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Ganzar LA, Salvo D, Burford K, Zhang Y, Kohl HW, Hoelscher DM. Longitudinal changes in objectively-measured physical activity and sedentary time among school-age children in Central Texas, US during the COVID-19 pandemic. Int J Behav Nutr Phys Act 2022; 19:56. [PMID: 35590329 PMCID: PMC9117593 DOI: 10.1186/s12966-022-01299-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 05/11/2022] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Most available evidence on the effects of the COVID-19 pandemic on child movement behaviors is from cross-sectional studies using self-report measures. This study aimed to identify change trajectories and their associated factors for objectively-assessed physical activity and sedentary time among an ethnically and socioeconomically diverse sample of school-age children from Central Texas, U.S.A., during COVID-19. METHODS Pre- (Sept. 2019 - Feb. 2020) and during- (Oct. 2020 - March 2021) COVID-19 physical activity and sedentary behavior data were collected for school-age children (8-11 years) enrolled in the Safe Travel Environment Evaluation in Texas Schools (STREETS) cohort study. Daily time spent in moderate- to vigorous-intensity physical activity (MVPA) and sedentary time were assessed using GT3X-wBT Actigraph accelerometers. Parent surveys were used to assess socio-ecological factors. Latent class linear mixed models were used to identify change trajectories of MVPA and sedentary time. Logistic regression models were used to assess the association between socio-ecological characteristics with physical activity and sedentary time change trajectory groups. RESULTS There was a significant decrease in mean daily MVPA (- 9.4 mins, SD = 18.54) and an increase in sedentary behavior (0.83 hrs, SD = 1.18). Two trajectory groups were identified for MVPA ('decrease MPVA' and 'maintain high MVPA'), with the majority (82.1%) being in the 'decrease MVPA' group. Three trajectory groups were identified for sedentary behavior ('moderate increase sedentary, 'steep increase sedentary,' and 'decrease sedentary'), with most children (78.5%) being in the 'moderate increase' group. Girls had significantly lower odds of being in the 'maintain high MVPA' group than boys (OR = 0.27, 95% CI = 0.11, 0.61). Children living in neighborhoods with higher perceived social cohesion had significantly higher odds of being in the 'maintain high MVPA' group (OR = 1.22, 95% CI = 1.06, 1.41), while those in neighborhoods with higher social cohesion had lower odds of being in the 'decrease sedentary' group (OR = 0.86, 95% CI = 0.74, 0.99). CONCLUSIONS Declines in physical activity and increases in sedentary time among most school-age children during COVID-19 in a socioeconomically and ethnically diverse U.S. sample, were observed in our study, especially among girls. These findings highlight the need to counteract the short-term negative changes in movement behaviors in response to COVID-19 among children.
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Affiliation(s)
- Leigh Ann Ganzar
- Michael & Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, 1616 Guadalupe, Austin, TX 78701 USA
| | - Deborah Salvo
- Prevention Research Center in St. Louis, Brown School, Washington University, 1 Brookings Dr, St. Louis, MO 63130 USA
| | - Katie Burford
- Michael & Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, 1616 Guadalupe, Austin, TX 78701 USA
| | - Yuzi Zhang
- Michael & Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, 1616 Guadalupe, Austin, TX 78701 USA
| | - Harold W. Kohl
- Michael & Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, 1616 Guadalupe, Austin, TX 78701 USA
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX 78712 USA
| | - Deanna M. Hoelscher
- Michael & Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, 1616 Guadalupe, Austin, TX 78701 USA
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Abstract
This Open Forum describes the process of integrating personal experience; clinical experience in providing care; and research background, methods, and data in creating an arts project (i.e., an opera) highlighting veterans' resilience and recovery in the context of posttraumatic stress disorder and homelessness. Specifically, an approach of using research interviews to identify storylines and characters for veterans, along with personal and clinical experiences to frame provider characters and stories, is described to illustrate an arts-in-medicine approach to portraying recovery among veterans.
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Affiliation(s)
- Kenneth B Wells
- Jane and Terry Semel Institute for Neuroscience and Human Behavior Center for Health Services and Society, University of California, Los Angeles, and Healing and Education through the Arts (HEArts), Los Angeles
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3
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Vansteenkiste T, Morrens M, Westerhof GJ. Images of Recovery: A PhotoVoice Study on Visual Narratives of Personal Recovery in Persons with Serious Mental Illness. Community Ment Health J 2021; 57:1151-1163. [PMID: 33230705 DOI: 10.1007/s10597-020-00746-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 11/05/2020] [Indexed: 11/28/2022]
Abstract
Personal recovery has become a guiding paradigm in mental health services. Most research on recovery is based on the exploration of personal stories of service users through verbal methods. As not everyone with psychiatric problems is able to verbally formulate a recovery narrative, the current study assesses personal recovery through PhotoVoice, with emphasis on visualisation, small stories and participation. Two ten-week groups were conducted with 18 participants living with severe mental illnesses. They participated in both the collection and analysis of visual narratives. Across the images produced by participants, four main recovery themes were found : People, Places, Activities and Finding Meaning. Compared to other frameworks, the emphasis participants put on the theme Places adds value to the understanding of recovery processes. Furthermore, participants showed that recovery is about dealing with vulnerabilities as well as aspiring a meaningful life. This study demonstrates that exploring visual narratives is powerful within recovery oriented mental health.
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Affiliation(s)
- Tom Vansteenkiste
- Zorggroep Multiversum, Mortsel, Antwerp, Belgium. .,Department of Psychology, Health & Technology, University of Twente, Enschede, The Netherlands.
| | - Manuel Morrens
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,University of Antwerp Department of Psychiatry, Campus Duffel, Duffel, Belgium
| | - Gerben J Westerhof
- Department of Psychology, Health & Technology, University of Twente, Enschede, The Netherlands
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Woodgate RL, Tennent P, Legras N. Understanding Youth's Lived Experience of Anxiety through Metaphors: A Qualitative, Arts-Based Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:4315. [PMID: 33921770 PMCID: PMC8074263 DOI: 10.3390/ijerph18084315] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 04/14/2021] [Accepted: 04/15/2021] [Indexed: 12/26/2022]
Abstract
Living with anxiety can be a complex, biopsychosocial experience that is unique to each person and embedded in their contexts and lived worlds. Scales and questionnaires are necessary to quantify anxiety, yet these approaches are not always able to reflect the lived experience of psychological distress experienced by youth. Guided by hermeneutic phenomenology, our research aimed to amplify the voices of youth living with anxiety. Fifty-eight youth living with anxiety took part in in-depth, open-ended interviews and participatory arts-based methods (photovoice and ecomaps). Analysis was informed by van Manen's method of data analysis with attention to lived space, lived body, lived time, and lived relationships, as well as the meanings of living with anxiety. Youth relied on the following metaphors to describe their experiences: A shrinking world; The heavy, heavy backpack; Play, pause, rewind, forward; and A fine balance. Overall, youth described their anxiety as a monster, contributing to feelings of fear, loss, and pain, but also hope. The findings from this study can contribute to the reduction of barriers in knowledge translation by encouraging the use of narrative and visual metaphors as a communicative tool to convey youth's lived experience of anxiety to researchers, clinicians, and the public.
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Affiliation(s)
- Roberta Lynn Woodgate
- Rady Faculty of Health Sciences, College of Nursing, University of Manitoba, 89 Curry Place, Winnipeg, Manitoba, MB R3T 2N2, Canada; (P.T.); (N.L.)
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5
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Abstract
The literature supports the effectiveness of systems-based integrated care models, particularly collaborative care, to improve access, quality of care, and health outcomes for behavioral health conditions. There is growing evidence for the promise of collaborative care to reduce behavioral health disparities for racial and ethnic, low-income, and other at-risk populations. Using rapid literature review, this article highlights what is known about how collaborative care may promote health equity for behavioral health conditions, by reducing disparities in access, quality, and outcomes of care. Further, it explores innovative intervention and engagement strategies to promote behavioral health equity for at-risk groups.
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Affiliation(s)
- Maga E Jackson-Triche
- UCSF Health, UCSF Weill Institute for Neurosciences, 401 Parnassus Avenue, Suite LP 342, San Francisco, CA 94143-2211, USA.
| | - Jürgen Unützer
- Department of Psychiatry and Behavioral Sciences, University of Washington, 1959 Northeast Pacific Street, Seattle, WA 98195-6560, USA
| | - Kenneth B Wells
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, 10920 Wilshire Boulevard, Suite 300, Los Angeles, CA 90024-6505, USA; Department of Health Policy and Management, Fielding School of Public Health, Los Angeles, CA, USA; Center for Health Services and Society, Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA, USA; California Center for Excellence in Behavioral Health, Greater Los Angeles VA Health System, Los Angeles, CA, USA
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Luger TM, Hamilton AB, True G. Measuring Community-Engaged Research Contexts, Processes, and Outcomes: A Mapping Review. Milbank Q 2020; 98:493-553. [PMID: 32428339 PMCID: PMC7296434 DOI: 10.1111/1468-0009.12458] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Policy Points Community‐engaged research (CEnR) engenders meaningful academic‐community partnerships to improve research quality and health outcomes. CEnR has increasingly been adopted by health care systems, funders, and communities looking for solutions to intractable problems. It has been difficult to systematically measure CEnR's impact, as most evaluations focus on project‐specific outcomes. Similarly, partners have struggled with identifying appropriate measures to assess outcomes of interest. To make a case for CEnR's value, we must demonstrate the impacts of CEnR over time. We compiled recent measures and developed an interactive data visualization to facilitate more consistent measurement of CEnR's theoretical domains.
Context Community‐engaged research (CEnR) aims to engender meaningful academic‐community partnerships to increase research quality and impact, improve individual and community health, and build capacity for uptake of evidence‐based practices. Given the urgency to solve society's pressing public health problems and increasing competition for funding, it is important to demonstrate CEnR's value. Most evaluations focus on project‐specific outcomes, making it difficult to demonstrate CEnR's broader impact. Moreover, it is challenging for partnerships to identify assessments of interest beyond process measures. We conducted a mapping review to help partnerships find and select measures to evaluate CEnR projects and to characterize areas where further development of measures is needed. Methods We searched electronic bibliographic databases using relevant search terms from 2009 to 2018 and scanned CEnR projects to identify unpublished measures. Through review and reduction, we found 69 measures of CEnR's context, process, or outcomes that are potentially generalizable beyond a specific health condition or population. We abstracted data from descriptions of each measure to catalog purpose, aim (context, process, or outcome), and specific domains being measured. Findings We identified 28 measures of the conditions under which CEnR is conducted and factors to support effective academic‐community collaboration (context); 43 measures evaluating constructs such as group dynamics and trust (process); and 43 measures of impacts such as benefits and challenges of CEnR participation and system and capacity changes (outcomes). Conclusions We found substantial variation in how academic‐community partnerships conceptualize and define even similar domains. Achieving more consistency in how partnerships evaluate key constructs could reduce measurement confusion apparent in the literature. A hybrid approach whereby partnerships discuss common metrics and develop locally important measures can address CEnR's multiple goals. Our accessible data visualization serves as a convenient resource to support partnerships’ evaluation goals and may help to build the evidence base for CEnR through the use of common measures across studies.
