You are making it sound like you are talking to a child': exploring community sentiment on developing and disseminating tailored sexual health education resources for migrants. HEALTH EDUCATION RESEARCH 2024:cyae014. [PMID: 38568929 DOI: 10.1093/her/cyae014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 03/06/2024] [Accepted: 03/15/2024] [Indexed: 04/05/2024]
Abstract
Health communication is a critical component of public health, which includes health education resources. Resource effectiveness is improved where health literacy demands, including the cultural appropriateness of resources, match the intended audience. International guidelines support the tailoring of resources for migrants from culturally and linguistically diverse backgrounds (CaLD). Five focus groups (n = 18) and interviews (n = 9) with people from CaLD migrant backgrounds explored community perspectives on sexual health resources developed by a state department of health, specifically clarity, comprehensiveness, cultural appropriateness and strategies for dissemination. We identified three major thematic areas relating to simplicity, cultural norms and beliefs and dissemination. Participants recommended resource delivery in different formats as part of a broader intervention. Generally, sexual health information was deemed appropriate and easily understood. However, the resources used simplified language that participants reported was vague and inaccurate at times, potentially contributing to misinformation and reinforcing stigma relating both to the status of being a migrant and sexual health. Findings suggest the need for more nuanced health resource development beyond translation and language simplification. Resources developed in different formats, including different health literacy demands, using approaches that engage the target group in design and dissemination and contextualized within a comprehensive health promotion project, are likely to be more effective.
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Affiliation(s)
| | - Gemma Crawford
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Bentley, WA 6102, Australia
| | - Meagan Roberts
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Bentley, WA 6102, Australia
| | - Daniel Vujcich
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Curtin University, Bentley, WA 6102, Australia
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Clark EC, Baidoobonso S, Phillips KAM, Noonan LL, Bakker J, Burnett T, Stoby K, Dobbins M. Mobilizing community-driven health promotion through community granting programs: a rapid systematic review. BMC Public Health 2024; 24:932. [PMID: 38561718 PMCID: PMC10983705 DOI: 10.1186/s12889-024-18443-8] [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: 12/20/2023] [Accepted: 03/26/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Effective health promotion responds to the unique needs of communities. Community granting programs that fund community-driven health promotion initiatives are a potential mechanism to meet those unique needs. While numerous community health-focused programs are available, the various strategies used by granting programs to foster engagement, administer grants and support awardees have not been systematically evaluated. This rapid systematic review explores the administration of community granting programs and how various program components impact process and population health outcomes. METHODS A systematic search was conducted across three databases: Medline, SocINDEX, and Political Science Database. Single reviewers completed screening, consistent with a rapid review protocol. Studies describing or evaluating community granting programs for health or public health initiatives were included. Data regarding program characteristics were extracted and studies were evaluated for quality. A convergent integrated approach was used to analyze quantitative and qualitative findings. RESULTS Thirty-five community granting programs, described in 36 studies, were included. Most were descriptive reports or qualitative studies conducted in the USA. Program support for grant awardees included technical assistance, workshops and training, program websites, and networking facilitation. While most programs reported on process outcomes, few reported on community or health outcomes; such outcomes were positive when reported. Programs reported that many funded projects were likely sustainable beyond program funding, due to the development of awardee skills, new partnerships, and securing additional funding. From the perspectives of program staff and awardees, facilitators included the technical assistance and workshops provided by the programs, networking amongst awardees, and the involvement of community members. Barriers included short timelines to develop proposals and allocate funds. CONCLUSIONS This review provides a comprehensive overview of health-related community granting programs. Grant awardees benefit from technical assistance, workshops, and networking with other awardees. Project sustainability is enhanced by the development of new community partnerships and grant-writing training for awardees. Community granting programs can be a valuable strategy to drive community health, with several key elements that enhance community mobilization. REGISTRATION PROSPERO #CRD42023399364.
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Affiliation(s)
- Emily C Clark
- National Collaborating Centre for Methods and Tools, McMaster University, McMaster Innovation Park, 175 Longwood Rd S, Suite 210a, Hamilton, ON, L8P 0A1, Canada
| | - Shamara Baidoobonso
- Department of Health and Wellness, Government of Prince Edward Island, Chief Public Health Office, 16 Fitzroy St, Charlottetown, PE, C1A 7N8, Canada
| | - Karen A M Phillips
- Department of Health and Wellness, Government of Prince Edward Island, Chief Public Health Office, 16 Fitzroy St, Charlottetown, PE, C1A 7N8, Canada
| | - Laura Lee Noonan
- Department of Health and Wellness, Government of Prince Edward Island, Chief Public Health Office, 16 Fitzroy St, Charlottetown, PE, C1A 7N8, Canada
| | - Jiselle Bakker
- Department of Health and Wellness, Government of Prince Edward Island, Chief Public Health Office, 16 Fitzroy St, Charlottetown, PE, C1A 7N8, Canada
| | - Trish Burnett
- National Collaborating Centre for Methods and Tools, McMaster University, McMaster Innovation Park, 175 Longwood Rd S, Suite 210a, Hamilton, ON, L8P 0A1, Canada
| | - Karlene Stoby
- National Collaborating Centre for Methods and Tools, McMaster University, McMaster Innovation Park, 175 Longwood Rd S, Suite 210a, Hamilton, ON, L8P 0A1, Canada
| | - Maureen Dobbins
- National Collaborating Centre for Methods and Tools, McMaster University, McMaster Innovation Park, 175 Longwood Rd S, Suite 210a, Hamilton, ON, L8P 0A1, Canada.
- School of Nursing, McMaster University, Health Sciences Centre 2J20, 1280 Main St W, Hamilton, ON, L8S 4K1, Canada.
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Polson B, Crozier AJ, Dollman J, Gunn KM. 'If you want something to happen, you have to do it yourself': Understanding rural Australian's perspectives of health volunteering. Health Promot J Austr 2024; 35:311-320. [PMID: 37227095 DOI: 10.1002/hpja.752] [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: 12/01/2022] [Revised: 05/03/2023] [Accepted: 05/10/2023] [Indexed: 05/26/2023] Open
Abstract
ISSUE ADDRESSED Rurality is associated with poorer health outcomes and access to health services, yet a strength of rural living includes community cohesion indicated by high rates of volunteering. While volunteerism is an effective means to target health needs in resource-restricted contexts, research on volunteerism to address rural Australian health needs is limited. This research aimed to explore rural adults' perspectives of volunteerism in local activities and programs that had a direct health related benefit (health volunteering). METHODS Eight people from the Murray Mallee region of South Australia participated during April 2021, ranging in age from 32 to 75 years. Participants were invited to one-on-one interviews that occurred via a phone call or teleconference meeting, which were audio-recorded and transcribed verbatim to facilitate thematic analysis. RESULTS Seven main themes emerged. Participants identified that (1) health volunteering takes many forms, (2) health volunteering affords local ownership and accessibility, (3) health volunteers have particular skills and values, but also (4) gain social benefits and learn new skills. Rural health volunteering was also associated with (5) a variety of personal costs, and (6) there are several environmental barriers and (7) facilitators to rural health volunteering that should be considered when designing health programs. CONCLUSION Results provide insight into how rural communities can enhance the development and application of volunteering roles to support health volunteering. SO WHAT?: Including local champions, reducing the financial burden and developing support networks for volunteers are practical suggestions to enhance levels of volunteering for health in rural settings.
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Affiliation(s)
- Bianca Polson
- Allied Health and Human Performance Unit, University of South Australia, Adelaide, South Australia, Australia
| | - Alyson J Crozier
- Allied Health and Human Performance Unit, University of South Australia, Adelaide, South Australia, Australia
- Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, Adelaide, South Australia, Australia
| | - Jim Dollman
- Allied Health and Human Performance Unit, University of South Australia, Adelaide, South Australia, Australia
- Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, Adelaide, South Australia, Australia
| | - Kate M Gunn
- Department for Rural Health, Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
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Wang G, Chang F, Gu Z, Kasraian D, van Wesemael PJV. Co-designing community-level integral interventions for active ageing: a systematic review from the lens of community-based participatory research. BMC Public Health 2024; 24:649. [PMID: 38424550 PMCID: PMC10905784 DOI: 10.1186/s12889-024-18195-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 02/23/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND While community-level interventions for promoting active ageing have received increasing attention and there is a trend to leverage technology to support traditional physical or social interventions, little hands-on guidance exists for designing these integral interventions. This study aimed to examine the interventions reported in the literature guided by Community-Based Participatory Research (CBPR) principles. The goal is to extract insights that inform future practices in co-designing integral interventions for active ageing. METHODS The systematic review focused on community-level interventions promoting active ageing that integrated physical, social, and digital elements, i.e., integral interventions. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. The included interventions were analysed abductively based on the CBPR principles. RESULTS A total of 13 studies were included, and 24 design considerations were generated under eight categories. Further reflection identified the interrelated nature of these design considerations and pinpointed the gaps in current research. This study highlights the urgency and importance of sharing recruitment methods and resource allocation details, recording and reporting collaboration specifics, and disseminating findings to stakeholders beyond academia. CONCLUSIONS This study offers valuable insights and practical guidance to researchers and practitioners developing community-level integral interventions for active ageing. The findings also serve as a starting point for accumulating knowledge and practice in co-designing integral interventions for active ageing at the community level. The next crucial phase involves evaluating these design considerations within real-world cases to assess their applicability and identify potential areas for improvement.
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Affiliation(s)
- Gubing Wang
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, Netherlands.
