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Rosen MS, Rogers AE, J Von Seggern M, Grimm BL, Ramos AK, Schenkelberg MA, Idoate RE, Dzewaltowski DA. Investigate-Design-Practice-Reflect: An Iterative Community-Engaged Action Process to Improve Population Health. J Community Health 2024; 49:1106-1117. [PMID: 39110360 DOI: 10.1007/s10900-024-01385-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2024] [Indexed: 09/20/2024]
Abstract
BACKGROUND Community-based coalitions are a common strategy for community engagement efforts targeting the improvement of a variety of population health outcomes. The typical processes that coalitions follow to organize efforts include steps that are sequential, slow, and time intensive. These processes also limit local decision-making to the selection of evidence-based policies or programs. METHODS We present a process control theory-based Community Action Process, Investigate-Design-Practice-Reflect (IDPR), where community hubs (i.e., coalitions) organize agile efforts in a non-sequential, rapid, and efficient manner to harness local assets and data to make decisions regarding the provision and production of population health services. Using qualitative methods, we illustrate and analyze the use of IDPR in a one community case study as part of Wellscapes, a Type 3-hybrid implementation-effectiveness community randomized controlled trial to improve children's population health physical activity. RESULTS We found community members followed the IDPR Community Action Process to rapidly design, organize, deliver, and receive feedback on a community-based, children's population physical activity prototype, an afterschool Play-in-the-Park opportunity for all children. DISCUSSION Following IDPR afforded the community coalition timely learning through feedback within a process that coordinated decisions regarding what community services met community needs (provision decisions) and how to organize the production of the population health services (production decisions).
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Affiliation(s)
- Marisa S Rosen
- College of Public Health, Department of Health Promotion, University of Nebraska Medical Center, Omaha, NE, USA.
| | - Ann E Rogers
- College of Public Health, Department of Health Promotion, University of Nebraska Medical Center, Omaha, NE, USA
| | - Mary J Von Seggern
- College of Public Health, Department of Health Promotion, University of Nebraska Medical Center, Omaha, NE, USA
| | - Brandon L Grimm
- College of Public Health, Department of Health Promotion, University of Nebraska Medical Center, Omaha, NE, USA
| | - Athena K Ramos
- College of Public Health, Department of Health Promotion, University of Nebraska Medical Center, Omaha, NE, USA
| | - Michaela A Schenkelberg
- College of Education, Health, and Human Sciences, School of Health and Kinesiology, University of Nebraska at Omaha, Omaha, NE, USA
| | - Regina E Idoate
- College of Public Health, Department of Health Promotion, University of Nebraska Medical Center, Omaha, NE, USA
| | - David A Dzewaltowski
- College of Public Health, Department of Health Promotion, University of Nebraska Medical Center, Omaha, NE, USA
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Bogic M, Hebert LE, Evanson A, Wright B, Fruhbauerova M, Petras A, Jansen K, Shaw J, Bradshaw S, O'Leary M, Zacher T, Smoker K, Comtois KA, Nelson L. Connected for life: How social connectedness can help prevent suicide in American Indian and Alaska Native communities. Arch Psychiatr Nurs 2024; 51:259-267. [PMID: 39034087 PMCID: PMC11376686 DOI: 10.1016/j.apnu.2024.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 06/09/2024] [Indexed: 07/23/2024]
Abstract
Enhancing social support and connectedness can reduce suicide risk, yet few studies have examined this effect in American Indian and Alaska Native (AI/AN) adults. We assessed suicidal ideation and behavior, thwarted belongingness, social support, enculturation, historical trauma, and traumatic life events in 709 AI/AN adults at high risk of suicide from five AI/AN communities. Suicidal ideation was associated with thwarted belongingness and protected against by social support and engaging in AI/AN ceremonies. Among those who made lifetime suicide attempts, traumatic life events, symptoms of depression/anxiety due to historical trauma, and thwarted belongingness were linked to more attempts. More engagement in cultural practices was associated with fewer suicide attempts. Higher levels of social support were associated with more suicide attempts, an observation potentially attributable to the cross-sectional nature of the study. Interventions should focus on protective factors and context-specific interventions emphasizing community history, values, and strengths.
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Affiliation(s)
- Marija Bogic
- Washington State University Health Sciences Spokane, 412 E. Spokane Falls Blvd., Spokane, WA 99202, United States of America.
| | - Luciana E Hebert
- Washington State University Health Sciences Spokane, 412 E. Spokane Falls Blvd., Spokane, WA 99202, United States of America.
| | - Anna Evanson
- University of Washington, Box 359911, Harborview Medical Center, Seattle, WA 98195, United States of America.
| | - Barbara Wright
- University of Washington, Box 359911, Harborview Medical Center, Seattle, WA 98195, United States of America.
| | - Martina Fruhbauerova
- University of Washington, Box 359911, Harborview Medical Center, Seattle, WA 98195, United States of America.
| | - Anthippy Petras
- Washington State University Health Sciences Spokane, 412 E. Spokane Falls Blvd., Spokane, WA 99202, United States of America.
| | - Kelley Jansen
- Southcentral Foundation, 4085 Tudor Centre Drive, Anchorage, AK 99577, United States of America.
| | - Jennifer Shaw
- Southcentral Foundation, 4085 Tudor Centre Drive, Anchorage, AK 99577, United States of America.
| | - Sam Bradshaw
- Cherokee Nation Behavioral Health Prevention, 1510 East Shawnee Circle, Tahlequah, OK 74464, United States of America.
| | - Marcia O'Leary
- Missouri Breaks Industries Research Inc., US Highway 18, P.O. Box 5003, Pine Ridge, SD 57770, United States of America.
| | - Tracy Zacher
- Missouri Breaks Industries Research Inc., US Highway 18, P.O. Box 5003, Pine Ridge, SD 57770, United States of America.
| | - Kenny Smoker
- Fort Peck Tribes HPDP, 417 13th Ave East, Poplar, MT 59255, United States of America
| | - Katherine Anne Comtois
- University of Washington, Box 359911, Harborview Medical Center, Seattle, WA 98195, United States of America.
| | - Lonnie Nelson
- Washington State University Health Sciences Spokane, 412 E. Spokane Falls Blvd., Spokane, WA 99202, United States of America.
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Packard-Winkler M, Golding L, Tewodros T, Faerber E, Webb Girard A. Core Principles and Practices for the Design, Implementation, and Evaluation of Social and Behavior Change for Nutrition in Low- and Middle-Income Contexts with Special Applications for Nutrition-Sensitive Agriculture. Curr Dev Nutr 2024; 8:104414. [PMID: 39224137 PMCID: PMC11367532 DOI: 10.1016/j.cdnut.2024.104414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 07/05/2024] [Accepted: 07/09/2024] [Indexed: 09/04/2024] Open
Abstract
Background There is currently no cogent set of standards to guide the design, implementation and evaluation of nutrition social and behavior change (SBC), including for nutrition-sensitive agriculture (NSA). Objectives We aimed to capture, consolidate, and describe SBC core principles and practices (CPPs), reflecting professional consensus, and to offer programmatic examples that illustrate their application for NSA projects in low- and middle-income countries. Methods We conducted a narrative review following a 4-step iterative process to identify and describe SBC CPPs. We first reviewed general SBC frameworks and technical documents and developed a preliminary list of CPPs and their definitions. Following review and feedback from 8 content experts, we revised the CPPs, incorporating the panel's feedback, and conducted a more specific search of the peer-reviewed and gray literature. We presented a revised draft of the CPPs to 26 NSA researchers, practitioners, and implementers at the 2022 Agriculture, Nutrition and Health Academy annual conference. We then conducted a focused review of each CPP, and 3 content experts rereviewed the final draft. Results We reviewed ∼475 documents and resources resulting in a set of 4 core principles: 1) following a systematic, strategic method in designing, implementing, and evaluating SBC activities; 2) ensuring design and implementation are evidence-based; 3) grounding design and implementation in theory; and 4) authentically engaging communities. Additionally, we identified 11 core practices and mapped these to the different stages in the SBC design, implementation, and evaluation cycle. Detailed descriptions, illustrative examples and resources for implementation are provided for each CPP. Conclusions An explicit set of CPPs for SBC can serve as a guide for design, research, implementation, and evaluation of nutrition and NSA programs; help standardize knowledge sharing and production; and contribute to improved quality of implementation. Broader consultation with SBC practitioners and researchers will further consensus on this work.
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Affiliation(s)
| | - Lenette Golding
- Save the Children U.S., Department of Global Health, Washington, DC, United States
| | - Tsedenia Tewodros
- Hubert Department of Global Health, Rollins School of Public Health at Emory University, Atlanta, GA, United States
| | - Emily Faerber
- Dietetics and Nutrition Department, College of Health, University of Alaska Anchorage, Anchorage, AK, United States
| | - Amy Webb Girard
- Hubert Department of Global Health, Rollins School of Public Health at Emory University, Atlanta, GA, United States
- Nutrition and Health Sciences Program, Laney Graduate School, Emory University, Atlanta, GA, United States
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Rink E, Stotz SA, Johnson-Jennings M, Huyser K, Collins K, Manson SM, Berkowitz SA, Hebert L, Byker Shanks C, Begay K, Hicks T, Dennison M, Jiang L, Firemoon P, Johnson O, Anastario M, Ricker A, GrowingThunder R, Baldwin J. "We don't separate out these things. Everything is related": Partnerships with Indigenous Communities to Design, Implement, and Evaluate Multilevel Interventions to Reduce Health Disparities. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2024; 25:474-485. [PMID: 38598040 PMCID: PMC11239303 DOI: 10.1007/s11121-024-01668-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2024] [Indexed: 04/11/2024]
Abstract
Multilevel interventions (MLIs) are appropriate to reduce health disparities among Indigenous peoples because of their ability to address these communities' diverse histories, dynamics, cultures, politics, and environments. Intervention science has highlighted the importance of context-sensitive MLIs in Indigenous communities that can prioritize Indigenous and local knowledge systems and emphasize the collective versus the individual. This paradigm shift away from individual-level focus interventions to community-level focus interventions underscores the need for community engagement and diverse partnerships in MLI design, implementation, and evaluation. In this paper, we discuss three case studies addressing how Indigenous partners collaborated with researchers in each stage of the design, implementation, and evaluation of MLIs to reduce health disparities impacting their communities. We highlight the following: (1) collaborations with multiple, diverse tribal partners to carry out MLIs which require iterative, consistent conversations over time; (2) inclusion of qualitative and Indigenous research methods in MLIs as a way to honor Indigenous and local knowledge systems as well as a way to understand a health disparity phenomenon in a community; and (3) relationship building, maintenance, and mutual respect among MLI partners to reconcile past research abuses, prevent extractive research practices, decolonize research processes, and generate co-created knowledge between Indigenous and academic communities.
