1
|
Foster KN, Bright CF, Beatty K, de Jong J, Surles K, Ventura L, Kidd MJ. "Breaking Bread" With Respondents: Strategies to Increase Response Rates and Create Long-Term Cooperation With Health Clinic Administrators. FAMILY & COMMUNITY HEALTH 2024; 47:304-313. [PMID: 38874218 DOI: 10.1097/fch.0000000000000409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2024]
Abstract
BACKGROUND AND OBJECTIVES To fully understand the impact of unintended pregnancy, as well as to evaluate the implementation and outcomes of programs targeted at reducing unintended pregnancy, it is critical that researchers be able to collect comprehensive data from health clinics that provide these services in vulnerable communities. METHODS Our paper details recruitment and incentive strategies, as well as the theories that guided them, which allowed us to achieve a high survey response rate among health clinic administrators in public health clinics in 2 Southeastern states-South Carolina and Alabama-both of which have high rates of unintended pregnancy. RESULTS Grounded in organizational theory, and utilizing the Tailored Design Method, we achieved a 68% response rate utilizing paper and web survey administration with multiple contact modes. Our incentive structure comprised both traditional cash-based and food-based incentives. CONCLUSIONS Findings indicate high response rates are achievable despite high survey burden (ie, detailed information, length of survey). We found that sample screening was critical and that food-based incentives made an impression on respondents that positively impacted the researcher-respondent relationship. Providing detailed methodology and additional literature will assist researchers working with similar populations-a gap in the applied methodological literature that was problematic at the project's onset.
Collapse
Affiliation(s)
- Kelly N Foster
- Applied Social Research Lab, East Tennessee State University, Johnson City, Tennessee (Drs Foster and Bright and Ms Kidd); and Department of Health Services Management and Policy, East Tennessee State University, Johnson City, Tennessee (Drs Beatty and Surles and Mss de Jong and Ventura)
| | | | | | | | | | | | | |
Collapse
|
2
|
Seven M, Adawudu EA, Moraitis AM, Evans BD, Sturgeon S, Wenzel J, Hammer MJ. Experiences in Recruitment for Hispanic, Non-Hispanic Black, and Other Non-White Cancer Survivors Through Community Outreach and Other Targeted Approaches. Semin Oncol Nurs 2024:151719. [PMID: 39217031 DOI: 10.1016/j.soncn.2024.151719] [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: 02/29/2024] [Revised: 06/13/2024] [Accepted: 07/25/2024] [Indexed: 09/04/2024]
Abstract
OBJECTIVES Recruitment of racial/ethnic underserved populations in oncology research is essential to address health disparities. This article presents strategies and lessons learned from community outreach and other approaches for recruiting non-Hispanic Black, Hispanic, and other non-White survivors of cancer into a pilot study that investigated biopsychosocial determinants of health behaviors. METHODS We critically examined the participant recruitment approaches to explore challenges and successful strategies and develop recommendations for future studies. Direct recruitment strategies included engaging with research staff members' personal community contacts/liaisons and participating in community outreach events (eg, farmers' markets, block parties, library events, cancer awareness events). Indirect recruitment strategies included posting and distribution of study flyers in community centers (eg, LIVESTRONG® at the YMCA, churches, libraries), online platforms (eg, FORCE, Survivor Journey website), and invitation letters sent to individuals identified as eligible through a single state cancer registry. RESULTS Between April 2022 and May 2023, among the 64 individuals recruited, 36 were non-Hispanic Black, 25 were Hispanic, and three were American Indian/Alaska Native people. The use of a state cancer registry (64.1%), snowballing/word of mouth (7.8%), and advertisement through an established cancer support organization (ie, FORCE) website (7.8%) were the most effective strategies in this study. CONCLUSION Recruitment of non-Hispanic Black, Hispanic, and other non-White people into biobehavioral studies through community-engaged research is challenging and requires long-term commitment and engagement with partners from target communities and affiliated organizations. IMPLICATION FOR NURSING PRACTICE Registries and community outreach events can build trust for successful enrollment. Using multiple strategies can provide the best opportunities to reach diverse populations and enroll them in cancer-related research studies.
Collapse
Affiliation(s)
- Memnun Seven
- Elaine Marieb College of Nursing, University of Massachusetts Amherst, Amherst, Massachusetts.
| | - Emefa Awo Adawudu
- Elaine Marieb College of Nursing, University of Massachusetts Amherst, Amherst, Massachusetts
| | | | - Brenda D Evans
- School of Public Health & Health Sciences, University of Massachusetts Amherst, Amherst, Massachusetts
| | - Susan Sturgeon
- School of Public Health & Health Sciences, University of Massachusetts Amherst, Amherst, Massachusetts
| | - Jennifer Wenzel
- Johns Hopkins University School of Nursing, Baltimore, Maryland
| | | |
Collapse
|
3
|
Iacono G, Elsaesser C, Dominique Courts CL. "My resistance melts away": The role of mindfulness in supporting participatory researchers' efforts to share power with youth co-researchers. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2024. [PMID: 38959292 DOI: 10.1002/ajcp.12760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 05/09/2024] [Accepted: 06/12/2024] [Indexed: 07/05/2024]
Abstract
Youth participatory action research (YPAR) is an approach widely utilized in various social science disciplines (e.g., community psychology, social work, public health), which requires researchers to share power with youth co-researchers and to collaborate across identities to work equitably. Understanding what approaches and practices support YPAR adult facilitators' ability to share power is a vital area of knowledge that can support greater freedom in how researchers approach YPAR. Mindfulness offers a powerful set of tools for adult researchers to track their reactions and equitably collaborate with youth co-researchers. Drawing on insights from our youth participatory research, the present study employed a collaborative autoethnography to integrate our unique experiences as YPAR facilitators. We reflected on a core research question: How does mindfulness inform and support our YPAR work? Two major themes emerged that relate to power-sharing in YPAR: (1) Mindfulness supports our ability to overcome barriers to being present in facilitating YPAR groups; (2) Facilitator presence fosters deeper connection with youth co-researchers and stronger collaboration. Mindfulness can provide researchers a holistic, strengths-based approach in youth collaboration, and may also provide skillful tools for researchers to counter the pressures of White supremacy culture in academia.
Collapse
Affiliation(s)
- Gio Iacono
- School of Social Work, University of Connecticut, Hartford, Connecticut, USA
| | - Caitlin Elsaesser
- School of Social Work, University of Connecticut, Hartford, Connecticut, USA
| | | |
Collapse
|
4
|
Kantor LM, Cruz N, Adams C, Akhimien C, Allibay Abdulkadir F, Battle C, Oluwayemi M, Salimon O, Won SH, Niraula S, Lassiter T. Black Women's Maternal Health: Insights From Community Based Participatory Research in Newark, New Jersey. Behav Med 2024; 50:224-231. [PMID: 37382100 DOI: 10.1080/08964289.2023.2226852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 04/05/2023] [Accepted: 06/14/2023] [Indexed: 06/30/2023]
Abstract
This study on Black women's maternal health engaged a group of six community members in a community based participatory research project in a state with one of the largest racial disparities in maternal mortality and severe maternal morbidity in the United States. The community members conducted 31 semi-structured interviews with other Black women who had given birth within the past 3 years to examine their experiences throughout the perinatal and post-partum period. Four main themes emerged: (1) challenges related to the structure of healthcare, including insurance gaps, long wait times, lack of co-location of services, and financial challenges for both insured and uninsured people; (2) negative experiences with healthcare providers, including dismissal of concerns, lack of listening, and missed opportunities for relationship building; (3) preference for racial concordance with providers and experiences with discrimination across multiple dimensions; and (4) mental health concerns and lack of social support. CBPR is a research methodology that could be more widely deployed to illuminate the experiences of community members in order to develop solutions to complex problems. The results indicate that Black women's maternal health will benefit from multi-level interventions with changes driven by insights from Black women.
Collapse
Affiliation(s)
| | - Naomi Cruz
- Rutgers School of Public Health, Newark, NJ, USA
| | | | | | | | | | | | | | | | | | | |
Collapse
|
5
|
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.
Collapse
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
| |
Collapse
|
6
|
Li ACM, Mak WWS, Chan KKY, Corrigan PW, Larson J, Chan AFC, Chan CLF. Honest, Open, Proud (HOP) for people with mental illness in Hong Kong: a randomized controlled trial. Soc Psychiatry Psychiatr Epidemiol 2024; 59:769-780. [PMID: 37582863 DOI: 10.1007/s00127-023-02545-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 07/30/2023] [Indexed: 08/17/2023]
Abstract
BACKGROUND Self-stigma among people with mental illness is negatively associated with personal and clinical recovery. Due to the concealable nature of mental illness, people with mental illness experience constant struggles between concealment and disclosure. Disclosure of mental health challenges can potentially minimize negative impacts of self-stigma and enhance self-esteem and sense of empowerment. Honest, Open, Proud (HOP) is a peer-led intervention that promotes autonomous and dignified decisions about disclosure. PURPOSE This study examined the effectiveness of HOP on concealment motivation, empowerment, self-stigma, stigma stress, and recovery among people with lived experience of mental illness in Hong Kong. METHODOLOGY A total of 162 participants with a mean age of 45.38 were recruited and randomized into intervention group and waitlist control group. Participants in the intervention group were invited to attend a 6-session HOP group intervention. RESULTS Significant improvement in optimism score from the empowerment scale was found in the intervention group compared to the waitlist control group and the effect was sustained at 1-month follow-up. However, significant changes were not found in other outcome variables. CONCLUSION Only improvement in optimism was observed in the current study. Future study needs to examine the effects of HOP with further modification to maximize the benefit for people with lived experience of mental illness in the local context.
Collapse
Affiliation(s)
- Amanda C M Li
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong, China
| | - Winnie W S Mak
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong, China.
| | - Kelly K Y Chan
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong, China
| | | | - Jon Larson
- Illinois Institute of Technology, Chicago, IL, USA
| | - Alice F C Chan
- Vocational Rehabilitation Services, New Life Psychiatric Rehabilitation Association, Hong Kong, China
| | - Christopher L F Chan
- Community Services, New Life Psychiatric Rehabilitation Association, Hong Kong, China
| |
Collapse
|
7
|
Miller SJ, Sly JR, Rolfo C, Mack P, Villanueva A, Mazor M, Weber E, Lin JJ, Smith CB, Taioli E. Multi-cancer early detection (MCED) tests: prioritizing equity from bench to bedside. HEALTH AFFAIRS SCHOLAR 2024; 2:qxae039. [PMID: 38783890 PMCID: PMC11114468 DOI: 10.1093/haschl/qxae039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 03/14/2024] [Accepted: 04/18/2024] [Indexed: 05/25/2024]
Abstract
Multi-cancer early detection (MCED) tests are blood-based tests designed to screen for signals of multiple cancers. There is growing interest and investment in examining the potential benefits and applications of MCED tests. If MCED tests are shown to have clinical utility, it is important to ensure that all people-regardless of their demographic or socioeconomic background-equitably benefit from these tests. Unfortunately, with health care innovation, such considerations are often ignored until after inequities emerge. We urge for-profit companies, scientists, clinicians, payers, and government agencies to prioritize equity now-when MCEDs are still being developed and researched. In an effort to avoid creating and exacerbating cancer inequities, we propose 9 equity considerations for MCEDs.
Collapse
Affiliation(s)
- Sarah J Miller
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States
- Department of Family Medicine and Community Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States
| | - Jamilia R Sly
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States
- Department of Family Medicine and Community Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States
| | - Christian Rolfo
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States
- Center for Thoracic Oncology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States
| | - Philip Mack
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States
- Center for Thoracic Oncology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States
| | - Augusto Villanueva
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States
- Mount Sinai Liver Cancer Program, Division of Liver Diseases, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States
| | - Melissa Mazor
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States
- Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States
| | - Ellerie Weber
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States
| | - Jenny J Lin
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States
- Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States
| | - Cardinale B Smith
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States
- Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States
| | - Emanuela Taioli
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States
- Department of Thoracic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States
- Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States
| |
Collapse
|
8
|
Vepachedu S, Nurzenska A, Lohiniva AL, Hudi AH, Deku S, Birungi J, Greiner K, Sherlock J, Campbell C, Foster L. Understanding COVID-19 vaccination behaviors and intentions in Ghana: A Behavioral Insights (BI) study. PLoS One 2024; 19:e0292532. [PMID: 38335165 PMCID: PMC10857727 DOI: 10.1371/journal.pone.0292532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 09/21/2023] [Indexed: 02/12/2024] Open
Abstract
INTRODUCTION Vaccine uptake is influenced by a variety of factors. Behavioral Insights (BI) can be used to address vaccine hesitancy to understand the factors that influence the decision to take or refuse a vaccine. METHODOLOGY This two-part study consisted of a survey designed to identify the influence of various drivers of people's COVID-19 vaccination status and their intention to take the vaccine in Ghana, as well as an experiment to test which of several behaviorally informed message frames had the greatest effect on vaccine acceptance. Data was collected from a total of 1494 participants; 1089 respondents (73%) reported already being vaccinated and 405 respondents (27%) reported not being vaccinated yet. The mobile phone-based surveys were conducted between December 2021 and January 2022 using Random Digit Dialing (RDD) to recruit study participants. Data analysis included regression models, relative weights analyses, and ANOVAs. RESULTS The findings indicated that vaccine uptake in Ghana is influenced more by social factors (what others think) than by practical factors such as ease of vaccination. Respondents' perceptions of their family's and religious leaders' attitudes towards the vaccine were among the most influential drivers. Unexpectedly, healthcare providers' positive attitudes about the COVID-19 vaccine had a significant negative relationship with respondents' vaccination behavior. Vaccine intention was positively predicted by risk perception, ease of vaccination, and the degree to which respondents considered the vaccine effective. Perceptions of religious leaders' attitudes also significantly and positively predicted respondents' intention to get vaccinated. Although perceptions of religious leaders' views about the vaccine are an important driver of vaccine acceptance, results asking respondents to rank-order who influences them suggest that people may not be consciously aware-or do not want to admit-the degree to which they are affected by what religious leaders think. Message frames that included fear, altruism, social norms were all followed by positive responses toward the vaccine, as were messages with three distinct messengers: Ghana Health Services, a doctor, and religious leaders. CONCLUSIONS What drives COVID-19 vaccine intentions does not necessarily drive behaviors. The results of this study can be used to develop appropriate COVID-19 vaccine uptake strategies targeting the most important drivers of COVID-19 vaccine acceptance, using effective message frames.