- Department of Built Environment, Urbanism and Urban Architecture, Eindhoven University of Technology, Eindhoven, Netherlands.
| | - Fangyuan Chang
- School of Design, Shanghai Jiao Tong University, Shanghai, China.
| | - Zhenyu Gu
- School of Design, Shanghai Jiao Tong University, Shanghai, China
| | - Dena Kasraian
- Department of Built Environment, Urbanism and Urban Architecture, Eindhoven University of Technology, Eindhoven, Netherlands
| | - Pieter J V van Wesemael
- Department of Built Environment, Urbanism and Urban Architecture, Eindhoven University of Technology, Eindhoven, Netherlands
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Klazura G, Stephens C, Musinguzi E, Mugarura R, Nyonyintono J, Laverde R, Nimanya S, Situma M, Bua E, Yap A, Sims T, Ozgediz D, Kisa P. Pediatric Emergency Surgery Course in Uganda: Long-Term Follow-Up and Insights From Further Dissemination. J Surg Res 2024; 295:837-845. [PMID: 38194867 PMCID: PMC10922965 DOI: 10.1016/j.jss.2023.11.058] [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: 03/01/2023] [Revised: 11/13/2023] [Accepted: 11/18/2023] [Indexed: 01/11/2024]
Abstract
INTRODUCTION Approximately 170 pediatric surgeons are needed for the 24 million children in Uganda. There are only seven. Consequently, general surgeons manage many pediatric surgical conditions. In response, stakeholders created the Pediatric Emergency Surgery Course (PESC) for rural providers, given three times in 2018-2019. We sought to understand the course's long-term impact, current pediatric surgery needs, and determine measures for improvement. METHODS In October 2021, we distributed the same test given in 2018-2019. Student's t-test was used to compare former participants' scores to previous scores. The course was delivered again in May 2022 to new participants. We performed a quantitative needs assessment and also conducted a focus group with these participants. Finally, we interviewed Surgeon in Chiefs at previous sites. RESULTS Twenty three of the prior 45 course participants re-took the PESC course assessment. Alumni scored on average 71.9% ± 18% correct. This was higher from prior precourse test scores of 55.4% ± 22.4%, and almost identical to the 2018-2019 postcourse scores 71.9% ± 14%. Fifteen course participants completed the needs assessment. Participants had low confidence managing pediatric surgical disease (median Likert scale ≤ 3.0), 12 of 15 participants endorsed lack of equipment, and eight of 15 desired more educational resources. Qualitative feedback was positive: participants valued the pragmatic lessons and networking with in-country specialists. Further training was suggested, and Chiefs noted the need for more trained staff like anesthesiologists. CONCLUSIONS Participants favorably reviewed PESC and retained knowledge over three years later. Given participants' interest in more training, further investment in locally derived educational efforts must be prioritized.
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Affiliation(s)
- Greg Klazura
- Department of Surgery, University of Illinois at Chicago, Loyola University Medical Center.
| | - Caroline Stephens
- University of California San Francisco, Center for Health Equity in Surgery and Anesthesia
| | | | | | | | - Ruth Laverde
- University of California San Francisco, Center for Health Equity in Surgery and Anesthesia
| | | | | | | | - Ava Yap
- University of California San Francisco, Center for Health Equity in Surgery and Anesthesia
| | - Thomas Sims
- Department of Surgery, University of Illinois at Chicago
| | - Doruk Ozgediz
- University of California San Francisco, Center for Health Equity in Surgery and Anesthesia
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Silva JGN, Silva SDS, Gomes TCM, Nascimento GDS, Valentim LDA, Quaresma TC, Fernandes FDP, Oliveira SMSD, Moraes WP. Empowering Riverine Communities in the Amazon: Strategies for Preventing Rabies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:117. [PMID: 38276811 PMCID: PMC10815026 DOI: 10.3390/ijerph21010117] [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: 10/10/2023] [Revised: 11/11/2023] [Accepted: 11/13/2023] [Indexed: 01/27/2024]
Abstract
Rabies, caused by the Lyssavirus genus, is a highly lethal zoonotic disease transmitted by animals such as bats and domestic and wild carnivores to humans, claiming nearly 100% of lives. In Brazil, recent evidence suggests an increasing role of bats in human deaths from rabies, particularly in the Amazon region. This neglected tropical disease disproportionately affects impoverished and vulnerable populations in rural areas, where approximately 80% of human cases are concentrated. This article presents research conducted in riverine communities of the Tapajós/Arapiuns Extractive Reserve in Brazil to combat rabies in September 2022. The study adopted a participatory and collaborative approach, involving community members, healthcare professionals, and educators. Prioritizing proactive interventions, the health team administered prophylactic vaccinations to 30 individuals residing in communities exposed to the Lyssavirus. Educational activities focused on dispelling myths and raising awareness about preventive measures, with 100% of individuals reporting prior doubts about the disease, emphasizing the essential nature of the clarification, especially regarding preventive aspects. This study underscores the importance of community involvement, personalized interventions, and ongoing education to effectively combat rabies. By reinforcing public health policies and promoting health education, we can empower communities to take proactive measures in rabies prevention, leading to a reduction in incidence and an improvement in quality of life.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Waldiney Pires Moraes
- Department of Health, Federal University of Western Pará/UFOPA, Santarém 68040-090, Brazil
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26
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Kreiml V, Sauter A, Abu-Omar K, Eickmann S, Herrmann-Johns A. "That's like therapy"-A qualitative study on socially disadvantaged women's views on the effects of a community-based participatory research project on their health and health behavior. Front Public Health 2024; 12:1339556. [PMID: 38304180 PMCID: PMC10830699 DOI: 10.3389/fpubh.2024.1339556] [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: 11/16/2023] [Accepted: 01/08/2024] [Indexed: 02/03/2024] Open
Abstract
Background Regular physical activity has positive effects on both physical and mental health. Nevertheless, socially disadvantaged women are often insufficiently physically active. Through needs-based physical activity offers, community-based participatory research (CBPR) projects have the potential to reach these women and increase the effectiveness of physical activity interventions by supporting women's empowerment, health, and health behaviors. This study aimed to examine socially disadvantaged women's views on the effects of long-term participation in Bewegung als Investition in Gesundheit (BIG, i.e., movement as an investment in health), a long-standing German CBPR project, on their health and health behavior. Methods Semi-structured qualitative interviews were conducted with 30 participating women at five BIG sites across Germany between April and August 2022. The interviews were recorded, transcribed verbatim, and analyzed using framework analysis. Results Women reported that participation in BIG classes contributed to their physical, mental, and social health. For many women, the positive effects on their mental and social wellbeing were most important. In addition to increased fitness and improved physical endurance, many participating women were able to expand their social networks, thus receiving further social support, and improve their self-esteem, self-confidence, and self-efficacy. Furthermore, participation in BIG physical activity classes positively influenced the health awareness of many women helping them to improve their activity level and diet over time. Conclusion Our results suggest that CBPR projects, such as the BIG project, can increase physical activity among socially disadvantaged groups and contribute to their overall health and wellbeing. CBPR projects could thus be considered a key element of health promotion for this target group. Future interventional research is required to confirm and further explore the effects of CBPR interventions and to examine whether the effects can be replicated in other settings.
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Affiliation(s)
- Verena Kreiml
- Department of Epidemiology and Preventive Medicine, Medical Sociology, University of Regensburg, Regensburg, Germany
| | - Alexandra Sauter
- Department of Epidemiology and Preventive Medicine, Medical Sociology, University of Regensburg, Regensburg, Germany
| | - Karim Abu-Omar
- Department of Sport Science and Sport, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Sascha Eickmann
- Department of Epidemiology and Preventive Medicine, Medical Sociology, University of Regensburg, Regensburg, Germany
| | - Anne Herrmann-Johns
- Department of Epidemiology and Preventive Medicine, Medical Sociology, University of Regensburg, Regensburg, Germany
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
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Mathew P, Chandy SJ, Sivaraman S, Ranjalkar J, Ali HM, Thomas SA. Formulating a Community-Centric Indicator Framework to Quantify One Health Drivers of Antibiotic Resistance: A Preliminary Step towards Fostering 'Antibiotic-Smart Communities'. Antibiotics (Basel) 2024; 13:63. [PMID: 38247622 PMCID: PMC10812418 DOI: 10.3390/antibiotics13010063] [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: 11/28/2023] [Revised: 12/28/2023] [Accepted: 01/02/2024] [Indexed: 01/23/2024] Open
Abstract
Antibiotic resistance (ABR) is increasing the mortality and morbidity associated with infectious diseases, besides increasing the cost of healthcare, saturating health system capacity, and adversely affecting food security. Framing an appropriate narrative and engaging local communities through the 'One Health' approach is essential to complement top-down measures. However, the absence of objective criteria to measure the performance of ABR interventions in community settings makes it difficult to mobilize interest and investment for such interventions. An exercise was therefore carried out to develop an indicator framework for this purpose. A comprehensive list of indicators was developed from experiences gathered through community engagement work in a local panchayat (small administrative area) in Kerala, India and a consultative process with health, veterinary, environment, and development experts. A prioritization exercise was carried out by global experts on ABR, looking at appropriateness, feasibility, and validity. A 15-point indicator framework was designed based on the prioritization process. The final set of indicators covers human health, animal health, environment management, and Water Sanitation and Hygiene (WASH) domains. The indicator framework was piloted in the panchayat (located in Kerala), which attained a score of 34 (maximum 45). The score increased when interventions were implemented to mitigate the ABR drives, indicating that the framework is sensitive to change. The indicator framework was tested in four sites from three other Indian states with different socioeconomic and health profiles, yielding different scores. Those collecting the field data were able to use the framework with minimal training. It is hoped that, this indicator framework can help policymakers broadly understand the factors contributing to ABR and measure the performance of interventions they choose to implement in the community as part of National Action Plan on AMR.
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Affiliation(s)
- Philip Mathew
- ReAct Asia Pacific, Department of Pharmacology and Clinical Pharmacology, Christian Medical College, Vellore 632002, Tamil Nadu, India; (P.M.); (S.S.); (H.M.A.); (S.A.T.)
| | - Sujith J. Chandy
- Department of Pharmacology and Clinical Pharmacology, Christian Medical College, Vellore 632002, Tamil Nadu, India;
| | - Satya Sivaraman
- ReAct Asia Pacific, Department of Pharmacology and Clinical Pharmacology, Christian Medical College, Vellore 632002, Tamil Nadu, India; (P.M.); (S.S.); (H.M.A.); (S.A.T.)
| | - Jaya Ranjalkar
- ReAct Asia Pacific, Department of Pharmacology and Clinical Pharmacology, Christian Medical College, Vellore 632002, Tamil Nadu, India; (P.M.); (S.S.); (H.M.A.); (S.A.T.)
| | - Hyfa Mohammed Ali
- ReAct Asia Pacific, Department of Pharmacology and Clinical Pharmacology, Christian Medical College, Vellore 632002, Tamil Nadu, India; (P.M.); (S.S.); (H.M.A.); (S.A.T.)
| | - Shruthi Anna Thomas
- ReAct Asia Pacific, Department of Pharmacology and Clinical Pharmacology, Christian Medical College, Vellore 632002, Tamil Nadu, India; (P.M.); (S.S.); (H.M.A.); (S.A.T.)