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Affiliation(s)
- Elizabeth Rink
- Department of Health and Human Development, Montana State University, 312 Herrick Hall, Bozeman, MT, 59715, USA.
| | - Sarah A Stotz
- Department of Food Science and Human Nutrition, Colorado State University, 502 West Lake Street, Fort Collins, CO, 80526, USA
| | - Michelle Johnson-Jennings
- Division of Indigenous Environmental Health and Land-Based Healing, Indigenous Wellness Research Institute, University of Washington, Gergerding Hall GBO, Box 351202, Seattle, WA, USA
| | - Kimberly Huyser
- Department of Sociology, Research, and Development/CIEDAR Center, COVID-19 Indigenous Engagement, University of British Columbia, 310-6251 Cecil Green Park Road, Vancouver, BC, V6T 1Z1, Canada
| | - Katie Collins
- CIEDAR co-Lead. Department of Psychology, University of Saskatchewan, 9 Campus Drive, 154 Arts, Saskatoon, SK, S7N 5A5, Canada
| | - Spero M Manson
- Colorado School of Public Health, Centers for American Indian and Alaska Native Health, University of Colorado Anschutz Medical Campus, 13055 East 17th Avenue, Aurora, CO, 80045, USA
| | - Seth A Berkowitz
- Division of General Medicine and Clinical Epidemiology, Department of Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC; Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, 725 M.L.K. Jr Blvd, Chapel Hill, NC, 27516, USA
| | - Luciana Hebert
- Institute for Research and Education to Advance Community Health (IREACH), Elson S. Floyd College of Medicine, Washington State University, 1100 Olive Way #1200, Seattle, WA, 98101, USA
| | - Carmen Byker Shanks
- Gretchen Swanson Center for Nutrition, 14301 FNB Pkwy #100, Omaha, NE, 68154, USA
| | - Kelli Begay
- Maven Collective Consulting, LLC, 15712 N Pennsylvania Avenue Cube 5, Edmond, OK, 73013, USA
| | - Teresa Hicks
- Teresa Hicks Consulting, 1107 East Babcock Street, Bozeman, MT, 59715, USA
| | - Michelle Dennison
- Oklahoma City Indian Clinic, 4913 W Reno Ave, 856 Health Sciences Quad, Suite 3400, Oklahoma City, OK, 73127, USA
| | - Luohua Jiang
- Department of Epidemiology and Biostatistics; UCI Health Sciences Complex, University of California Irvine, Program in Public Health, 856 Health Sciences Quad, Suite 3400, Irvine, CA, 92617, USA
| | - Paula Firemoon
- Fort Peck Community College, 605 Indian Ave.,, Poplar, MT, 59255, USA
| | - Olivia Johnson
- Fort Peck Community College, 605 Indian Ave.,, Poplar, MT, 59255, USA
| | - Mike Anastario
- Center for Health Equity Research, Northern Arizona University, P.O. Box 4065, Suite 120, Flagstaff, AZ, 86011-4065, USA
| | - Adriann Ricker
- Fort Peck Tribal Health Department, 501 Medicine Bear Road, Poplar, MT, 59255, USA
| | - Ramey GrowingThunder
- Fort Peck Tribes Language and Culture Department, 603 Court Ave., Poplar, MT, 59255, USA
| | - Julie Baldwin
- Center for Health Equity Research, Northern Arizona University, P.O. Box 4065, Suite 120, Flagstaff, AZ, 86011-4065, USA
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Grant AK, Felner JK, Castañeda Y, Pratap P, Hebert-Beirne J. Leveraging Key Informant Interviews to Inform Intervention Development: The Greater Lawndale Healthy Work Project. COMMUNITY HEALTH EQUITY RESEARCH & POLICY 2024; 44:429-438. [PMID: 37607529 DOI: 10.1177/2752535x231196395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/24/2023]
Abstract
BACKGROUND The Greater Lawndale Healthy Work project is a sequential mixed methods community based participatory research project that examines work as a structural determinant of health and builds community capacity for healthy work in a predominantly Black and Latinx community in Chicago known as Greater Lawndale (GL). OBJECTIVES We interviewed community leaders in GL as key informants to understand the barriers to healthy work and inform intervention development. METHODS We conducted a directed content analysis of transcripts from 20 key informants and coded the social ecology and type of intervention. RESULTS Every key informant mentioned at least one asset in GL, showing an opportunity to employ a capacity-oriented approach to intervention development. Key informants suggested a variety of interventions to address precarious work across levels of the social ecology, with individual and community level interventions being the most salient. CONCLUSION Through this approach, we were able to navigate tensions and challenges in conducting research for community-wide change. Key informant stakeholder interviews can be leveraged to meaningfully inform intervention development and support the development of multi-level, sustainable, and culturally acceptable interventions that advance health equity.
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Affiliation(s)
| | - Jennifer K Felner
- Institute for Behavioral and Community Health, San Diego State University School of Public Health
| | - Yvette Castañeda
- Environmental and Occupational Health Sciences, University of Illinois Chicago School of Public Health, Chicago, IL, USA
| | - Preethi Pratap
- Environmental and Occupational Health Sciences, University of Illinois Chicago School of Public Health, Chicago, IL, USA
| | - Jeni Hebert-Beirne
- Community Health Sciences, University of Illinois Chicago School of Public Health, Chicago, IL, USA
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Jaramillo ET. Place-based strengths and vulnerabilities for mental wellness among rural minority older adults: an intervention development study protocol. BMJ Open 2024; 14:e088348. [PMID: 38844399 PMCID: PMC11163646 DOI: 10.1136/bmjopen-2024-088348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Accepted: 05/24/2024] [Indexed: 06/12/2024] Open
Abstract
INTRODUCTION Severe inequities in depression and its diagnosis and treatment among rural-dwelling, racial-minority and ethnic-minority older adults compared with their urban white counterparts result in cognitive impairment, comorbidities and increased mortality, presenting a growing public health concern as the United States (US) population ages. These inequities are often attributable to social and environmental factors, including economic insecurity, histories of trauma, gaps in transportation and safety-net services, and disparities in access to policy-making processes rooted in colonialism. This constellation of factors renders racial-minority and ethnic-minority older adults 'structurally vulnerable' to mental ill health. Fewer data exist on protective factors associated with social and environmental contexts, such as social support, community attachment and a meaningful sense of place. Scholarship on the social determinants of health widely recognises the importance of such place-based factors. However, little research has examined how they shape disparities in depression and treatment specifically, limiting the development of practical approaches addressing these factors and their effects on mental well-being for rural minority populations. METHODS AND ANALYSIS This community-driven mixed-method study uses quantitative surveys, qualitative interviews and ecological network research with 125 rural American Indian and Latinx older adults in New Mexico and 28 professional and non-professional social supporters to elucidate how place-based vulnerabilities and protective factors shape experiences of depression among older adults. Data will serve as the foundation of a community-driven plan for a multisystem intervention focused on the place-based causes of disparities in depression. Intervention Mapping will guide the intervention development process. ETHICS AND DISSEMINATION This study has been reviewed and approved by the University of New Mexico Health Sciences Center Institutional Review Board. All participants will provide informed consent. Study results will be disseminated within the community of study through community meetings and presentations, as well as broadly via peer-reviewed journals, conference presentations and social media.
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Affiliation(s)
- Elise Trott Jaramillo
- College of Population Health, University of New Mexico, Albuquerque, New Mexico, USA
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Iuliano A, Burgess RA, Shittu F, King C, Bakare AA, Valentine P, Haruna I, Colbourn T. Linking communities and health facilities to improve child health in low-resource settings: a systematic review. Health Policy Plan 2024; 39:613-635. [PMID: 38619140 PMCID: PMC11145907 DOI: 10.1093/heapol/czae028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 02/22/2024] [Accepted: 04/12/2024] [Indexed: 04/16/2024] Open
Abstract
Community-facility linkage interventions are gaining popularity as a way to improve community health in low-income settings. Their aim is to create/strengthen a relationship between community members and local healthcare providers. Representatives from both groups can address health issues together, overcome trust problems, potentially leading to participants' empowerment to be responsible for their own health. This can be achieved via different approaches. We conducted a systematic literature review to explore how this type of intervention has been implemented in rural and low or lower-middle-income countries, its various features and how/if it has helped to improve child health in these settings. Publications from three electronic databases (Web of Science, PubMed and Embase) up to 03 February 2022 were screened, with 14 papers meeting the inclusion criteria (rural setting in low/lower-middle-income countries, presence of a community-facility linkage component, outcomes of interest related to under-5 children's health, peer-reviewed articles containing original data written in English). We used Rosato's integrated conceptual framework for community participation to assess the transformative and community-empowering capacities of the interventions, and realist principles to synthesize the outcomes. The results of this analysis highlight which conditions can lead to the success of this type of intervention: active inclusion of hard-to-reach groups, involvement of community members in implementation's decisions, activities tailored to the actual needs of interventions' contexts and usage of mixed methods for a comprehensive evaluation. These lessons informed the design of a community-facility linkage intervention and offer a framework to inform the development of monitoring and evaluation plans for future implementations.