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Affiliation(s)
- Tana M Luger
- VA Greater Los Angeles Healthcare System, Health Services Research and Development Center for the Study of Healthcare Innovation, Implementation and Policy
| | - Alison B Hamilton
- VA Greater Los Angeles Healthcare System, Health Services Research and Development Center for the Study of Healthcare Innovation, Implementation and Policy.,David Geffen School of Medicine, University of California, Los Angeles
| | - Gala True
- Southeast Louisiana Veterans Healthcare System, South Central Mental Illness Research, Education, and Clinical Center.,Louisiana State University School of Medicine, Section of Community and Population Medicine
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Abstract
Promoting population mental health and meeting the burdens of mental illness is a priority public health challenge of the 21st century. But too little attention has been placed on how to design and sustain the scope of strategies and commitments that credibly live up to the full breadth of that challenge. ThriveNYC is an effort by New York City to fill that gap, through a public health approach backed by investment in resources and leadership. ThriveNYC can by example help mobilize a larger community of investigators and policymakers to consider how to meet this challenge, to get to consensus on key elements for effective action and implementation, to reimagine who and what the mental health "system" includes, and, in doing so, to strengthen the social contract that underlies well-being.
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Affiliation(s)
- Gary Belkin
- Gary Belkin is with the Office of the Mayor, New York, NY. Chirlane McCray is First Lady of New York City
| | - Chirlane McCray
- Gary Belkin is with the Office of the Mayor, New York, NY. Chirlane McCray is First Lady of New York City
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Dawson CT, Wu W, Fennie KP, Ibañez G, Cano MÁ, Pettit JW, Trepka MJ. Perceived neighborhood social cohesion moderates the relationship between neighborhood structural disadvantage and adolescent depressive symptoms. Health Place 2019; 56:88-98. [PMID: 30711776 DOI: 10.1016/j.healthplace.2019.01.001] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 12/21/2018] [Accepted: 01/04/2019] [Indexed: 11/17/2022]
Abstract
There is a dearth of research exploring the moderating role of the social environment on neighborhood structural disadvantage and depressive symptoms, particularly among adolescents. Therefore, we examined if adolescent perceptions of neighborhood social cohesion and safety moderated the association between neighborhood structural disadvantage and adolescent depressive symptoms. This cross-sectional study used data from the National Longitudinal Study of Adolescent to Adult Health (Add Health). The study sample consisted of 12,105 adolescents enrolled in 9th-12th grades during the 1994-1995 school year across the United States (U.S.). Mixed effects multilevel modeling was used to determine if adolescent perceptions of neighborhoods moderated the relationship between neighborhood structural disadvantage and adolescent depressive symptoms. Results showed that perceived neighborhood social cohesion moderated the relationship between neighborhood structural disadvantage and adolescent depressive symptoms (p ≤ 0.001). At higher levels of perceived neighborhood social cohesion, neighborhood structural disadvantage was associated with decreased depressive symptoms. Findings suggest that improving perceived neighborhood social cohesion may decrease adolescent depressive symptoms, particularly in neighborhoods with high disadvantage. This aspect of the neighborhood social environment may serve as a target for structural and other interventions to address the growing burden of depression among adolescents.
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Affiliation(s)
- Christyl T Dawson
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th Street, AHC-5 487, Miami, FL 33199, USA.
| | - Wensong Wu
- Department of Mathematics and Statistics, School of Integrated Science and Humanity, Florida International University, 11200 SW 8th Street, DM 430, Miami, FL 33199, USA
| | - Kristopher P Fennie
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th Street, AHC-5 487, Miami, FL 33199, USA
| | - Gladys Ibañez
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th Street, AHC-5 487, Miami, FL 33199, USA
| | - Miguel Á Cano
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th Street, AHC-5 487, Miami, FL 33199, USA
| | - Jeremy W Pettit
- Department of Psychology, School of Integrated Science and Humanity, Florida International University, 11200 SW 8th Street, DM 256, Miami, FL 33199, USA
| | - Mary Jo Trepka
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th Street, AHC-5 487, Miami, FL 33199, USA
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9
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Lippman SA, Leddy AM, Neilands TB, Ahern J, MacPhail C, Wagner RG, Peacock D, Twine R, Goin DE, Gómez‐Olivé FX, Selin A, Tollman SM, Kahn K, Pettifor A. Village community mobilization is associated with reduced HIV incidence in young South African women participating in the HPTN 068 study cohort. J Int AIDS Soc 2018; 21 Suppl 7:e25182. [PMID: 30334377 PMCID: PMC6192897 DOI: 10.1002/jia2.25182] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 07/20/2018] [Indexed: 01/23/2023] Open
Abstract
INTRODUCTION Adolescent girls and young women (AGYW) in South Africa bear a disproportionate burden of HIV. Community mobilization (CM), defined as community members taking collective action to achieve a common goal related to health, equity and rights, has been associated with increased HIV testing and condom use and has been called a 'critical enabler' for addressing the HIV epidemic. However, limited research has examined whether CM is associated with HIV incidence among AGYW. METHODS We examine the association of CM with incident HIV among AGYW (ages 13 to 21) enrolled in the HPTN 068 cohort in the Agincourt Health and socio-Demographic Surveillance System, South Africa. This analysis includes 2292 participants residing in 26 villages where cross-sectional, population-based surveys were conducted to measure CM among 18- to 35-year-old residents in 2012 and 2014. HPTN 068 participants completed up to five annual visits that included an HIV test (2011 to 2016). Household-level data were collected from AGYW parents/guardians and census data is updated annually. Mean village-level CM scores were created using a validated community mobilization measure with seven components (social cohesion, social control, critical consciousness, shared concerns, organizations and networks, leadership and collective action). We used pooled generalized estimating equation regression with a Poisson distribution to estimate risk ratios (RR) for the association of village-level CM score and CM components with incident HIV infection, accounting for village-level clustering and adjusting for key covariates. RESULTS There were 194 incident infections over the follow-up period. For every additional standard deviation of village-level CM there was 12% lower HIV incidence (RR: 0.88, 95% CI: 0.79, 0.98) after adjusting for individual, household and community characteristics. CM components associated with lower HIV incidence included critical consciousness (RR: 0.88; CI: 0.79, 0.97) and leadership (RR: 0.87; CI: 0.79, 0.95); while not statistically significant, social cohesion (RR: 0.91; CI: 0.81, 1.01), shared concerns (RR: 0.90; CI: 0.81, 1.00), and organizations and networks (RR: 0.91; CI: 0.79, 1.03) may also play a protective role. CONCLUSIONS These results suggest that having strong community social resources will reduce AGYW's risk of HIV acquisition. Work to mobilize communities, focusing on building social cohesion, shared concerns, critical consciousness, and effective and accountable leadership, can fortify prevention programming for AGYW.
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Affiliation(s)
- Sheri A Lippman
- Center for AIDS Prevention StudiesUniversity of CaliforniaSan FranciscoCAUSA
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt)School of Public HealthFaculty of Health SciencesUniversity of the WitwatersrandJohannesburgSouth Africa
| | - Anna M Leddy
- Center for AIDS Prevention StudiesUniversity of CaliforniaSan FranciscoCAUSA
| | - Torsten B Neilands
- Center for AIDS Prevention StudiesUniversity of CaliforniaSan FranciscoCAUSA
| | - Jennifer Ahern
- Division of EpidemiologySchool of Public HealthUniversity of California BerkeleyBerkeleyCAUSA
| | - Catherine MacPhail
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt)School of Public HealthFaculty of Health SciencesUniversity of the WitwatersrandJohannesburgSouth Africa
- School of Health and SocietyUniversity of WollongongWollongongNSWAustralia
- Wits Reproductive Health and HIV Research InstituteUniversity of the WitwatersrandJohannesburgSouth Africa
| | - Ryan G Wagner
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt)School of Public HealthFaculty of Health SciencesUniversity of the WitwatersrandJohannesburgSouth Africa
- Division of Epidemiology and Global HealthDepartment of Public Health and Clinical MedicineUmeå Centre for Global Health ResearchUmeå UniversityUmeåSweden
| | - Dean Peacock
- Sonke Gender JusticeCape TownSouth Africa
- School of Public HealthUniversity of Cape TownCape TownSouth Africa
| | - Rhian Twine
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt)School of Public HealthFaculty of Health SciencesUniversity of the WitwatersrandJohannesburgSouth Africa
| | - Dana E Goin
- Division of EpidemiologySchool of Public HealthUniversity of California BerkeleyBerkeleyCAUSA
| | - F Xavier Gómez‐Olivé
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt)School of Public HealthFaculty of Health SciencesUniversity of the WitwatersrandJohannesburgSouth Africa
| | - Amanda Selin
- Gillings School of Global Public HealthUniversity of North Carolina at Chapel HillChapel HillNCUSA
| | - Stephen M Tollman
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt)School of Public HealthFaculty of Health SciencesUniversity of the WitwatersrandJohannesburgSouth Africa
- Division of Epidemiology and Global HealthDepartment of Public Health and Clinical MedicineUmeå Centre for Global Health ResearchUmeå UniversityUmeåSweden
- INDEPTH NetworkAccraGhana
| | - Kathleen Kahn
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt)School of Public HealthFaculty of Health SciencesUniversity of the WitwatersrandJohannesburgSouth Africa
- Division of Epidemiology and Global HealthDepartment of Public Health and Clinical MedicineUmeå Centre for Global Health ResearchUmeå UniversityUmeåSweden
| | - Audrey Pettifor
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt)School of Public HealthFaculty of Health SciencesUniversity of the WitwatersrandJohannesburgSouth Africa
- Gillings School of Global Public HealthUniversity of North Carolina at Chapel HillChapel HillNCUSA
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10
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Belin TR, Jones A, Tang L, Chung B, Stockdale SE, Jones F, Wright A, Sherbourne CD, Perlman J, Pulido E, Ong MK, Gilmore J, Miranda J, Dixon E, Jones L, Wells KB. Maintaining Internal Validity in Community Partnered Participatory Research: Experience from the Community Partners in Care Study. Ethn Dis 2018; 28:357-364. [PMID: 30202188 DOI: 10.18865/ed.28.s2.357] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objective With internal validity being a central goal of designed experiments, we seek to elucidate how community partnered participatory research (CPPR) impacts the internal validity of public health comparative-effectiveness research. Methods Community Partners in Care (CPIC), a study comparing a community-coalition intervention to direct technical assistance for disseminating depression care to vulnerable populations, is used to illustrate design choices developed with attention to core CPPR principles. The study-design process is reviewed retrospectively and evaluated based on the resulting covariate balance across intervention arms and on broader peer-review assessments. Contributions of the CPIC Council and the study's design committee are highlighted. Results CPPR principles contributed to building consensus around the use of randomization, creating a sampling frame, specifying geographic boundaries delimiting the scope of the investigation, grouping similar programs into pairs or other small blocks of units, collaboratively choosing random-number-generator seeds to determine randomized intervention assignments, and addressing logistical constraints in field operations. Study protocols yielded samples that were well-balanced on background characteristics across intervention arms. CPIC has been recognized for scientific merit, has drawn attention from policymakers, and has fueled ongoing research collaborations. Conclusions Creative and collaborative fulfillment of CPPR principles reinforced the internal validity of CPIC, strengthening the study's scientific rigor by engaging complementary areas of knowledge and expertise among members of the investigative team.