Collapse
Affiliation(s)
- Swathi Vepachedu
- Center for Advanced Hindsight, Duke University, Durham, NC, United States of America
- Department of Psychology, North Carolina State University, Raleigh, NC, United States of America
| | | | | | | | | | | | - Karen Greiner
- UNICEF Regional Office Central and West Africa, Dakar, Senegal
| | - Joseph Sherlock
- Center for Advanced Hindsight, Duke University, Durham, NC, United States of America
| | - Chelsi Campbell
- Center for Advanced Hindsight, Duke University, Durham, NC, United States of America
- Department of Psychology, North Carolina State University, Raleigh, NC, United States of America
| | - Lori Foster
- Department of Psychology, North Carolina State University, Raleigh, NC, United States of America
- School of Management Studies, University of Cape Town, Cape Town, South Africa
| |
Collapse
|
9
|
Ooms T, Klaser K, Ishkanian A. The role of academia practice partnerships in the well-being economy: Retracing synergies between health and social sciences using bibliometric analysis. Health Policy 2023; 138:104936. [PMID: 37922743 DOI: 10.1016/j.healthpol.2023.104936] [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: 05/13/2023] [Revised: 10/12/2023] [Accepted: 10/27/2023] [Indexed: 11/07/2023]
Abstract
Well-being economies develop policies at the intersection of health and socio-economic inequalities. These policies are often informed by data-driven approaches, such as quality-of-life indicators. However, despite great efforts in measurement, it is known that the perspectives of underserved and unhealthy populations are not always fully captured. This raises the question to what extent well-being economy policies, informed by data alone, can adequately improve well-being for all. In this paper we investigate the potential of academia practice partnerships (AcPrac) in facilitating transfer and production of knowledge and skills between researchers and practitioners (including decision makers, governments, and communities) to create well-being policies informed by both data and people. We use bibliometric analysis to visualise the current state of knowledge on AcPrac. We find that 1) the health field has made the largest scientific contribution in this area, 2) cross-fertilization, which is at the heart of the well-being economy approach, is starting to take place between health and social sciences, and 3) concerns for equity are a shared value underlying transdisciplinary partnerships for well-being. Our findings contribute to understanding the role of AcPrac in advancing well-being economies and informing policy, but further research is needed to draw conclusions about its effectiveness.
Collapse
Affiliation(s)
| | - Klaudijo Klaser
- Department of Economics and Management, University of Trento.
| | - Armine Ishkanian
- LSE Department of Social Policy and Executive Director of the LSE Atlantic Fellows for Social and Economic Equity.
| |
Collapse
|
10
|
Grieve LM, Murthy VS. Experience conducting a community-engaged student research project involving an underrepresented community: A reflective essay. J Genet Couns 2023; 32:1232-1237. [PMID: 37752687 DOI: 10.1002/jgc4.1799] [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: 11/30/2022] [Revised: 07/07/2023] [Accepted: 09/15/2023] [Indexed: 09/28/2023]
Abstract
Recruiting racially and ethnically underrepresented participants into genetics research studies has been challenging. While many institutions have taken steps to address the inequity in genetics research, genetic counseling training programs have the chance to inspire students to engage with underrepresented communities through utilizing different research methodologies. These methodologies can help students focus on research projects that increase access to genetics services and improve clinical care. Community-engaged research (CER) presents a pedagogical approach to enhance service-learning opportunities for students. Furthermore, it allows students to develop practical research skills for doing research with the community, rather than on the community. CER is a collaborative community-academic partnership that leads to mutual benefit and outcomes such as inclusion and engagement of the community in research, building trust and relationships, and increasing cultural awareness and exposure. In addition, CER can be used to address research and healthcare inequities by providing opportunities for genetics professionals and trainees to work closely with underrepresented populations. We aim to highlight the opportunities CER provides to students, mentors, and faculty within the context of graduate research in genetic counseling training from the experiences of a student and an educator. In addition, we hope to emphasize the necessity for projects like these to address the gaps in participation of underrepresented patient populations in research and identify areas that are mutually beneficial to improve health outcomes, patient care experiences, access, and service delivery. This reflective essay illustrates the completion of a CER project that was developed in collaboration with community members to address gaps in clinical genetics services in Indigenous healthcare.
Collapse
Affiliation(s)
- LilyAnne M Grieve
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Vinaya S Murthy
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, Indiana, USA
| |
Collapse
|
11
|
Foláyan MO, Haire B. What's trust got to do with research: why not accountability? Front Res Metr Anal 2023; 8:1237742. [PMID: 38025960 PMCID: PMC10679329 DOI: 10.3389/frma.2023.1237742] [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: 06/12/2023] [Accepted: 10/20/2023] [Indexed: 12/01/2023] Open
Abstract
This paper explores the intricate dynamics of trust, power, and vulnerability in the relationship between researchers and study participants/communities in the field of bioethics. The power and knowledge imbalances between researchers and participants create a structural vulnerability for the latter. While trust-building is important between researchers and study participants/communities, the consenting process can be challenging, often burdening participants with power abrogation. Trust can be breached. The paper highlights the contractual nature of the research relationship and argues that trust alone cannot prevent exploitation as power imbalances and vulnerabilities persist. To protect participants, bioethics guidance documents promote accountability and ethical compliance. These documents uphold fairness in the researcher-participant relationship and safeguard the interests of socially vulnerable participants. The paper also highlights the role of shared decision-making and inclusive deliberation with diverse stakeholders and recommends that efforts should be made by researchers to clarify roles and responsibilities, while research regulatory agents should transform the research-participant relationship into a legal-based contract governed by accountability principles. While trust remains important, alternative mechanisms may be needed to ensure ethical research practices and protect the interests of participants and communities. Striking a balance between trust and accountability is crucial in this regard.
Collapse
Affiliation(s)
| | - Bridget Haire
- Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| |
Collapse
|
12
|
Mohammadzadeh M, Taras A, Stock C. Participant recruitment among vulnerable populations: An experience from a qualitative study among refugee adolescents in Germany. OPEN RESEARCH EUROPE 2023; 2:47. [PMID: 37974661 PMCID: PMC10652035 DOI: 10.12688/openreseurope.14654.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/26/2023] [Indexed: 11/19/2023]
Abstract
When it comes to actual practice, comparing to theoretical plans, the study progress is much more complicated due to both predicted and unpredicted challenges in the study participant recruitment. The situation is even more difficult if the research team deal with a vulnerable population. The current article represents and discusses the recruitment process for a currently unpublished qualitative study, conducted in Germany in 2021, as the first phase of our project: SC-SD4ASA: A self-care/self-development guidebook for asylum-seeking adolescents. First a brief of the study methodology is outlined and then, the strategies used to reach the potential participants including major/government organizations for refugees, private organizations and local centers, social media, youth's favorite public places, and participatory strategy are discussed. Finally, our experience of participant recruitment challenges in this study is reviewed. We hope that the points raised from our experience can be helpful to other researchers in the same field. Overall, the experience of recruiting our participants emphasized the necessity for a dedicated point of contact for consultation and the provision of resources to connect with potential participants for researchers in the field of refugee and migrant health. Furthermore, the influence of trustworthy individuals, particularly within the community, should not be underestimated. Their assistance can significantly benefit the advancement of a research project.
Collapse
Affiliation(s)
- Marjan Mohammadzadeh
- Institute of Health and Nursing Science, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, 13353, Germany
| | - Asra Taras
- Institute of Health and Nursing Science, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, 13353, Germany
| | - Christiane Stock
- Institute of Health and Nursing Science, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, 13353, Germany
- Unit for Health Promotion Research, University of Southern Denmark, Dengevej 14, 6705, Esbjerg, Denmark
| |
Collapse
|
13
|
Houle N, Lerario MP, Levi SV. Spectral analysis of strident fricatives in cisgender and transfeminine speakersa). THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2023; 154:3089-3100. [PMID: 37962405 PMCID: PMC10651311 DOI: 10.1121/10.0022387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 08/24/2023] [Accepted: 10/10/2023] [Indexed: 11/15/2023]
Abstract
The spectral features of /s/ and /ʃ/ carry important sociophonetic information regarding a speaker's gender. Often, gender is misclassified as a binary of male or female, but this excludes people who may identify as transgender or nonbinary. In this study, we use a more expansive definition of gender to investigate the acoustics (duration and spectral moments) of /s/ and /ʃ/ across cisgender men, cisgender women, and transfeminine speakers in voiced and whispered speech and the relationship between spectral measures and transfeminine gender expression. We examined /s/ and /ʃ/ productions in words from 35 speakers (11 cisgender men, 17 cisgender women, 7 transfeminine speakers) and 34 speakers (11 cisgender men, 15 cisgender women, 8 transfeminine speakers), respectively. In general, /s/ and /ʃ/ center of gravity was highest in productions by cisgender women, followed by transfeminine speakers, and then cisgender men speakers. There were no other gender-related differences. Within transfeminine speakers, /s/ and /ʃ/ center of gravity and skewness were not related to the time proportion expressing their feminine spectrum gender or their Trans Women Voice Questionnaire scores. Taken together, the acoustics of /s/ and /ʃ/ may signal gender group identification but may not account for within-gender variation in transfeminine gender expression.
Collapse
Affiliation(s)
- Nichole Houle
- Department of Speech, Language, and Hearing Sciences, Boston University, Boston, Massachusetts 02215, USA
| | | | - Susannah V Levi
- Department of Communicative Sciences and Disorders, New York University, New York, New York 10012, USA
| |
Collapse
|
14
|
Brockhoven F, Raphael M, Currier J, Jäderholm C, Mody P, Shannon J, Starling B, Turner-Uaandja H, Pashayan N, Arteaga I. REPRESENT recommendations: improving inclusion and trust in cancer early detection research. Br J Cancer 2023; 129:1195-1208. [PMID: 37689805 PMCID: PMC10575902 DOI: 10.1038/s41416-023-02414-8] [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: 01/20/2023] [Revised: 08/01/2023] [Accepted: 08/21/2023] [Indexed: 09/11/2023] Open
Abstract
Detecting cancer early is essential to improving cancer outcomes. Minoritized groups remain underrepresented in early detection cancer research, which means that findings and interventions are not generalisable across the population, thus exacerbating disparities in cancer outcomes. In light of these challenges, this paper sets out twelve recommendations to build relations of trust and include minoritized groups in ED cancer research. The Recommendations were formulated by a range of stakeholders at the 2022 REPRESENT consensus-building workshop and are based on empirical data, including a systematic literature review and two ethnographic case studies in the US and the UK. The recommendations focus on: Long-term relationships that build trust; Sharing available resources; Inclusive and accessible communication; Harnessing community expertise; Unique risks and benefits; Compensation and support; Representative samples; Demographic data; Post-research support; Sharing results; Research training; Diversifying research teams. For each recommendation, the paper outlines the rationale, specifications for how different stakeholders may implement it, and advice for best practices. Instead of isolated recruitment, public involvement and engagement activities, the recommendations here aim to advance mutually beneficial and trusting relationships between researchers and research participants embedded in ED cancer research institutions.
Collapse
Grants
- EICEDAAP\100011 Cancer Research UK
- Cancer Research UK (CRUK)
- The International Alliance for Cancer Early Detection, an alliance between Cancer Research UK [EICEDAAP\100011], Canary Center at Stanford University, the University of Cambridge, OHSU Knight Cancer Institute, University College London and the University of Manchester.
- This work was supported by the International Alliance for Cancer Early Detection, an alliance between Cancer Research UK [EICEDAAP\100011], Canary Center at Stanford University, the University of Cambridge, OHSU Knight Cancer Institute, University College London and the University of Manchester.
Collapse
Affiliation(s)
| | - Maya Raphael
- Department of Social Anthropology, University of Cambridge, Cambridge, UK
| | - Jessica Currier
- Division of Oncological Sciences, Oregon Health & Science University, Portland, OR, USA
| | - Christina Jäderholm
- School of Public Health, Oregon Health & Science University-Portland State University, Portland, OR, USA
| | - Perveez Mody
- Department of Social Anthropology, University of Cambridge, Cambridge, UK
| | - Jackilen Shannon
- Division of Oncological Sciences, Oregon Health & Science University, Portland, OR, USA
| | - Bella Starling
- Vocal, Manchester University NHS Foundation Trust, Manchester, UK
| | | | - Nora Pashayan
- Department of Applied Health Research, University College London, London, UK
| | - Ignacia Arteaga
- Department of Social Anthropology, University of Cambridge, Cambridge, UK.