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Gamo BR, Park DB. Sense of community affects community satisfaction: Mediating role of community participation. JOURNAL OF COMMUNITY PSYCHOLOGY 2024; 52:258-275. [PMID: 37883204 DOI: 10.1002/jcop.23096] [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: 06/25/2023] [Revised: 10/04/2023] [Accepted: 10/10/2023] [Indexed: 10/27/2023]
Abstract
Community satisfaction is a central component of community development because it indicates the overall contentment of residents with their community. As such, it can indicate the directions for community development. This study is aimed at examining a sense of community and community participation as factors influencing community satisfaction in the Yirgachefe district of Ethiopia. We collected data from 360 randomly selected household heads (male = 80.2%, female = 19.2%) residing in 12 rural communities. We used structural equation modeling to analyze the data. Results revealed that residents with a higher sense of community were more likely to have participated in their community and to be satisfied with their community. However, sense of community only indirectly influenced community satisfaction and had an insignificant direct effect on community satisfaction. There is a fully mediating effect of community participation between sense of community and community satisfaction. We propose policy implications based on the study.
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Affiliation(s)
- Bereket Roba Gamo
- Department of Agricultural Environment, National Institute of Agricultural Sciences, Rural Development Administration, Wanju-gun, Jeollabuk-do, Republic of Korea
- Department of Rural Development, Hawassa University, Hawassa, Ethiopia
| | - Duk-Byeong Park
- Department of Community Development, Kongju National University, Yesan-gun, Chungnam, Republic of Korea
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Araujo PND, Santana FR, Oliveira PSD, Gatto Júnior JR, Santos FLD, Santos KS, Fortuna CM. [The influence of the institutions on local health councils]. Aten Primaria 2024; 56:102780. [PMID: 37820468 PMCID: PMC10570949 DOI: 10.1016/j.aprim.2023.102780] [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: 06/14/2023] [Revised: 09/01/2023] [Accepted: 09/12/2023] [Indexed: 10/13/2023] Open
Abstract
OBJECTIVE To analyze the influences of the institutions in the operation of the Local Health councils. DESIGN qualitative, descriptive and exploratory study. STUDY SETTING 02 Primary Health Care services of a municipality in the inland of the state of São Paulo, Brazil. PARTICIPANTS twenty-four members of the Local Health Councils and 4 key informants. METHODS Supported by the theoretical methodological framework of Institutional Analysis. Data were produced through 28 semi-structured interviews, observation and participation in the activities of the councils and recording in the research diary. Data were organized and analyzed by the process of transcription, transposition and reconstitution. RESULTS The institutions act in the territories represented by social actors who occupy positions and functions within the Primary Health Care services, evidencing the perpetuation of hierarchization with valorization of the speeches of professionals and managers to the detriment of patients and predominance of bureaucratized meetings. The social actors reproduce the ideals of the collective to which they belong in these spaces. CONCLUSIONS The health management teams do not recognize the different forces that act in the health territory, however, these forces interfere in the activities performed and in health care. The groups act both in formal spaces through official representatives who meet and discuss issues in collegiate meetings and in informal spaces, and constitute forces in dispute in the health territory.
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Affiliation(s)
- Priscila Norié de Araujo
- Programa de Posgrado Enfermería en Salud Pública, Escuela de Enfermería de Ribeirão Preto, Universidad de São Paulo, Ribeirão Preto, São Paulo, Brasil
| | - Fabiana Ribeiro Santana
- Departamento de Salud Colectiva, Instituto de Patología Tropical y Salud Pública, Universidad Federal de Goiás, Goiânia, Goiás, Brasil
| | - Poliana Silva de Oliveira
- Programa de Posgrado Enfermería en Salud Pública, Escuela de Enfermería de Ribeirão Preto, Universidad de São Paulo, Ribeirão Preto, São Paulo, Brasil
| | - José Renato Gatto Júnior
- Departamento de Enfermería Psiquiátrica y Ciencias Humanas, Escuela de Enfermería de Ribeirão Preto, Universidad de São Paulo, Ribeirão Preto, São Paulo, Brasil
| | - Felipe Lima Dos Santos
- Programa de Posgrado Enfermería en Salud Pública, Escuela de Enfermería de Ribeirão Preto, Universidad de São Paulo, Ribeirão Preto, São Paulo, Brasil; Laboratoire École-Mutations-Apprentissages, CY Cergy Paris Université, Gennevilliers, Francia
| | - Karen Silva Santos
- Programa de Posgrado Enfermería en Salud Pública, Escuela de Enfermería de Ribeirão Preto, Universidad de São Paulo, Ribeirão Preto, São Paulo, Brasil; Laboratoire Éducation et Diversité en Espaces Francophones, Université de Limoges, Limoges, Francia
| | - Cinira Magali Fortuna
- Programa de Posgrado Enfermería en Salud Pública, Escuela de Enfermería de Ribeirão Preto, Universidad de São Paulo, Ribeirão Preto, São Paulo, Brasil; Programa de Posgrado Enfermería en Salud Pública, Departamento de Enfermería Materno-Infantil y Salud Pública, Escuela de Enfermería de Ribeirão Preto, Universidad de São Paulo, Ribeirão Preto, São Paulo, Brasil.
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Nasiri A, Farshidi H, Rezaei F, Dehdari T, Kazemi A, Rezapour H, Goshtaei M. Perceived barriers of migrants and refugees to vaccinate their children against Measles and polio: a study in Iran. Int J Equity Health 2023; 22:253. [PMID: 38057773 DOI: 10.1186/s12939-023-02075-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 12/04/2023] [Indexed: 12/08/2023] Open
Abstract
BACKGROUND This study examined the perceived barriers of migrants and refugees to vaccinating their children against measles and polio in Iran. METHODS First, an instrument was developed and validated through several steps. Next, 1,067 parents who had not vaccinated their children against polio and measles or had delayed receiving any dose of these two vaccines until the age of 15 were selected from 16 provinces and completed the instrument. Finally, the data were analyzed. RESULTS The results of the explanatory factor analysis showed that the perceived barriers affecting vaccination against polio and measles vaccines were categorized into five factors: low knowledge, negative attitude, communication challenges, lack of participation in vaccination programs, and problems related to migration and refugees. Additionally, the results indicated a significant difference in the mean score of perceived barriers based on participants' level of education, economic status, and nationality. CONCLUSION The identified barriers may provide a perspective for developing effective efforts in this area. Interventions should focus on parents with low education and poor economic status.
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Affiliation(s)
- Amir Nasiri
- Department of Health Education and Health Promotion, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Hossein Farshidi
- Rajaie Cardiovascular, Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Farshid Rezaei
- Health Education and Promotion Department, Deputy of Public Health, MOHME, Tehran, Iran
| | - Tahereh Dehdari
- Health Promotion Research Center, Iran University of Medical Sciences, Tehran, Iran.
| | - Afrouzeh Kazemi
- Health Education and Promotion Department, Deputy of Public Health, MOHME, Tehran, Iran
| | - Hamid Rezapour
- Health Education and Promotion Department, Deputy of Public Health, MOHME, Tehran, Iran
| | - Massomeh Goshtaei
- Health Education and Promotion Department, Deputy of Public Health, Iran University of Medical Sciences, Tehran, Iran
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Omosigho PO, John OO, Musa MB, Aboelhassan YMEI, Olabode ON, Bouaddi O, Mengesha DT, Micheal AS, Modber MAKA, Sow AU, Kheir SGM, Shomuyiwa DO, Adebimpe OT, Manirambona E, Lucero-Prisno DE. Stigma and infectious diseases in Africa: examining impact and strategies for reduction. Ann Med Surg (Lond) 2023; 85:6078-6082. [PMID: 38098545 PMCID: PMC10718398 DOI: 10.1097/ms9.0000000000001470] [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: 07/31/2023] [Accepted: 10/24/2023] [Indexed: 12/17/2023] Open
Abstract
Stigma poses a significant barrier to accessing care, managing, and preventing infectious diseases in Africa. The authors conducted an extensive search across Scopus, PubMed, ScienceDirect, and Google Scholar to identify relevant English-language articles, with no constraints on publication dates, using the keywords "Stigma," and "Infectious Disease," in conjunction with "Africa." This article explores the multifaceted nature of stigma associated with infectious diseases, highlighting its impact on healthcare access and public health outcomes. It delves into the current situation of infectious disease-related stigma in Africa, emphasizing the various diseases and contexts affected. The article identifies drivers of stigma, including negative attitudes, misinformation, and institutional practices, and discusses their role in perpetuating discrimination. Importantly, it provides recommendations for addressing infectious disease stigma in Africa through comprehensive strategies encompassing health education, contact-based interventions, professionalized counselling and peer support services, and community engagement. The article calls for collaboration among governments, healthcare organizations, NGOs, and community leaders to implement holistic strategies that prioritize inclusivity and stigma reduction. Ultimately, it underscores the urgent need to combat stigma to improve healthcare access and outcomes for individuals affected by infectious diseases in Africa.