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Affiliation(s)
- Thomas R Belin
- UCLA Department of Biostatistics, Center for Health Sciences, Los Angeles, CA.,UCLA Department of Psychiatry and Biobehavioral Sciences, Los Angeles, CA.,UCLA Semel Institute Center for Health Services and Society, Los Angeles, CA
| | - Andrea Jones
- Healthy African American Families II, Los Angeles, CA
| | - Lingqi Tang
- UCLA Department of Psychiatry and Biobehavioral Sciences, Los Angeles, CA.,UCLA Semel Institute Center for Health Services and Society, Los Angeles, CA
| | - Bowen Chung
- UCLA Department of Psychiatry and Biobehavioral Sciences, Los Angeles, CA.,UCLA Semel Institute Center for Health Services and Society, Los Angeles, CA.,Harbor-UCLA Medical Center, Torrance, CA
| | - Susan E Stockdale
- UCLA Department of Psychiatry and Biobehavioral Sciences, Los Angeles, CA.,Greater Los Angeles VA Medical Center, Sepulveda, CA
| | - Felica Jones
- Healthy African American Families II, Los Angeles, CA
| | - Aziza Wright
- Healthy African American Families II, Los Angeles, CA
| | | | | | | | - Michael K Ong
- Greater Los Angeles VA Medical Center, Sepulveda, CA.,UCLA Department of Medicine, Los Angeles, CA
| | | | - Jeanne Miranda
- UCLA Department of Psychiatry and Biobehavioral Sciences, Los Angeles, CA.,UCLA Semel Institute Center for Health Services and Society, Los Angeles, CA
| | | | - Loretta Jones
- Healthy African American Families II, Los Angeles, CA
| | - Kenneth B Wells
- UCLA Department of Psychiatry and Biobehavioral Sciences, Los Angeles, CA.,UCLA Semel Institute Center for Health Services and Society, Los Angeles, CA.,RAND Corporation, Santa Monica, CA.,UCLA Department of Health Policy and Management, Center for Health Sciences, Los Angeles, CA
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11
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Hankerson SH, Wells K, Sullivan MA, Johnson J, Smith L, Crayton L, Miller-Sethi F, Brooks C, Rule A, Ahmad-Llewellyn J, Rhem D, Porter X, Croskey R, Simpson E, Butler C, Roberts S, James A, Jones L. Partnering with African American Churches to Create a Community Coalition for Mental Health. Ethn Dis 2018; 28:467-474. [PMID: 30202200 DOI: 10.18865/ed.28.s2.467] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Community partnered participatory research (CPPR) emphasizes community engagement, respect, and empowerment as guiding principles to promote mental health equity. This article describes the "Vision" stage of a CPPR-informed model to implement evidence-based practices for depression in two African American churches in Harlem, New York. Essential parts of the Vision include engagement of stakeholders and collaborative planning. The engagement process increased awareness about the project via a community-focused mental health symposium. The collaborative planning stage resulted in creating a multi-disciplinary Community Coalition for Mental Health, establishing the Coalition's values, agreeing to change the initial chosen study intervention from Interpersonal Counseling to Mental Health First Aid, and developing a website to disseminate the group's work. Key lessons learned from our partnered process are: 1) support from the lead pastor is crucial; 2) balancing community and academic interests can be challenging; 3) icebreaker activities foster relationships and reinforce CPPR principles; 4) multiple communication channels can enhance community participation; and, 5) should organize data in ways that make them easier to interpret.
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Affiliation(s)
| | - Kenneth Wells
- University of California at Los Angeles, Center for Health Services and Society, Los Angeles, CA
| | - Martha Adams Sullivan
- The Parish of St. Charles Borromeo, Resurrection and All Saints; Citywide Behavioral Health Coalition for Black Elders, Inc, New York, NY
| | - Joyce Johnson
- HOPE Center, First Corinthian Baptist Church, Monroe College; New York, NY
| | - Laura Smith
- Teacher's College, Columbia University, New York, NY
| | | | - Faith Miller-Sethi
- Department of Psychiatry-Epidemiology, Columbia University, New York, NY
| | - Clarencetine Brooks
- New York City Department of Health & Mental Hygiene, Office of Consumer Affairs, New York, NY
| | - Alana Rule
- Teacher's College, Columbia University, New York, NY
| | | | | | | | - Raymond Croskey
- Medgar Evers College; Columbia University School of Medicine, New York, NY
| | | | - Charles Butler
- Harlem Congregations for Community Improvement, New York, NY
| | - Samuel Roberts
- College of Arts & Sciences, Mailman School of Public Health, Columbia University, New York, NY
| | - Alicia James
- The PAM Project: Maternal Mental Heath for Mothers of Color, New York, NY
| | - Loretta Jones
- Healthy African American Families II, Los Angeles, CA
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12
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Ross A, Reavley N, Too LS, Pirkis J. Evaluation of a novel approach to preventing railway suicides: the community stations project. JOURNAL OF PUBLIC MENTAL HEALTH 2018. [DOI: 10.1108/jpmh-06-2017-0022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The purpose of this paper is to describe an evaluation of the Community Stations Project. The Community Stations Project was designed to address railway suicides in two ways: by improving the station environment in a manner that might improve community members’ feelings of wellbeing; and raising community members’ awareness of poor mental health and likelihood of reaching out to at-risk individuals. It involved four types of interventions (arts and culture, music, food and coffee, and “special events”) delivered at four stations in Victoria.
Design/methodology/approach
A short anonymous survey was administered to community members on iPads at the four participating railway stations during the implementation of the interventions (between October and December 2016). The survey included questions about respondents’ demographics, their awareness of the intervention(s), their views of the station, their attitudes towards people with poor mental health and their emotional wellbeing.
Findings
A total of 1,309 people took part in the survey. Of these, 48 per cent of community members surveyed reporting noticing an intervention at their station. Noticing the events was associated with positive views of the station, improved understanding of poor mental health, and a greater likelihood of reaching out to someone who might be at risk of poor mental health. Awareness of intervention events was not associated with respondents’ own emotional wellbeing.
Practical implications
Continuing to focus efforts on mental health awareness activities may further strengthen the impact of the Community Stations Project interventions and ultimately prevent suicides at railway stations.
Originality/value
This paper evaluates a novel approach to improving wellbeing and understanding of poor mental health in the train station environment.
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Keegan R, Grover LT, Patron D, Sugarman OK, Griffith K, Sonnier S, Springgate BF, Jumonville LC, Gardner S, Massey W, Miranda J, Chung B, Wells KB, Phillippi S, Trapido E, Ramirez A, Meyers D, Haywood C, Landry C, Wennerstrom A. Case Study of Resilient Baton Rouge: Applying Depression Collaborative Care and Community Planning to Disaster Recovery. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E1208. [PMID: 29890659 PMCID: PMC6025623 DOI: 10.3390/ijerph15061208] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 05/29/2018] [Accepted: 05/30/2018] [Indexed: 11/16/2022]
Abstract
BACKGROUND Addressing behavioral health impacts of major disasters is a priority of increasing national attention, but there are limited examples of implementation strategies to guide new disaster responses. We provide a case study of an effort being applied in response to the 2016 Great Flood in Baton Rouge. METHODS Resilient Baton Rouge was designed to support recovery after major flooding by building local capacity to implement an expanded model of depression collaborative care for adults, coupled with identifying and responding to local priorities and assets for recovery. For a descriptive, initial evaluation, we coupled analysis of documents and process notes with descriptive surveys of participants in initial training and orientation, including preliminary comparisons among licensed and non-licensed participants to identify training priorities. RESULTS We expanded local behavioral health service delivery capacity through subgrants to four agencies, provision of training tailored to licensed and non-licensed providers and development of advisory councils and partnerships with grassroots and government agencies. We also undertook initial efforts to enhance national collaboration around post-disaster resilience. CONCLUSION Our partnered processes and lessons learned may be applicable to other communities that aim to promote resilience, as well as planning for and responding to post-disaster behavioral health needs.
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Affiliation(s)
- Robin Keegan
- Resilient Baton Rouge, 100 North Street, Suite 900, Baton Rouge, LA 70802, USA.
| | - Leslie T Grover
- Resilient Baton Rouge, 100 North Street, Suite 900, Baton Rouge, LA 70802, USA.
| | - David Patron
- Semel Institute for Neuroscience and Human Behavior, UCLA David Geffin School of Medicine, 10833 Le Conte Ave, Los Angeles, CA 90095, USA.
| | - Olivia K Sugarman
- School of Medicine, Section of Community and Population Medicine, Louisiana State University Health Sciences Center, 433 Bolivar St, New Orleans, LA 70112, USA.
| | - Krystal Griffith
- Semel Institute for Neuroscience and Human Behavior, UCLA David Geffin School of Medicine, 10833 Le Conte Ave, Los Angeles, CA 90095, USA.
| | - Suzy Sonnier
- Executive Director, Baton Rouge Health District.
| | - Benjamin F Springgate
- School of Medicine, Section of Community and Population Medicine, Louisiana State University Health Sciences Center, 433 Bolivar St, New Orleans, LA 70112, USA.
| | | | - Sarah Gardner
- Baton Rouge Area Foundation, 100 North Street, Suite 900, Baton Rouge, LA 70802, USA.
| | - Willie Massey
- Resilient Baton Rouge, 100 North Street, Suite 900, Baton Rouge, LA 70802, USA.
| | - Jeanne Miranda
- Semel Institute for Neuroscience and Human Behavior, UCLA David Geffin School of Medicine, 10833 Le Conte Ave, Los Angeles, CA 90095, USA.
| | - Bowen Chung
- Semel Institute for Neuroscience and Human Behavior, UCLA David Geffin School of Medicine, 10833 Le Conte Ave, Los Angeles, CA 90095, USA.
| | - Kenneth B Wells
- Semel Institute for Neuroscience and Human Behavior, UCLA David Geffin School of Medicine, 10833 Le Conte Ave, Los Angeles, CA 90095, USA.
| | - Stephen Phillippi
- School of Medicine, Section of Community and Population Medicine, Louisiana State University Health Sciences Center, 433 Bolivar St, New Orleans, LA 70112, USA.
| | - Ed Trapido
- School of Medicine, Section of Community and Population Medicine, Louisiana State University Health Sciences Center, 433 Bolivar St, New Orleans, LA 70112, USA.
| | - Alexa Ramirez
- School of Medicine, Section of Community and Population Medicine, Louisiana State University Health Sciences Center, 433 Bolivar St, New Orleans, LA 70112, USA.
| | - Diana Meyers
- St. Anna's Episcopal Church, 1313 Esplanade Ave, New Orleans, LA 70116, USA.
| | - Catherine Haywood
- Louisiana Community Health Outreach Network, 1226 N. Broad, New Orleans, LA 70119, USA.
| | - Craig Landry
- UCLA Center for Health Services and Society, Los Angeles, CA 90095, USA.
| | - Ashley Wennerstrom
- Department of Medicine, Tulane University School of Medicine, 1430 Tulane Ave. SL-16 New Orleans, LA 70112, USA.