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Affiliation(s)
- Agnese Iuliano
- Institute for Global Health, University College London, 30 Guilford Street, London WC1N 1EH, United Kingdom
| | - Rochelle Ann Burgess
- Institute for Global Health, University College London, 30 Guilford Street, London WC1N 1EH, United Kingdom
| | - Funmilayo Shittu
- Department of Paediatrics, University of Ibadan, CW23+FJV University College Hospital, Queen Elizabeth I I Road, Agodi, Ibadan, Oyo 00285, Nigeria
- Department of Global Public Health, Karolinska Institutet, Norrbackagatan 4, Stockholm 171 76, Sweden
| | - Carina King
- Institute for Global Health, University College London, 30 Guilford Street, London WC1N 1EH, United Kingdom
- Department of Global Public Health, Karolinska Institutet, Norrbackagatan 4, Stockholm 171 76, Sweden
| | - Ayobami Adebayo Bakare
- Department of Global Public Health, Karolinska Institutet, Norrbackagatan 4, Stockholm 171 76, Sweden
- Department of Community Medicine, University of Ibadan, CW22+H4W, Queen Elizabeth I I Road, Agodi, Ibadan, Oyo 200285, Nigeria
| | - Paula Valentine
- Save the Children, 1 St John’s Ln, London EC1M 4AR, United Kingdom
| | - Ibrahim Haruna
- Save the Children International, Plot 773 Cadastral Zone B03, Wuye District, Ankuru 902101, Nigeria
| | - Tim Colbourn
- Institute for Global Health, University College London, 30 Guilford Street, London WC1N 1EH, United Kingdom
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Pope KJ, Lightfoot AF, Harrison LM, Getz D, Gittelsohn J, Ward D, Hannon TS, Erinosho T. Listening to the community: identifying obesity prevention strategies for rural preschool-aged children. Front Public Health 2024; 12:1372890. [PMID: 38883193 PMCID: PMC11177876 DOI: 10.3389/fpubh.2024.1372890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 05/13/2024] [Indexed: 06/18/2024] Open
Abstract
Multi-level interventions promoting healthy weight in rural preschool children aged 2-5 years are limited. With the goal of developing a community-informed obesity prevention intervention for rural preschool-aged children, the purpose of this descriptive study was to identify: (1) community settings and intervention strategies to prioritize for an intervention; (2) potential implementation challenges and solutions; and (3) immediate interventions the study team and community partners could collaboratively implement. Workshops occurred in two rural communities in Indiana (2 workshops) and North Carolina (2 workshops), with high obesity rates. A guide was developed to moderate discussions and participants voted to rank community settings and intervention strategies. There were 9-15 participants per workshop, including parents, childcare providers, and representatives of community organizations. Community settings identified as priorities for child obesity prevention included the home, educational settings (preschools), food outlets, recreational facilities, and social media. Priority intervention strategies included providing nutrition and physical activity education, increasing access to healthy foods and physical activity in the built environment, and enhancing food security. Potential intervention implementation challenges centered on poor parental engagement; using personalized invitations and providing transportation support to families were proffered solutions. Immediate interventions to collaboratively implement focused on making playgrounds esthetically pleasing for physical activity using game stencils, and nutrition education for families via quarterly newsletters. This participatory approach with community partners provided insight into two rural communities' needs for child obesity prevention, community assets (settings) to leverage, and potential intervention strategies to prioritize. Findings will guide the development of a multi-level community-based intervention.
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Affiliation(s)
- Katherine Jochim Pope
- Department of Applied Health Science, Indiana University Bloomington, Bloomington, IN, United States
| | - Alexandra F Lightfoot
- Department of Health Behavior, North Carolina Translational and Clinical Sciences Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | | | - Deborah Getz
- Department of Applied Health Science, Indiana University Bloomington, Bloomington, IN, United States
| | - Joel Gittelsohn
- Department of International Health, Johns Hopkins University, Baltimore, MD, United States
| | - Dianne Ward
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Tamara S Hannon
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Temitope Erinosho
- Department of Applied Health Science, Indiana University Bloomington, Bloomington, IN, United States
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Goodkind JR, Van Horn ML, Hess JM, Lardier D, Vasquez Guzman CE, Ramirez J, Echeverri Herrera S, Blackwell M, Lemus A, Ruiz-Negron B, Choe R. Protocol of the study: Multilevel community-based mental health intervention to address structural inequities and adverse disparate consequences of COVID-19 pandemic on Latinx Immigrants and African refugees. PLoS One 2024; 19:e0298369. [PMID: 38626038 PMCID: PMC11020834 DOI: 10.1371/journal.pone.0298369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 01/22/2024] [Indexed: 04/18/2024] Open
Abstract
The NIMH-funded Multilevel Community-Based Mental Health Intervention to Address Structural Inequities and Adverse Disparate Consequences of COVID-19 Pandemic on Latinx Immigrants and African Refugees study aims to advance the science of multilevel interventions to reduce the disparate, adverse mental health, behavioral, and socioeconomic consequences of the COVID-19 pandemic that are a result of complex interactions between underlying structural inequities and barriers to health care. The study tests three nested levels of intervention: 1) an efficacious 4-month advocacy and mutual learning model (Refugee and Immigrant Well-being Project, RIWP); 2) engagement with community-based organizations (CBOs); and 3) structural policy changes enacted in response to the pandemic. This community-based participatory research (CBPR) study builds on long-standing collaboration with five CBOs. By including 240 Latinx immigrants and 60 African refugees recruited from CBO partners who are randomly assigned to treatment-as-usual CBO involvement or the RIWP intervention and a comparison group comprised of a random sample of 300 Latinx immigrants, this mixed methods longitudinal waitlist control group design study with seven time points over 36 months tests the effectiveness of the RIWP intervention and engagement with CBOs to reduce psychological distress, daily stressors, and economic precarity and increase protective factors (social support, access to resources, English proficiency, cultural connectedness). The study also tests the ability of the RIWP intervention and engagement with CBOs to increase access to the direct benefits of structural interventions. This paper reports on the theoretical basis, design, qualitative and quantitative analysis plan, and power for the study.
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Affiliation(s)
- Jessica R. Goodkind
- Department of Sociology, University of New Mexico, Albuquerque, NM, United States of America
| | - M. Lee Van Horn
- Department of Individual, Family, and Community Education, University of New Mexico, Albuquerque, NM, United States of America
| | - Julia Meredith Hess
- Department of Pediatrics, University of New Mexico, Albuquerque, NM, United States of America
| | - David Lardier
- Department of Psychiatry and Behavioral Sciences, University of New Mexico, Albuquerque, NM, United States of America
| | - Cirila Estela Vasquez Guzman
- Department of Sociology, University of New Mexico, Albuquerque, NM, United States of America
- Department of Family Medicine, Oregon Health & Science University, Portland, Oregon, United States of America
| | - Janet Ramirez
- Department of Sociology, University of New Mexico, Albuquerque, NM, United States of America
| | | | - Meredith Blackwell
- Department of Psychology, University of New Mexico, Albuquerque, NM, United States of America
| | - Alejandra Lemus
- Department of Sociology, University of New Mexico, Albuquerque, NM, United States of America
| | - Bianca Ruiz-Negron
- Department of Sociology, University of New Mexico, Albuquerque, NM, United States of America
| | - Ryeora Choe
- Department of Sociology, University of New Mexico, Albuquerque, NM, United States of America
- United Voices for Newcomer Rights, Albuquerque, New Mexico, United States of America
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Nogueira González P, Gil González D, Álvarez-Dardet Díaz C. [Lights and shadows in the implementation of community action for health]. GACETA SANITARIA 2024; 38:102387. [PMID: 38608387 DOI: 10.1016/j.gaceta.2024.102387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 02/01/2024] [Accepted: 02/03/2024] [Indexed: 04/14/2024]
Abstract
OBJECTIVE To explore the experiences of individuals who develop projects and interventions where community participation-action constitutes a strategic tool for reducing health inequalities. METHOD Qualitative study based on semi-structured, in-depth online interviews with individuals considered experts in the development of health promotion strategies involving community participation. A total of 12 individuals from the healthcare, social healthcare, academic, and associative backgrounds were selected. The texts were analyzed following the thematic content analysis approach. RESULTS The prominent strength of the processes involving the interviewed individuals is their participatory approach. However, there is no genuine commitment to promoting community participation from primary healthcare, and precarity has been identified as a significant weakness in the development of participatory health promotion projects. The sustainability of participatory processes relies on the transfer of knowledge to the community and their empowerment. CONCLUSIONS Participatory processes have demonstrated their ability to reposition the community as an essential part of the healthcare system. It would be interesting to use a measurement tool for participation in all community health actions, both to guide their design and planning and to assess the depth of participation and its impact on the process. Enhancing community action expectations for health in the near future involves promoting a community-oriented approach in primary care and intersectoral collaboration, which requires a significant institutional and policy commitment.
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Affiliation(s)
| | - Diana Gil González
- Grupo de Investigación en Salud Pública, Universidad de Alicante, Alicante, España; Departamento de Enfermería Comunitaria, Medicina Preventiva, Salud Pública e Historia de la Ciencia, Facultad de Ciencias de la Salud, Universidad de Alicante, Alicante, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España
| | - Carlos Álvarez-Dardet Díaz
- Grupo de Investigación en Salud Pública, Universidad de Alicante, Alicante, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España
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Ashida S, Hellem A, Bucklin R, Carson M, Casteel C. Developing Community-Level Implementation Networks to Connect Older Adults to Evidence-Based Falls Prevention Programs. Health Promot Pract 2024:15248399241237953. [PMID: 38509756 DOI: 10.1177/15248399241237953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2024]
Abstract
Background: Evidence-based falls prevention programs are available in many communities, but participation in such programs remains low. This study aimed to develop community-based referral networks of organizations to facilitate the uptake of evidence-based falls prevention programs through engaging older adults at risk for falls with the RememberingWhen™ program and connecting them to evidence-based programs in Midwestern communities. Methods: Guided by the Practical, Robust Implementation and Sustainability Model (PRISM), referral networks were developed in two Midwestern communities (urban and micropolitan) through a seven-step community engagement plan: establishing and operationalizing the State-level Advisory Board (SAB), identifying falls prevention resources, conducting community assessments, developing Local Advisory Groups (LAG), operationalizing the LAG, developing referral network and protocols, and implementing the network. Semistructured interviews guided by the RE-AIM framework were conducted with members of the SAB, LAG, administrators and staff from organizations that participated in networks, and older adult participants. Results: After participating in the development of referral networks, participants felt they learned important skills that they can use to develop additional collaborations and networks in the future, emphasized the benefits of building community capacity among organizations with common missions. Interview data yielded strategies on enhancing the referral network's reach, impact, adoption, implementation efficiency, and maintenance. Conclusion: Future sustainability studies of such networks should explore identified challenges and strategies to sustain efforts. Results highlight the importance of ongoing funds to support the efforts of organizational networks in communities.