- Early Cancer Institute, University of Cambridge, Cambridge, UK.
| |
Collapse
|
15
|
Naeem I, Aroua M, Chowdhury N, Saini V, Quan H, Turin TC. Color coded health data: factors related to willingness to share health information in South Asian community members in Canada. Int J Popul Data Sci 2023; 8:2134. [PMID: 37670959 PMCID: PMC10476700 DOI: 10.23889/ijpds.v8i1.2134] [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] [Indexed: 09/07/2023] Open
Abstract
Introduction Data unavailability poses multiple challenges in many health fields, especially within ethnic subgroups in Canada, who may be hesitant to share their health data with researchers. Since health information availability is controlled by the participant, it is important to understand the willingness to share health information by an ethnic population to increase data availability within ethnocultural communities. Methods We employed a qualitative descriptive approach to better understand willingness to share health information by South Asian participants and operated through a lens that considered the cultural and sociodemographic aspect of ethnocultural communities. A total of 22 in-depth interviews were conducted between March and July 2020. Results The results of this study show that health researchers should aim to develop a mutually beneficial information-sharing partnership with communities, with an emphasis on the ethnocultural and socio-ecological aspects of health within populations. Conclusion The findings support the need for culturally sensitive and respectful engagement with the community, ethically sound research practices that make participants feel comfortable in sharing their information, and an easy sharing process to share health information feasibly.
Collapse
Affiliation(s)
- Iffat Naeem
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Meriem Aroua
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Nashit Chowdhury
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Vineet Saini
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Research and Innovation, Public Health Evidence and Innovation, Provincial Population and Public Health, Alberta Health Services, Calgary, Alberta, Canada
| | - Hude Quan
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Tanvir C. Turin
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| |
Collapse
|
16
|
Rink E, Anastario M, Peterson M, FireMoon P, Johnson O, GrowingThunder R, Ricker A, Cox G, Holder S, Baldwin JA. Baseline results from NenŨnkUmbi/EdaHiYedo: A randomized clinical trial to improve sexual and reproductive health among American Indian adolescents. J Adolesc 2023; 95:844-859. [PMID: 36890753 PMCID: PMC11290810 DOI: 10.1002/jad.12158] [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: 07/13/2022] [Revised: 02/11/2023] [Accepted: 02/13/2023] [Indexed: 03/10/2023]
Abstract
We report on baseline findings from NenUnkUmbi/EdaHiYedo, a community based participatory research randomized controlled trial with American Indian adolescents to reduce sexual and reproductive health disparities. American Indian adolescents aged 13-19 years participated in a baseline survey that was administered in five schools. We used zero-inflated negative binomial regression to evaluate how the count of protected sexual acts was associated with independent variables of interest. We stratified models by self-reported gender of adolescents and tested for a two-way interaction effect between gender and the independent variable of interest. Two hundred twenty-three girls and 222 boys (n = 445) were sampled. The average number of lifetime partners was 1.0 (standard deviation = 1.7). Each additional lifetime partner was associated with a 50% increase in the number of protected sexual acts incident rate ratio (IRR = 1.5, 95% confidence interval [CI] 1.1-1.9) and more than a twofold increase in the likelihood of not having protected sexual acts (adjusted odd ratio [aOR] = 2.6, 95% CI 1.3-5.1). Each additional number of substances used in adolescentss' lifetime was associated with an increased likelihood of not having protected sexual acts (aOR = 1.2, 95% CI 1.0-1.5). In boys, each one standard deviation increase in depression severity was associated with a 50% reduction in the number of times a condom was used adjusted IRR (aIRR = 0.5, 95% CI 0.4-0.6, p < .001). Each 1-unit increase in positive prospections of pregnancy was associated with a pronounced decrease likelihood of not having protected sexual acts (aOR = 0.01, 95% CI 0.0-0.1). Findings support the importance of tribally driven tailoring of sexual and reproducive health interventions and services for American Indian adolescents.
Collapse
Affiliation(s)
- Elizabeth Rink
- Department of Health and Human Development, Montana State University, Bozeman, Montana, USA
| | - Mike Anastario
- Robert Stempel College of Public Health & Social Work, Florida International University, Florida, Miami, USA
| | - Malory Peterson
- Department of Health and Human Development, Montana State University, Bozeman, Montana, USA
| | | | | | - Ramey GrowingThunder
- Language and Culture Department, Fort Peck Assiniboine and Sioux Tribes, Poplar, Montana, USA
| | - Adriann Ricker
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | - Genevieve Cox
- Department of Health and Human Development, Montana State University, Bozeman, Montana, USA
| | - Shannon Holder
- Department of Health and Human Development, Montana State University, Bozeman, Montana, USA
| | - Julie A Baldwin
- Center for Health Equity Research, Northern Arizona University, Flagstaff, Arizona, USA
| |
Collapse
|
17
|
Cherewick M, Dahl RE, Rubin D, Leiferman JA, Njau PF. Psychometric validation of the collective asset Utu: associations with coping strategies and resilience during adolescence. Glob Health Res Policy 2023; 8:15. [PMID: 37198701 DOI: 10.1186/s41256-023-00303-4] [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: 07/25/2022] [Accepted: 05/07/2023] [Indexed: 05/19/2023] Open
Abstract
BACKGROUND Utu is a Kiswahili term with a long history of cultural significance in Tanzania. It conveys a value system of shared, collective humanity. While variants of Utu have been studied in other contexts, a measure of Utu that captures this important collective asset has not been developed in Tanzania. The aims of this study were to (1) examine dimensional constructs that represent Utu, (2) validate a measurement scale of Utu for use with adolescents, (3) examine differences between orphan and non-orphan adolescents in self-reported Utu and, (4) examine structural paths between adverse life experiences, coping strategies, Utu, and resilience. METHODS: This study collected survey data from adolescents from three districts in peri-urban Tanzania in two samples: 189 orphan adolescents ages 10-17 in May 2020 and 333 non-orphan adolescents ages 10-14 in August 2020. Confirmatory factor analysis was used to validate the hypothesized factor structure of the developed Utu measure. Structural equation models were used to examine path associations with adverse life experiences, coping and resilience. RESULTS The five dimensional constructs comprising the Utu measure included Resource Sharing, Group Solidarity, Respect and Dignity, Collectivity, and Compassion. Confirmatory factor analysis of the Utu measure demonstrated excellent fit (CFI = 0.98; TLI = 0.97; SRMR = 0.024; RMSEA = 0.046) and internal consistency (α = 0.94) among adolescents in this study. Positive, significant associations were found between Utu and coping (β = 0.29, p < 0.001) and Utu and intra/interpersonal and collective resilience (β = 0.13, p < 0.014). Utu was not significantly associated with adverse life experiences, age or gender. CONCLUSIONS A five-dimensional measurement scale for Utu was validated in a sample of orphan and non-orphan adolescents in Tanzania. Utu is a collective asset associated with higher levels of reported resilience in both orphan and non-orphan adolescent populations in Tanzania. Promoting Utu may be an effective universal public health prevention approach. Implications for adolescent programming are discussed.
Collapse
Affiliation(s)
- Megan Cherewick
- Department of Community and Behavioral Health, Colorado School of Public Health, University of Colorado Anschutz, 13001 East 17th Place, Aurora, CO, 80045, USA.
| | - Ronald E Dahl
- Institute of Human Development, University of California Berkeley, 2121 Berkeley Way West, Berkeley, CA, 94720-1690, USA
| | - Daphna Rubin
- Department of Community and Behavioral Health, Colorado School of Public Health, University of Colorado Anschutz, 13001 East 17th Place, Aurora, CO, 80045, USA
| | - Jenn A Leiferman
- Department of Community and Behavioral Health, Colorado School of Public Health, University of Colorado Anschutz, 13001 East 17th Place, Aurora, CO, 80045, USA
| | - Prosper F Njau
- Health for a Prosperous Nation, P.O. Box 13650, Dar es Salaam, Tanzania
| |
Collapse
|
18
|
Caballero E, Minnis A, Parmar D, Zerofsky M, Comfort M, Raymond-Flesch M. Labeling in a Latinx Community: Public Health Implications for Youth and Role in Community Narratives. RESEARCH SQUARE 2023:rs.3.rs-2626181. [PMID: 36993344 PMCID: PMC10055544 DOI: 10.21203/rs.3.rs-2626181/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
Background Youth of color are disproportionately subjected to negative formal and informal labels by parents, peers, and teachers. This study examined the consequences of such labels on health-protective behaviors, wellbeing, peer networks and school engagement. Methods In-depth interviews were conducted with 39 adolescents and 20 mothers from a predominantly Latinx and immigrant agricultural community in California. Teams of coders completed iterative rounds of thematic coding to identify and refine key themes. Results Dichotomous labeling of "good" and "bad" was pervasive. Youth labeled as "bad" experienced limited educational opportunities, exclusion from peers, and community disengagement. Additionally, preservation of "good kid" labels compromised health protective-behaviors including foregoing contraception. Participants pushed back on negative labeling when it was applied to close family or community acquaintances. Discussion Targeted interventions that foster social belonging and connection rather than exclusion may facilitate health protective behaviors and have positive implications for future trajectories among youth.
Collapse
|
19
|
Brothers S, Palayew A, Simon C, Coulter A, Strichartz K, Voyles N, Vincent L. Patient experiences of methadone treatment changes during the first wave of COVID-19: a national community-driven survey. Harm Reduct J 2023; 20:31. [PMID: 36894968 PMCID: PMC9996563 DOI: 10.1186/s12954-023-00756-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 02/13/2023] [Indexed: 03/11/2023] Open
Abstract
BACKGROUND During COVID-19, the Substance Abuse and Mental Health Services Administration (SAMHSA) allowed Methadone Maintenance Treatment (MMT) programs to relax in-person MMT requirements to reduce COVID-19 exposure. This study examines patient-reported changes to in-person methadone clinic attendance requirements during COVID-19. METHODS From June 7, 2020, to July 15, 2020, a convenience sample of methadone patients (N = 392) were recruited in collaboration with National Survivors Union (NSU) in 43 states and Washington D.C. through social media (Facebook, Reddit, Twitter, and Web site pop-ups). The community-driven research (CDR) online survey collected information on how patient take-home methadone dosing and in-person drug testing, counseling, and clinic visit frequency changed prior to COVID-19 (before March 2020) to during COVID-19 (June and July 2020). RESULTS During the study time period, the percentage of respondents receiving at least 14 days of take-home doses increased from 22 to 53%, while the percentage receiving one or no take-home doses decreased from 22.4% before COVID-19 to 10.2% during COVID-19. In-person counseling attendance decreased from 82.9% to 19.4%. While only 3.3% of respondents accessed counseling through telehealth before COVID-19, this percentage increased to 61.7% during COVID-19. Many respondents (41.3%) reported visiting their clinics in person once a week or more during COVID-19. CONCLUSIONS During the first wave of COVID-19, methadone patients report decreased in-person clinic attendance and increased take-home doses and use of telehealth for counseling services. However, respondents reported considerable variations, and many were still required to make frequent in-person clinic visits, which put patients at risk of COVID-19 exposure. Relaxations of MMT in-person requirements during COVID-19 should be consistently implemented and made permanent, and patient experiences of these changes should be explored further.
Collapse
Affiliation(s)
- Sarah Brothers
- Department of Sociology, Pennsylvania State University, University Park, USA.
| | - Adam Palayew
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - Caty Simon
- Methadone Advocacy Working Group, National Survivors Union, Greensboro, NC, USA
- NC Survivors Union, Greensboro, NC, USA
- Whose Corner Is It Anyway, Holyoke, MA, USA
| | - Abby Coulter
- Methadone Advocacy Working Group, National Survivors Union, Greensboro, NC, USA
| | - Knina Strichartz
- Methadone Advocacy Working Group, National Survivors Union, Greensboro, NC, USA
| | - Nick Voyles
- Methadone Advocacy Working Group, National Survivors Union, Greensboro, NC, USA
| | - Louise Vincent
- Methadone Advocacy Working Group, National Survivors Union, Greensboro, NC, USA
- NC Survivors Union, Greensboro, NC, USA
| |
Collapse
|
20
|
Termansen T, Bloch P, Tørslev MK, Vardinghus-Nielsen H. Tingbjerg Changing Diabetes: experiencing and navigating complexity in a community-based health promotion initiative in a disadvantaged neighbourhood in Copenhagen, Denmark. BMC Public Health 2023; 23:392. [PMID: 36841764 PMCID: PMC9958318 DOI: 10.1186/s12889-023-15291-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 02/20/2023] [Indexed: 02/27/2023] Open
Abstract
As a response to the complexity of reducing health inequity there has been a rise in community-based health promotion interventions adhering to the principles of complexity thinking. Such interventions often work with adaptive practice and constitute themselves in complex webs of collaborations between multiple stakeholders. However, few efforts have been made to articulate how complexity can be navigated and addressed by stakeholders in practice. This study explores how partners experience and navigate complexity in the partnership behind Tingbjerg Changing Diabetes (TCD), a community-based intervention addressing health and social development in the disadvantaged neighborhood of Tingbjerg in urban Copenhagen. The study provides important insights on the role of context and how it contributes complexity in community-based health promotion.The study is based on 18 months of ethnographic fieldwork in the local community including participant observations and 9 in-depth interviews with key partner representatives. Findings show that complexity in TCD can be characterized by unpredictability in actions and outcomes, undefined purpose and direction, and differing organizational logics. Factors that support partners' navigation in complexity include connectivity, embracing a flexible intervention framework, autonomy, and quick responsiveness. The study showcases the interdependency between the intervention and the context of the disadvantaged neighborhood of Tingbjerg and encourages stakeholders and researchers to embrace the messiness of complexity, and to pay attention to ways through which messiness and unpredictability can be handled.