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Bowen DJ, Hyams T, Goodman M, West KM, Harris‐Wai J, Yu J. Systematic Review of Quantitative Measures of Stakeholder Engagement. Clin Transl Sci 2017; 10:314-336. [PMID: 28556620 PMCID: PMC5593160 DOI: 10.1111/cts.12474] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 04/17/2017] [Indexed: 01/23/2023] Open
Affiliation(s)
- DJ Bowen
- University of WashingtonSeattleWashingtonUSA
| | - T Hyams
- University of WashingtonSeattleWashingtonUSA
| | - M Goodman
- College of Global Public HealthNew York UniversityNew YorkNew YorkUSA
| | - KM West
- University of WashingtonSeattleWashingtonUSA
| | - J Harris‐Wai
- University of CaliforniaSan FranciscoCaliforniaUSA
| | - J‐H Yu
- Department of PediatricsUniversity of WashingtonSeattleWashingtonUSA
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Díez J, Conde P, Sandin M, Urtasun M, López R, Carrero JL, Gittelsohn J, Franco M. Understanding the local food environment: A participatory photovoice project in a low-income area in Madrid, Spain. Health Place 2017; 43:95-103. [DOI: 10.1016/j.healthplace.2016.11.012] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 10/08/2016] [Accepted: 11/14/2016] [Indexed: 11/24/2022]
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Abstract
In the past few decades, photovoice research has gained prominence, providing context rich insights through participants' photographs and narratives. Emergent within the field of photovoice research have been health studies embracing diverse illness issues. The goal of this scoping review article was to describe the use of photovoice in mental illness, paying particular attention to the following: (1) the study design and methods, (2) empirical findings, and (3) dissemination strategies. Nine qualitative studies (seven drawing from primary and two secondary analyses) featuring diverse approaches to analysis of data comprising individual and/or focus group interviews using participant-produced photographs were included in the review. Described were participant's experiences of living with mental illness and/or substance overuse, including feelings of loneliness and being marginalized, along with their support care needs (e.g. physical, emotional, and spiritual) to garner self-confidence, respite, and/or recovery. Empirically, the reviewed articles confirmed the value of participant-produced photographs for obtaining in-depth understandings about individual's mental illness experiences while a focus on stigma and recovery was prominent. In terms of dissemination, while most of the published articles shared some participants' photographs and narratives, less evident were strategies to actively engage the public or policymakers with the images. Recommendations for future photovoice research include conducting formal analyses of participant photographs and strategically lobbying policymakers and raising public awareness through virtual and "in person" photo exhibitions while de-stigmatizing and affirming the experiences of those who are challenged by mental illness.
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Cyril S, Smith BJ, Possamai-Inesedy A, Renzaho AMN. Exploring the role of community engagement in improving the health of disadvantaged populations: a systematic review. Glob Health Action 2015; 8:29842. [PMID: 26689460 PMCID: PMC4685976 DOI: 10.3402/gha.v8.29842] [Citation(s) in RCA: 219] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Revised: 11/02/2015] [Accepted: 11/20/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Although community engagement (CE) is widely used in health promotion, components of CE models associated with improved health are poorly understood. This study aimed to examine the magnitude of the impact of CE on health and health inequalities among disadvantaged populations, which methodological approaches maximise the effectiveness of CE, and components of CE that are acceptable, feasible, and effective when used among disadvantaged populations. DESIGN The systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We carried out methodological assessments of the included studies using rating scales. The analysis focussed on model synthesis to identify the key CE components linked to positive study outcomes and comparative analysis between positive study outcomes, processes, and quality indicators of CE. RESULTS Out of 24 studies that met our inclusion criteria, 21 (87.5%) had positively impacted health behaviours, public health planning, health service access, health literacy, and a range of health outcomes. More than half of the studies (58%) were of good quality, whereas 71% and 42% of studies showed good community involvement in research and achieved high levels of CE, respectively. Key CE components that affected health outcomes included real power-sharing, collaborative partnerships, bidirectional learning, incorporating the voice and agency of beneficiary communities in research protocol, and using bicultural health workers for intervention delivery. CONCLUSIONS The findings suggest that CE models can lead to improved health and health behaviours among disadvantaged populations if designed properly and implemented through effective community consultation and participation. We also found several gaps in the current measurement of CE in health intervention studies, which suggests the importance of developing innovative approaches to measure CE impact on health outcomes in a more rigorous way.
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Affiliation(s)
- Sheila Cyril
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- School of Social Sciences and Psychology, Western Sydney University, Penrith, NSW, Australia
| | - Ben J Smith
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Alphia Possamai-Inesedy
- Office of the Pro-Vice Chancellor Arts (Education), Western Sydney University, Bankstown, NSW, Australia
| | - Andre M N Renzaho
- Humanitarian and Development Studies, School of Social Sciences and Psychology, Western Sydney University, Penrith, NSW, Australia;
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Chung B, Ngo VK, Ong MK, Pulido E, Jones F, Gilmore J, Stoker-Mtume N, Johnson M, Tang L, Wells KB, Sherbourne C, Miranda J. Participation in Training for Depression Care Quality Improvement: A Randomized Trial of Community Engagement or Technical Support. Psychiatr Serv 2015; 66:831-9. [PMID: 25930037 PMCID: PMC4582783 DOI: 10.1176/appi.ps.201400099] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Community engagement and planning (CEP) could improve dissemination of depression care quality improvement in underresourced communities, but whether its effects on provider training participation differ from those of standard technical assistance, or resources for services (RS), is unknown. This study compared program- and staff-level participation in depression care quality improvement training among programs enrolled in CEP, which trained networks of health care and social-community agencies jointly, and RS, which provided technical support to individual programs. METHODS Matched programs from health care and social-community service sectors in two communities were randomly assigned to RS or CEP. Data were from 1,622 eligible staff members from 95 enrolled programs. Primary outcomes were any staff trained (for programs) and total hours of training (for staff). Secondary staff-level outcomes were hours of training in specific depression collaborative care components. RESULTS CEP programs were more likely than RS programs to participate in any training (p=.006). Within health care sectors, CEP programs were more likely than RS programs to participate in training (p=.016), but within social-community sectors, there was no difference in training by intervention. Among staff who participated in training, mean training hours were greater among CEP programs versus RS programs for any type of training (p<.001) and for training related to each component of depression care (p<.001) except medication management. CONCLUSIONS CEP may be an effective strategy to promote staff participation in depression care improvement efforts in underresourced communities.
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Affiliation(s)
- Bowen Chung
- Dr. Chung is with the Department of Psychiatry, Harbor-University of California, Los Angeles (UCLA), Medical Center, and he is also with RAND Health, RAND Corporation, Santa Monica, California, where Dr. Ngo, Dr. Wells, Dr. Sherbourne, and Dr. Miranda are also affiliated (e-mail: ). Dr. Wells and Dr. Miranda are also with the Center for Health Services and Society, Department of Psychiatry, UCLA, where Mrs. Pulido, Dr. Johnson, and Dr. Tang are also affiliated. Dr. Johnson is also with the U.S. Department of Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, where Dr. Ong is affiliated. Dr. Ong is also with the Department of Medicine, UCLA. Ms. Jones is with Healthy African American Families II, Los Angeles. Mr. Gilmore is with Behavioral Health Services, Inc. Ms. Stoker-Mtume is with Shields for Families, Los Angeles
| | - Victoria K Ngo
- Dr. Chung is with the Department of Psychiatry, Harbor-University of California, Los Angeles (UCLA), Medical Center, and he is also with RAND Health, RAND Corporation, Santa Monica, California, where Dr. Ngo, Dr. Wells, Dr. Sherbourne, and Dr. Miranda are also affiliated (e-mail: ). Dr. Wells and Dr. Miranda are also with the Center for Health Services and Society, Department of Psychiatry, UCLA, where Mrs. Pulido, Dr. Johnson, and Dr. Tang are also affiliated. Dr. Johnson is also with the U.S. Department of Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, where Dr. Ong is affiliated. Dr. Ong is also with the Department of Medicine, UCLA. Ms. Jones is with Healthy African American Families II, Los Angeles. Mr. Gilmore is with Behavioral Health Services, Inc. Ms. Stoker-Mtume is with Shields for Families, Los Angeles
| | - Michael K Ong
- Dr. Chung is with the Department of Psychiatry, Harbor-University of California, Los Angeles (UCLA), Medical Center, and he is also with RAND Health, RAND Corporation, Santa Monica, California, where Dr. Ngo, Dr. Wells, Dr. Sherbourne, and Dr. Miranda are also affiliated (e-mail: ). Dr. Wells and Dr. Miranda are also with the Center for Health Services and Society, Department of Psychiatry, UCLA, where Mrs. Pulido, Dr. Johnson, and Dr. Tang are also affiliated. Dr. Johnson is also with the U.S. Department of Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, where Dr. Ong is affiliated. Dr. Ong is also with the Department of Medicine, UCLA. Ms. Jones is with Healthy African American Families II, Los Angeles. Mr. Gilmore is with Behavioral Health Services, Inc. Ms. Stoker-Mtume is with Shields for Families, Los Angeles
| | - Esmeralda Pulido
- Dr. Chung is with the Department of Psychiatry, Harbor-University of California, Los Angeles (UCLA), Medical Center, and he is also with RAND Health, RAND Corporation, Santa Monica, California, where Dr. Ngo, Dr. Wells, Dr. Sherbourne, and Dr. Miranda are also affiliated (e-mail: ). Dr. Wells and Dr. Miranda are also with the Center for Health Services and Society, Department of Psychiatry, UCLA, where Mrs. Pulido, Dr. Johnson, and Dr. Tang are also affiliated. Dr. Johnson is also with the U.S. Department of Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, where Dr. Ong is affiliated. Dr. Ong is also with the Department of Medicine, UCLA. Ms. Jones is with Healthy African American Families II, Los Angeles. Mr. Gilmore is with Behavioral Health Services, Inc. Ms. Stoker-Mtume is with Shields for Families, Los Angeles
| | - Felica Jones
- Dr. Chung is with the Department of Psychiatry, Harbor-University of California, Los Angeles (UCLA), Medical Center, and he is also with RAND Health, RAND Corporation, Santa Monica, California, where Dr. Ngo, Dr. Wells, Dr. Sherbourne, and Dr. Miranda are also affiliated (e-mail: ). Dr. Wells and Dr. Miranda are also with the Center for Health Services and Society, Department of Psychiatry, UCLA, where Mrs. Pulido, Dr. Johnson, and Dr. Tang are also affiliated. Dr. Johnson is also with the U.S. Department of Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, where Dr. Ong is affiliated. Dr. Ong is also with the Department of Medicine, UCLA. Ms. Jones is with Healthy African American Families II, Los Angeles. Mr. Gilmore is with Behavioral Health Services, Inc. Ms. Stoker-Mtume is with Shields for Families, Los Angeles
| | - James Gilmore
- Dr. Chung is with the Department of Psychiatry, Harbor-University of California, Los Angeles (UCLA), Medical Center, and he is also with RAND Health, RAND Corporation, Santa Monica, California, where Dr. Ngo, Dr. Wells, Dr. Sherbourne, and Dr. Miranda are also affiliated (e-mail: ). Dr. Wells and Dr. Miranda are also with the Center for Health Services and Society, Department of Psychiatry, UCLA, where Mrs. Pulido, Dr. Johnson, and Dr. Tang are also affiliated. Dr. Johnson is also with the U.S. Department of Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, where Dr. Ong is affiliated. Dr. Ong is also with the Department of Medicine, UCLA. Ms. Jones is with Healthy African American Families II, Los Angeles. Mr. Gilmore is with Behavioral Health Services, Inc. Ms. Stoker-Mtume is with Shields for Families, Los Angeles
| | - Norma Stoker-Mtume
- Dr. Chung is with the Department of Psychiatry, Harbor-University of California, Los Angeles (UCLA), Medical Center, and he is also with RAND Health, RAND Corporation, Santa Monica, California, where Dr. Ngo, Dr. Wells, Dr. Sherbourne, and Dr. Miranda are also affiliated (e-mail: ). Dr. Wells and Dr. Miranda are also with the Center for Health Services and Society, Department of Psychiatry, UCLA, where Mrs. Pulido, Dr. Johnson, and Dr. Tang are also affiliated. Dr. Johnson is also with the U.S. Department of Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, where Dr. Ong is affiliated. Dr. Ong is also with the Department of Medicine, UCLA. Ms. Jones is with Healthy African American Families II, Los Angeles. Mr. Gilmore is with Behavioral Health Services, Inc. Ms. Stoker-Mtume is with Shields for Families, Los Angeles