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Affiliation(s)
| | - Okesanya Olalekan John
- Department of Medical Laboratory Science, Neuropsychiatric Hospital, Aro, Abeokuta
- Global Health Focus Africa, Abuja
| | | | | | | | - Oumnia Bouaddi
- International School of Public Health, Mohammed VI University of Health Sciences, Casablanca
- Mohammed VI Center For Research and Innovation, Rabat, Morocco
| | | | - Abioye Sunday Micheal
- Faculty of Basic Medical Sciences, Department of Public Health, Adeleke University, Ede, Osun State
| | | | - Alhaji Umar Sow
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown
| | | | | | | | - Emery Manirambona
- College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
- Research Unit, Global Health Focus, Bujumbura, Burundi
| | - Don Eliseo Lucero-Prisno
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
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Singh H, Fulton J, Mirzazada S, Saragosa M, Uleryk EM, Nelson MLA. Community-Based Culturally Tailored Education Programs for Black Communities with Cardiovascular Disease, Diabetes, Hypertension, and Stroke: Systematic Review Findings. J Racial Ethn Health Disparities 2023; 10:2986-3006. [PMID: 36508135 PMCID: PMC10645635 DOI: 10.1007/s40615-022-01474-5] [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: 09/28/2022] [Revised: 11/17/2022] [Accepted: 11/21/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Community-based culturally tailored education (CBCTE) programs for chronic diseases may reduce health disparities; however, a synthesis across chronic diseases is lacking. We explored (1) the characteristics and outcomes of CBCTE programs and (2) which strategies for culturally appropriate interventions have been used in CBCTE programs, and how they have been implemented. METHODS A systematic review was conducted by searching three databases to identify empirical full-text literature on CBCTE programs for Black communities with cardiovascular disease, hypertension, diabetes, or stroke. Studies were screened in duplicate, then data regarding study characteristics, participants, intervention, and outcomes were extracted and analyzed. Cultural tailoring strategies within programs were categorized using Kreuter and colleagues' framework. RESULTS Of the 74 studies, most were conducted in the USA (97%) and delivered in one site (53%; e.g., church/home). CBCTE programs targeted diabetes (65%), hypertension (30%), diabetes and hypertension (1%), cardiovascular disease (3%), and stroke (1%). Reported program benefits included physiological, medication-related, physical activity, and literacy. Cultural tailoring strategies included peripheral (targeted Black communities), constituent-involving (e.g., community informed), evidential (e.g., integrated community resources), linguistic (e.g., delivered in community's dialect/accent), and sociocultural (e.g., integrated community members' religious practices). CONCLUSIONS CBCTE programs may have beneficial outcomes, but a small sample size limited several. The strategies identified can be adopted by programs seeking to culturally tailor. Future interventions should clearly describe community members' roles/involvement and deliver programs in multiple locations to broaden reach. TRIAL REGISTRATION PROSPERO CRD42021245772.
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Affiliation(s)
- Hardeep Singh
- Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, 500 University Avenue Toronto, Toronto, ON, M5G 1V7, Canada.
- KITE, Toronto Rehabilitation Institute, University Health Network, 520 Sutherland Drive, Toronto, ON, Canada.
- Temerty Faculty of Medicine, Rehabilitation Science Institute, University of Toronto, 500 University Avenue Toronto, Toronto, ON, M5G 1V7, Canada.
| | - Joseph Fulton
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- March of Dimes Canada, 10 Overlea Blvd, Toronto, ON, Canada
| | - Sofia Mirzazada
- Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, 500 University Avenue Toronto, Toronto, ON, M5G 1V7, Canada
| | - Marianne Saragosa
- Bridgepoint Collaboratory for Research and Innovation, Lunenfeld-Tanenbaum Research Institute, Sinai Health System, 1 Bridgepoint Drive, Toronto, ON, Canada
| | | | - Michelle L A Nelson
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- March of Dimes Canada, 10 Overlea Blvd, Toronto, ON, Canada
- Bridgepoint Collaboratory for Research and Innovation, Lunenfeld-Tanenbaum Research Institute, Sinai Health System, 1 Bridgepoint Drive, Toronto, ON, Canada
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Iuliano A, Shittu F, Colbourn T, Salako J, Bakare D, Bakare AAA, King C, Graham H, McCollum ED, Falade AG, Uchendu O, Haruna I, Valentine P, Burgess R. Community perceptions matter: a mixed-methods study using local knowledge to define features of success for a community intervention to improve quality of care for children under-5 in Jigawa, Nigeria. BMJ Open 2023; 13:e069213. [PMID: 37973546 PMCID: PMC10660644 DOI: 10.1136/bmjopen-2022-069213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 09/22/2023] [Indexed: 11/19/2023] Open
Abstract
OBJECTIVES In this study, we used the information generated by community members during an intervention design process to understand the features needed for a successful community participatory intervention to improve child health. DESIGN We conducted a concurrent mixed-methods study (November 2019-March 2020) to inform the design and evaluation of a community-facility linkage participatory intervention. SETTING Kiyawa Local Government Area (Jigawa State, Nigeria)-population of 230 000 (n=425 villages). PARTICIPANTS Qualitative data included 12 community conversations with caregivers of children under-5 (men, older and younger women; n=9 per group), 3 focus group discussions (n=10) with ward development committee members and interviews with facility heads (n=3). Quantitative data comprised household surveys (n=3464) with compound heads (n=1803) and women (n=1661). RESULTS We analysed qualitative data with thematic network analysis and the surveys with linear regression-results were triangulated in the interpretation phase. Participants identified the following areas of focus: community health education; facility infrastructure, equipment and staff improvements; raising funds to make these changes. Community involvement, cooperation and empowerment were recognised as a strategy to improve child health, and the presence of intermediate bodies (development committees) was deemed important to improve communication and solve problems between community and facility members. The survey showed functional community relations' dynamics, with high levels of internal cohesion (78%), efficacy in solving problems together (79%) and fairness of the local leaders (82%). CONCLUSIONS Combining the results from this study and critical theories on successful participation identified community-informed features for a contextually tailored community-facility link intervention. The need to promote a more inclusive approach to future child health interventions was highlighted. In addition to health education campaigns, the relationship between community and healthcare providers needs strengthening, and development committees were identified as an essential feature for successfully linking communities and facilities for child health. TRIAL REGISTRATION NUMBER ISRCTN39213655.
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Affiliation(s)
- Agnese Iuliano
- UCL Institute for Global Health, University College London, London, UK
| | - Funmilayo Shittu
- Department of Paediatrics, University of Ibadan, Ibadan, Nigeria
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Timothy Colbourn
- UCL Institute for Global Health, University College London, London, UK
| | - Julius Salako
- Department of Paediatrics, University of Ibadan, Ibadan, Nigeria
| | - Damola Bakare
- Department of Paediatrics, University of Ibadan, Ibadan, Nigeria
| | - Ayobami Adebayo A Bakare
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Department of Community Medicine, University of Ibadan, Ibadan, Nigeria
| | - Carina King
- UCL Institute for Global Health, University College London, London, UK
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Hamish Graham
- Centre for International Child Health, University of Melbourne, MCRI, Royal Children's Hospital, Parkville, Victoria, Australia
| | - Eric D McCollum
- Eudowood Division of Pediatric Respiratory Sciences, Department of Pediatrics, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Adegoke G Falade
- Department of Paediatrics, University of Ibadan, Ibadan, Nigeria
- Department of Paediatrics, University College Hospital Ibadan, Ibadan, Oyo, Nigeria
| | - Obioma Uchendu
- Department of Community Medicine, University of Ibadan, Ibadan, Nigeria
| | | | | | - Rochelle Burgess
- UCL Institute for Global Health, University College London, London, UK
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Hogan TH, O'Rourke BP, Weeks E, Silvera GA, Choi S. Top-level leaders and implementation strategies to support organizational diversity, equity, inclusion, and belonging (DEIB) interventions: a qualitative study of top-level DEIB leaders in healthcare organizations. Implement Sci 2023; 18:59. [PMID: 37936190 PMCID: PMC10631201 DOI: 10.1186/s13012-023-01319-7] [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: 01/27/2023] [Accepted: 10/24/2023] [Indexed: 11/09/2023] Open
Abstract
BACKGROUND The Black Lives Matter movement and COVID-19 pandemic motivated the wide-scale adoption of diversity, equity, inclusion, and belonging (DEIB) initiatives within healthcare organizations and the creation of DEIB top-level leader positions. The next step is to understand how these leaders contribute to the implementation of DEIB interventions, a task with notable salience due to not only the historical difficulties associated with DEIB strategy execution, but also the substantial evidence that leadership plays a significant role in implementation processes. Therefore, the objective of this qualitative study is to understand the role of top-level DEIB leaders in the implementation of healthcare organizational DEIB interventions. METHODS A qualitative research approach which used an in-depth semi-structured interview approach was employed. We conducted thirty-one 60-90-min semi-structured interviews with DEIB top-level leaders between February 2022 and October 2022 over Zoom. An iterative coding process was used to identify the key implementation strategies and activities of DEIB top-level leaders. RESULTS Interviewees were mostly Black, majority female, and mostly heterosexual and had a variety of educational backgrounds. We identified the DEIB top-level leader as the DEIB strategy implementation champion. These leaders drive five DEIB implementation strategies: (1) People, (2) Health Equity, (3) Monitoring and Feedback, (4) Operational Planning and Communication, and (5) External Partners. Within these, we identified 19 significant activities that describe the unique implementation strategies supported by the DEIB top-level leaders. CONCLUSIONS To move toward sustained commitment to DEIB, the organization must focus on not only establishing DEIB interventions, but on their successful implementation. Our findings help explicate the implementation activities that drive the DEIB initiatives of healthcare organizations and the role of DEIB leaders. Our work can help healthcare organizations systematically identify how to support the success of DEIB organizational interventions.
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Affiliation(s)
- Tory H Hogan
- The Division of Health Services Management and Policy, The College of Public Health, The Ohio State University, 1841 Neil Avenue, Columbus, OH, 43210, USA.
| | - Brian P O'Rourke
- The Division of Health Services Management and Policy, The College of Public Health, The Ohio State University, 1841 Neil Avenue, Columbus, OH, 43210, USA
| | - Eddie Weeks
- The Division of Health Services Management and Policy, The College of Public Health, The Ohio State University, 1841 Neil Avenue, Columbus, OH, 43210, USA
| | - Geoffrey A Silvera
- The Department of Health Services Administration, The School of Health Professions, The University of Alabama at Birmingham, School of Health Professions Bldg., 1716 9th Avenue South, Birmingham, AL, 35233, USA
| | - Seongwon Choi
- The Department of Management, The College of Business and Economics, California State University, Los Angeles, 5154 University Dr, Los Angeles, CA, 90032, USA
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Makama M, Skouteris H, Moran LJ, Hill B, Redman LM, Lim S. Co-designing a community lifestyle intervention program to reduce postpartum weight retention. Health Expect 2023; 27:e13905. [PMID: 37920876 PMCID: PMC10726270 DOI: 10.1111/hex.13905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 09/12/2023] [Accepted: 10/22/2023] [Indexed: 11/04/2023] Open
Abstract
BACKGROUND Postpartum weight retention is a major contributor to obesity in later life resulting in long-term health consequences in women. Postpartum lifestyle interventions are known to be effective in reducing postpartum weight retention and improving the overall health and wellbeing of mothers but have poor reach and engagement. This study describes the engagement of mothers with young children in the development of a theory- and evidence-based intervention to reduce postpartum weight retention. METHODS A participatory design methodology with input from a community mothers' group, literature reviews and an expert advisory group was applied. Mothers who were members of 'Mothers of Preschoolers' (MOPS) were invited to participate in a focus group discussion and two co-design workshop sessions. RESULTS Thirteen women participated in a focus group discussion and 12 women in each co-design workshop. We found that mothers valued having social support from their peers, practical support such as meal delivery, and learning opportunities that focus on the mother's health and wellbeing. The advisory group suggested leveraging the unique skills and prior experiences of mothers within the group and developing a curriculum that mothers can be trained to deliver. CONCLUSION A program that emphasizes the strengths and value of mothers can increase their self-worth and self-confidence resulting in intrinsic motivation to improve lifestyle behaviours. An intervention designed to be implemented by MOPS for its members and incorporated into their regular sessions has the potential for feasibility and acceptability among mothers with young children. PATIENT OR PUBLIC CONTRIBUTION Mothers with young children were part of the program planners and were involved in the design and conduct of this study and in the interpretation of the findings. A member of a community mothers' group recruited other mothers with young children within the group to participate in a series of sessions to discuss their experiences of the postpartum period and preferences for a lifestyle program. The mothers identified the behavioural outcomes and program goals for a postpartum lifestyle program and then generated the program ideas based on these.