Collapse
Affiliation(s)
- Tina Termansen
- Department of Health Promotion Research, Steno Diabetes Center Copenhagen, Borgmester Ib Juuls Vej 83, 2730, Herlev, Denmark. .,Department of Health Sciences and Technology, Aalborg University, Selma Lagerløfs Vej 249, 9260, Gistrup, Denmark.
| | - Paul Bloch
- Department of Health Promotion Research, Steno Diabetes Center Copenhagen, Borgmester Ib Juuls Vej 83, 2730, Herlev, Denmark
| | - Mette Kirstine Tørslev
- Department of Health Promotion Research, Steno Diabetes Center Copenhagen, Borgmester Ib Juuls Vej 83, 2730, Herlev, Denmark
| | - Henrik Vardinghus-Nielsen
- Department of Health Sciences and Technology, Aalborg University, Selma Lagerløfs Vej 249, 9260, Gistrup, Denmark
| |
Collapse
|
21
|
Turbyfill C, Thomas I, Agravat N, Prasher JM, Nett RJ, Stevens M, Ricaldi JN, Dunams TM, Brickhouse-Frazier L, Carter MD, Gebru Y, King A, May CS, Miller JD, Oguh C, Pullman A, Roman K, Rose C, Scherr R, Sidibe T, Soelaeman R, Weinstein J, Wilson T, Tran CH. The Impact of Community-Based Testing Sites and Gift Incentives on COVID-19 Testing Uptake in Maryland, April 29 - May 9, 2021. Am J Health Promot 2023; 37:228-232. [PMID: 36007095 PMCID: PMC9412132 DOI: 10.1177/08901171221119796] [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] [Indexed: 02/03/2023]
Abstract
PURPOSE Information on incentives for COVID-19 testing is needed to understand effective practices that encourage testing uptake. We describe characteristics of those who received an incentive after performing a rapid antigen test. DESIGN Cross-sectional descriptive analysis of survey data. SETTING During April 29-May 9, 2021, COVID-19 rapid antigen testing was offered in 2 Maryland cities. SAMPLE Convenience sample of 553 adults (≥18 years) who tested and received an incentive; 93% consented to survey. MEASURES Survey questions assessed reasons for testing, testing history, barriers, and demographics. ANALYSIS Robust Poisson regressions were used to determine characteristic differences based on testing history and between participants who would re-test in the future without an incentive vs participants who would not. RESULTS The most common reasons for testing were the desire to be tested (n = 280; 54%) and convenience of location (n = 146; 28%). Those motivated by an incentive to test (n = 110; 21%) were 5.83 times as likely to state they would not test again without an incentive, compared to those with other reasons for testing (95% CI: 2.67-12.72, P < .001). CRITICAL LIMITATIONS No comparative study group. CONCLUSION Results indicate internal motivation and convenience were prominent factors supporting testing uptake. Incentives may increase community testing participation, particularly among people who have never tested. Keywords COVID-19, pandemic, incentives, health behavior, community testing.
Collapse
Affiliation(s)
- Caitlin Turbyfill
- Centers for Disease Control and
Prevention (CDC), Atlanta, GA, USA,Oak Ridge Associated Universities, ORISE Fellowship, Oak Ridge, TN,
USA
| | - Isabel Thomas
- Centers for Disease Control and
Prevention (CDC), Atlanta, GA, USA,Oak Ridge Associated Universities, ORISE Fellowship, Oak Ridge, TN,
USA
| | - Namita Agravat
- Centers for Disease Control and
Prevention (CDC), Atlanta, GA, USA,Namita Agravat, MPH, CDC ELC Project
Officer, 1600 Clifton Rd., Atlanta, DGA, 30333, USA.
| | - Joanna M Prasher
- Centers for Disease Control and
Prevention (CDC), Atlanta, GA, USA
| | - Randall J Nett
- Centers for Disease Control and
Prevention (CDC), Atlanta, GA, USA
| | - Melody Stevens
- Centers for Disease Control and
Prevention (CDC), Atlanta, GA, USA
| | | | - Tambra M Dunams
- Centers for Disease Control and
Prevention (CDC), Atlanta, GA, USA
| | | | | | - Yonathan Gebru
- Centers for Disease Control and
Prevention (CDC), Atlanta, GA, USA
| | - Ashley King
- Centers for Disease Control and
Prevention (CDC), Atlanta, GA, USA
| | - Coral S May
- eTrueNorth with Health and Human
Services (HHS), Washington, DC, USA
| | | | - Chigo Oguh
- Maryland Department of Health
(MDH), Baltimore, ML, USA
| | - Amanda Pullman
- Centers for Disease Control and
Prevention (CDC), Atlanta, GA, USA
| | - Kaylin Roman
- Centers for Disease Control and
Prevention (CDC), Atlanta, GA, USA
| | - Charles Rose
- Centers for Disease Control and
Prevention (CDC), Atlanta, GA, USA
| | - Robert Scherr
- eTrueNorth with Health and Human
Services (HHS), Washington, DC, USA
| | | | - Rieza Soelaeman
- Centers for Disease Control and
Prevention (CDC), Atlanta, GA, USA
| | | | - Todd Wilson
- Centers for Disease Control and
Prevention (CDC), Atlanta, GA, USA
| | - Cuc H Tran
- Centers for Disease Control and
Prevention (CDC), Atlanta, GA, USA
| |
Collapse
|
22
|
MacDonald SE, Kenzie L, Letendre A, Bill L, Shea-Budgell M, Henderson R, Barnabe C, Guichon JR, Colquhoun A, Ganshorn H, Bedingfield N, Vandenboogaard PD, Bednarczyk RA, Glaze S, Nelson G. Barriers and supports for uptake of human papillomavirus vaccination in Indigenous people globally: A systematic review. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001406. [PMID: 36962871 PMCID: PMC10021254 DOI: 10.1371/journal.pgph.0001406] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 12/08/2022] [Indexed: 01/09/2023]
Abstract
Despite the availability of effective and safe human papillomavirus (HPV) vaccines that reduce the incidence and impact of cervical cancer and other cancers, HPV vaccine coverage rates remain persistently low and the cervical cancer burden disproportionately high among Indigenous people globally. This study aimed to systematically identify, appraise, and summarize the literature on documented barriers and supports to HPV vaccination in Indigenous populations internationally. Forty-three studies were included and an inductive, qualitative, thematic synthesis was applied. We report on 10 barrier themes and 7 support themes to vaccine uptake, and provide a quantitative summary of metrics. Focusing on Indigenous perspectives reported in the literature, we propose recommendations on community-research collaboration, culturally safe intergenerational and gender-equitable community HPV vaccine education, as well as multi-level transparency to ensure informed consent is secured in the context of reciprocal relationships. Although the voices of key informant groups (e.g., HPV-vaccine eligible youth and community Elders) are underrepresented in the literature, the identification of barriers and supports to HPV vaccination in a global Indigenous context might help inform researchers and health policy makers who aim to improve HPV vaccine uptake in Indigenous populations.
Collapse
Affiliation(s)
| | - Lisa Kenzie
- Faculty of Nursing, University of Alberta, Edmonton, Canada
| | - Angeline Letendre
- Cancer Prevention and Screening Innovation, Alberta Health Services, Edmonton, Canada
| | - Lea Bill
- Alberta First Nations Information Governance Centre, Calgary, Canada
| | | | - Rita Henderson
- Department of Family Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Cheryl Barnabe
- Department of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Juliet R Guichon
- Department of Community Health Sciences and Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Amy Colquhoun
- Performance Reporting, Alberta Health, Edmonton, Canada
| | - Heather Ganshorn
- Libraries and Cultural Resources, University of Calgary, Calgary, Canada
| | - Nancy Bedingfield
- Department of Community Health Sciences and Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | | | - Robert A Bednarczyk
- Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Sarah Glaze
- Tom Baker Cancer Centre, University of Calgary, Calgary, Canada
| | - Gregg Nelson
- Department of Obstetrics and Gynecology, University of Calgary, Calgary, Canada
| |
Collapse
|
23
|
Stallings SC, Cunningham-Erves J, Frazier C, Ichimura JS, Hurd TC, Jurinsky J, Acquaye A, Dalton JS, Wilkins CH. Development and Validation of the Perceptions of Research Trustworthiness Scale to Measure Trust Among Minoritized Racial and Ethnic Groups in Biomedical Research in the US. JAMA Netw Open 2022; 5:e2248812. [PMID: 36580334 PMCID: PMC9856656 DOI: 10.1001/jamanetworkopen.2022.48812] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
IMPORTANCE Historically, trust in biomedical research has been lower among minoritized racial and ethnic groups who are underrepresented in and excluded from research, with the same groups experiencing worse health outcomes. Unfortunately, instruments that measure trust may not capture components of trust relevant to minoritized racial and ethnic groups. OBJECTIVE To develop and validate a scale to measure trust in biomedical research among minoritized racial and ethnic groups. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional, community-based survey study compared trust and distrust in biomedical research among Black, Latino, and White subgroups in the US using the Perceptions of Research Trustworthiness (PoRT) scale. The scale was developed between March 22, 2016, and September 19, 2018, as part of this study, and its structure, reliability, and validity were examined during pilot (n = 381) and validation (n = 532) phases between February 4, 2019, and July 27, 2021. Convenience samples of adult participants (aged ≥18 years) were recruited locally (Nashville, Tennessee, and San Antonio, Texas) and nationally through the ResearchMatch and Cint online platforms. MAIN OUTCOMES AND MEASURES Overall and individual item Trust and Distrust subscale scores were compared. Overall Trust and Distrust scores were compared by race and ethnicity using a Kruskal-Wallis H test and individual item scores were compared using independent samples t test. RESULTS Of the 532 participants in the scale validation study, 144 (27.1%) were Black, 90 (16.9%) were Latino, and 282 (53.0%) were White. Participants had a median age of 43 years (range, 18-90 years), 352 (66.2%) were women, and 198 (37.2%) had educational attainment levels less than a college degree. Factor analysis of the 18-item PoRT scale revealed a 2-factor structure with two 9-item PoRT subscales (Trust and Distrust), which demonstrated high internal consistency (Cronbach α = 0.72 and 0.87, respectively). Mean (SD) Trust subscale scores were lower among Black (34.33 [2.02]) and Latino (34.55 [1.97]) participants compared with White participants (36.32 [1.81]; P < .001). Mean (SD) Distrust subscale scores were higher among Black (21.0 [2.15]) and Latino (20.53 [2.21]) participants compared with White participants (18.4 [2.03]; P < .001). Individual item results showed that Black and Latino participants were less trusting and more distrusting than White individuals on items related to risks, harms, secrecy, confidentiality, and privacy. CONCLUSIONS AND RELEVANCE These findings suggest that the PoRT scale incorporates trust and trustworthiness concepts relevant among Black and Latino individuals and may allow more precise assessment of trust in research among these groups.
Collapse
Affiliation(s)
- Sarah C. Stallings
- Division of Geriatric Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
- Meharry-Vanderbilt Alliance, Nashville, Tennessee
| | | | - Carleigh Frazier
- Public Health Department, University of California, Merced, Visalia
| | | | - Thelma C. Hurd
- Department of Surgery, University of Texas Health Science Center, San Antonio
- Department of Human and Organizational Development, Peabody College of Education and Human Development, Vanderbilt University, Nashville, Tennessee
| | - Jordan Jurinsky
- Department of Human and Organizational Development, Peabody College of Education and Human Development, Vanderbilt University, Nashville, Tennessee
| | - Amber Acquaye
- Department of Human and Organizational Development, Peabody College of Education and Human Development, Vanderbilt University, Nashville, Tennessee
| | | | - Consuelo H. Wilkins
- Division of Geriatric Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
- Meharry-Vanderbilt Alliance, Nashville, Tennessee
| |
Collapse
|
24
|
Coombe CM, Simbeni S, Neal A, Allen AJ, Gray C, Guzman JR, Lichtenstein RL, Marsh EE, Piechowski P, Reyes AG, Rowe Z, Weinert J, Israel BA. Building the foundation for equitable and inclusive research: Seed grant programs to facilitate development of diverse CBPR community-academic research partnerships. J Clin Transl Sci 2022; 7:e2. [PMID: 36755548 PMCID: PMC9879886 DOI: 10.1017/cts.2022.495] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 10/20/2022] [Accepted: 10/29/2022] [Indexed: 11/25/2022] Open
Abstract
Introduction The effectiveness of community-based participatory research (CBPR) partnerships to address health inequities is well documented. CBPR integrates knowledge and perspectives of diverse communities throughout the research process, following principles that emphasize trust, power sharing, co-learning, and mutual benefits. However, institutions and funders seldom provide the time and resources needed for the critical stage of equitable partnership formation and development. Methods Since 2011, the Detroit Urban Research Center, collaborating with other entities, has promoted the development of new community-academic research partnerships through two grant programs that combine seed funding with capacity building support from community and academic instructors/mentors experienced in CBPR. Process and outcomes were evaluated using mixed methods. Results From 2011 to 2021, 50 partnerships received grants ranging from $2,500 to $30,000, totaling $605,000. Outcomes included equitable partnership infrastructure and processes, innovative pilot research, translation of findings to interventions and policy change, dissemination to multiple audiences, new proposals and projects, and sustained community-academic research partnerships. All partnerships continued beyond the program; over half secured additional funding. Conclusions Keys to success included participation as community-academic teams, dedicated time for partnership/relationship development, workshops to develop equity-based skills, relationships, and projects, expert community-academic instructor guidance, and connection to additional resources. Findings demonstrate that small amounts of seed funding for newly forming community-academic partnerships, paired with capacity building support, can provide essential time and resources needed to develop diverse, inclusive, equity-focused CBPR partnerships. Building such support into funding initiatives and through academic institutions can enhance impact and sustainability of translational research toward advancing health equity.