| | - Megan Johnson
- Dr. Chung is with the Department of Psychiatry, Harbor-University of California, Los Angeles (UCLA), Medical Center, and he is also with RAND Health, RAND Corporation, Santa Monica, California, where Dr. Ngo, Dr. Wells, Dr. Sherbourne, and Dr. Miranda are also affiliated (e-mail: ). Dr. Wells and Dr. Miranda are also with the Center for Health Services and Society, Department of Psychiatry, UCLA, where Mrs. Pulido, Dr. Johnson, and Dr. Tang are also affiliated. Dr. Johnson is also with the U.S. Department of Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, where Dr. Ong is affiliated. Dr. Ong is also with the Department of Medicine, UCLA. Ms. Jones is with Healthy African American Families II, Los Angeles. Mr. Gilmore is with Behavioral Health Services, Inc. Ms. Stoker-Mtume is with Shields for Families, Los Angeles
| | - Lingqi Tang
- Dr. Chung is with the Department of Psychiatry, Harbor-University of California, Los Angeles (UCLA), Medical Center, and he is also with RAND Health, RAND Corporation, Santa Monica, California, where Dr. Ngo, Dr. Wells, Dr. Sherbourne, and Dr. Miranda are also affiliated (e-mail: ). Dr. Wells and Dr. Miranda are also with the Center for Health Services and Society, Department of Psychiatry, UCLA, where Mrs. Pulido, Dr. Johnson, and Dr. Tang are also affiliated. Dr. Johnson is also with the U.S. Department of Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, where Dr. Ong is affiliated. Dr. Ong is also with the Department of Medicine, UCLA. Ms. Jones is with Healthy African American Families II, Los Angeles. Mr. Gilmore is with Behavioral Health Services, Inc. Ms. Stoker-Mtume is with Shields for Families, Los Angeles
| | - Kenneth Brooks Wells
- Dr. Chung is with the Department of Psychiatry, Harbor-University of California, Los Angeles (UCLA), Medical Center, and he is also with RAND Health, RAND Corporation, Santa Monica, California, where Dr. Ngo, Dr. Wells, Dr. Sherbourne, and Dr. Miranda are also affiliated (e-mail: ). Dr. Wells and Dr. Miranda are also with the Center for Health Services and Society, Department of Psychiatry, UCLA, where Mrs. Pulido, Dr. Johnson, and Dr. Tang are also affiliated. Dr. Johnson is also with the U.S. Department of Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, where Dr. Ong is affiliated. Dr. Ong is also with the Department of Medicine, UCLA. Ms. Jones is with Healthy African American Families II, Los Angeles. Mr. Gilmore is with Behavioral Health Services, Inc. Ms. Stoker-Mtume is with Shields for Families, Los Angeles
| | - Cathy Sherbourne
- Dr. Chung is with the Department of Psychiatry, Harbor-University of California, Los Angeles (UCLA), Medical Center, and he is also with RAND Health, RAND Corporation, Santa Monica, California, where Dr. Ngo, Dr. Wells, Dr. Sherbourne, and Dr. Miranda are also affiliated (e-mail: ). Dr. Wells and Dr. Miranda are also with the Center for Health Services and Society, Department of Psychiatry, UCLA, where Mrs. Pulido, Dr. Johnson, and Dr. Tang are also affiliated. Dr. Johnson is also with the U.S. Department of Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, where Dr. Ong is affiliated. Dr. Ong is also with the Department of Medicine, UCLA. Ms. Jones is with Healthy African American Families II, Los Angeles. Mr. Gilmore is with Behavioral Health Services, Inc. Ms. Stoker-Mtume is with Shields for Families, Los Angeles
| | - Jeanne Miranda
- Dr. Chung is with the Department of Psychiatry, Harbor-University of California, Los Angeles (UCLA), Medical Center, and he is also with RAND Health, RAND Corporation, Santa Monica, California, where Dr. Ngo, Dr. Wells, Dr. Sherbourne, and Dr. Miranda are also affiliated (e-mail: ). Dr. Wells and Dr. Miranda are also with the Center for Health Services and Society, Department of Psychiatry, UCLA, where Mrs. Pulido, Dr. Johnson, and Dr. Tang are also affiliated. Dr. Johnson is also with the U.S. Department of Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, where Dr. Ong is affiliated. Dr. Ong is also with the Department of Medicine, UCLA. Ms. Jones is with Healthy African American Families II, Los Angeles. Mr. Gilmore is with Behavioral Health Services, Inc. Ms. Stoker-Mtume is with Shields for Families, Los Angeles
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Garnett BR, Wendel J, Banks C, Goodridge A, Harding R, Harris R, Hacker K, Chomitz VR. Challenges of Data Dissemination Efforts Within a Community-Based Participatory Project About Persistent Racial Disparities in Excess Weight. Prog Community Health Partnersh 2015; 9:289-98. [PMID: 26412770 PMCID: PMC5665364 DOI: 10.1353/cpr.2015.0047] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Despite universal environmental and policy-focused initiatives that resulted in declines in obesity among children in Cambridge, Massachusetts, disparities persist among racial/ethnic groups. In response, a community coalition formed the Healthy Eating and Living Project (HELP), to investigate and disseminate findings regarding disparities in excess weight among Cambridge Black youth (ages 6-14), with the aim of facilitating reciprocal learning and community mobilization to ultimately increase community engagement and inform prevention efforts. OBJECTIVES This paper details the theoretical framework, methods, and results of disseminating HELP findings to various sectors of the Cambridge Black/African American (Black) community. METHODS First, using a community-based participatory research (CBPR) approach, the HELP coalition analyzed existing data and conducted qualitative studies with Cambridge Black families to better understand the sociocultural and familial determinants of excess weight. We then developed presentation and print materials and used different dissemination approaches. We solicited feedback to inform the dissemination process and mobilization of obesity prevention efforts. RESULTS We disseminated information through six community groups (parents, students, pastors, men's health group, community leaders, and a health coalition), email lists, and websites. Reciprocal learning among and between HELP and community members yielded data presentation challenges, as well as prevention effort ideas and barriers. CONCLUSION Dissemination of local health data should be considered both as a strategy to increase community engagement and as an intervention to promote collective efficacy and community change. Careful attention should be dedicated to the language used when communicating racial disparities in excess weight to various community groups.
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Chung B, Ong M, Ettner SL, Jones F, Gilmore J, McCreary M, Sherbourne C, Ngo V, Koegel P, Tang L, Dixon E, Miranda J, Belin TR, Wells KB. 12-month outcomes of community engagement versus technical assistance to implement depression collaborative care: a partnered, cluster, randomized, comparative effectiveness trial. Ann Intern Med 2014; 161:S23-34. [PMID: 25402400 PMCID: PMC4235578 DOI: 10.7326/m13-3011] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Depression collaborative care implementation using community engagement and planning (CEP) across programs improves 6-month client outcomes in minority communities, compared with technical assistance to individual programs (resources for services [RS]). However, 12-month outcomes are unknown. OBJECTIVE To compare effects of CEP and RS on mental health-related quality of life (MHRQL) and use of services among depressed clients at 12 months. DESIGN Matched health and community programs (n = 93) in 2 communities randomly assigned to receive CEP or RS. (ClinicalTrials.gov: NCT01699789). MEASUREMENTS Self-reported MHRQL and services use at baseline, 6 months, and 12 months. SETTING Los Angeles, California. PATIENTS 1018 adults with depressive symptoms (8-item Patient Health Questionnaire score ≥10), 88% of whom were an ethnic minority. INTERVENTION CEP and RS to implement depression collaborative care. MEASUREMENTS The primary outcome was poor MHRQL (12-item mental health composite score ≤40) at baseline, 6 months, and 12 months; the secondary outcome was use of services at 12 months. RESULTS At 6 months, the finding that CEP outperformed RS to reduce poor MHRQL was significant but sensitive to underlying statistical assumptions. At 12 months, some analyses suggested that CEP was advantageous to MHRQL, whereas others did not confirm a significant difference favoring CEP. The finding that CEP reduced behavioral health hospitalizations at 6 months was less evident at 12 months and was sensitive to underlying statistical assumptions. Other services use did not significantly differ between interventions at 12 months. LIMITATION Data are self-reported, and findings are sensitive to modeling assumptions. CONCLUSION In contrast to 6-month results, no consistent effects of CEP on reducing the likelihood of poor MHRQL and behavioral health hospitalizations were found at 12 months. Still, given the needs of underresourced communities, the favorable profile of CEP, and the lack of evidence-based alternatives, CEP remains a viable strategy for policymakers and communities to consider. PRIMARY FUNDING SOURCE National Institute of Mental Health, Robert Wood Johnson Foundation, California Community Foundation, National Library of Medicine, and National Institutes of Health/National Center for Advancing Translational Science for the UCLA Clinical and Translational Science Institute.
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Affiliation(s)
- Bowen Chung
- Department of Psychiatry, Harbor-UCLA Medical Center/Los Angeles Biomedical Research Institute, David Geffen School of Medicine at UCLA
- Center for Health Services and Society, Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Bio-behavioral Sciences, David Geffen School of Medicine at UCLA
- RAND Corporation, David Geffen School of Medicine at UCLA
| | - Michael Ong
- Division of General Internal Medicine and Health Services Research, Department of Internal Medicine, David Geffen School of Medicine at UCLA
- Greater Los Angeles VA Healthcare System. at UCLA
| | - Susan L. Ettner
- Division of General Internal Medicine and Health Services Research, Department of Internal Medicine, David Geffen School of Medicine at UCLA
- Department of Health Policy and Management, UCLA Fielding School of Public Health, at UCLA
| | | | | | - Michael McCreary
- Center for Health Services and Society, Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Bio-behavioral Sciences, David Geffen School of Medicine at UCLA
| | | | - Victoria Ngo
- RAND Corporation, David Geffen School of Medicine at UCLA
| | - Paul Koegel
- RAND Corporation, David Geffen School of Medicine at UCLA
| | - Lingqi Tang
- Center for Health Services and Society, Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Bio-behavioral Sciences, David Geffen School of Medicine at UCLA
| | | | - Jeanne Miranda
- Center for Health Services and Society, Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Bio-behavioral Sciences, David Geffen School of Medicine at UCLA
| | - Thomas R. Belin
- Center for Health Services and Society, Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Bio-behavioral Sciences, David Geffen School of Medicine at UCLA
- Department of Biostatistics, Fielding School of Public Health at UCLA
| | - Kenneth B. Wells
- Center for Health Services and Society, Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Bio-behavioral Sciences, David Geffen School of Medicine at UCLA
- RAND Corporation, David Geffen School of Medicine at UCLA
- Department of Health Policy and Management, UCLA Fielding School of Public Health, at UCLA
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Halbert CH, Bellamy S, Briggs V, Bowman M, Delmoor E, Kumanyika S, Rogers R, Purnell J, Weathers B, Johnson JC. Collective efficacy and obesity-related health behaviors in a community sample of African Americans. J Community Health 2014; 39:124-31. [PMID: 24026302 DOI: 10.1007/s10900-013-9748-z] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The social environment is important to body mass index and obesity. However, it is unknown if perceptions of the social environment are associated with obesity-related behaviors in populations at greatest risk for being overweight or obese. We evaluated the relationship between collective efficacy and diet and physical activity in a community-based sample of African American adults who were residents in an urban area. Data were collected as part of an academic-community partnership from November 2009 to 2011. We evaluated whether participants met the recommended guidelines for diet and physical activity based on collective efficacy and their sociodemographic background, health care variables, and self-efficacy in a community-based sample of African American adults (n = 338) who were residents in the Philadelphia, PA metropolitan area. Overall, many participants did not meet the recommended guidelines for fruit and vegetable intake or physical activity. The likelihood of meeting the recommended guidelines for fruit intake increased with greater levels of collective efficacy (OR 1.56, 95 % CI 1.18, 2.07, p = 0.002) and self-efficacy for diet (OR 1.56, 95 % CI 1.19, 2.04, p = 0.001). Collective efficacy was not associated with physical activity and the positive association between collective efficacy and vegetable intake was not statistically significant (OR 1.25, 95 % CI 0.94, 1.65, p = 0.12). It is important to determine the most effective methods and settings for improving diet and physical activity behaviors in urban African Americans. Enhancing collective efficacy may be important to improving adherence to recommended guidelines for obesity-related health behaviors.