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Affiliation(s)
- Maureen Makama
- Monash Centre for Health Research and ImplementationMonash UniversityClaytonVictoriaAustralia
| | - Helen Skouteris
- Health and Social Care Unit, School of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
- Warwick Business SchoolWarwick UniversityCoventryUK
| | - Lisa J. Moran
- Monash Centre for Health Research and ImplementationMonash UniversityClaytonVictoriaAustralia
| | - Briony Hill
- Health and Social Care Unit, School of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
| | - Leanne M. Redman
- Pennington Biomedical Research CenterLouisiana State UniversityBaton RougeLouisianaUSA
| | - Siew Lim
- Health Systems and Equity, Eastern Health Clinical SchoolMonash UniversityBox HillVictoriaAustralia
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Kesale AM, Kinyaga A, Mwakasangula E, Mollel H, Rashid SS. Who makes health governance decisions at the local level? A cross sectional study from primary health facilities in Tanzania. Health Sci Rep 2023; 6:e1691. [PMID: 37936618 PMCID: PMC10626029 DOI: 10.1002/hsr2.1691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 10/16/2023] [Accepted: 10/23/2023] [Indexed: 11/09/2023] Open
Abstract
Background and Aims Lower- and middle-income countries have decentralized decision-making at the community level, as well as community governance structures, to encourage community participation in governance processes, particularly in primary healthcare (PHC). In Tanzania, decentralization resulted in the establishment of Health Facility Governing Committees (HFGCs) to encourage community participation in the governance of primary health facilities to improve the quality and responsiveness of health service delivery. Nonetheless, despite the presence of HFGCs, PHC delivery remains ineffective and of poor quality. It is unclear who makes governance decisions at PHC facilities to ensure that services delivered are of expected quality and respond the community's needs, tastes, and preferences. This paper aims to assess the perspectives of members of the HFGC on who make governance decision in the context of fiscal decentralization. Design and Methods A cross-section design was used to collect both quantitative and qualitative data. A four-multistage sampling technique was adopted to selects regions, council, health facilities, and HFGC members. Respondents who participated in structured questionnaire responses were chosen using proportional sampling, whereas those who participated in in-depth interviews and Focus Group Discussions were chosen using purposive selection. The data was analyzed descriptively and thematically. Results The study revealed that HFGCs members perceive that governance decisions in primary health facilities are primarily made by the health facility management, and later are presented in HFGCs. As such, HFGCs are used a passively used to justify participation in decision that was already made by the management, which contradict with the principal of decentralization that emphasizes community participation on fiscal decisions. Conclusion Decentralization of PHC facilities does not guarantee the participation of community members in fiscal decision of their respective primary health facilities through HFGCs. HFGC is passively used governance structure to substitute community participation in primary health facilities' fiscal decisions. Enforcement mechanisms are required to facilitate effective community participation.
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Affiliation(s)
- Anosisye M. Kesale
- Department of Local Government Management, School of Public Administration and ManagementMzumbe UniversityMorogoroTanzania
| | - Ally Kinyaga
- Center for ReformsInnovation, Health Policies and Implementation Research (CeRIHI)DodomaTanzania
| | - Eliza Mwakasangula
- Department of Public Service and Human Resource Management, School of Public Administration and ManagementMzumbe UniversityMorogoroTanzania
| | - Henry Mollel
- Department of Health SystemMzumbe UniversityMbeyaTanzania
| | - Seif S. Rashid
- PATH, Data Use PartnershipCenter of Digital and Data ExcellenceDar Es SalaamTanzania
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Briguglio M, Cordani C, Langella F, Perazzo P, Pregliasco FE, Banfi G, Wainwright TW. Why Treat Patients with a Major Orthopaedic Surgery Only to Send Them Back to the Vulnerable Conditions That Made Them Sick in the First Place? A Conceptual Scenario to Improve Patient's Journey. Int J Gen Med 2023; 16:4729-4735. [PMID: 37881478 PMCID: PMC10593966 DOI: 10.2147/ijgm.s431055] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 09/22/2023] [Indexed: 10/27/2023] Open
Abstract
Individuals with severe cartilage degeneration of the hip or knee or collapsed vertebrae that cause spine deformities can suffer from joint and neuropathic pain in the back, disuse of the affected limb, and restriction of movements. Surgical intervention is the most widespread and successful solution to date. There is a general belief that eating healthy and staying physically and mentally active might have a preventive role against musculoskeletal disease occurrence, while instead, we are more certain of the benefits deriving from a healthy diet and exercise therapy after major orthopaedic procedures. These aspects are in fact vital components in enhanced recovery after surgery programmes. However, they are applied in hospital settings, are often centre-dependent, and lack primary and tertiary preventive efficacy since end once the patient is discharged. There is the lack of initiatives at the territorial level that ensure a continuum in the patient's journey towards orthopaedic surgery, home transition, and a healthy and long-lasting life. The expert panel advocates the integration of an intermediate lifestyle clinic that promotes healthy eating, physical activity, and sleep hygiene. In this facility directed by professionals in enhancing recovery after surgery, patients can be referred after the surgical indication and before home discharge. Surgery is in fact a moment when individuals are more curious to do their best to heal and stay healthy, representing a timepoint and opportunity for educating patients on how lifestyle changes may optimise not only their surgical recovery but also long-term future health state.
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Affiliation(s)
- Matteo Briguglio
- Laboratory of Nutritional Sciences, IRCCS Orthopedic Institute Galeazzi, Milan, Italy
| | - Claudio Cordani
- Department of Biomedical, Surgical, and Dental Sciences, University “La Statale”, Milan, Italy
- Scientific Direction, IRCCS Orthopedic Institute Galeazzi, Milan, Italy
| | | | - Paolo Perazzo
- Intensive Care Unit, IRCCS Orthopedic Institute Galeazzi, Milan, Italy
| | - Fabrizio Ernesto Pregliasco
- Health Management, IRCCS Orthopedic Institute Galeazzi, Milan, Italy
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Giuseppe Banfi
- Scientific Direction, IRCCS Orthopedic Institute Galeazzi, Milan, Italy
- Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, Milan, Italy
| | - Thomas W Wainwright
- Orthopaedic Research Institute, Bournemouth University, Bournemouth, UK
- Physiotherapy Department, University Hospitals Dorset NHS Foundation Trust, Bournemouth, UK
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Mahmoodi H, Bolbanabad AM, Shaghaghi A, Zokaie M, Gheshlagh RG, Afkhamzadeh A. Barriers to implementing health programs based on community participation: the Q method derived perspectives of healthcare professional. BMC Public Health 2023; 23:2019. [PMID: 37848872 PMCID: PMC10580595 DOI: 10.1186/s12889-023-16961-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 10/11/2023] [Indexed: 10/19/2023] Open
Abstract
BACKGROUND Community participation in implementing health programs leads to positive organizational, social and individual consequences. This study aimed to investigate the prospects of a sample of Iranian healthcare professionals about their perceived barriers to implementing health programs based on community participation. METHODS This was a cross-sectional study that employed a Q-methodology approach. Twenty health professional sorted the 47 statements into a 9-column Q-sort diagram ranging from - 4 as not important to + 4 as very important. The data were analyzed with PQMethod 2.35 software. The centroid factor analysis and varimax rotation were used for data analysis. Factors identified were interpreted and described in terms of the participants perspectives on the phenomenon. RESULTS Analysis of the study participants' viewpoints (the Q-sorts) resulted in a five factor solution (accounted for 57% of the total variance) to endorse the main barriers to the implementation of health programs based on community participation in Iran. Barriers related to government, health programs, lack of necessary skills amongst health professionals and weak coordination between departments, barriers related to community, lack of understanding of goals, benefits and transparency of roles and responsibilities were among the important emanated factors to implementing health programs based community participation. CONCLUSION Health policymakers and managers should consider the five mentioned identified barriers based on the community when planning and implementing the health program participation and try to empower the community to implement the programs in Iran.