Collapse
Affiliation(s)
- Chris M. Coombe
- School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Sophia Simbeni
- School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Aaron Neal
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA
| | | | - Carol Gray
- Michigan Social Health Interventions to Eliminate Disparities (MSHIELD), University of Michigan, Ann Arbor, MI, USA
| | | | | | - Erica E. Marsh
- Michigan Institute for Clinical & Health Research (MICHR), University of Michigan, Ann Arbor, MI, USA
| | - Patricia Piechowski
- Michigan Institute for Clinical & Health Research (MICHR), University of Michigan, Ann Arbor, MI, USA
| | | | | | - Julia Weinert
- Poverty Solutions, University of Michigan, Ann Arbor, MI, USA
| | | |
Collapse
|
25
|
Leston J, Wenger H, Reilley B, Craig Rushing S, Rink E, Warren H, Howe J, Bloomquist P, Tah T, Jeffries I, Iralu J, Thorpe P, Apostolou A, Taylor MM. Creating a path forward: understanding the context of sexual health and sexually transmitted infections in American Indian/Alaska Native populations – a review. Sex Health 2022; 19:286-298. [PMID: 35760766 PMCID: PMC11081199 DOI: 10.1071/sh22040] [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: 03/04/2022] [Accepted: 05/17/2022] [Indexed: 11/23/2022]
Abstract
This review assessed sexual health and sexually transmitted infection (STI) burden among American Indian/Alaska Native (AI/AN) peoples within the context of current clinical and public health services. We conducted a review of published literature about sexual health and bacterial STIs among AI/AN populations in the United States using Medline (OVID), CINAHL (EbscoHost) and Scopus. Peer-reviewed journals published during 1 January 2005-2 December 2021 were included and supplemented by other publicly available literature. A total of 138 articles from reference lists met inclusion criteria, including 85 peer-review articles and 53 additional references. Results indicate a disproportionate burden of STIs is carried by AI/AN populations compared to non-Hispanic Whites. Risk for STIs in AI/AN people has origins in historical trauma and structural and social determinants of health. STI services are available for AI/AN populations, but many barriers to care exist. Community-based sexual health programming has been successful, but has thus far focused primarily on adolescents and young adults. A myriad of factors contributes to high rates of STIs among AI/AN populations. Longstanding disparities show a clear need to increase the availability of integrated, low-barrier STI prevention and treatment services. Implementation of multi-level (individual, physician, clinic, healthcare organisation, and/or community level), culturally relevant sexual health and STI interventions should be community-based and person-centred, acknowledge social determinants of health, and grounded in deep respect and understanding of AI/AN histories and cultures.
Collapse
Affiliation(s)
- Jessica Leston
- Northwest Portland Area Indian Health Board, Portland, OR, USA
| | | | - Brigg Reilley
- Northwest Portland Area Indian Health Board, Portland, OR, USA
| | | | | | - Hannah Warren
- Alaska Native Tribal Health Consortium, Anchorage, AK, USA
| | - Jean Howe
- Northern Navajo Medical Center, Indian Health Service, Shiprock, NM, USA
| | | | - Tina Tah
- Indian Health Service Headquarters, Rockville, MD, USA
| | - Itai Jeffries
- Northwest Portland Area Indian Health Board, Portland, OR, USA
| | - Jonathan Iralu
- Gallup Indian Medical Center, Indian Health Service, Gallup, NM, USA
| | - Phoebe Thorpe
- U.S. Centers for Disease Control and Prevention, Division of STD Prevention, Atlanta, GA, USA
| | | | - Melanie M. Taylor
- U.S. Centers for Disease Control and Prevention, Division of HIV Prevention, Atlanta, GA, USA
| |
Collapse
|
26
|
Erickson CM, Clark LR, Umucu E, Vo NH, Volgman AS, Chin NA, Ketchum FB, Jones CH, Gleason CE, Aggarwal NT. Cardiology clinic patient attitudes toward and potential personal utility of genetic testing: Findings from a unique multiracial clinical sample. J Genet Couns 2022; 31:989-997. [PMID: 35460578 PMCID: PMC9545732 DOI: 10.1002/jgc4.1573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 03/06/2022] [Accepted: 03/24/2022] [Indexed: 12/02/2022]
Abstract
As more is understood about the hereditary nature of disease risk, the utility of genetic testing within cardiovascular medicine is increasingly being explored. Although testing may afford more personalized risk stratification, there is a paucity of information regarding patient knowledge, attitudes, and beliefs toward genetic testing among cardiology patients. Participants (n = 530) recruited primarily from a cardiology clinic filled out a 41-item written questionnaire assessing knowledge, beliefs, and attitudes toward genetic testing, motivators and detractors for considering genetic testing, and perceived likelihood for behavior change after hypothetical genetic testing risk stratification. Path analysis was used to test the hypothetical models predicting the likelihood of getting a genetic test and making behavior changes following genetic testing. The patient population was late-middle-aged (59.0 ± 14.5 years), majority women (61.5%), and about half reported having a bachelor's degree. 58.1% of participants self-identified as White, 25.7% as African American or Black, 6.8% as Spanish, Latino, or Hispanic, 3.0% as Asian or Pacific Islander, and 0.5% as Native American. Gender (being a woman) and more years of education were related to greater knowledge about genetic testing. Racial identity and years of education were related to beliefs about genetic testing. Beliefs, but not knowledge, were related to more positive attitudes and a higher likelihood of pursuing genetic testing. Positive attitudes were related to greater perceived personal control (PPC). Furthermore, attitudes and PPC were related to higher likelihood of lifestyle change after genetic testing. These results highlight the need to integrate the experiences of racialized communities into education/counseling efforts. Most educational counseling efforts lack a nuanced discussion of social determinants of health or beliefs. In addition to factual information, educational counseling must also address people's beliefs, concerns, and the intersecting experiences and identities, which shape patients' relationships with the evolving landscape of healthcare and personalized medicine.
Collapse
Affiliation(s)
- Claire M. Erickson
- Neuroscience & Public Policy ProgramUniversity of Wisconsin‐Madison School of Medicine and Public HealthMadisonWisconsinUSA
- Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
| | - Lindsay R. Clark
- Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
- Geriatric Research Education and Clinical CenterWilliam S. Middleton Memorial Veterans HospitalMadisonWisconsinUSA
| | - Emre Umucu
- Department of Counseling, Educational Psychology and Special EducationMichigan State University College of EducationEast LansingMichiganUSA
| | - Nhi H. Vo
- Beth Israel Deaconess Medical CenterHarvard Medical SchoolBostonMassachusettsUSA
| | | | - Nathaniel A. Chin
- Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
| | - Fred B. Ketchum
- Department of NeurologyUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
| | - Carolyn H. Jones
- Department of PediatricsRush University Medical CenterChicagoIllinoisUSA
| | - Carey E. Gleason
- Geriatric Research Education and Clinical CenterWilliam S. Middleton Memorial Veterans HospitalMadisonWisconsinUSA
- Division of Geriatrics and GerontologyDepartment of MedicineUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
| | - Neelum T. Aggarwal
- Department of Neurological SciencesRush University Medical CenterChicagoIllinoisUSA
- Rush Alzheimer's Disease CenterChicagoIllinoisUSA
| |
Collapse
|
27
|
Shaw JL, Beans JA, Noonan C, Smith JJ, Mosley M, Lillie KM, Avey JP, Ziebell R, Simon G. Validating a predictive algorithm for suicide risk with Alaska Native populations. Suicide Life Threat Behav 2022; 52:696-704. [PMID: 35293010 PMCID: PMC9378560 DOI: 10.1111/sltb.12853] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 12/09/2021] [Accepted: 01/11/2022] [Indexed: 11/29/2022]
Abstract
INTRODUCTION The American Indian/Alaska Native (AI/AN) suicide rate in Alaska is twice the state rate and four times the U.S. rate. Healthcare systems need innovative methods of suicide risk detection. The Mental Health Research Network (MHRN) developed suicide risk prediction algorithms in a general U.S. PATIENT POPULATION METHODS We applied MHRN predictors and regression coefficients to electronic health records of AI/AN patients aged ≥13 years with behavioral health diagnoses and primary care visits between October 1, 2016, and March 30, 2018. Logistic regression assessed model accuracy for predicting and stratifying risk for suicide attempt within 90 days after a visit. We compared expected to observed risk and assessed model performance characteristics. RESULTS 10,864 patients made 47,413 primary care visits. Suicide attempt occurred after 589 (1.2%) visits. Visits in the top 5% of predicted risk accounted for 40% of actual attempts. Among visits in the top 0.5% of predicted risk, 25.1% were followed by suicide attempt. The best fitting model had an AUC of 0.826 (95% CI: 0.809-0.843). CONCLUSIONS The MHRN model accurately predicted suicide attempts among AI/AN patients. Future work should develop clinical and operational guidance for effective implementation of the model with this population.
Collapse
Affiliation(s)
- Jennifer L Shaw
- Division of Organizational Development and Innovation, Research and Data Services Department, Southcentral Foundation, Anchorage, Alaska, USA
| | - Julie A Beans
- Division of Organizational Development and Innovation, Research and Data Services Department, Southcentral Foundation, Anchorage, Alaska, USA
| | - Carolyn Noonan
- Institute for Research and Education to Advance Community Health, Washington State University, Seattle, Washington, USA
| | - Julia J Smith
- Division of Organizational Development and Innovation, Research and Data Services Department, Southcentral Foundation, Anchorage, Alaska, USA
| | - Mike Mosley
- Division of Organizational Development and Innovation, Research and Data Services Department, Southcentral Foundation, Anchorage, Alaska, USA
| | - Kate M Lillie
- Division of Organizational Development and Innovation, Research and Data Services Department, Southcentral Foundation, Anchorage, Alaska, USA
| | - Jaedon P Avey
- Division of Organizational Development and Innovation, Research and Data Services Department, Southcentral Foundation, Anchorage, Alaska, USA
| | - Rebecca Ziebell
- Kaiser Permanente Washington Health Research Institute, Seattle, Washington, USA
| | - Gregory Simon
- Kaiser Permanente Washington Health Research Institute, Seattle, Washington, USA
| |
Collapse
|
28
|
Soper K, Geske JA, Bronner L, Godfrey M. Improving Student Understanding of Academic Assessment Vocabulary Words Using Visual Cues: A Collaborative Effort. JOURNAL OF COMMUNITY ENGAGEMENT AND SCHOLARSHIP 2022; 15:1. [PMID: 36081415 PMCID: PMC9451170 DOI: 10.54656/jces.v15i1.52] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Many students have difficulty understanding terms from the academic register such as "analyze," "discuss," and "compare." This issue may be exacerbated for some Native American students, especially those who live on reservations with limited exposure to mainstream cultures. In this community-based participatory research project, academic investigators partnered with educators and community members from Native communities in Nebraska and South Dakota to expand students' academic vocabulary and improve student achievement. Together, we formed a team in which community members collaborated with academic investigators to develop word-wall cards incorporating dual-coding theory-that is, combining visual and verbal cues-to help students understand academic vocabulary words. Paivio's dual-coding theory postulates that verbal and visual information are encoded in separate but interconnected pathways and that concepts encoded via both pathways are more easily remembered. Accordingly, presenting information using multiple mediums, such as graphs, photographs, or demonstrations, may enhance learning. These cards were shared with community educators who used them in their classrooms. We present evidence that incorporating these multimodal tools into classrooms may improve students' understanding of academic vocabulary. Through this partnership, educators in Native American communities were able to represent their lived experiences. Teachers and administrators in Native American and non-Native classrooms could easily partner with other experts to incorporate similar innovations in their own schools and classrooms.
Collapse
Affiliation(s)
- Kim Soper
- University of Nebraska Medical Center
| | | | | | | |
Collapse
|
29
|
Rink E, Firemoon P, Anastario M, Johnson O, GrowingThunder R, Ricker A, Peterson M, Baldwin J. Rationale, Design, and Methods for Nen Unkumbi/Edahiyedo ("We Are Here Now"): A Multi-Level Randomized Controlled Trial to Improve Sexual and Reproductive Health Outcomes in a Northern Plains American Indian Reservation Community. Front Public Health 2022; 10:823228. [PMID: 35910931 PMCID: PMC9326233 DOI: 10.3389/fpubh.2022.823228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 04/29/2022] [Indexed: 12/01/2022] Open
Abstract
American Indian (AI) youth in the United States experience disproportionate sexual and reproductive health (SRH) disparities relative to their non-Indigenous, white counterparts, including increased rates of sexually transmitted infections (STIs), earlier sexual debut, increased rates of teen birth, and reduced access to SRH services. Past research shows that to improve SRH outcomes for AI youth in reservation communities, interventions must address complex factors and multiple levels of community that influence sexual risk behaviors. Here, we describe development of a multi-level, multi-component randomized controlled trial (RCT) to intervene upon SRH outcomes in a Northern Plains American Indian reservation community. Our intervention is rooted in a community based participatory research framework and is evaluated with a stepped wedge design that integrates 5 reservation high schools into a 5-year, cluster-randomized RCT. Ecological Systems Theory was used to design the intervention that includes (1) an individual level component of culturally specific SRH curriculum in school, (2) a parental component of education to improve parent-child communication about SRH and healthy relationships, (3) a community component of cultural mentorship, and (4) a systems-level component to improve delivery of SRH services from reservation healthcare agencies. In this article we present the rationale and details of our research design, instrumentation, data collection protocol, analytical methods, and community participation in the intervention. Our intervention builds upon existing community strengths and integrates traditional Indigenous knowledge and values with current public health knowledge to reduce SRH disparities.