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Affiliation(s)
- Chanita Hughes Halbert
- Department of Psychiatry and Behavioral Sciences, Hollings Cancer Center, Medical University of South Carolina, 68 President Street, Suite BE103, Charleston, SC, 29425, USA,
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22
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Using community-based participatory mixed methods research to understand preconception health in African American communities of Arizona. Matern Child Health J 2014; 17:1862-71. [PMID: 23229170 DOI: 10.1007/s10995-012-1206-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The article discusses Arizona's strategic implementation and evaluation of the first time motherhood initiative grant (FTMI) to understand preconception health among African American men and women in Arizona. Longitudinal focus groups assessed whether African American men and women in the targeted areas comprehended and recalled the messages related to preconception health. Matched pre and posttests assessed community members' knowledge of preconception as well as physicians' perceptions on preconception health and care. Focus-group data were transcribed and coded by independent coders to conduct content analyses. Inter-rater reliability and agreement among coders, bivariate and multivariate statistics were conducted for quantitative matched pre and posttests data using SAS v9.2 (SAS Institute, Cary, NC). The social marketing campaign had limited impact in recall and comprehension of the preconception health message among African American men and women. Data from focus groups revealed that African American men and women perceived preconception health to be vital. And results from the pretest and posttests of community-based presentations, further supported this finding. Evidence from Grand Round presentations indicated that practitioners and health care providers had diverging views on preconception health. Use of community-based participatory mixed methods research can facilitate better understanding of the efficacy of strategic interventions such as FTMI and can provide valuable information on preconception health. Cost limitations often prohibit extensive evaluation of social marketing campaigns, hence, evaluators and researchers should assess the feasibility of conducting an efficacy study versus an effectiveness study in evaluating social marketing campaigns.
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The relation between social cohesion and smoking cessation among Black smokers, and the potential role of psychosocial mediators. Ann Behav Med 2014; 45:249-57. [PMID: 23135831 DOI: 10.1007/s12160-012-9438-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND Social cohesion, the self-reported trust and connectedness between neighbors, may affect health behaviors via psychosocial mechanisms. PURPOSE Relations between individual perceptions of social cohesion and smoking cessation were examined among 397 Black treatment-seeking smokers. METHODS Continuation ratio logit models examined the relation of social cohesion and biochemically verified continuous smoking abstinence through 6 months post-quit. Indirect effects were examined in single mediator models using a nonparametric bootstrapping procedure. All analyses controlled for sociodemographics, tobacco dependence, and treatment. RESULTS The total effect of social cohesion on continuous abstinence was non-significant (β = 0.05, p = 0.10). However, social cohesion was associated with social support, positive affect, negative affect, and stress, which, in turn, were each associated with abstinence in adjusted models (ps < 0.05). CONCLUSIONS Results suggest that social cohesion may facilitate smoking cessation among Black smokers through desirable effects on psychosocial mechanisms that can result from living in a community with strong interpersonal connections.
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Edwards KM, Mattingly MJ, Dixon KJ, Banyard VL. Community matters: intimate partner violence among rural young adults. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2014; 53:198-207. [PMID: 24473923 DOI: 10.1007/s10464-014-9633-7] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Drawing on social disorganization theory, the current study examined the extent to which community-level poverty rates and collective efficacy influenced individual reports of intimate partner violence (IPV) perpetration, victimization, and bystander intervention among a sample of 178 young adults (18-24; 67.4% women) from 16 rural counties across the eastern US who completed an online survey that assessed demographic information, IPV perpetration, victimization, bystander intervention, and collective efficacy. We computed each county's poverty rate from the 2007-2011 American Community Survey. Generalized estimating equations demonstrated that after controlling for individual-level income status, community-level poverty positively predicted IPV victimization and perpetration for both men and women. Collective efficacy was inversely related to IPV victimization and perpetration for men; however, collective efficacy was unrelated to IPV victimization and perpetration for women. Whereas IPV bystander intervention was positively related to collective efficacy and inversely related to individual-level income status for both men and women, community-level poverty was unrelated to IPV bystander intervention for both men and women. Overall, these findings provide some support for social disorganization theory in explaining IPV among rural young adults, and underscore the importance of multi-level IPV prevention and intervention efforts focused around community-capacity building and enhancement of collective efficacy.
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Affiliation(s)
- Katie M Edwards
- Department of Psychology, University of New Hampshire, Durham, NH, 03824, USA,
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Mango J, Cabiling E, Jones L, Lucas-Wright A, Williams P, Wells K, Pulido E, Meldrum M, Ramos A, Chung B. Community Partners in Care (CPIC): Video Summary of Rationale, Study Approach / Implementation, and Client 6-month Outcomes. CES4HEALTH.INFO 2014; 2014:87LWR5H2. [PMID: 25364622 PMCID: PMC4212316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
"Community Partners in Care (CPIC): Video Summary of Rationale, Study Approach / Implementation, and Client 6-month Outcomes" is a 2 minute, 46 second video summarizing the study rationale, study approach, and the 6-month outcomes. The video was produced by four agencies: Healthy African American Families II, a health advocacy organization in South Los Angeles; Behavioral Health Services, the largest substance/alcohol abuse service provider in LA County; UCLA; and RAND Health; contract filmmakers Eileen Cabiling and Joe Mango handled cinematography, editing, and video support. The individuals appearing in the video are key CPIC community and academic partners. The celebratory tone of the video is consistent with a Community Partnered Participatory Research approach, a local variant of participatory action research, where study findings are celebrated by the partners, and dissemination efforts include approaches intended for general audiences, especially from low-income, low-literacy, minority communities, in addition to traditional academic products like peer-reviewed scientific manuscripts. The CPIC video offers a community perspective on the study results to our partners, the general public, other scientists and policy makers. We designed the video to teach community and healthcare partners how to adapt and implement the CPIC depression care model and to offer other community -academic partnerships an example of a non-traditional product developed for dissemination from an NIH-funded research study.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Ana Ramos
- David Geffen School of Medicine at UCLA
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Haldeman KM, Cadigan RJ, Davis A, Goldenberg A, Henderson GE, Lassiter D, Reavely E. Community engagement in US biobanking: multiplicity of meaning and method. Public Health Genomics 2014; 17:84-94. [PMID: 24556734 DOI: 10.1159/000357958] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Accepted: 11/28/2013] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND/AIMS Efforts to improve individual and population health increasingly rely on large-scale collections of human biological specimens and associated data. Such collections or 'biobanks' are hailed as valuable resources for facilitating translational biomedical research. However, biobanks also raise important ethical considerations, such as whether, how and why biobanks might engage with those who contributed specimens. This paper examines perceptions and practices of community engagement (CE) among individuals who operate 6 diverse biobanks in the US. METHODS Twenty-four people from a diverse group of 6 biobanks were interviewed in-person or via telephone from March to July 2011. Interview transcripts were coded and analyzed for common themes. RESULTS Emergent themes include how biobank personnel understand 'community' and CE as it pertains to biobank operations, information regarding the diversity of practices of CE, and the reasons why biobanks conduct CE. CONCLUSION Despite recommendations from federal agencies to conduct CE, the interpretation of CE varies widely among biobank employees, ultimately affecting how CE is practiced and what goals are achieved.
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Affiliation(s)
- K M Haldeman
- Department of Social Medicine, University of North Carolina, Chapel Hill, N.C., USA
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Chung B, Meldrum M, Jones F, Brown A, Jones L. Perceived sources of stress and resilience in men in an African American community. Prog Community Health Partnersh 2014; 8:441-51. [PMID: 25727976 PMCID: PMC4361032 DOI: 10.1353/cpr.2014.0053] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Little is known about the perceived causes of stress and what strategies African American men use to promote resiliency. Participatory research approaches are recommended as an approach to engage minority communities. A key goal of participatory research is to shift the locus of control to community partners. OBJECTIVE To understand perceived sources of stress and tools used to promote resiliency in African American men in South Los Angeles. METHODS Our study utilized a community-partnered participatory research approach to collect and analyze open-ended responses from 295 African American men recruited at a local, cultural festival in Los Angeles using thematic analysis and the Levels of Racism framework. RESULTS Almost all men (93.2%) reported stress. Of those reporting stress, 60.8% reported finances and money and 43.2% reported racism as a specific cause. More than 60% (63.4%) reported that they perceived available sources of help to deal with stress. Of those noting a specific source of help for stress (n = 76), 42.1% identified religious faith. Almost all of participants (92.1%) mentioned specific sources of resiliency such as religion and family. CONCLUSIONS Stress owing to psychosocial factors such as finances and racism are common among African American men. But, at the same time, most men found support for resiliency to ameliorate stress in religion and family. Future work to engage African American men around alleviating stress and supporting resiliency should both take into account the perceived causes of stress and incorporate culturally appropriate sources of resiliency support.
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Wells KB, Jones L, Chung B, Dixon EL, Tang L, Gilmore J, Sherbourne C, Ngo VK, Ong MK, Stockdale S, Ramos E, Belin TR, Miranda J. Community-partnered cluster-randomized comparative effectiveness trial of community engagement and planning or resources for services to address depression disparities. J Gen Intern Med 2013; 28:1268-78. [PMID: 23649787 PMCID: PMC3785665 DOI: 10.1007/s11606-013-2484-3] [Citation(s) in RCA: 135] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2012] [Revised: 02/27/2013] [Accepted: 04/22/2013] [Indexed: 11/07/2022]
Abstract
BACKGROUND Depression contributes to disability and there are ethnic/racial disparities in access and outcomes of care. Quality improvement (QI) programs for depression in primary care improve outcomes relative to usual care, but health, social and other community-based service sectors also support clients in under-resourced communities. Little is known about effects on client outcomes of strategies to implement depression QI across diverse sectors. OBJECTIVE To compare the effectiveness of Community Engagement and Planning (CEP) and Resources for Services (RS) to implement depression QI on clients' mental health-related quality of life (HRQL) and services use. DESIGN Matched programs from health, social and other service sectors were randomized to community engagement and planning (promoting inter-agency collaboration) or resources for services (individual program technical assistance plus outreach) to implement depression QI toolkits in Hollywood-Metro and South Los Angeles. PARTICIPANTS From 93 randomized programs, 4,440 clients were screened and of 1,322 depressed by the 8-item Patient Health Questionnaire (PHQ-8) and providing contact information, 1,246 enrolled and 1,018 in 90 programs completed baseline or 6-month follow-up. MEASURES Self-reported mental HRQL and probable depression (primary), physical activity, employment, homelessness risk factors (secondary) and services use. RESULTS CEP was more effective than RS at improving mental HRQL, increasing physical activity and reducing homelessness risk factors, rate of behavioral health hospitalization and medication visits among specialty care users (i.e. psychiatrists, mental health providers) while increasing depression visits among users of primary care/public health for depression and users of faith-based and park programs (each p < 0.05). Employment, use of antidepressants, and total contacts were not significantly affected (each p > 0.05). CONCLUSION Community engagement to build a collaborative approach to implementing depression QI across diverse programs was more effective than resources for services for individual programs in improving mental HRQL, physical activity and homelessness risk factors, and shifted utilization away from hospitalizations and specialty medication visits toward primary care and other sectors, offering an expanded health-home model to address multiple disparities for depressed safety-net clients.