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Affiliation(s)
| | | | | | | | - Carri Casteel
- University of Iowa, Iowa City, IA, USA
- University of Iowa Injury Prevention Research Center, Iowa City, IA, USA
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Bekteshi V, Sifat M, Kendzor DE. Reaching the unheard: overcoming challenges in health research with hard-to-reach populations. Int J Equity Health 2024; 23:61. [PMID: 38500133 PMCID: PMC10946112 DOI: 10.1186/s12939-024-02145-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 03/03/2024] [Indexed: 03/20/2024] Open
Abstract
PURPOSE Addressing obstacles such as logistical complexities, social stigma, and the impact of historical traumas is essential for the successful inclusion of underrepresented groups in health research. METHODS This article reviews engagement and interview techniques used to ethically engage recently settled Afghan refugees in Oklahoma and rural Mexican-born women in Illinois in research. The paper concludes with a reflective discussion on the challenges and lessons learned. RESULTS Creative strategies to engage hard-to-reach populations in research included considering the participants' socioeconomic and cultural contexts in their interactions and developing community partnerships to establish trust and obtain reliable data. Other engagement strategies were communicating in the participants' preferred language, providing assistance with reading and responding to study questions for those with low literacy, employing research staff from the population of interest, and recruiting in specific locations where the populations of interest live. CONCLUSIONS Community engagement is essential at all stages of research for building trust in hard-to-reach populations, achieving inclusivity in health research, and ensuring that interventions are culturally sensitive and effective.
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Affiliation(s)
- Venera Bekteshi
- Dodge Family College of Arts and Sciences, School of Social Work, University of Oklahoma, Norman, OK, USA.
| | - Munjireen Sifat
- Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, USA
| | - Darla E Kendzor
- Department of Family and Preventive Medicine, TSET Health Promotion Research Center, Cancer Prevention and Control Program, University of Oklahoma Health Sciences Center, Stephenson Cancer Center, Oklahoma City, OK, USA
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Tuda D, Bochicchio L, Stefancic A, Hawes M, Chen JH, Powell BJ, Cabassa LJ. Using the matrixed multiple case study methodology to understand site differences in the outcomes of a Hybrid Type 1 trial of a peer-led healthy lifestyle intervention for people with serious mental illness. Transl Behav Med 2023; 13:919-927. [PMID: 37844273 PMCID: PMC10724107 DOI: 10.1093/tbm/ibad060] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2023] Open
Abstract
Site differences in implementation trial outcomes are common but often not examined. In a Hybrid Type 1 trial examining the effectiveness-implementation of a peer-led group life-style balance (PGLB) intervention for people with serious mental illness (SMI) in three supportive housing agencies, we found that PGLB recipients' physical health outcomes differed by study sites. The matrixed multiple case study methodology was used to explore how implementation outcomes and changes in context of usual care (UC) services contributed to these site differences. Two implementation outcomes (i.e. PGLB fidelity ratings and intervention recipients' acceptability of PGLB and UC) and changes in healthcare services integration at the study sites were examined. ANOVAs were used to examine site differences in fidelity ratings and client satisfaction. Directed content analysis was used to analyze leadership interviews to identify changes in the context of UC services. Site 3 showed a trend approaching significance (P = .05) towards higher fidelity ratings. High levels of satisfaction with PGLB were reported at all sites. Significant differences in PGLB recipients' satisfaction with UC were found, with Site 3 reporting the lowest levels of satisfaction. Agency leaders reported an increase in prioritizing client's health throughout the trial with sites differing in how these priorities were put into action. Differences in PGLB recipients' satisfaction with UC, and changes in healthcare service integration seemed to have contributed to the site differences in our trial. The matrixed multiple case study methodology is a useful approach to identify implementation outcomes contributing to the heterogeneity of multisite implementation trial results.
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Affiliation(s)
- Daniela Tuda
- George Warren Brown School of Social Work, Washington University in St. Louis Campus Box 1196, One Brookings Drive, St. Louis, MO 63130-4899, USA
- Center for Mental Health Services Research, Brown School, Washington University in St. Louis, One Brookings Drive, St. Louis, MO 63130, USA
| | - Lauren Bochicchio
- School of Nursing, Columbia University, 560 West 168th Street, New York, NY 10032, USA
| | - Ana Stefancic
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, 1051 Riverside Drive, Unit 98, New York, NY 10032, USA
- New York State Psychiatric Institute, 1051 Riverside Dr, New York, NY 10032, USA
| | - Mark Hawes
- George Warren Brown School of Social Work, Washington University in St. Louis Campus Box 1196, One Brookings Drive, St. Louis, MO 63130-4899, USA
- Center for Mental Health Services Research, Brown School, Washington University in St. Louis, One Brookings Drive, St. Louis, MO 63130, USA
| | - Jun-Hong Chen
- George Warren Brown School of Social Work, Washington University in St. Louis Campus Box 1196, One Brookings Drive, St. Louis, MO 63130-4899, USA
| | - Byron J Powell
- George Warren Brown School of Social Work, Washington University in St. Louis Campus Box 1196, One Brookings Drive, St. Louis, MO 63130-4899, USA
- Center for Mental Health Services Research, Brown School, Washington University in St. Louis, One Brookings Drive, St. Louis, MO 63130, USA
- Center for Dissemination and Implementation, Institute for Public Health, Washington University in St. Louis, 600 S Taylor Ave, St. Louis, MO 63110, USA
- Division of Infectious Diseases, John T. Milliken Department of Medicine, School of Medicine, Washington University in St. Louis, 660 S Euclid Ave, St. Louis, MO 63110, USA
| | - Leopoldo J Cabassa
- George Warren Brown School of Social Work, Washington University in St. Louis Campus Box 1196, One Brookings Drive, St. Louis, MO 63130-4899, USA
- Center for Mental Health Services Research, Brown School, Washington University in St. Louis, One Brookings Drive, St. Louis, MO 63130, USA
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Chebli P, Đoàn LN, Thompson RL, Chin M, Sabounchi N, Foster V, Huang TTK, Trinh-Shevrin C, Kwon SC, Yi SS. Identifying opportunities for collective action around community nutrition programming through participatory systems science. Cancer Causes Control 2023; 34:1043-1058. [PMID: 37481755 PMCID: PMC10979368 DOI: 10.1007/s10552-023-01751-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 07/04/2023] [Indexed: 07/25/2023]
Abstract
PURPOSE To apply principles of group model building (GMB), a participatory systems science approach, to identify barriers and opportunities for collective impact around nutrition programming to reduce cancer risk for immigrant communities in an urban environment. METHODS We convened four in-person workshops applying GMB with nine community partners to generate causal loop diagrams (CLDs)-a visual representation of hypothesized causal relationships between variables and feedback structures within a system. GMB workshops prompted participants to collaboratively identify programmatic goals and challenges related to (1) community gardening, (2) nutrition education, (3) food assistance programs, and (4) community-supported agriculture. Participants then attended a plenary session to integrate findings from all workshops and identify cross-cutting ideas for collective action. RESULTS Several multilevel barriers to nutrition programming emerged: (1) food policies center the diets and practices of White Americans and inhibit culturally tailored food guidelines and funding for culturally appropriate nutrition education; (2) the lack of culturally tailored nutrition education in communities is a missed opportunity for fostering pride in immigrant food culture and sustainment of traditional food practices; and (3) the limited availability of traditional ethnic produce in food assistance programs serving historically marginalized immigrant communities increases food waste and worsens food insecurity. CONCLUSION Emergent themes coalesced around the need to embed cultural tailoring into all levels of the food system, while also considering other characteristics of communities being reached (e.g., language needs). These efforts require coordinated actions related to food policy and advocacy, to better institutionalize these practices within the nutrition space.
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Affiliation(s)
- Perla Chebli
- Section for Health Equity, Department of Population Health, NYU Grossman School of Medicine, 180 Madison Ave, 8th Floor, New York, NY, 10016, USA.
| | - Lan N Đoàn
- Section for Health Equity, Department of Population Health, NYU Grossman School of Medicine, 180 Madison Ave, 8th Floor, New York, NY, 10016, USA
| | - Rachel L Thompson
- Center for Systems and Community Design, CUNY Graduate School of Public Health and Health Policy, 55 W 125th St, New York, NY, 10027, USA
| | - Matthew Chin
- Section for Health Equity, Department of Population Health, NYU Grossman School of Medicine, 180 Madison Ave, 8th Floor, New York, NY, 10016, USA
| | - Nasim Sabounchi
- Center for Systems and Community Design, CUNY Graduate School of Public Health and Health Policy, 55 W 125th St, New York, NY, 10027, USA
| | - Victoria Foster
- Section for Health Equity, Department of Population Health, NYU Grossman School of Medicine, 180 Madison Ave, 8th Floor, New York, NY, 10016, USA
| | - Terry T K Huang
- Center for Systems and Community Design, CUNY Graduate School of Public Health and Health Policy, 55 W 125th St, New York, NY, 10027, USA
| | - Chau Trinh-Shevrin
- Section for Health Equity, Department of Population Health, NYU Grossman School of Medicine, 180 Madison Ave, 8th Floor, New York, NY, 10016, USA
| | - Simona C Kwon
- Section for Health Equity, Department of Population Health, NYU Grossman School of Medicine, 180 Madison Ave, 8th Floor, New York, NY, 10016, USA
| | - Stella S Yi
- Section for Health Equity, Department of Population Health, NYU Grossman School of Medicine, 180 Madison Ave, 8th Floor, New York, NY, 10016, USA
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Klepac B, Mowle A, Riley T, Craike M. Government, governance, and place-based approaches: lessons from and for public policy. Health Res Policy Syst 2023; 21:126. [PMID: 38031069 PMCID: PMC10685506 DOI: 10.1186/s12961-023-01074-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 11/10/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND Place-based approaches are increasingly applied to address the determinants of health, many of which are complex problems, to ultimately improve population health outcomes. Through public policy, government actions can affect the effectiveness of place-based approaches by influencing the conceptualisation, development, implementation, governance, and/or evaluation of place-based approaches. Despite the important role of public policy, there has been limited examination of public policy related to place-based approaches. We add to the limited knowledge base by analysing Australian national public policy, to explore: (1) the definitions, conceptualisations, and characteristics of place-based approaches in public policy; (2) the government's perception and communication of its role in place-based approaches; and (3) the extent to which government policy reflects the necessary conditions for successful place-based governance developed by Marsh and colleagues, namely localised context, embedded learning, and reciprocal accountability. METHODS This research was underpinned by the Theory of Systems Change and methodologically informed by the READ approach to document analysis. Ritchie and Spencer's framework method was utilised to analyse the data. RESULTS We identified and reviewed 67 policy documents. In terms of conceptualisation, common characteristics of place-based approaches related to collaboration, including community in decision-making, responsiveness to community needs, and suitability of place-based approaches to address complex problems and socio-economic determinants of health. Three roles of government were identified: funder, partner, and creator of a supportive policy environment. From the three criteria for successful place-based governance, localised context was the most dominant across the documents and reciprocal accountability the least. CONCLUSIONS Based on our findings, we drew key implications for public policy and research. There was a disproportionate emphasis on the bottom-up approach across the documents, which presents the risk of diminishing government interest in place-based approaches, potentially burdening communities experiencing disadvantage beyond their capacities. Governments engaged in place-based approaches should work towards a more balanced hybrid approach to place-based approaches that maintain the central functions of government while allowing for successful place-based governance. This could be achieved by promoting consistency in conceptualisations of 'place-based', employing an active role in trust building, advancing the creation of a supportive policy environment, and embedding 'learning' across place-based approaches.