Collapse
Affiliation(s)
- Elizabeth Rink
- Department of Health and Human Development, Montana State University, Bozeman, MT, United States
| | | | - Michael Anastario
- AHC5, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, United States
| | | | - Ramey GrowingThunder
- Language and Culture Department, Fort Peck Assiniboine and Sioux Tribes, Poplar, MT, United States
| | - Adriann Ricker
- School of Nursing, Johns Hopkins University, Baltimore, MD, United States
| | - Malory Peterson
- Department of Health and Human Development, Montana State University, Bozeman, MT, United States
| | - Julie Baldwin
- Center for Health Equity Research, Northern Arizona University, Flagstaff, AZ, United States
| |
Collapse
|
30
|
Webster K, Dunn TJ, Horsley SM. Understanding health inequalities in COVID-19: a description of a pragmatic community-based consultation method. Perspect Public Health 2022; 142:196-198. [PMID: 35833550 DOI: 10.1177/17579139221105970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Karielle Webster
- Public Health, Derby City Council, The Council House, Derby DE1 2FS, UK
| | - Thomas J Dunn
- Public Health, Derby City Council, Derby, UK.,Honorary Assistant Professor, Lifespan and Population Health, University of Nottingham, Nottingham, UK
| | | |
Collapse
|
31
|
Cultural Greenspaces: Synthesizing Knowledge and Experience in Nova Scotia’s African-Canadian Communities through Participatory Research and SoftGIS. SOCIAL SCIENCES-BASEL 2022. [DOI: 10.3390/socsci11070281] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Greenspaces are integral components of communities and provide numerous benefits. However, human development threatens these spaces, particularly in communities of color where histories of racial injustice persist and environmental vulnerabilities remain. A step towards preventing the loss of important cultural greenspaces is documenting knowledge and experience. This research employed community-based participatory techniques to study the relationship between the landscape and African-Canadian communities around Preston, Nova Scotia, the oldest and largest in Canada. Community-directed meetings created collaborative-based knowledge about perceptions surrounding land use change while identifying valued greenspaces. This paper studies the relationships between the community’s greenspaces and the benefits to psychological, social, and physical aspects of human wellbeing. This relationship is operationalized through the use of a public participation geographic information system (PPGIS), SoftGIS, which activates the greenspace–human wellbeing relationship through interaction and its map-based survey data collection. Results indicate residents predominately visited greenspaces near a church or community center for social wellbeing benefits to interact with neighbors and friends, to cookout, or to bring children outside. This research contributes to a greater understanding of the Preston area’s greenspace identification and qualification, resident behavior, and cultural perspectives to inform strategies and goals for engaging government agencies surrounding policy and land use planning. This research illustrates frameworks for improving building capacity and promoting racial equity within the urbanization process in other communities.
Collapse
|
32
|
Velez C, Nuechterlein B, Connors S, RedShirt Tyon G, Roane TM, Mays DC. Application of the Indigenous evaluation framework to a university certificate program for building cultural awareness in science, technology, engineering, and mathematics. EVALUATION AND PROGRAM PLANNING 2022; 92:102066. [PMID: 35298956 DOI: 10.1016/j.evalprogplan.2022.102066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 09/23/2021] [Accepted: 03/01/2022] [Indexed: 06/14/2023]
Abstract
This paper presents a case example of the Indigenous Evaluation Framework as applied to a science, technology, engineering, and mathematics (STEM) education pilot program. Indigenous methodologies include knowledge and data that are inclusive of historically marginalized groups, are highly meaningful, valid, and useful for all. A paradigm shift from Western evaluation methodologies to Indigenous evaluation is necessary when evaluating STEM programs that are committed to increasing recruitment, retention, and graduation of students from historically marginalized groups. This paper describes the use of the Indigenous Evaluation Framework during the first two years of the newly created Environmental Stewardship of Indigenous Lands program at the University of Colorado Denver. We discuss the importance of the Indigenous Evaluation Framework and how it informs the development and continued improvements to the program that also provides agency to program leads and participants.
Collapse
Affiliation(s)
- Christine Velez
- The Evaluation Center, University of Colorado Denver, 1391 Speer Boulevard, Suite 340, Denver CO 80204, United States
| | - Bridget Nuechterlein
- The Evaluation Center, University of Colorado Denver, 1391 Speer Boulevard, Suite 340, Denver CO 80204, United States
| | - Susan Connors
- The Evaluation Center, University of Colorado Denver, 1391 Speer Boulevard, Suite 340, Denver CO 80204, United States
| | - Grace RedShirt Tyon
- University of Colorado Anschutz Medical Campus, Colorado School of Public Health, Centers for American Indian & Alaska Native Health, Nighthorse Campbell Native Health Building, 13055 East 17th Avenue, Mail Stop F800, Aurora, CO 80045, United States
| | - Timberley M Roane
- University of Colorado Denver, Department of Integrative Biology, Campus Box 171, PO Box 173364, Denver, CO 80217, United States
| | - David C Mays
- University of Colorado Denver, Department of Civil Engineering, Campus Box 113, PO Box 173364, Denver, CO 80217, United States.
| |
Collapse
|
33
|
Nilsson S, Smurthwaite K, Aylward LL, Kay M, Toms LM, King L, Marrington S, Hobson P, Barnes C, Rotander A, Kirk MD, Mueller JF, Braeunig J. Biomonitoring of per- and polyfluoroalkyl substances (PFAS) exposure in firefighters: Study design and lessons learned from stakeholder and participant engagement. Int J Hyg Environ Health 2022; 242:113966. [DOI: 10.1016/j.ijheh.2022.113966] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 03/21/2022] [Accepted: 03/23/2022] [Indexed: 01/09/2023]
|
34
|
Kornbluh M. Facilitation strategies for conducting focus groups attending to issues of power. QUALITATIVE RESEARCH IN PSYCHOLOGY 2022. [DOI: 10.1080/14780887.2022.2066036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Mariah Kornbluh
- University of South Carolina, Department of Psychology, Columbia, South Carolina, USA
| |
Collapse
|
35
|
Baumer NT, Becker ML, Capone GT, Egan K, Fortea J, Handen BL, Head E, Hendrix JE, Litovsky RY, Strydom A, Tapia IE, Rafii MS. Conducting clinical trials in persons with Down syndrome: summary from the NIH INCLUDE Down syndrome clinical trials readiness working group. J Neurodev Disord 2022; 14:22. [PMID: 35321660 PMCID: PMC8942061 DOI: 10.1186/s11689-022-09435-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 03/10/2022] [Indexed: 11/10/2022] Open
Abstract
The recent National Institute of Health (NIH) INCLUDE (INvestigation of Co-occurring conditions across the Lifespan to Understand Down syndromE) initiative has bolstered capacity for the current increase in clinical trials involving individuals with Down syndrome (DS). This new NIH funding mechanism offers new opportunities to expand and develop novel approaches in engaging and effectively enrolling a broader representation of clinical trials participants addressing current medical issues faced by individuals with DS. To address this opportunity, the NIH assembled leading clinicians, scientists, and representatives of advocacy groups to review existing methods and to identify those areas where new approaches are needed to engage and prepare DS populations for participation in clinical trial research. This paper summarizes the results of the Clinical Trial Readiness Working Group that was part of the INCLUDE Project Workshop: Planning a Virtual Down Syndrome Cohort Across the Lifespan Workshop held virtually September 23 and 24, 2019.
Collapse
Affiliation(s)
- Nicole T Baumer
- Department of Neurology, Division of Developmental Medicine, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, USA
| | - Mara L Becker
- Department of Pediatrics, Duke University School of Medicine, Durham, USA
| | - George T Capone
- Department of Pediatrics, Kennedy Krieger Institute, The Johns Hopkins School of Medicine, Baltimore, USA
| | | | - Juan Fortea
- Sant Pau Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
- CIBERNED, Madrid, Spain
- Barcelona Down Medical Center, Fundació Catalana de Síndrome de Down, Barcelona, Spain
| | | | - Elizabeth Head
- Department of Pathology & Laboratory Medicine, University of California, Irvine, USA
| | | | - Ruth Y Litovsky
- Waisman Center, University of Wisconsin, Madison, USA
- Department of Communication Sciences and Disorders, University of Wisconsin, Madison, USA
| | - Andre Strydom
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, London, UK
- King's College London & South London and the Maudsley NHS Trust, London, UK
| | - Ignacio E Tapia
- Division of Pulmonary and Sleep Medicine, Children's Hospital of Philadelphia Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - Michael S Rafii
- Alzheimer's Therapeutic Research Institute, Keck School of Medicine, University of Southern California, Los Angeles, USA.
| |
Collapse
|
36
|
Allen S, Held S, Milne-Price S, McCormick A, Feng D, Inouye J, Schure M, Castille D, Howe RB, Pitts M, Keene S, Belone L, Wallerstein N. Community sharing: Contextualizing Western research notions of contamination within an Indigenous research paradigm. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2022; 69:145-156. [PMID: 34534371 PMCID: PMC8926935 DOI: 10.1002/ajcp.12552] [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] [Received: 02/09/2021] [Revised: 07/26/2021] [Accepted: 08/10/2021] [Indexed: 06/13/2023]
Abstract
Báa nnilah is a chronic illness self-management program designed by and for the Apsáalooke (Crow) community. Arising from a collaboration between an Indigenous nonprofit organization and a university-based research team, Báa nnilah's development, implementation, and evaluation have been influenced by both Indigenous and Western research paradigms (WRPs). Báa nnilah was evaluated using a randomized wait-list control group design. In a WRP, contamination, or intervention information shared by the intervention group with the control group, is actively discouraged as it makes ascertaining causality difficult, if not impossible. This approach is not consonant with Apsáalooke cultural values that include the encouragement of sharing helpful information with others, supporting an Indigenous research paradigm's (IRP) goal of benefiting the community. The purpose of this paper is to address contamination and sharing as an area of tension between WRP and IRP. We describe how the concepts of contamination and sharing within Báa nnilah's implementation and evaluation are interpreted differently when viewed from these contrasting paradigms, and set forth a call for greater exploration of Indigenous research approaches for developing, implementing, and evaluating intervention programs in Indigenous communities. (Improving Chronic Illness Management with the Apsáalooke Nation: The Báa nnilah Project.: NCT03036189), ClinicalTrials. gov: NCT03036189).
Collapse
Affiliation(s)
- Sarah Allen
- Family Life and Human Development, Southern Utah University, Cedar City, Utah, USA
| | - Suzanne Held
- Health and Human Development, Montana State University, Bozeman, Montana, USA
| | - Shauna Milne-Price
- Contra Costa Health Services, Contra Costa Family Medicine Residency, University of Washington School of Medicine, Martinez, California, USA
| | - Alma McCormick
- Executive Director of Messengers for Health, Messengers for Health, Crow Agency, Montana, USA
| | - Du Feng
- Department of Nursing, University of Nevada, Las Vegas, Nevada, USA
| | - Jillian Inouye
- John Burns School of Medicine, University of Hawaii, Honolulu, Hawaii, USA
| | - Mark Schure
- Health and Human Development, Montana State University, Bozeman, Montana, USA
| | - Dottie Castille
- National Institute on Minority Health and Health Disparities, Division of Community Health and Population Sciences, National Institutes of Health, Bethesda, Maryland, USA
| | - Rae B Howe
- Executive Director of Messengers for Health, Messengers for Health, Crow Agency, Montana, USA
| | - Mikayla Pitts
- Health and Human Development, Montana State University, Bozeman, Montana, USA
| | - Shannen Keene
- Division of the Seattle Indian Health Board, Urban Indian Health Institute, Seattle, Washington, USA
| | - Lorenda Belone
- Health Sciences Center: Center for Participatory Research, University of New Mexico, Albuquerque, New Mexico, USA
| | - Nina Wallerstein
- Health Sciences Center: Center for Participatory Research, University of New Mexico, Albuquerque, New Mexico, USA
| |
Collapse
|
37
|
Responding to Health Disparities in Behavioral Weight Loss Interventions and COVID-19 in Black Adults: Recommendations for Health Equity. J Racial Ethn Health Disparities 2022; 9:739-747. [PMID: 35192179 PMCID: PMC8862701 DOI: 10.1007/s40615-022-01269-8] [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: 10/22/2021] [Revised: 02/15/2022] [Accepted: 02/16/2022] [Indexed: 11/18/2022]
Abstract
COVID-19 has disproportionately impacted Black adults with high prevalence and mortality rates. Obesity is a central factor in the severity of COVID-19 and related treatment. Behavioral weight loss interventions are an efficacious treatment for obesity, but consistently, Black men and women are minimally represented, and weight loss outcomes are less than clinically significant thresholds. This commentary draws parallels between COVID-19 racial disparities, disparate obesity rates, weight loss treatment outcomes, and underlying systemic racial context. This paper also indicates paths forward to address racialized societal norms in obesity treatment to advance health equity in obesity and reduce acute disease vulnerability. Recommendations for behavioral medicine practice and policy include (1) expanding the research lens to prioritize Black scholars and institutions to generate innovative research questions, (2) creating trustworthy relationships with Black community members to bolster recruitment and retention, (3) employing qualitative methods to facilitate better intervention design and uncover influences of racialized social context, (4) centering Black adults in weight loss interventions, and (5) using multilevel approaches that integrate policy into interventions. Moving forward, this commentary aims to make plain the multilayered form and function of racism, its impact on COVID-19 and obesity, and offer pathways to improve behavioral weight loss interventions that can produce more equitable outcomes.
Collapse
|
38
|
Boland SE, Ivanich J, Wesner CA, Tuitt NR, Zacher T, Asdigian NL, Whitesell NR. Crisis-Resilient and Antiracist Approaches to Community-Based Participatory Research During COVID-19 and Beyond. HEALTH EDUCATION & BEHAVIOR 2022; 49:11-16. [PMID: 34730051 PMCID: PMC9832471 DOI: 10.1177/10901981211054791] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Social and health inequities among communities of color are deeply embedded in the United States and were exacerbated by the COVID-19 pandemic. Community-based participatory research (CBPR) is a powerful approach to advance health equity. However, emergencies both as global as a pandemic or as local as a forest fire have the power to interrupt research programs and weaken community relationships. Drawing from Public Health Critical Race Praxis (PHCRP), as well as our research experience during the pandemic, this article proposes an expansion of prior CBPR principles with an emphasis on advocacy and storytelling, community investment, and flexibility. The article summarizes key principles of CBPR and PHCRP, contextualizes their relevance in COVID-19, and outlines a practical vision for crisis-resilient research through deeper engagement with antiracism scholarship. Structural barriers remain an issue, so policy changes to funding and research institutions are recommended, as well, to truly advance health equity.