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Miranda J, Ong MK, Jones L, Chung B, Dixon EL, Tang L, Gilmore J, Sherbourne C, Ngo VK, Stockdale S, Ramos E, Belin TR, Wells KB. Community-partnered evaluation of depression services for clients of community-based agencies in under-resourced communities in Los Angeles. J Gen Intern Med 2013; 28:1279-87. [PMID: 23670566 PMCID: PMC3785668 DOI: 10.1007/s11606-013-2480-7] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2012] [Revised: 02/27/2013] [Accepted: 04/18/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND As medical homes are developing under health reform, little is known regarding depression services need and use by diverse safety-net populations in under-resourced communities. For chronic conditions like depression, primary care services may face new opportunities to partner with diverse community service providers, such as those in social service and substance abuse centers, to support a collaborative care model of treating depression. OBJECTIVE To understand the distribution of need and current burden of services for depression in under-resourced, diverse communities in Los Angeles. DESIGN Baseline phase of a participatory trial to improve depression services with data from client screening and follow-up surveys. PARTICIPANTS Of 4,440 clients screened from 93 programs (primary care, mental health, substance abuse, homeless, social and other community services) in 50 agencies, 1,322 were depressed according to an eight-item Patient Health Questionnaire (PHQ-8) and gave contact information; 1,246 enrolled and 981 completed surveys. Ninety-three programs, including 17 primary care/public health, 18 mental health, 20 substance abuse, ten homeless services, and 28 social/other community services, participated. MAIN MEASURES Comparisons by setting in 6-month retrospective recall of depression services use. KEY RESULTS Depression prevalence ranged from 51.9 % in mental health to 17.2 % in social-community programs. Depressed clients used two settings on average to receive depression services; 82 % used any setting. More clients preferred counseling over medication for depression treatment. CONCLUSIONS Need for depression care was high, and a broad range of agencies provide depression care. Although most participants had contact with primary care, most depression services occurred outside of primary care settings, emphasizing the need to coordinate and support the quality of community-based services across diverse community settings.
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Affiliation(s)
- Jeanne Miranda
- Department of Psychiatry, David Geffen School of Medicine, UCLA, Los Angeles, USA,
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Wells KB, Springgate BF, Lizaola E, Jones F, Plough A. Community engagement in disaster preparedness and recovery: a tale of two cities--Los Angeles and New Orleans. Psychiatr Clin North Am 2013; 36:451-66. [PMID: 23954058 PMCID: PMC3780560 DOI: 10.1016/j.psc.2013.05.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Awareness of the impact of disasters globally on mental health is increasing. Known difficulties in preparing communities for disasters and a lack of focus on relationship building and organizational capacity in preparedness and response have led to a greater policy focus on community resiliency as a key public health approach to disaster response. In this article, the authors describe how an approach to community engagement for improving mental health services, disaster recovery, and preparedness from a community resiliency perspective emerged from their work in applying a partnered, participatory research framework, iteratively, in Los Angeles County and the City of New Orleans.
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Affiliation(s)
- Kenneth B Wells
- Center for Health Services and Society, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, 10920 Wilshire Boulevard, Suite 300, Los Angeles, CA 90024, USA.
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Wells KB, Tang J, Lizaola E, Jones F, Brown A, Stayton A, Williams M, Chandra A, Eisenman D, Fogleman S, Plough A. Applying community engagement to disaster planning: developing the vision and design for the Los Angeles County Community Disaster Resilience initiative. Am J Public Health 2013; 103:1172-80. [PMID: 23678916 DOI: 10.2105/ajph.2013.301407] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Community resilience (CR) is a priority for preparedness, but few models exist. A steering council used community-partnered participatory research to support workgroups in developing CR action plans and hosted forums for input to design a pilot demonstration of implementing CR versus enhanced individual preparedness toolkits. Qualitative data describe how stakeholders viewed CR, how toolkits were developed, and demonstration design evolution. Stakeholders viewed community engagement as facilitating partnerships to implement CR programs when appropriately supported by policy and CR resources. Community engagement exercises clarified motivations and informed action plans (e.g., including vulnerable populations). Community input identified barriers (e.g., trust in government) and CR-building strategies. A CR toolkit and demonstration comparing its implementation with individual preparedness were codeveloped. Community-partnered participatory research was a useful framework to plan a CR initiative through knowledge exchange.
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Affiliation(s)
- Kenneth B Wells
- Center for Health Services and Society, University of California, Los Angeles, CA, USA.
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Garcia CM, Aguilera-Guzman RM, Lindgren S, Gutierrez R, Raniolo B, Genis T, Vazquez-Benitez G, Clausen L. Intergenerational photovoice projects: optimizing this mechanism for influencing health promotion policies and strengthening relationships. Health Promot Pract 2012; 14:695-705. [PMID: 23132840 DOI: 10.1177/1524839912463575] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Intergenerational photovoice groups are promising for promoting health through the topic that is explored and through group dynamics that can foster healthy relationships and communication. To investigate the potential benefits of intergenerational photovoice projects, photovoice groups were conducted in urban Minnesota, United States, and in rural Morelos, Mexico, between 2009 and 2012 with Mexican-origin adults and their adolescent relatives. Seven photovoice groups of adult-adolescent dyads met for eight sessions and developed exhibits highlighting their views on health and migration and made policy recommendations, using messages conveyed through their words and photographs. Informal process evaluation and focus groups were used to elicit feedback about photovoice project participation. Photovoice project themes were descriptively analyzed. Focus group evaluation data were thematically summarized, and facilitator reflections were descriptively summarized to identify factors associated with intergenerational photovoice groups. Seventy-five participants were recruited. Photovoice themes represented effects of migration on health, family, and well-being. The following two evaluative themes were identified: (a) participant sentiments about the benefits of photovoice participation and (b) facilitator observations of intergenerational photovoice group benefits and challenges. Participants described opportunities to learn new things and barriers to healthy relationships that the project was eliminating by providing them with time to work together. Used in health promotion, photovoice is a valuable tool that contributes to understanding the complex underlying factors influencing behaviors and health.
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Chou KL. Perceived discrimination and depression among new migrants to Hong Kong: the moderating role of social support and neighborhood collective efficacy. J Affect Disord 2012; 138:63-70. [PMID: 22284018 DOI: 10.1016/j.jad.2011.12.029] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2011] [Revised: 12/17/2011] [Accepted: 12/17/2011] [Indexed: 10/14/2022]
Abstract
BACKGROUND Although it is well known that perceived discrimination is a risk factor contributing to depressive symptoms among immigrants, most previous studies (1) did not distinguish between discrimination based on immigrant status and race and (2) used cross-sectional data. AIMS To address these limitations, the present study examined whether perceived discrimination affects depressive symptomatology in a representative sample of newly arrived immigrants from Mainland China to Hong Kong using longitudinal data over a period of one year. METHODS A representative sample of 347 migrants aged 18 and older were interviewed face to face in 2007 and 2008. The 20-item Center for Epidemiology Studies of Depression (CES-D) scale was used to measure depressive symptoms and a series of sociodemographic questions (age, gender, marital status, education, and personal income), stress due to perceived discrimination, social support, and neighborhood collective efficacy were also included. RESULTS Perceived discrimination was significantly associated with depressive symptoms one year later, after adjusting for depressive symptoms at baseline assessment, sociodemographic characteristics, social support, and neighborhood collective efficacy. Moreover, both social support and neighborhood collective efficacy moderated the effect of perceived discrimination on depressive symptoms. CONCLUSIONS Perceived discrimination is a common experience for new Mainland immigrants to Hong Kong, and it predicts depressive symptoms. Therefore, interventions that reduce discrimination and strengthen social support and neighborhood collective efficacy should be designed and implemented to improve the mental health of new immigrants in Hong Kong.
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Affiliation(s)
- Kee-Lee Chou
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China.
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Abstract
Depression contributes substantially to the global burden of disease and disability. Population-level factors that shape depression may be efficient targets for intervention to decrease the depression burden. The authors aimed to identify the relation between neighborhood collective efficacy and major depression. Analyses were conducted on data from the New York Social Environment Study (n = 4,000), a representative study of residents of New York, New York, conducted in 2005. Neighborhood collective efficacy was measured as the average neighborhood response on a well-established scale. Major depression was assessed with the Patient Health Questionnaire. A marginal modeling approach was applied to present results on the additive scale relevant to public health and intervention. Analyses were adjusted for demographic and socioeconomic characteristics, recent life events that could contribute to both depression and change in residence, and individual perception of collective efficacy. Collective efficacy was related to major depression among older adults; marginal models estimated a 6.2% (95% confidence interval: 0.1, 17.5) lower prevalence of depression if all older adults (65 years and older) had lived in high versus low collective efficacy neighborhoods. Similar results were suggested among younger adults; however, the confidence interval crossed the null. These and other study findings suggest that community-randomized trials targeting collective efficacy merit consideration.
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Affiliation(s)
- Jennifer Ahern
- Division of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley, California 94720-7358, USA.
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Mendel P, Ngo VK, Dixon E, Stockdale S, Jones F, Chung B, Jones A, Masongsong Z, Khodyakov D. Partnered evaluation of a community engagement intervention: use of a kickoff conference in a randomized trial for depression care improvement in underserved communities. Ethn Dis 2011; 21:S1-88. [PMID: 22352084 PMCID: PMC3582700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
Community partnered research and engagement strategies are gaining recognition as innovative approaches to improving health care systems and reducing health disparities in underserved communities. These strategies may have particular relevance for mental health interventions in low income, minority communities in which there often is stigma and silence surrounding conditions such as depression and difficulty in implementing improved access and quality of care. At the same time, there is a relative dearth of evidence on the effectiveness of specific community engagement interventions and on the design, process, and context of these interventions necessary for understanding their implementation and generalizability. This article evaluates one of a number of community engagement strategies employed in the Community Partners in Care (CPIC) study, the first randomized controlled trial of the role of community engagement in adapting and implementing evidence-based depression care. We specifically describe the unique goals and features of a community engagement kickoff conference as used in CPIC and provide evidence on the effectiveness of this type of intervention by analyzing its impact on: 1) stimulating a dialog sense of collective efficacy, and opportunities for learning and networking to address depression and depression care in the community; 2) activating interest and participation in CPIC's randomized trial of two different ways to implement evidence-based quality improvement programs for depression across diverse community agencies; and 3) introducing evidence-based toolkits and collaborative care models to potential participants in both intervention conditions and other community members. We evaluated the effectiveness of the conference through a community-partnered process in which both community and academic project members were involved in study design, data collection and analysis. Data sources include participant conference evaluation forms (n = 187 over two conferences; response rate 59%) and qualitative observation field notes of each conference session. Mixed methods for the analysis consist of descriptive statistics of conference evaluation form ratings, as well as thematic analysis of evaluation form write-in comments and qualitative observation notes. Results indicate the effectiveness of this type of event for each of the three main goals, and provide insights into intervention implementation and use of similar community engagement strategies for other studies.