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Affiliation(s)
- Hassan Mahmoodi
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
- Department of Vice Chancellor for Health Affairs, Health Education and Promotion Group, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Amjad Mohamadi Bolbanabad
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran.
| | - Abdolreza Shaghaghi
- Department of Health Education and Promotion, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mehdi Zokaie
- Department of Vice Chancellor for Health Affairs, Population, Family and School Health Group, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Reza Ghanei Gheshlagh
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Abdorrahim Afkhamzadeh
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
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Dada S, Aivalli P, De Brún A, Barreix M, Chelwa N, Mutunga Z, Vwalika B, Gilmore B. Understanding communication in community engagement for maternal and newborn health programmes in low- and middle-income countries: a realist review. Health Policy Plan 2023; 38:1079-1098. [PMID: 37650702 PMCID: PMC10566325 DOI: 10.1093/heapol/czad078] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 08/20/2023] [Accepted: 08/29/2023] [Indexed: 09/01/2023] Open
Abstract
As community engagement (CE) is implemented for sustainable maternal and newborn health (MNH) programming, it is important to determine how these approaches work. Low- and middle-income countries (LMICs) have become a particular focus for MNH CE activities due to their high burden of maternal and neonatal deaths. MNH messaging and communication to engage communities are likely to differ by context, but how these approaches are actually developed and implemented within CE is not well understood. Understanding how communications in CE actually work is vital in the translation of learnings across programmes and to inform future projects. The purpose of this realist review is to describe how, why, to what extent and for whom communications in CE contribute to MNH programming in LMICs. After searching academic databases, grey literature and literature suggested by the expert advisory committee, documents were included if they described the CE communication processes/activities used for MNH programming in an LMIC. Relevant documents were assessed for richness (depth of insight) and rigor (trustworthiness and coherence of data/theories). Data were extracted as context-mechanism-outcome configurations (CMOCs) and synthesized into demi-regularities to contribute to theory refinement. After screening 416 records, 45 CMOCs were extracted from 11 documents. This informed five programme theories explaining that communications in CE for an MNH programme work when: communities are actively involved throughout the programme, the messaging and programme are acceptable, communication sources are trusted, the community has a reciprocal relationship with the programme and the community sees value in the programme. While these findings reflect what is often anecdotally known in CE or acknowledged in communications theory, they have implications for policy, practice and research by highlighting the importance of centring the community's needs and priorities throughout the stages of developing and implementing communications for CE in MNH.
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Affiliation(s)
- Sara Dada
- UCD Centre for Interdisciplinary Research Education and Innovation in Health Systems (UCD IRIS Centre), University College Dublin, School of Nursing Midwifery and Health Systems , Belfield, Dublin 4, Ireland
- School of Nursing Midwifery and Health Systems, University College Dublin, Belfield, Dublin 4, Ireland
| | - Praveenkumar Aivalli
- UCD Centre for Interdisciplinary Research Education and Innovation in Health Systems (UCD IRIS Centre), University College Dublin, School of Nursing Midwifery and Health Systems , Belfield, Dublin 4, Ireland
- School of Nursing Midwifery and Health Systems, University College Dublin, Belfield, Dublin 4, Ireland
| | - Aoife De Brún
- UCD Centre for Interdisciplinary Research Education and Innovation in Health Systems (UCD IRIS Centre), University College Dublin, School of Nursing Midwifery and Health Systems , Belfield, Dublin 4, Ireland
- School of Nursing Midwifery and Health Systems, University College Dublin, Belfield, Dublin 4, Ireland
| | - Maria Barreix
- UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction, Department of Sexual and Reproductive Health and Research, World Health Organization, Avenue Appia 20, 1211, Geneva 27, Switzerland
| | | | | | - Bellington Vwalika
- Department of Obstetrics and Gynaecology, University of Zambia School of Medicine, Lusaka, Zambia
| | - Brynne Gilmore
- UCD Centre for Interdisciplinary Research Education and Innovation in Health Systems (UCD IRIS Centre), University College Dublin, School of Nursing Midwifery and Health Systems , Belfield, Dublin 4, Ireland
- School of Nursing Midwifery and Health Systems, University College Dublin, Belfield, Dublin 4, Ireland
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Moskal Ł, Reszka K, Szewczyk K, Matkowski R, Błaszczyk D, Maciejczyk A. I Choose Health. It is OncoLogical!-Informative and Educational Campaign Dedicated to the High School Students in Poland. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2023; 38:1608-1613. [PMID: 37171530 PMCID: PMC10176273 DOI: 10.1007/s13187-023-02308-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/27/2023] [Indexed: 05/13/2023]
Abstract
Cancer is the second most common cause of death in Poland and the number of new cases is expected to increase by 28% over the next 10 years. Despite modifications and expenditure growth in the Polish health care system, oncological treatment outcomes are lower comparing to the other European Union countries. Early preventative interventions are effective in reducing the total number of cancers and improving early detection. OnkoLogika is an educational campaign launched in 2016 by the Comprehensive Cancer Centre, aimed at improving cancer awareness. One hundred and twenty students from 25 high schools of the Lower Silesia region in Poland participated in the OnkoLogika program, which consisted of four-segment workshops containing pre-/post-tests, theoretical and practical parts within the project. The mean number of correct answers from the both tests improved after educational intervention (p < 0.001). Students' knowledge increased, especially in relation to risk factors of breast cancer development (416.31% increase), HPV-related cancers (344.81% increase), risk factors and red flag signs of skin melanoma (120.31% and 99.05% increase respectively). Approx. 86% of participants were satisfied with the OnkoLogika with 14% of respondents being dissatisfied and 94% declared increased awareness about cancer prophylaxis. High schools students indicated insufficient time (250; 16.67%) and lack of details considering presented cancers (80; 5.33%) to be the major weaknesses of the program. Nevertheless, 94% of participants would recommend OnkoLogika to a friend. OnkoLogika promotes healthy lifestyle and helps acquire necessary knowledge about chosen cancers.
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Affiliation(s)
- Łukasz Moskal
- Department of Oncology, Wroclaw Medical University, Wrocław, Poland.
| | - Konrad Reszka
- Department of Oncology, Wroclaw Medical University, Wrocław, Poland
| | - Krzysztof Szewczyk
- Department of Oncology, Wroclaw Medical University, Wrocław, Poland
- Department of Surgical Oncology, Comprehensive Cancer Center, Wrocław, Poland
| | - Rafał Matkowski
- Department of Oncology, Wroclaw Medical University, Wrocław, Poland
- Department of Surgical Oncology, Comprehensive Cancer Center, Wrocław, Poland
| | | | - Adam Maciejczyk
- Comprehensive Cancer Center, Wrocław, Poland
- Department of Radiation Oncology, Comprehensive Cancer Center, Wrocław, Poland
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Kanamori Y, Ide-Okochi A. Meaning of community activity participation for older adults in couple households. Int J Nurs Sci 2023; 10:468-475. [PMID: 38020833 PMCID: PMC10667302 DOI: 10.1016/j.ijnss.2023.09.003] [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: 04/01/2023] [Revised: 08/09/2023] [Accepted: 09/12/2023] [Indexed: 12/01/2023] Open
Abstract
Objective Currently, 65.3% of older adults in Japan live in couple households. If one partner dies, the other may be unable to reconstruct their lifestyles, have health problems, or become isolated. Participation in community activities helps them maintain physical, mental, and social health. This study aimed to clarify the meaning of participation in community activities among older adults in couple households. Methods Semi-structured individual interviews were used to collect data. In February 2019, six adults aged 65 and above who had lived with their spouses for at least one year and continuously participated in community activities were interviewed in Miyazaki City, Japan. Data were analyzed using the KJ method (a qualitative method that organizes ideas in a bottom-up fashion developed by Kawakita Jiro), supervised by a professional instructor. Results The results revealed seven symbols using this method: 1) building a cooperative relationship with a spouse: respect the willingness to work hard for members; 2) consideration for relationships with other organizations: pay attention to every detail; 3) proactive attitude: don't leave everything to others, 4) attitude of questioning one's way of being: myself in connection to others, 5) connection among participants: increased awareness directed toward others, 6) spiritual fulfillment: time, place, and opportunity for outings, 7) physical and mental self-control for continued community activities: growing awareness of health care. Conclusions For older adults in couple households, it is found that participation in community activities helps them receive support from their spouses and gain a proactive attitude, and the connection between participants contributes to physical and mental control and also improves their health.
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Affiliation(s)
- Yumie Kanamori
- School of Health Sciences, Kumamoto University, Kumamoto City, Japan
| | - Ayako Ide-Okochi
- School of Health Sciences, Kumamoto University, Kumamoto City, Japan
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Gusoff GM, Zuckerman D, Pham BH, Ryan GW. Moving upstream: healthcare partnerships addressing social determinants of health through community wealth building. BMC Public Health 2023; 23:1824. [PMID: 37726750 PMCID: PMC10510172 DOI: 10.1186/s12889-023-16761-x] [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: 01/04/2023] [Accepted: 09/14/2023] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND Healthcare-based interventions addressing social needs such as food and housing generally fail to impact the upstream wealth and power inequities underlying those needs. However, a small number of US healthcare organizations have begun addressing these upstream inequities by partnering with community wealth building initiatives. These initiatives include community land trusts, resident-owned communities, and worker cooperatives, which provide local residents ownership and control over their housing and workplaces. While these partnerships represent a novel, upstream approach to the social determinants of health, no research has yet evaluated them. METHODS To assess the current state and key aspects of healthcare-community wealth building partnerships, we conducted a multiple case study analysis using semi-structured interviews with thirty-eight key informants across ten partnerships identified through the Healthcare Anchor Network. To analyze the interviews, we used a two-stage coding process. First, we coded responses based on the phase of the intervention to which they corresponded: motivation, initiation, implementation, or evaluation. Then we assessed responses within each aspect for common themes and variation on salient topics. RESULTS Partnerships were generally motivated by a combination of community needs, such as affordable housing and living wage jobs, and health system interests, such as workforce housing and supply chain resilience. Initiating projects required identifying external partners, educating leadership, and utilizing risk mitigation strategies to obtain health system buy-in. Implementation took various forms, with healthcare organizations providing financial capital in the form of grants and loans, social capital in the form of convening funders and other stakeholders, and/or capacity building support in the form of strategic planning or technical assistance resources. To evaluate projects, healthcare organizations used more process and community-level metrics rather than metrics based on individual health outcomes or returns on investment. Based on best practices from each partnership phase, we provide a roadmap for healthcare organizations to develop effective community wealth building partnerships. CONCLUSIONS Assessing healthcare partnerships with community wealth building organizations yields key strategies healthcare organizations can use to develop more effective partnerships to address the upstream causes of poor health.