Collapse
Affiliation(s)
- Sarah E. Boland
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Jerreed Ivanich
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Chelsea A. Wesner
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO
- University of South Dakota, Vermillion, SD
| | - Nicole R. Tuitt
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Tracy Zacher
- Missouri Breaks Industries Research, Inc., Eagle Butte, SD
| | - Nancy L. Asdigian
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Nancy Rumbaugh Whitesell
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO
| |
Collapse
|
39
|
McDonald F, Robinson K, Gallagher AL, Pettigrew J. Exploring the co-involvement of disabled adolescents in participatory action research; protocol for a critical interpretative synthesis. HRB Open Res 2022; 4:79. [PMID: 34988367 PMCID: PMC8689409 DOI: 10.12688/hrbopenres.13343.1] [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] [Accepted: 07/06/2021] [Indexed: 11/20/2022] Open
Abstract
Background: Participatory action research (PAR) provides an opportunity for academic researchers and adolescents to co-conduct research within an area of shared interest. Reciprocal learning occurs as co-researchers acquire research skills and knowledge, and academic researchers gain understanding of the issue being examined, from the perspective of those with lived experience. All members of the research team have a shared responsibility for the research and decision-making processes. PAR has predominantly involved adults as co-researchers. However, in recent years more effort has been made to co-conduct research with adolescents. The aim of this review is to interrogate the practices of academic researchers employing a PAR approach when working along-side disabled adolescents. Methods/design: A critical interpretive synthesis (CIS) will be conducted, allowing for a diverse range of evidence to be drawn from. A systematic search of nine databases, from 1990 onwards, will be conducted first. Reference checking will occur to elicit further relevant data. Following screening, further purposive sampling will be completed to facilitate the development of concepts and theory in line with the on-going analysis and synthesis of findings. Data analysis will involve interpretation of included papers in relation to the principles of PAR and a ‘best-practice’ framework will be developed. During analysis particular emphasis will be given to the identification of potential social barriers to the participation of disabled adolescents in PAR. Discussion: PAR is widely employed but little is known about its use when working with disabled adolescents. This current CIS will critically question the current practices of academic researchers employing PAR when working along-side disabled adolescents and future research through the best practice framework we will develop.
Collapse
Affiliation(s)
- Fiona McDonald
- School of Allied Health, Health Research Institute, University of Limerick, Limerick, V94 T9PX, Ireland
| | - Katie Robinson
- School of Allied Health, Health Research Institute, University of Limerick, Limerick, V94 T9PX, Ireland
| | - Aoife L Gallagher
- School of Allied Health, Health Research Institute, University of Limerick, Limerick, V94 T9PX, Ireland
| | - Judith Pettigrew
- School of Allied Health, Health Research Institute, University of Limerick, Limerick, V94 T9PX, Ireland
| |
Collapse
|
40
|
Champine RB, Hoffman EE, Matlin SL, Strambler MJ, Tebes JK. "What Does it Mean to be Trauma-Informed?": A Mixed-Methods Study of a Trauma-Informed Community Initiative. JOURNAL OF CHILD AND FAMILY STUDIES 2022; 31:459-472. [PMID: 35018088 PMCID: PMC8736308 DOI: 10.1007/s10826-021-02195-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/21/2021] [Indexed: 05/04/2023]
Abstract
Trauma during childhood has the potential to adversely affect one's physical, cognitive, emotional, and social development across the life span. However, the adverse effects of trauma can be prevented and mitigated through holistic services and supports that are trauma-informed. The Pottstown Trauma-Informed Community Connection (PTICC) is a community-based initiative that aims to build a trauma-informed community through training diverse stakeholders (e.g., school staff, providers, community leaders, parents) on the potential signs and symptoms of child trauma and how to create safe physical and emotional environments for children and families. This paper presents findings from a mixed-methods study of education and community partners' (N = 82) experiences in PTICC and their understandings of what it means to become trauma-informed. Paired sample t-tests found significant changes in participants' beliefs about trauma-informed practice, but there were no changes in participants' perceptions of the impacts of PTICC on their use of trauma-informed practices and supports. Focus groups with education (n = 6) and community (n = 5) partners found that participants regarded being "trauma-informed" as reframing one's perspective, being more self-reflective, acquiring skills to respond more effectively to others who have experienced trauma, and having a sense of hope for the future. Findings also revealed perceived benefits of trauma training and challenges associated with getting others to buy-in to trauma-informed work. Potential methodological considerations for future community-engaged research in building trauma-informed communities are discussed. These considerations include the need to address ceiling effects, disaggregate data, and mitigate challenges associated with participant engagement.
Collapse
Affiliation(s)
- Robey B. Champine
- Division of Public Health, Michigan State University College of Human Medicine, Flint, MI 48502 USA
- Division of Prevention and Community Research, Yale School of Medicine, New Haven, CT 06511 USA
| | - Erin E. Hoffman
- Division of Prevention and Community Research, Yale School of Medicine, New Haven, CT 06511 USA
- College of Science and Health, Department of Psychology, DePaul University, Chicago, IL 60604 USA
| | - Samantha L. Matlin
- Division of Prevention and Community Research, Yale School of Medicine, New Haven, CT 06511 USA
- The Scattergood Foundation, 1501 Cherry Street, Philadelphia, PA 19102 USA
| | - Michael J. Strambler
- Division of Prevention and Community Research, Yale School of Medicine, New Haven, CT 06511 USA
| | - Jacob Kraemer Tebes
- Division of Prevention and Community Research, Yale School of Medicine, New Haven, CT 06511 USA
| |
Collapse
|
41
|
Tamysetty S, Babu GR, Sahu B, Shapeti S, Ravi D, Lobo E, Varughese CS, Bhide A, Madhale A, Manyal M, Kamble M, Konar A, Sarkar P, Das DK, Mukherjee PS, Singh K, Chauhan AS, Naskar A, Bhatia R, Khetrapal S. Predictors of COVID-19 Vaccine Confidence: Findings from Slums of Four Major Metro Cities of India. Vaccines (Basel) 2021; 10:60. [PMID: 35062720 PMCID: PMC8781952 DOI: 10.3390/vaccines10010060] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/27/2021] [Accepted: 11/29/2021] [Indexed: 02/08/2023] Open
Abstract
There are limited studies on COVID vaccine confidence at the household level in urban slums, which are at high risk of COVID-19 transmission due to overcrowding and poor living conditions. The objective was to understand the reasons influencing COVID-19 vaccine confidence, in terms of barriers and enablers faced by communities in urban slums and informal settlements in four major metro cities in India. A mixed method approach was adopted, where in field studies were conducted during April-May 2021. First, a survey of at least 50 subjects was conducted among residents of informal urban settlements who had not taken any dose of the COVID-19 vaccine in Mumbai, Bengaluru, Kolkata and Delhi; second, a short interview with five subjects who had taken at least one dose of the vaccine in each of the four cities to understand the factors that contributed to positive behaviour and, finally, an in-depth interview of at least 3 key informants in each city to ascertain the vaccination pattern in the communities. The reasons were grouped under contextual, individual/group and vaccine/vaccination specific issues. The most frequent reason (27.7%) was the uncertainty of getting the vaccine. The findings show the need for increasing effectiveness of awareness campaigns, accessibility and the convenience of vaccination, especially among vulnerable groups, to increase the uptake.
Collapse
Affiliation(s)
- Sathyanarayana Tamysetty
- Indian Institute of Public Health, Bangalore 560023, India; (G.R.B.); (B.S.); (S.S.); (D.R.); (E.L.)
| | - Giridhara R. Babu
- Indian Institute of Public Health, Bangalore 560023, India; (G.R.B.); (B.S.); (S.S.); (D.R.); (E.L.)
| | - Biswamitra Sahu
- Indian Institute of Public Health, Bangalore 560023, India; (G.R.B.); (B.S.); (S.S.); (D.R.); (E.L.)
| | - Suresh Shapeti
- Indian Institute of Public Health, Bangalore 560023, India; (G.R.B.); (B.S.); (S.S.); (D.R.); (E.L.)
| | - Deepa Ravi
- Indian Institute of Public Health, Bangalore 560023, India; (G.R.B.); (B.S.); (S.S.); (D.R.); (E.L.)
| | - Eunice Lobo
- Indian Institute of Public Health, Bangalore 560023, India; (G.R.B.); (B.S.); (S.S.); (D.R.); (E.L.)
| | | | - Amita Bhide
- Tata Institute of Social Science, Mumbai 400088, India; (A.B.); (A.M.); (M.M.); (M.K.)
| | - Avinash Madhale
- Tata Institute of Social Science, Mumbai 400088, India; (A.B.); (A.M.); (M.M.); (M.K.)
| | - Mukta Manyal
- Tata Institute of Social Science, Mumbai 400088, India; (A.B.); (A.M.); (M.M.); (M.K.)
| | - Mahesh Kamble
- Tata Institute of Social Science, Mumbai 400088, India; (A.B.); (A.M.); (M.M.); (M.K.)
| | - Asokananda Konar
- Liver Foundation, Kolkata 700150, India; (A.K.); (P.S.); (D.K.D.); (P.S.M.)
| | - Pabak Sarkar
- Liver Foundation, Kolkata 700150, India; (A.K.); (P.S.); (D.K.D.); (P.S.M.)
| | - Dipesh Kumar Das
- Liver Foundation, Kolkata 700150, India; (A.K.); (P.S.); (D.K.D.); (P.S.M.)
| | | | - Kultar Singh
- Sambodhi Research and Communication, Pvt Ltd., Noida 201301, India; (K.S.); (A.S.C.); (A.N.)
| | - Ankur Singh Chauhan
- Sambodhi Research and Communication, Pvt Ltd., Noida 201301, India; (K.S.); (A.S.C.); (A.N.)
| | - Aditya Naskar
- Sambodhi Research and Communication, Pvt Ltd., Noida 201301, India; (K.S.); (A.S.C.); (A.N.)
| | - Rajesh Bhatia
- Asian Development Bank, New Delhi 110021, India; (R.B.); (S.K.)
| | | |
Collapse
|
42
|
Espinoza J, Sikder AT, Dickhoner J, Lee T. Assessing Health Data Security Risks in Global Health Partnerships: Development of a Conceptual Framework. JMIR Form Res 2021; 5:e25833. [PMID: 34889752 PMCID: PMC8701669 DOI: 10.2196/25833] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 06/30/2021] [Accepted: 10/10/2021] [Indexed: 01/23/2023] Open
Abstract
Background Health care databases contain a wealth of information that can be used to develop programs and mature health care systems. There is concern that the sensitive nature of health data (eg, ethnicity, reproductive health, sexually transmitted infections, and lifestyle information) can have significant impact on individuals if misused, particularly among vulnerable and marginalized populations. As academic institutions, nongovernmental organizations, and international agencies begin to collaborate with low- and middle-income countries to develop and deploy health information technology (HIT), it is important to understand the technical and practical security implications of these initiatives. Objective Our aim is to develop a conceptual framework for risk stratification of global health data partnerships and HIT projects. In addition to identifying key conceptual domains, we map each domain to a variety of publicly available indices that could be used to inform a quantitative model. Methods We conducted an overview of the literature to identify relevant publications, position statements, white papers, and reports. The research team reviewed all sources and used the framework method and conceptual framework analysis to name and categorize key concepts, integrate them into domains, and synthesize them into an overarching conceptual framework. Once key domains were identified, public international data sources were searched for relevant structured indices to generate quantitative counterparts. Results We identified 5 key domains to inform our conceptual framework: State of HIT, Economics of Health Care, Demographics and Equity, Societal Freedom and Safety, and Partnership and Trust. Each of these domains was mapped to a number of structured indices. Conclusions There is a complex relationship among the legal, economic, and social domains of health care, which affects the state of HIT in low- and middle-income countries and associated data security risks. The strength of partnership and trust among collaborating organizations is an important moderating factor. Additional work is needed to formalize the assessment of partnership and trust and to develop a quantitative model of the conceptual framework that can help support organizational decision-making.
Collapse
Affiliation(s)
- Juan Espinoza
- Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, CA, United States.,Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Abu Taher Sikder
- Innovation Studio, Children's Hospital Los Angeles, Los Angeles, CA, United States
| | - James Dickhoner
- Keck School of Medicine, University of Southern California, Los Angeles, CA, United States.,Innovation Studio, Children's Hospital Los Angeles, Los Angeles, CA, United States
| | - Thomas Lee
- Keck School of Medicine, University of Southern California, Los Angeles, CA, United States.,Department of Surgery, Children's Hospital Los Angeles, Los Angeles, CA, United States
| |
Collapse
|
43
|
Addressing cultural competence and bias in treating migrant workers in pharmacies: Pharmacy students learning and changing norms. Res Social Adm Pharm 2021; 18:3362-3368. [PMID: 34857481 DOI: 10.1016/j.sapharm.2021.11.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 11/13/2021] [Accepted: 11/24/2021] [Indexed: 11/20/2022]
Abstract
OBJECTIVE Little research addressed training pharmacy students on bias towards vulnerable patients such as migrant domestic workers (MDWs). This study evaluates a module addressing bias and cultural competence when working with MDWs in community pharmacies. METHODS Two cohorts of Lebanese Bachelor of pharmacy students completed this module as part of a core Public Health class. Guided by a social psychology framework, the module involved watching a lecture, discussing an article, watching a video addressing bias in healthcare, and taking an Implicit Association Test. Second, students interviewed one MDW and one pharmacist before filling a reflection worksheet. Students' reflections were analyzed qualitatively using content analysis. Further, to evaluate the module's impact quantitatively, an aggregate perception of helpfulness scale was created and validated. Items addressed students' own experience with the module as well as its impact on pharmacists interviewed by students. RESULTS Of 170 students completing the module and providing qualitative data, 131 were asked to fill a survey addressing perceptions of assignment helpfulness. Of those 131 students, 126 filled the survey. On a scale ranging from zero to four, the composite mean score for helpfulness was 3.4, SD = 0.5. Students reported a positive impact of the interview in improving awareness of bias for pharmacists they interviewed (mean = 3.5, SD = 0.6). Qualitative analysis produced insight into students' experience with the module including challenges in communication with MDWs; MDWs' experience with bias and its repercussions; predictability, or lack thereof, of assignment results; plans to address bias after taking the module; evaluation of interviewed pharmacist's service; and perceived pharmacists' impressions of the assignment. CONCLUSIONS A two-part module shows promise in educating pharmacy students about bias and cultural competence. Engaging target audience including pharmacists can make such experiences meaningful for students while providing a learning opportunity for those health professionals.