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Affiliation(s)
- Bojana Klepac
- Mitchell Institute for Education and Health Policy, Victoria University, Footscray Park Campus, Pathways in Place, Melbourne, VIC, Australia.
| | - Amy Mowle
- Mitchell Institute for Education and Health Policy, Victoria University, Footscray Park Campus, Pathways in Place, Melbourne, VIC, Australia
| | - Therese Riley
- Mitchell Institute for Education and Health Policy, Victoria University, Footscray Park Campus, Pathways in Place, Melbourne, VIC, Australia
| | - Melinda Craike
- Mitchell Institute for Education and Health Policy, Victoria University, Footscray Park Campus, Pathways in Place, Melbourne, VIC, Australia
- Institute for Health and Sport, Victoria University, Melbourne, VIC, Australia
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Michalski C, Ragunathan A, Foster A, Pagalan L, Chu C, Diemert LM, Helliwell JF, Urajnik D, Speidel R, Malti T, Fierheller D, Fusca L, Zenlea I, McKean S, Rosella LC. Towards a community-driven definition of community wellbeing: A qualitative study of residents. PLoS One 2023; 18:e0294721. [PMID: 37988338 PMCID: PMC10662708 DOI: 10.1371/journal.pone.0294721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 11/06/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND Understanding what promotes or hinders a community's capacity to serve the priorities of its residents is essential for the alignment of citizen needs and governance. Participatory approaches that engage community residents on the topic of community wellbeing are useful methods for defining outcomes that reflect a community's goals and priorities. Using qualitative focus group methods, the aim of this study was to outline bottom-up definitions of community wellbeing from a diverse pool of community residents in Ontario, Canada. METHODS Semi-structured, two-hour group interviews were conducted with adult (≥18 years) participants (N = 15) residing in four communities across Canada's largest province of Ontario. Participants were purposively selected from a pool of screening questionnaires to ensure diverse group compositions based on race, gender, age, and educational attainment. Interviews were thematically analysed using descriptive and interpretive methods to characterize resident conceptions of community wellbeing. RESULTS Focus group participants were between 18 and 75 years of age and most had lived in their local community for 5 or more years. Four major themes emerged: (1) a sense of community belonging is cultivated through shared spaces, routines, support, and identities; (2) a community constitutes the amenities and social contexts that enable residents to thrive; (3) effective regional decision-making must be community-informed; and (4) the wellbeing of a community relies on equal opportunities for engagement and participation. CONCLUSIONS Residents described their communities and their associated wellbeing as a combination of accessible amenities and opportunities to engage without marginalization. This study underscores the value of participatory approaches in community wellbeing research, where the viewpoint and life experience of residents is used to inform local decision-making and service delivery. Future research will capture more diverse perspectives towards community belonging, particularly from community newcomers, for the development of regionally appropriate indicators of community wellbeing.
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Affiliation(s)
- Camilla Michalski
- Population Health Analytics Lab, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Apira Ragunathan
- Population Health Analytics Lab, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Adrian Foster
- Population Health Analytics Lab, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Lief Pagalan
- Population Health Analytics Lab, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Schwartz Reisman Institute for Technology and Society, University of Toronto, Toronto, Ontario, Canada
| | - Casey Chu
- Population Health Analytics Lab, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Institute for Better Health, Trillium Health Partners, Mississauga, Ontario, Canada
| | - Lori M. Diemert
- Population Health Analytics Lab, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - John F. Helliwell
- Vancouver School of Economics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Diana Urajnik
- Centre for Rural and Northern Health Research, Laurentian University, Sudbury, Ontario, Canada
| | - Ruth Speidel
- Laboratory for Social-Emotional Development and Intervention, Department of Psychology, University of Toronto, Toronto, Ontario, Canada
| | - Tina Malti
- Laboratory for Social-Emotional Development and Intervention, Department of Psychology, University of Toronto, Toronto, Ontario, Canada
| | - Dianne Fierheller
- Family and Child Health Initiative, Trillium Health Partners, Mississauga, Ontario, Canada
| | - Laura Fusca
- Community Safety and Wellbeing Secretariat, Peel Region, Mississauga Ontario, Canada
| | - Ian Zenlea
- Family and Child Health Initiative, Trillium Health Partners, Mississauga, Ontario, Canada
| | - Scott McKean
- SafeTO, City of Toronto, Toronto, Ontario, Canada
| | - Laura C. Rosella
- Population Health Analytics Lab, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Institute for Better Health, Trillium Health Partners, Mississauga, Ontario, Canada
- Laboratory Medicine and Pathobiology, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
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17
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Thomas KA, Sibanda EL, Johnson C, Watadzaushe C, Ncube G, Hatzold K, Tumushime MK, Mutseta M, Ruhode N, Indravudh PP, Cowan FM, Neuman M. Do community measures impact the effectiveness of a community led HIV testing intervention. Secondary analysis of an HIV self-testing intervention in rural communities in Zimbabwe. BMC Infect Dis 2023; 22:974. [PMID: 37907871 PMCID: PMC10617038 DOI: 10.1186/s12879-023-08695-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 10/10/2023] [Indexed: 11/02/2023] Open
Abstract
BACKGROUND There is a growing body of evidence for the role that communities can have in producing beneficial health outcomes. There is also an increasing recognition of the effectiveness and success of community-led interventions to promote public health efforts. This study investigated whether and how community-level measures facilitate a community-led intervention to achieve improved HIV outcomes. METHODS This is a secondary analysis of survey data from a cluster randomised trial in 40 rural communities in Zimbabwe. The survey was conducted four months after the intervention was initiated. Communities were randomised 1:1 to either paid distribution arm, where HIV self-test (HIVST) kits were distributed by a paid distributor, or community-led whereby members of the community were responsible for organising and conducting the distribution of HIVST kits. We used mixed effects logistic regression to assess the effect of social cohesion, problem solving, and HIV awareness on HIV testing and prevention. RESULTS We found no association between community measures and the three HIV outcomes (self-testing, new HIV diagnosis and linkage to VMMC or confirmatory testing). However, the interaction analyses highlighted that in high social cohesion communities, the odds of new HIV diagnosis was greater in the community-led arm than paid distribution arm (OR 2.06 95% CI 1.03-4.19). CONCLUSION We found some evidence that community-led interventions reached more undiagnosed people living with HIV in places with high social cohesion. Additional research should seek to understand whether the effect of social cohesion is persistent across other community interventions and outcomes. TRIAL REGISTRATION PACTR201607001701788.
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Affiliation(s)
| | - Euphemia Lindelwe Sibanda
- Centre for Sexual Health and HIV/AIDS Research (CeSHHAR) Zimbabwe, Harare, Zimbabwe
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Cheryl Johnson
- HIV, Hepatitis and STI Department, World Health Organisation, Geneva, Switzerland
| | | | - Getrude Ncube
- Ministry of Health and Child Welfare, Harare, Zimbabwe
| | - Karin Hatzold
- Population Services International, Johannesburg, South Africa
| | - Mary K Tumushime
- Centre for Sexual Health and HIV/AIDS Research (CeSHHAR) Zimbabwe, Harare, Zimbabwe
| | - Miriam Mutseta
- Department of Sexual Reproductive Health Rights and Innovations, Population Services International Zimbabwe, Harare, Zimbabwe
| | - Nancy Ruhode
- Centre for Sexual Health and HIV/AIDS Research (CeSHHAR) Zimbabwe, Harare, Zimbabwe
| | | | - Frances M Cowan
- Centre for Sexual Health and HIV/AIDS Research (CeSHHAR) Zimbabwe, Harare, Zimbabwe
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Melissa Neuman
- London School of Hygiene & Tropical Medicine (LSHTM), London, UK
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Riley T, Hopkins L, Gomez M, Davidson S, Jacob J. System Action Learning: Reorientating Practice for System Change in Preventive Health. SYSTEMIC PRACTICE AND ACTION RESEARCH 2023:1-16. [PMID: 37359404 PMCID: PMC10060912 DOI: 10.1007/s11213-023-09638-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/07/2023] [Indexed: 03/31/2023]
Abstract
It is now widely accepted that many of the problems we face in public health are complex, from chronic disease to COVID-19. To grapple with such complexity, researchers have turned to both complexity science and systems thinking to better understand the problems and their context. Less work, however, has focused on the nature of complex solutions, or intervention design, when tackling complex problems. This paper explores the nature of system intervention design through case illustrations of system action learning from a large systems level chronic disease prevention study in Australia. The research team worked with community partners in the design and implementation of a process of system action learning designed to reflect on existing initiatives and to reorient practice towards responses informed by system level insights and action. We were able to observe and document changes in the mental models and actions of practitioners and in doing so shine a light on what may be possible once we turn our attention to the nature and practice of system interventions.