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Affiliation(s)
- Geoffrey M Gusoff
- National Clinician Scholars Program & Department of Family Medicine, University of California, Los Angeles, 1100 Glendon Ave, Suite 900, Los Angeles, CA, 90024, USA.
| | - David Zuckerman
- Healthcare Anchor Network, 2202 18th St. NW, Suite 317, Washington, DC, 20009, USA
| | - Bich Ha Pham
- Healthcare Anchor Network, 2202 18th St. NW, Suite 317, Washington, DC, 20009, USA
| | - Gery W Ryan
- Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, 100 South Los Robles Avenue, Pasadena, CA, 91101, USA
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Yoshioka-Maeda K, Katayama T, Fujii H, Shiomi M, Hosoya N, Mayama T. Effectiveness of a web-based learning program for promoting local healthcare planning competencies. Public Health Nurs 2023; 40:685-695. [PMID: 37482903 DOI: 10.1111/phn.13229] [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: 04/07/2023] [Revised: 07/06/2023] [Accepted: 07/11/2023] [Indexed: 07/25/2023]
Abstract
OBJECTIVE To determine the effectiveness of a web-based educational program regarding local healthcare planning by public health nurses (PHNs) in Japan. DESIGN A single-blind randomized controlled trial. SAMPLE Full-time PHNs working for local governments across Japan. MEASUREMENTS The primary outcome was nurses' self-perception of competencies in public health policy. The secondary outcome was self-perception of knowledge, skills, and perspectives regarding local healthcare planning. We analyzed intergroup differences using the intention-to-treat principle and the Mann-Whitney U-test. INTERVENTION The intervention group received six web-based learning modules including substantial knowledge and skills regarding local healthcare planning based on the analysis, design, development, implementation, and evaluation model and adult learning theory. RESULTS Totally, 273 PHNs registered, and 38 were excluded without completing the baseline survey; 235 were randomly allocated to either the intervention (n = 118) or control (n = 117) groups. Sixty-four participants in the intervention group completed the program. Over 70% of the participants lacked opportunities to learn about local healthcare planning. The intervention group showed significant improvement in self-perception of competencies, knowledge, and skills regarding local healthcare planning, except for items related to evaluation. CONCLUSIONS The web-based learning program effectively improved participants' self-perception of competencies in local healthcare planning.
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Affiliation(s)
- Kyoko Yoshioka-Maeda
- Department of Community Health Nursing, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Takafumi Katayama
- Department of Statistics and Computer Science, College of Nursing Art and Science, University of Hyogo, Akashi City, Hyogo, Japan
| | - Hitoshi Fujii
- Department of Medical Statistics, School of Nursing, Mejiro University, Saitama City, Saitama, Japan
| | - Misa Shiomi
- Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto City, Kyoto, Japan
| | - Noriko Hosoya
- Department of Nursing, Faculty of Healthcare Sciences, Chiba Prefectural University of Health Sciences, Chiba City, Chiba, Japan
| | - Tatsushi Mayama
- Faculty of Policy Studies, Doshisha University, Kyoto City, Kyoto, Japan
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Luke KL, Rawluk A, McAdie T, Smith BP, Warren-Smith AK. How equestrians conceptualise horse welfare: Does it facilitate or hinder change? Anim Welf 2023; 32:e59. [PMID: 38487466 PMCID: PMC10937214 DOI: 10.1017/awf.2023.79] [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: 05/25/2023] [Revised: 08/04/2023] [Accepted: 08/08/2023] [Indexed: 03/17/2024]
Abstract
More than ever the welfare of horses in equestrian sport is in the spotlight. In response to this scrutiny, one peak body, the Federation Equestre Internationale (FEI) has created an Equine Ethics and Wellbeing Commission to protect their sport's longevity. However, for welfare-based strategies to be successful, the conceptualisation of horse welfare must align across various stakeholders, including the general public. The value-laden nature of welfare makes agreement on its definition, even among scientists, difficult. Given little is known about how equestrians conceptualise horse welfare, we interviewed 19 Australian amateur equestrians using a semi-structured format. Systems thinking and the Five Domains Model provided the theoretical framework and informed our methods. Using reflexive thematic analysis, three themes were identified: (1) good horse welfare is tangible; (2) owners misinterpret unwanted horse behaviour; and (3) equestrians publicly minimise horse welfare issues but are privately concerned. Our results highlight participants' conceptualisations of horse welfare do not align with the Five Domains Model; participants' ideal of prioritising horse welfare does not align with their practice; and there is inconsistency between what participants share publicly and what they think privately about horse welfare. These findings can inform the development of programmes to improve ridden horse welfare throughout the horse industry. As a starting point, programmes that provide a safe space for equestrians to explore their private horse welfare concerns, and programmes that build a partnership mindset to facilitate knowledge exchange between all stakeholders are needed.
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Affiliation(s)
- Karen L Luke
- School of Health, Medical and Applied Sciences, Central Queensland University, Bruce Hwy, Rockhampton, QLD, 4702, Australia
| | - Andrea Rawluk
- School of Ecosystem and Forest Sciences, University of Melbourne, Parkville, Australia
| | - Tina McAdie
- School of Health, Medical and Applied Sciences, Central Queensland University, Bruce Hwy, Rockhampton, QLD, 4702, Australia
| | - Bradley P Smith
- School of Health, Medical and Applied Sciences, Central Queensland University, Bruce Hwy, Rockhampton, QLD, 4702, Australia
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Mirzadeh Koohshahi M. Explaining the barriers to donor participation in the field of health: a qualitative study. Ann Med Surg (Lond) 2023; 85:4378-4384. [PMID: 37663732 PMCID: PMC10473377 DOI: 10.1097/ms9.0000000000001109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 07/15/2023] [Indexed: 09/05/2023] Open
Abstract
Background Iran's health system is facing increasing costs and a lack of resources. Developing the financial participation of donors is one of the ways to strengthen the financial health system. Objective This research was done to explain the barriers to donors' participation in the field of health. Method This qualitative study was conducted in 2022 using semi-structured interviews with 22 experts, health donors, policymakers, and managers in Iran. The conventional content analysis method was also used for data analysis. Results The review and classification of the interviews showed that the participation of donors in the health system includes four main issues: the incompleteness of legal processes, the lack of continuous communication with the charity, management, and resources problems, and the insufficient awareness of the donors about the problems and needs of the health system and 18 subtopics. Conclusions Donors play an important role in financing, developing resources, providing health services, and financially supporting patients in Iran's health system. Therefore, by recognizing and removing obstacles to the participation of donors, policymakers and managers of the health system should target the participation of donors with proper planning, organization, guidance, and supervision, and avoid parallel work and waste of resources.
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Miller A, Brown L, Tamu C, Cairns A. Cape York Kidney Care: service description and baseline characteristics of a client-centred multidisciplinary specialist kidney health service in remote Australia. BMC Health Serv Res 2023; 23:907. [PMID: 37620879 PMCID: PMC10463956 DOI: 10.1186/s12913-023-09887-6] [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: 02/03/2023] [Accepted: 08/08/2023] [Indexed: 08/26/2023] Open
Abstract
BACKGROUND Chronic Kidney disease (CKD) is over-represented amongst First Nation people with more than triple the rate of CKD in those aged 15 years and over. The impact of colonisation, including harmful experiences of health practices and research, has contributed to these health inequities. Cape York Kidney Care (CYKC) has been created as an unique service which provides specialist care that aims to centre the client within a multidisciplinary team that is integrated within the primary care setting of the remote health clinics in six communities in western Cape York, Australia. This research aims to describe the Cape York Kidney Care service delivery model, and baseline service data, including aggregated client health measures. METHODS The model of care is described in detail. Review of the first 12 months of service provision has been undertaken with client demographic and clinical profile baseline data collected including kidney health measures. Participants are adults (> 18 years if age) with CKD grades 1-5. This data has been de-identified and aggregated. RESULTS CYKC reviewed 204 individuals, with 182 not previously been reviewed by specialist kidney health services. Three quarters of clients identified as Aboriginal. The average age was 55 with a high level of comorbidity, with majority having a history of hypertension and Type 2 diabetes (average Hba1c 8.2%). Just under one third had cardiovascular disease. A large proportion of people had either Grade 2 CKD (32%) or Grade 3 CKD (~ 30%), and over half had severely increased albuminuria (A3), with Type 2 diabetes being the predominant presumed cause of CKD. Most clients did not meet evidence-based targets for diabetes, blood pressure or lipids and half were self-reported smokers. The proportion of clients reviewed represents 6.2% of the adult population in the participating First Nation communities. CONCLUSION The CYKC model was able to target those clients at high risk of progression and increase the number of people with chronic kidney disease reviewed by specialist kidney services within community. Baseline data demonstrated a high burden of chronic disease that subsequently will increase risk of CKD progression and cardiovascular disease. People were seen to have more severe disease at younger ages, with a substantial number demonstrating risk factors for rapid progression of kidney disease including poorly controlled Type 2 diabetes and severely increased albuminuria. Further evaluation concerning implementation challenges, consumer and community satisfaction, and health outcomes is required.
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Affiliation(s)
- Andrea Miller
- Torres and Cape Hospital and Health Service, PO Box 341, Weipa, QLD, Australia.
- Murtupuni Centre for Rural and Remote Health, & Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, Queensland, Australia.
| | - Leanne Brown
- Torres and Cape Hospital and Health Service, PO Box 341, Weipa, QLD, Australia
- Murtupuni Centre for Rural and Remote Health, & Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, Queensland, Australia
| | - Clara Tamu
- Torres and Cape Hospital and Health Service, Ngurapai/Horn Island Primary Health Care Centre, Horn Island, Queensland, Australia
| | - Alice Cairns
- Murtupuni Centre for Rural and Remote Health, & Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, Queensland, Australia
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Endalamaw A, Khatri RB, Erku D, Nigatu F, Zewdie A, Wolka E, Assefa Y. Successes and challenges towards improving quality of primary health care services: a scoping review. BMC Health Serv Res 2023; 23:893. [PMID: 37612652 PMCID: PMC10464348 DOI: 10.1186/s12913-023-09917-3] [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: 12/05/2022] [Accepted: 08/14/2023] [Indexed: 08/25/2023] Open
Abstract
BACKGROUND Quality health services build communities' and patients' trust in health care. It enhances the acceptability of services and increases health service coverage. Quality primary health care is imperative for universal health coverage through expanding health institutions and increasing skilled health professionals to deliver services near to people. Evidence on the quality of health system inputs, interactions between health personnel and clients, and outcomes of health care interventions is necessary. This review summarised indicators, successes, and challenges of the quality of primary health care services. METHODS We used the preferred reporting items for systematic reviews and meta-analysis extensions for scoping reviews to guide the article selection process. A systematic search of literature from PubMed, Web of Science, Excerpta Medica dataBASE (EMBASE), Scopus, and Google Scholar was conducted on August 23, 2022, but the preliminary search was begun on July 5, 2022. The Donabedian's quality of care framework, consisting of structure, process and outcomes, was used to operationalise and synthesise the findings on the quality of primary health care. RESULTS Human resources for health, law and policy, infrastructure and facilities, and resources were the common structure indicators. Diagnosis (health assessment and/or laboratory tests) and management (health information, education, and treatment) procedures were the process indicators. Clinical outcomes (cure, mortality, treatment completion), behaviour change, and satisfaction were the common indicators of outcome. Lower cause-specific mortality and a lower rate of hospitalisation in high-income countries were successes, while high mortality due to tuberculosis and the geographical disparity in quality care were challenges in developing countries. There also exist challenges in developed countries (e.g., poor quality mental health care due to a high admission rate). Shortage of health workers was a challenge both in developed and developing countries. CONCLUSIONS Quality of care indicators varied according to the health care problems, which resulted in a disparity in the successes and challenges across countries around the world. Initiatives to improve the quality of primary health care services should ensure the availability of adequate health care providers, equipped health care facilities, appropriate financing mechanisms, enhance compliance with health policy and laws, as well as community and client participation. Additionally, each country should be proactive in monitoring and evaluation of performance indicators in each dimension (structure, process, and outcome) of quality of primary health care services.