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Affiliation(s)
- Peter Mendel
- RAND Corporation; 1776 Main Street; Santa Monica, CA 90407-2138, USA.
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Alegría M, Wong Y, Mulvaney-Day N, Nillni A, Proctor E, Nickel M, Jones L, Green B, Koegel P, Wright A, Wells KB. Community-based partnered research: new directions in mental health services research. Ethn Dis 2011; 21:S1-8-16. [PMID: 22352075 PMCID: PMC3653438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
OBJECTIVE Community-based participatory research has the potential to improve implementation of best practices to reduce disparities but has seldom been applied in mental health services research. This article presents the content and lessons learned from a national conference designed to stimulate such an application. DESIGN Mental health program developers collaborated in hosting a two-day conference that included plenary and break-out sessions, sharing approaches to community-academic partnership development, and preliminary findings from partnered research studies. Sessions were audiotaped, transcribed and analyzed by teams of academic and community conference participants to identify themes about best practices, challenges faced in partnered research, and recommendations for development of the field. Themes were illustrated with selections from project descriptions at the conference. SETTING AND PARTICIPANTS Participants, representing 9 academic institutions and 12 community-based agencies from four US census regions, were academic and community partners from five research centers funded by the National Institute of Mental Health, and also included staff from federal and non-profit funding agencies. RESULTS Five themes emerged: 1) Partnership Building; 2) Implementing and Supporting Partnered Research; 3) Developing Creative Dissemination Strategies; 4) Evaluating Impact; and 5) Training. CONCLUSIONS Emerging knowledge of the factors in the partnership process can enhance uptake of new interventions in mental health services. Conference proceedings suggested that further development of this field may hold promise for improved approaches to address the mental health services quality chasm and service disparities.
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Affiliation(s)
- Margarita Alegría
- Center for Multicultural Mental Health Research, Harvard Medical School, 120 Beacon St., Fourth Floor, Somerville, MA 02116, USA.
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Lizaola E, Schraiber R, Braslow J, Kataoka S, Springgate BF, Wells KB, Jones L. The Partnered Research Center for Quality Care: developing infrastructure to support community-partnered participatory research in mental health. Ethn Dis 2011; 21:S1-58-70. [PMID: 22352082 PMCID: PMC3715309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
Evidence-based programs have been shown to improve functioning and mental health outcomes, especially for vulnerable populations. However, these populations face numerous barriers to accessing care including lack of resources and stigma surrounding mental health issues. In order to improve mental health outcomes and reduce health disparities, it is essential to identify methods for reaching such populations with unmet need. A promising strategy for reducing barriers and improving access to care is Community Partnered Participatory Research (CPPR). Given the power of this methodology to transform the impact of research in resource-poor communities, we developed an NIMH-funded Center, the Partnered Research Center for Quality Care, to support partnerships in developing, implementing, and evaluating mental health services research and programs. Guided by a CPPR framework, center investigators, both community and academic, collaborate in all phases of research with the goal of establishing trust, building capacity, increasing buy-in, and improving the sustainability of interventions and programs. We engage in two-way capacity-building, which affords the opportunity for practical problems to be raised and innovative solutions to be developed. This article discusses the development and design of the Partnered Research Center for Quality Care and provides examples of partnerships that have been formed and the work that has been conducted as a result.
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Affiliation(s)
- Elizabeth Lizaola
- Center for Health Services and Society, University of California, Los Angeles Semel Institute for Neuroscience and Human Behavior, USA.
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Chung B, Jones L, Dixon EL, Miranda J, Wells K. Using a community partnered participatory research approach to implement a randomized controlled trial: planning community partners in care. J Health Care Poor Underserved 2010; 21:780-95. [PMID: 20693725 DOI: 10.1353/hpu.0.0345] [Citation(s) in RCA: 83] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
SUMMARY Quality improvement (QI) for depression in primary care can reduce disparities in outcomes. We describe how community-partnered participatory research was used to design Community Partners in Care, a randomized trial of community engagement to activate a multiple-agency network versus support for individual agencies to implement depression QI in underserved communities.
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Affiliation(s)
- Bowen Chung
- RAND Corporation, Santa Monica, CA 90509, USA.
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Gray N, Oré de Boehm C, Farnsworth A, Wolf D. Integration of creative expression into community-based participatory research and health promotion with Native Americans. FAMILY & COMMUNITY HEALTH 2010; 33:186-192. [PMID: 20531099 PMCID: PMC2902194 DOI: 10.1097/fch.0b013e3181e4bbc6] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Involvement in creative expression has the potential of engaging individuals in personal- and community-level change through reflection, empowerment, and the facilitation of connectedness. It is a process that can be a powerful component of community-based participatory research, as it can facilitate and support the principles of co-learning, egalitarian relationships, and respect for nonacademic knowledge. It is also a valuable means of appreciating culture and strengthening identity, which enhances health. This article reviews and discusses methods and benefits of incorporating creative expression into health promotion programs and community-based participatory research with Native Americans.
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Affiliation(s)
- Norma Gray
- University of Arizona Mel & Enid Zuckerman College of Public Health; Tucson, AZ
| | | | - Angela Farnsworth
- University of Arizona Mel & Enid Zuckerman College of Public Health; Tucson, AZ
| | - Denise Wolf
- North Public Health Center, King County Department of Public Health; Seattle, WA
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Katon W, Unützer J, Wells K, Jones L. Collaborative depression care: history, evolution and ways to enhance dissemination and sustainability. Gen Hosp Psychiatry 2010; 32:456-64. [PMID: 20851265 PMCID: PMC3810032 DOI: 10.1016/j.genhosppsych.2010.04.001] [Citation(s) in RCA: 154] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2010] [Revised: 04/05/2010] [Accepted: 04/06/2010] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To describe the history and evolution of the collaborative depression care model and new research aimed at enhancing dissemination. METHOD Four keynote speakers from the 2009 NIMH Annual Mental Health Services Meeting collaborated in this article in order to describe the history and evolution of collaborative depression care, adaptation of collaborative care to new populations and medical settings, and optimal ways to enhance dissemination of this model. RESULTS Extensive evidence across 37 randomized trials has shown the effectiveness of collaborative care vs. usual primary care in enhancing quality of depression care and in improving depressive outcomes for up to 2 to 5 years. Collaborative care is currently being disseminated in large health care organizations such as the Veterans Administration and Kaiser Permanente, as well as in fee-for-services systems and federally funded clinic systems of care in multiple states. New adaptations of collaborative care are being tested in pediatric and ob-gyn populations as well as in populations of patients with multiple comorbid medical illnesses. New NIMH-funded research is also testing community-based participatory research approaches to collaborative care to attempt to decrease disparities of care in underserved minority populations. CONCLUSION Collaborative depression care has extensive research supporting the effectiveness of this model. New research and demonstration projects have focused on adapting this model to new populations and medical settings and on studying ways to optimally disseminate this approach to care, including developing financial models to incentivize dissemination and partnerships with community populations to enhance sustainability and to decrease disparities in quality of mental health care.
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Affiliation(s)
- Wayne Katon
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA 98195, USA.
| | - Jürgen Unützer
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA 98195, USA
| | - Kenneth Wells
- Department of Psychiatry and Biobehavioral Sciences, UCLA Medical School, Los Angeles, CA 90095, USA
| | - Loretta Jones
- Charles R. Drew University of Medicine and Science, Los Angeles, CA 98059, USA
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Chung B, Jones L, Terry C, Jones A, Forge N, Norris KC. Story of Stone Soup: a recipe to improve health disparities. Ethn Dis 2010; 20:S2-9-14. [PMID: 20629241 PMCID: PMC3709872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
Abstract
Just as scientific articles are used as a way of sharing knowledge in scientific communities, stories are used as a way of transferring knowledge within African American communities. This article uses the story and metaphor of Stone Soup to illustrate the Healthy African American Families' (HAAF) Community Partnered Participatory Research (CPPR) method of engaging diverse partners to address health issues, such as preterm birth, depression, diabetes, and kidney disease, and to create community-wide change through education, capacity building, resource sharing, and intervention development.
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Affiliation(s)
- Bowen Chung
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California at Los Angeles, USA.
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Affiliation(s)
- Kenneth Wells
- Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Health Services Research Center, 10920 Wilshire Blvd, Ste 300, Los Angeles, CA 90024-6523, USA.
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Jones L, Wells K, Meade B. Celebrate victory. Ethn Dis 2009; 19:S6-71. [PMID: 20088082 PMCID: PMC4852691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
The promise of a community-partnered participatory research (CPPR) initiative to build capacity and reinforce assets is realized through a fully implemented Victory stage. This article reviews the process to plan for victory by including its goals in the main action plans and reviews several key activities that comprise the main accomplishments, which might include products for the community and scientific articles and presentations that are co-authored and co-presented; as well as partnered conferences and reflection retreats on major accomplishments and transitions. Because dealing with conflict is an important part of the work of projects in general and of developing victories, this article also reviews strategies to turn conflicts into celebrations of growth that can set the stage for the next phase of partnership development as well as for further partnered research.
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Affiliation(s)
- Loretta Jones
- Healthy African American Families II (HAAF), Los Angeles, CA 90008, USA.
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Khodyakov D, Mendel P, Dixon E, Jones A, Masongsong Z, Wells K. Community Partners in Care: Leveraging Community Diversity to Improve Depression Care for Underserved Populations. THE INTERNATIONAL JOURNAL OF DIVERSITY IN ORGANISATIONS, COMMUNITIES AND NATIONS 2009; 9:167-182. [PMID: 21528111 PMCID: PMC3082465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Research suggests that the quality and outcomes of depression treatment for adults can be substantially improved through "collaborative care" programs. However, there is a lack of resources required to implement such programs in vulnerable communities. Our paper examines the planning phase of the Community Partners in Care (CPIC) initiative, which addresses this problem through a unique approach in which academic institutions partner directly with a wide range of community-based and service organizations in all phases of the project fielded in two underserved communities in Los Angeles. CPIC offers a unique opportunity to understand how diverse organizations can work together to address community depression care needs and to analyze the potential strengths and tradeoffs of coordinating among such varied entities. This article focuses on intra-group dynamics that surround the process of participatory research and reports results of the first wave of process evaluation of the planning phase of the CPIC initiative. Our analysis explores two main themes: Community-Partnered Participatory Research and benefits and challenges of collaboration in diverse groups.
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Jones L, Meade B, Norris K, Lucas-Wright A, Jones F, Moini M, Jones A, Koegel P. Develop a vision. Ethn Dis 2009; 19:S6-30. [PMID: 20088078 PMCID: PMC4841670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
The Vision stage is the development of the agreed-upon framework for the study, including identifying the issue, the community, the stakeholders, and major aspects of the approach. Achieving the Vision requires planning through a Framing Committee, agreeing on a vision by sharing perspectives and identifying commonalities or "win-wins" that hold the partnership together for community benefit, and evaluating the emergence of the Vision and the partnership. Here, we review tools and strategies.
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Affiliation(s)
- Loretta Jones
- Healthy African American Families II (HAAF), Los Angeles, CA 90008, USA.
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