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Affiliation(s)
- Therese Riley
- The Australian Prevention Partnership Centre, The Sax Institute, Sydney, Australia
| | - Liza Hopkins
- The Australian Prevention Partnership Centre, The Sax Institute, Sydney, Australia
| | - Maria Gomez
- The Australian Prevention Partnership Centre, The Sax Institute, Sydney, Australia
| | - Seanna Davidson
- The Australian Prevention Partnership Centre, The Sax Institute, Sydney, Australia
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Koops-Van Hoffen HE, Lenthe van FJ, Poelman MP, Droomers M, Borlée F, Vendrig-De Punder YMR, Jambroes M, Kamphuis CBM. Understanding the mechanisms linking holistic housing renovations to health and well-being of adults in disadvantaged neighbourhoods: A realist review. Health Place 2023; 80:102995. [PMID: 36930992 DOI: 10.1016/j.healthplace.2023.102995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 11/30/2022] [Accepted: 02/17/2023] [Indexed: 03/17/2023]
Abstract
Holistic housing renovations combine physical housing improvements with social and socioeconomic interventions (e.g. referral to social services, debt counselling, involvement in decision-making, promoting social cohesion). This realist review aimed at understanding underlying mechanisms linking holistic housing renovations to health and well-being of adults in disadvantaged neighbourhoods. Following systematic and iterative searching, and relevance and quality appraisals, 18 scientific articles and reports were analysed. We identified three pathways via which physical housing improvements affect health, four pathways via which social and socioeconomic interventions affect health, and two pathways via which both reinforce each other in their health effects. Our findings are theoretically novel, relevant for those conducting holistic housing renovations, and point towards gaps in the literature.
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Affiliation(s)
- H E Koops-Van Hoffen
- Department of Human Geography and Spatial Planning, Utrecht University, P.O. 80115, 3508 TC, Utrecht, the Netherlands.
| | - F J Lenthe van
- Department of Human Geography and Spatial Planning, Utrecht University, P.O. 80115, 3508 TC, Utrecht, the Netherlands; Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, P.O. 2040, 3000 CA, Rotterdam, the Netherlands
| | - M P Poelman
- Chair Group Consumption and Healthy Lifestyles, Wageningen University & Research, P.O. 8130 (route 59), 6700 EW, Wageningen, the Netherlands
| | - M Droomers
- Department of Public Health, Municipality of Utrecht, P.O. 16200, 3500 CE, Utrecht, the Netherlands
| | - F Borlée
- Department of Public Health, Municipality of Utrecht, P.O. 16200, 3500 CE, Utrecht, the Netherlands
| | - Y M R Vendrig-De Punder
- Department of Public Health, Julius Center, University Medical Center, Huispostnummer 6.131 | P.O. 85500, 3508 GA, Utrecht, the Netherlands
| | - M Jambroes
- Department of Public Health, Julius Center, University Medical Center, Huispostnummer 6.131 | P.O. 85500, 3508 GA, Utrecht, the Netherlands
| | - C B M Kamphuis
- Department of Interdisciplinary Social Science, Utrecht University, P.O. 80140, 3584 CH, Utrecht, the Netherlands
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Allen J, Charles B, Fok CCT, Lee K, Grogan-Kaylor A, Rasmus S. Culturally grounded strategies for suicide and alcohol risk prevention delivered by rural Alaska Native communities: A dynamic wait-listed design evaluation of the Qungasvik intervention. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2023; 71:184-197. [PMID: 36214726 DOI: 10.1002/ajcp.12621] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 05/17/2022] [Accepted: 07/03/2022] [Indexed: 05/07/2023]
Abstract
We examined the effectiveness of the Qungasvik (Tools for Life) intervention in enhancing protective factors as a universal suicide and alcohol prevention strategy for young people ages 12-18 living in highly affected rural Alaska Native communities. Four communities were assigned to immediate intervention or to a dynamic wait list. Outcomes were analyzed for 239 young people at four time points over two years of community intervention. Outcomes assessed two ultimate variable protective factors buffering suicide and alcohol risk, and three intermediate variable protective factors at the individual, family, and community level. Dose dependent intervention effects were associated with growth in ultimate but not intermediate variables. This evaluation of the Qungasvik intervention provides support for the effectiveness of its Indigenous strategies for suicide and alcohol misuse prevention in this rural Alaska Native setting. Though findings did not provide support for a theory of change where growth in ultimate variables is occasioned through effects on intermediate variables, research designs focused on young people who enter intervention at lower levels of preexisting protection hold promise for better understanding of intervention change processes. The Qungasvik intervention is responsive to an acute public health need for effective rural Alaska Native suicide and alcohol risk prevention strategies.
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Affiliation(s)
- James Allen
- Department of Family Medicine and Biobehavioral Health and Memory Keepers Medical Discovery Team-American Indian and Rural Health Equity, University of Minnesota Medical School, Duluth Campus, Minneapolis, Minnesota, USA
- Center for Alaska Native Health Research, Institute for Arctic Biology, University of Alaska Fairbanks, Fairbanks, Alaska, USA
| | - Billy Charles
- Center for Alaska Native Health Research, Institute for Arctic Biology, University of Alaska Fairbanks, Fairbanks, Alaska, USA
| | - Carlotta Ching Ting Fok
- Center for Alaska Native Health Research, Institute for Arctic Biology, University of Alaska Fairbanks, Fairbanks, Alaska, USA
| | - KyungSook Lee
- Center for Alaska Native Health Research, Institute for Arctic Biology, University of Alaska Fairbanks, Fairbanks, Alaska, USA
| | | | - Stacy Rasmus
- Center for Alaska Native Health Research, Institute for Arctic Biology, University of Alaska Fairbanks, Fairbanks, Alaska, USA
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21
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Erhardt E, Murray-Krezan C, Regino L, Perez D, Bearer EL, Page-Reeves J. Associations between depression and diabetes among Latinx patients from low-income households in New Mexico. Soc Sci Med 2023; 320:115713. [PMID: 36706540 DOI: 10.1016/j.socscimed.2023.115713] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 01/05/2023] [Accepted: 01/18/2023] [Indexed: 01/22/2023]
Abstract
Depression and diabetes are co-occurring epidemics. This article explores the association between depression and diabetes in a cohort of Latinx patients with diabetes from low-income households. Data were gathered in Albuquerque, New Mexico (U.S.) between 2016 and 2020 as part of a patient-engaged comparative effectiveness trial comparing two culturally appropriate diabetes self-management programs-the Chronic Care Model (CCM) and the standard of care, Diabetes Self-Management Support Empowerment Model (DSMS). We proposed that the program most culturally and contextually situated in the life of the patient would have the greatest impact on diabetes self-management. Participants were enrolled as dyads-226 Latinx diabetes patient participants (PPs) from low-income households and 226 social support participants (SSPs). Data gathered at baseline, 3, 6, and 12 months included a measure of depression and A1c testing. Outcomes between programs were analyzed using longitudinal linear mixed modeling, adjusted for patient demographic characteristics and other potential confounding covariates. Patient A1c had an initial slight decrease at 3 months in both programs. At CCM, patients with a very high A1c (greater than 10%) demonstrated a clinically meaningful decrease in A1c over time. Patients at CCM experienced a large initial decrease in depression and continued to decrease throughout the study, while patients at DSMS showed a slight initial decrease through 6 months, but depression increased again by 12 months, nearly rebounding to baseline levels. A subgroup analysis revealed that a higher baseline A1c was associated with higher depression, and patients with higher A1c achieved greater reductions in depression at CCM than at DSMS. CCM scored higher on Consumer Assessment of Healthcare Providers and Systems cultural competence (CAHPS-CC). Interpretation of results suggests that the more culturally, contextually situated program, CCM, had better outcomes. This study demonstrates that culturally and contextually situating a diabetes intervention can deliver improved benefits for Latinx patients.
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Affiliation(s)
- Erik Erhardt
- Department of Mathematics and Statistics, University of New Mexico, 1 University of New Mexico, Albuquerque, NM, 87131, USA.
| | - Cristina Murray-Krezan
- Department of Internal Medicine, University of New Mexico, 1 University of New Mexico, Albuquerque, NM, 87131, USA; Department of Medicine, University of Pittsburgh, 200 Meyran Ave., Suite 300, Pittsburgh, PA, 15213, USA.
| | - Lidia Regino
- Office for Community Health, University of New Mexico, 1 University of New Mexico, Albuquerque, NM, 87131, USA.
| | - Daniel Perez
- Office for Community Health, University of New Mexico, 1 University of New Mexico, Albuquerque, NM, 87131, USA
| | - Elaine L Bearer
- Department of Pathology, University of New Mexico, 1 University of New Mexico, Albuquerque, NM, 87131, USA.
| | - Janet Page-Reeves
- Office for Community Health, University of New Mexico, 1 University of New Mexico, Albuquerque, NM, 87131, USA; Department of Family & Community Medicine, University of New Mexico, MSC09 5065, 1 University of New Mexico, Albuquerque, NM, 87131, USA.
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Page-Reeves J, Murray-Krezan C, Burge MR, Mishra SI, Regino L, Bleecker M, Perez D, McGrew HC, Bearer EL, Erhardt E. A patient-centered comparative effectiveness research study of culturally appropriate options for diabetes self-management. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.01.31.23285236. [PMID: 36778329 PMCID: PMC9915824 DOI: 10.1101/2023.01.31.23285236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
This project compared the effectiveness of two evidence-based models of culturally competent diabetes health promotion: The Diabetes Self-Management Support Empowerment Model (DSMS), and The Chronic Care Model (CCM). Our primary outcome was improvement in patient capacity for diabetes self-management as measured by the Diabetes Knowledge Questionnaire (DKQ) and the Patient Activation Measure (PAM). Our secondary outcome was patient success at diabetes self-management as measured by improvement in A1c, depression sores using the PHQ-9, and Body Mass Index (BMI). We also gathered data on the cultural competence of the program using the Consumer Assessment of Healthcare Providers and Systems Cultural Competence Set (CAHPS-CC). We compared patient outcomes in two existing sites in Albuquerque, New Mexico that serve a large population of Latino diabetes patients from low-income households. Participants were enrolled as dyads-a patient participant (n=226) and a social support participant (n=226). Outcomes over time and by program were analyzed using longitudinal linear mixed modeling, adjusted for patient participant demographic characteristics and other potential confounding covariates. Secondary outcomes were also adjusted for potential confounders. Interactions with both time and program helped to assess outcomes. This study did not find a difference between the two sites with respect to the primary outcome measures and only one of the three secondary outcomes showed differential results. The main difference between programs was that depression decreased more for CCM than for DSMS. An exploratory, subgroup analysis revealed that at CCM, patient participants with a very high A1c (>10) demonstrated a clinically meaningful decrease. However, given the higher cultural competence rating for the CCM, statistically significant improvement in depression, and the importance of social support to the patients, results suggest that a culturally and contextually situated diabetes self-management and education program design may deliver benefit for patients, especially for patients with higher A1c levels.