Collapse
|
44
|
Taylor M, Pratt ME, Whelan M. Exploring the Untapped Potential of Library-University Partnerships: A Focus on Early Learning. PUBLIC LIBRARY QUARTERLY 2021. [DOI: 10.1080/01616846.2021.2002095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Michelle Taylor
- Family and Consumer Sciences, California State University, Long Beach, USA
| | - Megan E. Pratt
- Hallie E. Ford Center for Healthy Children and Families, Oregon State University, Corvallis, USA
| | - Mariko Whelan
- Community Services, Scottsdale Public Library, Scottsdale, USA
| |
Collapse
|
45
|
Delva S, Waligora Mendez KJ, Cajita M, Koirala B, Shan R, Wongvibulsin S, Vilarino V, Gilmore DR, Han HR. Efficacy of Mobile Health for Self-management of Cardiometabolic Risk Factors: A Theory-Guided Systematic Review. J Cardiovasc Nurs 2021; 36:34-55. [PMID: 32040072 PMCID: PMC7713761 DOI: 10.1097/jcn.0000000000000659] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Although mobile health (mHealth) technologies are burgeoning in the research arena, there is a lack of mHealth interventions focused on improving self-management of individuals with cardiometabolic risk factors (CMRFs). OBJECTIVE The purpose of this article was to critically and systematically review the efficacy of mHealth interventions for self-management of CMRF while evaluating quality, limitations, and issues with disparities using the technology acceptance model as a guiding framework. METHODS PubMed, CINAHL, EMBASE, and Lilacs were searched to identify research articles published between January 2008 and November 2018. Articles were included if they were published in English, included adults, were conducted in the United States, and used mHealth to promote self-care or self-management of CMRFs. A total of 28 articles were included in this review. RESULTS Studies incorporating mHealth have been linked to positive outcomes in self-management of diabetes, physical activity, diet, and weight loss. Most mHealth interventions included modalities such as text messaging, mobile applications, and wearable technologies. There was a lack of studies that are (1) in resource-poor settings, (2) theoretically driven, (3) community-engaged research, (4) measuring digital/health literacy, (5) measuring and evaluating engagement, (6) measuring outcomes related to disease self-management, and (7) focused on vulnerable populations, especially immigrants. CONCLUSION There is still a lack of mHealth interventions created specifically for immigrant populations, especially within the Latino community-the largest growing minority group in the United States. In an effort to meet this challenge, more culturally tailored mHealth interventions are needed.
Collapse
|
46
|
Eisenhauer E, Williams KC, Warren C, Thomas-Burton T, Julius S, Geller AM. New Directions in Environmental Justice Research at the U.S. Environmental Protection Agency: Incorporating Recognitional and Capabilities Justice Through Health Impact Assessments. ENVIRONMENTAL JUSTICE (PRINT) 2021; 14:322-331. [PMID: 35237378 PMCID: PMC8884111 DOI: 10.1089/env.2021.0019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Affiliation(s)
| | | | - Camilla Warren
- U.S. Environmental Protection Agency, Atlanta, Georgia, USA
| | | | - Susan Julius
- Office of Research and Development, U.S. Environmental Protection Agency, Washington, District of Columbia, USA
| | - Andrew M. Geller
- Office of Research and Development, U.S. Environmental Protection Agency, Durham, North Carolina, USA
| |
Collapse
|
47
|
Kyoon Achan G, Eni R, Kinew KA, Phillips-Beck W, Lavoie JG, Katz A. The Two Great Healing Traditions: Issues, Opportunities, and Recommendations for an Integrated First Nations Healthcare System in Canada. Health Syst Reform 2021; 7:e1943814. [PMID: 34375567 DOI: 10.1080/23288604.2021.1943814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
The First Nations in Manitoba, Canada, are calling for active recognition and incorporation of holistic traditional healing and medicine ways and approaches by the mainstream healthcare system that has hitherto tended to ignore all but biomedical approaches. This request for recognition requires elaboration on areas of opportunity for collaboration that could positively influence both Indigenous and allopathic medicine. We discuss pathways to an integrated healthcare system as community-based primary healthcare transformation. A community-based participatory research approach was used to engage eight Manitoba First Nations communities. One hundred and eighty-three (183) in-depth, semi-structured key informant interviews were completed in all communities. Grounded theory guided data analysis using NVivo 10 software. We learned that increased recognition and incorporation of traditional healing and medical methods would enhance a newly envisioned funded health system. Elders and healers will be meaningfully involved in the delivery of community-based primary health care. Funding for traditional healing and medicines are necessary components of primary health care. An overall respect for Indigenous health knowledge would aid transformation in community-based primary health care. Recognition of and respect for traditional healing, healers, medicines, therapies, and approaches is also recommended as part of addressing the legacy and intergenerational impact of assimilative policies including Indian residential schools as the Truth and Reconciliation Commission of Canada has stated in its Calls to Action.
Collapse
Affiliation(s)
- Grace Kyoon Achan
- Children's Hospital Research Institute of Manitoba & Department of Community Health Sciences, Max Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Rachel Eni
- Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.,Snuneymuxw First Nation, Nanaimo, British Columbia, Canada
| | - Kathi Avery Kinew
- First Nation Health and Social Secretariat Manitoba, Winnipeg, Manitoba, Canada
| | - Wanda Phillips-Beck
- First Nation Health and Social Secretariat Manitoba, Winnipeg, Manitoba, Canada
| | - Josée G Lavoie
- Ongomiizwin- Indigenous Institute of Health and Healing, Department of Community Health Sciences, Max Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Alan Katz
- Manitoba Centre for Health Policy/Max Rady Faculty of Health Sciences, Winnipeg, Manitoba, Canada
| |
Collapse
|
48
|
Thakur N, Lovinsky-Desir S, Appell D, Bime C, Castro L, Celedón JC, Ferreira J, George M, Mageto Y, Mainous III AG, Pakhale S, Riekert KA, Roman J, Ruvalcaba E, Sharma S, Shete P, Wisnivesky JP, Holguin F. Enhancing Recruitment and Retention of Minority Populations for Clinical Research in Pulmonary, Critical Care, and Sleep Medicine: An Official American Thoracic Society Research Statement. Am J Respir Crit Care Med 2021; 204:e26-e50. [PMID: 34347574 PMCID: PMC8513588 DOI: 10.1164/rccm.202105-1210st] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Well-designed clinical research needs to obtain information that is applicable to the general population. However, most current studies fail to include substantial cohorts of racial/ethnic minority populations. Such underrepresentation may lead to delayed diagnosis or misdiagnosis of disease, wide application of approved interventions without appropriate knowledge of their usefulness in certain populations, and development of recommendations that are not broadly applicable.Goals: To develop best practices for recruitment and retention of racial/ethnic minorities for clinical research in pulmonary, critical care, and sleep medicine.Methods: The American Thoracic Society convened a workshop in May of 2019. This included an international interprofessional group from academia, industry, the NIH, and the U.S. Food and Drug Administration, with expertise ranging from clinical and biomedical research to community-based participatory research methods and patient advocacy. Workshop participants addressed historical and current mistrust of scientific research, systemic bias, and social and structural barriers to minority participation in clinical research. A literature search of PubMed and Google Scholar was performed to support conclusions. The search was not a systematic review of the literature.Results: Barriers at the individual, interpersonal, institutional, and federal/policy levels were identified as limiting to minority participation in clinical research. Through the use of a multilevel framework, workshop participants proposed evidence-based solutions to the identified barriers.Conclusions: To date, minority participation in clinical research is not representative of the U.S. and global populations. This American Thoracic Society research statement identifies potential evidence-based solutions by applying a multilevel framework that is anchored in community engagement methods and patient advocacy.
Collapse
|
49
|
Blåhed H, San Sebastián M. "If the reindeer die, everything dies": The mental health of a Sámi community exposed to a mining project in Swedish Sápmi. Int J Circumpolar Health 2021; 80:1935132. [PMID: 34219614 PMCID: PMC8259850 DOI: 10.1080/22423982.2021.1935132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
In 2006, a British mining company started the process of extracting ore from Gállok/Kallak, in Swedish Sápmi. These grounds are used all year round for reindeer herding by the Sámi community Jåhkågasska tjiellde. While environmental impact assessments should be conducted by law in any development project in Sweden, the health component included is usually vague. The aim of this study was to understand the experiences and perceptions of the Sámi community regarding the current and potential health effects of the proposed mine.A qualitative study, including six in-depth interviews with members of the community, was conducted in 2020. Interviews were analysed using thematic analysis. Five themes were identified and organised in current and future impacts. Current impacts included “It’s like David’s battle against Goliath”, “It’s a slow process that takes a lot of power and energy”, “It’s a defense … like, to protect oneself”; with future impacts including: “If the reindeer die, everything dies”, “You would feel that you do not possess any power, [you would feel] overridden, pushed away, not liked”.The fear of losing current and future generations’ livelihoods appeared to be the main mediators of the current and potential worsened mental health experienced by the community.
Collapse
Affiliation(s)
- Hanna Blåhed
- Department of Epidemiology and Global Health, Umeå University, Sweden
| | - Miguel San Sebastián
- Department of Epidemiology and Global Health, Umeå University, Sweden.,Várdduo, Center for Sámi Research, Umeå University, Umeå, Sweden
| |
Collapse
|
50
|
Blacksher E, Hiratsuka VY, Blanchard JW, Lund JR, Reedy J, Beans JA, Saunkeah B, Peercy M, Byars C, Yracheta J, Tsosie KS, O’Leary M, Ducheneaux G, Spicer PG. Deliberations with American Indian and Alaska Native People about the Ethics of Genomics: An Adapted Model of Deliberation Used with Three Tribal Communities in the United States. AJOB Empir Bioeth 2021; 12:164-178. [PMID: 34125006 PMCID: PMC8274345 DOI: 10.1080/23294515.2021.1925775] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND This paper describes the design, implementation, and process outcomes from three public deliberations held in three tribal communities. Although increasingly used around the globe to address collective challenges, our study is among the first to adapt public deliberation for use with exclusively Indigenous populations. In question was how to design deliberations for tribal communities and whether this adapted model would achieve key deliberative goals and be well received. METHODS We adapted democratic deliberation, an approach to stakeholder engagement, for use with three tribal communities to respect tribal values and customs. Public deliberation convenes people from diverse backgrounds in reasoned reflection and dialogue in search of collective solutions. The deliberation planning process and design were informed by frameworks of enclave deliberation and community-based participatory research, which share key egalitarian values. The deliberations were collaboratively designed with tribal leadership and extensive partner input and involvement in the deliberations. Each deliberation posed different, locally relevant questions about genomic research, but used the same deliberation structure and measures to gauge the quality and experience of deliberation. RESULTS A total of 52 individuals participated in the deliberations across all three sites. Deliberants were balanced in gender, spanned decades in age, and were diverse in educational attainment and exposure to health research. Overall, the deliberations were positively evaluated. Participant perceptions and external observer datasets depict three deliberations that offered intensive conversation experiences in which participants learned from one another, reported feeling respected and connected to one another, and endorsed this intensive form of engagement. CONCLUSION The adapted deliberations achieved key deliberative goals and were generally well received. Limitations of the study are described.
Collapse
Affiliation(s)
- Erika Blacksher
- Department of Bioethics and Humanities, University of Washington, Seattle, Washington, USA
| | | | - Jessica W. Blanchard
- Center for Applied Social Research, University of Oklahoma, Norman, Oklahoma, USA
| | - Justin R. Lund
- Department of Anthropology, University of Oklahoma, Norman, Oklahoma, USA
| | - Justin Reedy
- Department of Communication, University of Oklahoma, Norman, Oklahoma, USA
| | - Julie A. Beans
- South Central Foundation Research Department, Anchorage, Alaska, USA
| | - Bobby Saunkeah
- Chickasaw Nation Department of Health, Division of Research and Public Health, Ada, Oklahoma, USA
| | - Micheal Peercy
- Chickasaw Nation Department of Health, Division of Research and Public Health, Ada, Oklahoma, USA
| | - Christie Byars
- Chickasaw Nation Department of Health, Division of Research and Public Health, Ada, Oklahoma, USA
| | - Joseph Yracheta
- Missouri Breaks Industries, Inc, Research Department, Eagle Butte, South Dakota, USA
| | - Krystal S. Tsosie
- Missouri Breaks Industries, Inc, Research Department, Eagle Butte, South Dakota, USA
| | - Marcia O’Leary
- Missouri Breaks Industries, Inc, Research Department, Eagle Butte, South Dakota, USA
| | - Guthrie Ducheneaux
- Missouri Breaks Industries, Inc, Research Department, Eagle Butte, South Dakota, USA
| | - Paul G. Spicer
- Department of Anthropology, University of Oklahoma, Norman, Oklahoma, USA
| |
Collapse
|