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Affiliation(s)
- Aklilu Endalamaw
- School of Public Health, the University of Queensland, Brisbane, Australia.
- College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
| | - Resham B Khatri
- School of Public Health, the University of Queensland, Brisbane, Australia
- Health Social Science and Development Research Institute, Kathmandu, Nepal
| | - Daniel Erku
- School of Public Health, the University of Queensland, Brisbane, Australia
- Centre for Applied Health Economics, School of Medicine, Griffith University, Griffith, Australia
- Menzies Health Institute Queensland, Griffith University, Griffith, Australia
| | - Frehiwot Nigatu
- International Institute for Primary Health Care in Ethiopia, Addis Ababa, Ethiopia
| | - Anteneh Zewdie
- International Institute for Primary Health Care in Ethiopia, Addis Ababa, Ethiopia
| | - Eskinder Wolka
- International Institute for Primary Health Care in Ethiopia, Addis Ababa, Ethiopia
| | - Yibeltal Assefa
- School of Public Health, the University of Queensland, Brisbane, Australia
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Falisse JB, Nkengurutse H, Ntakarutimana L. Strengthening the community governance of healthcare services in 'fragile' settings: Evidence from Burundi and South Kivu, DR Congo. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001697. [PMID: 37582067 PMCID: PMC10427014 DOI: 10.1371/journal.pgph.0001697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 07/15/2023] [Indexed: 08/17/2023]
Abstract
Community governance, the direct (co-)management of public services by community members, is a popular approach to improve the quality of, and access to, healthcare services-including in so-called 'fragile' states. The effectiveness of such approach is, however, debated, and scholars and practitioners have emphasised the need to properly reflect on the contextual features that may influence social accountability interventions. We study a randomised intervention during which community-elected health facility committee members were trained on their roles and rights in the co-management of primary healthcare facilities. 328 publicly-funded health facilities of Burundi and Sud Kivu in DR Congo were followed over a period of one year. In Kivu, but not in Burundi, the intervention strengthened the position of the committee vis-à-vis the health facility nurses and affected the management of the facility. HFC members mostly focused on improving the elements most accessible to them: hiring staff and engaging in basic construction and maintenance work. Using survey data and interviews, we argue that part of the discrepancy in results between the two contexts can be explained by differences in health facilities' management (whether they primarily depend on a local church or more distant authorities) as well as different local histories of relationship to public service providers. The former affects the room available for change, while the latter affects the relevance of the citizens' committee as an acceptable way to interact with healthcare providers. No effect was found on the perceived quality of and access to services, and the committees, even when strengthened, appear disconnected from the citizens. The findings are an invitation to re-think the conditions under which bottom-up accountability mechanisms such as citizens committees can be effective in 'fragile' settings.
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Affiliation(s)
- Jean-Benoit Falisse
- School of Social and Political Science and Edinburgh Future Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Hugues Nkengurutse
- Centre d’analyse et de recherche interdisciplinaire pour le développement des grands lacs (CARID-RGL), Université du Lac Tanganyika, Burundi
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Bachfischer A, Barbosa MC, Rojas AAR, Bechler R, Schwienhorst-Stich EM, Kasang C, Simmenroth A, Parisi S. Implementing community based inclusive development for people with disability in Latin America: a mixed methods perspective on prioritized needs and lessons learned. Int J Equity Health 2023; 22:147. [PMID: 37542266 PMCID: PMC10403844 DOI: 10.1186/s12939-023-01966-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 07/18/2023] [Indexed: 08/06/2023] Open
Abstract
BACKGROUND Research on the needs of people with disability is scarce, which promotes inadequate programs. Community Based Inclusive Development interventions aim to promote rights but demand a high level of community participation. This study aimed to identify prioritized needs as well as lessons learned for successful project implementation in different Latin American communities. METHODS This study was based on a Community Based Inclusive Development project conducted from 2018 to 2021 led by a Columbian team in Columbia, Brazil and Bolivia. Within a sequential mixed methods design, we first retrospectively analyzed the project baseline data and then conducted Focus Group Discussions, together with ratings of community participation levels. Quantitative descriptive and between group analysis of the baseline survey were used to identify and compare sociodemographic characteristics and prioritized needs of participating communities. We conducted qualitative thematic analysis on Focus Group Discussions, using deductive main categories for triangulation: 1) prioritized needs and 2) lessons learned, with subcategories project impact, facilitators, barriers and community participation. Community participation was assessed via spidergrams. Key findings were compared with triangulation protocols. RESULTS A total of 348 people with disability from 6 urban settings participated in the baseline survey, with a mean age of 37.6 years (SD 23.8). Out of these, 18 participated within the four Focus Group Discussions. Less than half of the survey participants were able to read and calculate (42.0%) and reported knowledge on health care routes (46.0%). Unemployment (87.9%) and inadequate housing (57.8%) were other prioritized needs across countries. Focus Group Discussions revealed needs within health, education, livelihood, social and empowerment domains. Participants highlighted positive project impact in work inclusion, self-esteem and ability for self-advocacy. Facilitators included individual leadership, community networks and previous reputation of participating organizations. Barriers against successful project implementation were inadequate contextualization, lack of resources and on-site support, mostly due to the COVID-19 pandemic. The overall level of community participation was high (mean score 4.0/5) with lower levels in Brazil (3.8/5) and Bolivia (3.2/5). CONCLUSION People with disability still face significant needs. Community Based Inclusive Development can initiate positive changes, but adequate contextualization and on-site support should be assured.
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Affiliation(s)
- Andreas Bachfischer
- Department of General Practice, Institut Für Allgemeinmedizin, University Hospital Würzburg, Haus D7, Josef-Schneider-Straße 2, 97080, Würzburg, Germany.
| | - Martha Cecilia Barbosa
- DAHW Latin America, GLRA German Leprosy and Tuberculosis Relief Association, Bogotá, Colombia
| | | | - Reinaldo Bechler
- DAHW Latin America, GLRA German Leprosy and Tuberculosis Relief Association, Bogotá, Colombia
| | - Eva-Maria Schwienhorst-Stich
- Department of General Practice, Institut Für Allgemeinmedizin, University Hospital Würzburg, Haus D7, Josef-Schneider-Straße 2, 97080, Würzburg, Germany
| | - Christa Kasang
- DAHW HQ, GLRA German Leprosy and Tuberculosis Relief Association, Würzburg, Germany
| | - Anne Simmenroth
- Department of General Practice, Institut Für Allgemeinmedizin, University Hospital Würzburg, Haus D7, Josef-Schneider-Straße 2, 97080, Würzburg, Germany
| | - Sandra Parisi
- Department of General Practice, Institut Für Allgemeinmedizin, University Hospital Würzburg, Haus D7, Josef-Schneider-Straße 2, 97080, Würzburg, Germany
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Kale S, Hirani S, Vardhan S, Mishra A, Ghode DB, Prasad R, Wanjari M. Addressing Cancer Disparities Through Community Engagement: Lessons and Best Practices. Cureus 2023; 15:e43445. [PMID: 37711952 PMCID: PMC10498131 DOI: 10.7759/cureus.43445] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 08/13/2023] [Indexed: 09/16/2023] Open
Abstract
Cancer disparities continue to be a significant public health challenge, disproportionately affecting certain communities in terms of incidence, mortality, and access to quality care. Addressing these disparities requires a multifaceted approach that involves not only healthcare professionals and researchers but also the active participation and collaboration of the affected communities themselves. Community engagement has emerged as a promising strategy to reduce cancer disparities and promote health equity. This review article synthesizes the existing literature and examines the role of community engagement in addressing cancer disparities. It explores various approaches and best practices utilized in community engagement initiatives to empower and involve diverse populations in the fight against cancer. The review discusses key lessons learned from successful programs and identifies challenges faced in implementing such initiatives. The article highlights the importance of cultural competence, trust-building, and meaningful collaboration between stakeholders, including community leaders, healthcare providers, researchers, and policymakers. It emphasizes the significance of tailoring interventions to specific community needs, acknowledging cultural differences, and fostering a two-way exchange of knowledge and resources. Moreover, this review investigates the impact of community engagement on cancer prevention, early detection, treatment adherence, and survivorship outcomes. It sheds light on the role of community-based participatory research and other innovative strategies in generating evidence and facilitating the translation of research findings into real-world interventions. In conclusion, this review underlines the potential of community engagement in addressing cancer disparities and promoting health equity. By involving communities as active partners in cancer control efforts, healthcare systems can design more effective and sustainable interventions. This approach not only contributes to reducing cancer disparities but also fosters a sense of ownership and empowerment within the communities affected, paving the way for a more equitable and inclusive healthcare landscape.
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Affiliation(s)
- Swarali Kale
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Shoyeb Hirani
- Medicine, Mahatma Gandhi Mission (MGM) Medical College and Hospital, Aurangabad, IND
| | - Sauvik Vardhan
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Aditi Mishra
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Dewang B Ghode
- General Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Roshan Prasad
- Medicine and Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Mayur Wanjari
- Research and Development, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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