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Affiliation(s)
- Janet Page-Reeves
- Department of Family & Community Medicine, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, USA
- Office for Community Health, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, USA
| | - Cristina Murray-Krezan
- Department of Medicine, Division of General Internal Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | | | - Shiraz I. Mishra
- Department of Family & Community Medicine, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, USA
- Department of Pediatrics, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, USA
| | - Lidia Regino
- Office for Community Health, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, USA
| | - Molly Bleecker
- Office for Community Health, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, USA
| | - Daniel Perez
- Office for Community Health, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, USA
| | | | - Elaine L. Bearer
- Department of Pathology, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, USA
| | - Erik Erhardt
- Department of Mathematics and Statistics, University of New Mexico, Albuquerque, New Mexico, USA
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23
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de Jong MAJG, Wink G, Koelen MA, Wagemakers A. Unravelling mechanisms underlying the action principles of a community-based health promotion programme: a realist evaluation. Arch Public Health 2023; 81:9. [PMID: 36653819 PMCID: PMC9850519 DOI: 10.1186/s13690-023-01027-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 01/10/2023] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Since 1986, WHO has advised that applying action principles such as citizen participation and intersectoral collaboration leads to better health. However, less is known about the workability of these principles and how they trigger specific outcomes in interaction with the context. A critical realist perspective was applied to get a better understanding of what worked, and why it worked, in the context of a Dutch community-based health promotion programme (CBHPP). The aim of the study was to unravel the mechanisms underlying the action principles and find combinations of contextual factors and mechanisms that trigger outcomes in a CBHPP. METHODS In this single case study, a critical realist methodology was followed. Qualitative data used in this study originated from multiple sources and methods to ensure validity. They include evaluation sessions with coalition members (n = 6) and individual interviews (n = 6); group sessions with community workers (n = 1), a health broker (n = 1), and citizens (n = 12); and seven semi-annual progress reports and minutes of the coalition meetings. The collected data were then compared with the programme theory through a heuristic process of constructing, exploring, and refining context-mechanism-outcome configurations. RESULTS The programme initiated a variety of new activities that differed in content, intensity, duration, and number of participants, organised and implemented together with citizens. The most prominent mechanism underlying both action principles were programme-related, namely, patience, personal contact, contribution of budget, and the programme coordinator's leadership. Another important mechanism was creating visibility, which resulted in the involvement of the municipality and a budget to sustain the programme. CONCLUSION In this case study, personal contact, patience, perseverance, participatory action research activities, and visibility were found to be the most notable mechanisms underlying the citizen participation and intersectoral collaboration action principles. As the principle-based approach added value to the existing context and introduced most of the mechanisms that triggered the outcomes, it is recommended to include citizen participation and intersectoral collaboration not only as action principles but explicitly as targets in a CBHPP.
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Affiliation(s)
- Marja A. J. G. de Jong
- GGD IJsselland (Municipal Health Service), Zwolle, the Netherlands ,grid.4818.50000 0001 0791 5666Wageningen University and Research, chair Health and Society, Wageningen, the Netherlands
| | - Gerda Wink
- grid.10417.330000 0004 0444 9382Department of Primary and Community Care, Radboud University Medical Centre, AMPHI Academic Collaborative Centre, Nijmegen, the Netherlands
| | - Maria A. Koelen
- grid.4818.50000 0001 0791 5666Wageningen University and Research, chair Health and Society, Wageningen, the Netherlands
| | - Annemarie Wagemakers
- grid.4818.50000 0001 0791 5666Wageningen University and Research, chair Health and Society, Wageningen, the Netherlands
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24
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Mendez E, Munguia L, Ramirez Molina R, Herrera C, Regino L, Tellez M, Sandoval V, Perez J, Medina D, Vasquez C, Page-Reeves J. Our voices, our lives: Unforeseen stories after the violence and opening the door to becoming whole again. WOMEN'S HEALTH (LONDON, ENGLAND) 2023; 19:17455057231197159. [PMID: 37727110 PMCID: PMC10515508 DOI: 10.1177/17455057231197159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 06/18/2023] [Accepted: 08/08/2023] [Indexed: 09/21/2023]
Abstract
We are a group of 11 women in Albuquerque, New Mexico. Nine of us are immigrants from Mexico. One of us is from an immigrant household. One of us is neither. We have been working collaboratively on a research study called Tertulias (Spanish for "a social gathering"), which is an innovative women's peer support group approach we created to reduce social isolation, depression, and stress among women immigrants from Mexico, and to increase their resilience and sense of empowerment. In the process of implementing the Tertulias study, we are revealing the profound power of peer support, friendship, and small, quotidian kindnesses. But we are also exposing the immensity and scope of trauma, fear, loneliness, depression, and self-blame that exist in the Mexican immigrant community because of domestic violence. Our experience with domestic violence and with the consciousness-raising and support we found in Tertulias has made us want to be involved in a positive manner to do something about this issue in our community. We want our experience to mean something-to be used to make a difference. We are opening our hearts and sharing our stories and ideas. We wanted to be included as co-authors of this article because we want our stories to be received and heard by other women. We want to plant seeds to help other women find their inner strength to be able to escape from their chains. We have to return for others. It is a commitment-to understand how we were able to do it and share that with others. Through our experience participating in Tertulias, we learned that we could overcome what felt overwhelming and impenetrable. We could leave the violence and rediscover and recreate ourselves and our lives.
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Affiliation(s)
- Ernestina Mendez
- The University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | - Leticia Munguia
- The University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | | | - Cristina Herrera
- The University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | - Lidia Regino
- The University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | - Maria Tellez
- The University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | - Virginia Sandoval
- The University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | - Jackie Perez
- The University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | - Dulce Medina
- The University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | - Camille Vasquez
- The University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | - Janet Page-Reeves
- The University of New Mexico Health Sciences Center, Albuquerque, NM, USA
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25
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Fraser P, Whelan JM, Brown AD, Allender SE, Bell C, Bolton KA. System approaches to childhood obesity prevention: ground up experience of adaptation and real-world context. Public Health Nutr 2022; 26:1-4. [PMID: 36468439 PMCID: PMC10131143 DOI: 10.1017/s1368980022002531] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 11/17/2022] [Accepted: 11/22/2022] [Indexed: 12/07/2022]
Abstract
OBJECTIVE Childhood obesity prevention is critical to reducing the health and economic burden currently experienced by the Australian economy. System science has emerged as an approach to manage the complexity of childhood obesity and the ever-changing risk factors, resources and priorities of government and funders. Anecdotally, our experience suggests that inflexibility of traditional research methods and dense academic terminology created issues with those working in prevention practice. Therefore, this paper provides a refined description of research-specific terminology of scale-up, fidelity, adaptation and context, drawing from community-based system dynamics and our experience in designing, implementing and evaluating non-linear, community-led system approaches to childhood obesity prevention. DESIGN We acknowledge the importance of using a practice lens, rather than purely a research design lens, and provide a narrative on our experience and perspectives on scale-up, fidelity, context and adaptation through a practice lens. SETTING Communities. PARTICIPANTS Practice-based researcher experience and perspectives. RESULTS Practice-based researchers highlighted the key finding that community should be placed at the centre of the intervention logic. This allowed communities to self-organise with regard to stakeholder involvement, capacity, boundary identification, and co-creation of actions implemented to address childhood obesity will ensure scale-up, fidelity, context and adaptation are embedded. CONCLUSIONS We need to measure beyond primary anthropometric outcomes and focus on evaluating more about implementation, process and sustainability. We need to learn more from practitioners on the ground and use an implementation science lens to further understand how actions work. This is where solutions to sustained childhood obesity prevention will be found.
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Affiliation(s)
- Penny Fraser
- Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, School of Health and Social Development, Deakin University, Geelong, VIC, Australia
- Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, School of Medicine, Deakin University, 1 Gheringhap St, Geelong, VIC, Australia
| | - Jillian M Whelan
- Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, School of Medicine, Deakin University, 1 Gheringhap St, Geelong, VIC, Australia
| | - Andrew D Brown
- Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, School of Health and Social Development, Deakin University, Geelong, VIC, Australia
| | - Steven E Allender
- Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, School of Health and Social Development, Deakin University, Geelong, VIC, Australia
| | - Colin Bell
- Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, School of Medicine, Deakin University, 1 Gheringhap St, Geelong, VIC, Australia
| | - Kristy A Bolton
- Global Centre for Preventive Health and Nutrition (GLOBE), Institute for Health Transformation, School of Health and Social Development, Deakin University, Geelong, VIC, Australia
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
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26
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McEachern LW, Harris S, Valaitis R, Watson A, Yessis J, Zupko B, Hanning RM. Learning Circles: A Collaborative Approach to Enhance Local, Healthy and Traditional Foods for Youth in the Northerly Community of Hazelton/Upper Skeena, British Columbia, Canada. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15878. [PMID: 36497954 PMCID: PMC9737344 DOI: 10.3390/ijerph192315878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 11/23/2022] [Accepted: 11/24/2022] [Indexed: 06/17/2023]
Abstract
Youth health, long-term food sovereignty and the reclamation of traditional food-related knowledge are areas of concern within Indigenous communities in Canada. Learning Circles: Local Healthy Food to School (LC:LHF2S) built on an exemplar program in four predominantly Indigenous communities. In each, the initiative worked with interested community members to plan, implement and evaluate a range of activities aimed at enhancing access to local, healthy and traditional foods for schools and youth. This case study describes the context, process, outcomes and perceptions of implementation in one of the communities, Hazelton/Upper Skeena, located in northern British Columbia. Data were collected between 2016-2019 and included semi-directed interviews with community members and LCEF (n = 18), process reporting (e.g., LCEF reports, emails, conference calls and tracking data), photographs and video footage, and photovoice. Data were analyzed thematically. Hazelton/Upper Skeena has an active local and traditional food culture. Indigenous governance was supportive, and community members focused on partnership and leadership development, gardens, and food skills work. Findings point to strengths; traditional food, knowledge and practices are valued by youth and were prioritized. LC:LHF2S is a flexible initiative that aims to engage the broader community, and exemplifies some of the best practices recommended for community-based initiatives within Indigenous communities. Results indicate that a LC is a feasible venture in this community; one that can facilitate partnership-building and contribute to increased access to local and traditional food among school-aged youth. Recommendations based on community input may help the uptake of the model in similar communities across Canada, and globally.
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Affiliation(s)
- Louise W. McEachern
- School of Public Health Sciences, University of Waterloo, Waterloo, ON N2L 3G1, Canada
| | - Sandra Harris
- Gitxsan Government Commission, Hazelton, BC V0J 2A0, Canada
| | - Renata Valaitis
- School of Public Health Sciences, University of Waterloo, Waterloo, ON N2L 3G1, Canada
| | - Anissa Watson
- Storytellers Foundation, Hazelton, BC V0J 2A0, Canada
| | - Jennifer Yessis
- School of Public Health Sciences, University of Waterloo, Waterloo, ON N2L 3G1, Canada
| | - Barbara Zupko
- School of Public Health Sciences, University of Waterloo, Waterloo, ON N2L 3G1, Canada
| | - Rhona M. Hanning
- School of Public Health Sciences, University of Waterloo, Waterloo, ON N2L 3G1, Canada
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Southby K, Coan S, Rushworth S, South J, Bagnall AM, Lam T, Woodward J, Button D. The contribution of peer research in evaluating complex public health interventions: examples from two UK community empowerment projects. BMC Public Health 2022; 22:2164. [PMID: 36424569 PMCID: PMC9685878 DOI: 10.1186/s12889-022-14465-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 10/27/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Peer-research is steered and conducted by people with lived experience of the issues being researched. This paper explores the value of peer-research in two complex public health intervention evaluations in the UK. METHODS Reports from 18 peer research projects, completed by residents from 12 communities in the UK taking part in two community empowerment interventions, were analysed using cross-case analysis. RESULTS Undertaking peer research helped to build the evaluation and research skills within individual projects as well as providing data on other outcomes related to the programmes Theory of Change. Some peer researchers, however, felt unprepared for the activity despite support from the academic team and were unsatisfied with project outcomes. While peer research projects provided more opportunities for local residents to engage with the overall evaluations, there was an overreliance on people closely connected to the programmes to be peer researchers. The peer research projects explored topics that were broader than the aims and objectives of the overall programme evaluations. All provided insight into the context in which projects occurred, while some also informed understanding of programme change mechanisms. CONCLUSIONS Including peer research as part of complex public health intervention evaluations can help uncover important contextual and ecological details beyond the reach of more traditional evaluation data collection. Peer research can also empower and build research/evaluation capacity within communities, which is particularly pertinent for community empowerment interventions.
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Affiliation(s)
- Kris Southby
- grid.10346.300000 0001 0745 8880Leeds Beckett University, 519 Portland, City Campus, Leeds, LS1 3HE UK
| | - Susan Coan
- grid.10346.300000 0001 0745 8880Leeds Beckett University, 519 Portland, City Campus, Leeds, LS1 3HE UK
| | - Sara Rushworth
- grid.10346.300000 0001 0745 8880Leeds Beckett University, 519 Portland, City Campus, Leeds, LS1 3HE UK
| | - Jane South
- grid.10346.300000 0001 0745 8880Leeds Beckett University, 519 Portland, City Campus, Leeds, LS1 3HE UK
| | - Anne-Marie Bagnall
- grid.10346.300000 0001 0745 8880Leeds Beckett University, 519 Portland, City Campus, Leeds, LS1 3HE UK
| | - Tiffany Lam
- grid.422699.20000 0004 5930 2724Sustrans UK, 2 Cathedral Square, Bristol, BS1 5DD UK
| | - Jenny Woodward
- grid.10346.300000 0001 0745 8880Leeds Beckett University, 519 Portland, City Campus, Leeds, LS1 3HE UK
| | - Danial Button
- grid.422572.40000 0001 2289 0006New Economics Foundation, 10 Salamanca Place, London, SE1 7HB UK
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Rodriguez L, Murray-Krezan C, Regino L, Tellez M, Vasquez C, Sandoval V, Perez Rodriguez D, Pedigo B, Page-Reeves J. A Study of a Culturally and Contextually Situated Multimedia Approach to Recruit a Hard-to-Reach Spanish-Speaking Population for a Randomized Control Trial (RCT). J Empir Res Hum Res Ethics 2022; 17:461-470. [PMID: 35585705 PMCID: PMC11307171 DOI: 10.1177/15562646221102682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Study designs involving randomization can be difficult to communicate to participants, especially those with low literacy. The literature on strategies to explain research concepts is limited, especially for non-English speakers. We measured the effectiveness of a culturally and contextually situated multimedia approach to recruit a cohort of 60 female Mexican immigrants (FMI) to a randomized control trial (RCT) to reduce social isolation and depression. This strategy was designed to explain the concept of randomization, explain what participating in the research study entailed, and ensure informed consent. Potential participants viewed a presentation explaining the study and a video including animation with voice-over explaining the concept of randomization. We administered a pre/post survey. Respondents (N = 59) reported an increase in their understanding of randomization, intention to enroll, and attitude towards participating in research. We conclude that a culturally and contextually situated multimedia approach is an effective model when recruiting underrepresented populations with low literacy for RCTs.
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Affiliation(s)
| | | | - Lidia Regino
- Office for Community Health, University of New Mexico, Albuquerque, NM, USA
| | - Maria Tellez
- One Hope Centro de Vida Health Center, East Central Ministries, Albuquerque, NM, USA
| | | | - Virginia Sandoval
- One Hope Centro de Vida Health Center, East Central Ministries, Albuquerque, NM, USA
| | | | - Blanca Pedigo
- One Hope Centro de Vida Health Center, East Central Ministries, Albuquerque, NM, USA
| | - Janet Page-Reeves
- Office for Community Health, University of New Mexico, Albuquerque, NM, USA
- Department of Family and Community Medicine, University of New Mexico, Albuquerque, NM, USA
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29
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Nkimbeng M, Han HR, Szanton SL, Alexander KA, Davey-Rothwell M, Giger JT, Gitlin LN, Joo JH, Koeuth S, Marx KA, Mingo CA, Samuel LJ, Taylor JL, Wenzel J, Parisi JM. Exploring Challenges and Strategies in Partnering With Community-Based Organizations to Advance Intervention Development and Implementation With Older Adults. THE GERONTOLOGIST 2022; 62:1104-1111. [PMID: 34958098 PMCID: PMC9451017 DOI: 10.1093/geront/gnab190] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Indexed: 12/30/2022] Open
Abstract
Minoritized older adults face multiple health inequities and disparities, but are less likely to benefit from evidence-based health care interventions. With the increasing diversity of the U.S. aging population, there is a great promise for gerontology researchers to partner with racial/ethnic minority organizations and underrepresented communities to develop and implement evidence-based health interventions. Community-Based Participatory Research and Implementation Science offer guidance and strategies for researchers to develop and sustain community partnerships. However, researchers partnering with community organizations continue to face challenges in these collaborations, study outcomes, and sustainability. This may be especially true for those junior in their career trajectory or new to community-engaged research. The purpose of this forum article is to detail critical challenges that can affect gerontology researcher-community partnerships and relationships from the perspective of researchers. Seven challenges (pre- or mid-intervention design, implementation, and postimplementation phases) described within the Equity-focused Implementation Research for health programs framework are identified and discussed. Potential solutions are also presented. Planning for potential obstacles of the researcher-community partnerships can inform innovative solutions that will facilitate successful partnerships, thereby promoting the advancement of collaborative research between academic institutions and community organizations to improve older adult health outcomes.
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Affiliation(s)
- Manka Nkimbeng
- Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, Minnesota, USA
| | - Hae-Ra Han
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | - Sarah L Szanton
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health
| | | | - Melissa Davey-Rothwell
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Jarod T Giger
- University of Kentucky College of Social Work, Lexington, Kentucky, USA
| | - Laura N Gitlin
- Drexel University, College of Nursing and Health Professions, Philadelphia, Pennsylvania, USA
| | - Jin Hui Joo
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins Hospital, Baltimore, Maryland, USA
| | - Sokha Koeuth
- Drexel University, College of Nursing and Health Professions, Philadelphia, Pennsylvania, USA
| | - Katherine A Marx
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | - Chivon A Mingo
- Georgia State University, College of Arts & Sciences, Atlanta, Georgia, USA
| | - Laura J Samuel
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | - Janiece L Taylor
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | - Jennifer Wenzel
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | - Jeanine M Parisi
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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O'Loughlin EK, Kalubi J, Riglea T, Pelekanakis A, O'Loughlin JL. Correlates of perceived success of health-promoting interventions in elementary school. Health Promot Chronic Dis Prev Can 2022; 42:398-407. [PMID: 36165766 PMCID: PMC9559196 DOI: 10.24095/hpcdp.42.9.03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
INTRODUCTION School-based health-promoting interventions (HPIs) aim to support youth development and positively influence modifiable lifestyle behaviours. Identifying factors that contribute to or hinder the perceived success of HPIs could facilitate their adaptation, improve implementation and contribute to HPI sustainability. The objective of this study was to identify factors in three domains (school characteristics, characteristics of the HPI and factors related to planning and implementing the HPI) associated with perceived success of HPIs among school principals in elementary schools. METHODS Data were drawn from Project PromeSS, a cross-sectional survey of school principals and/or nominated staff members in a convenience sample of 171 public elementary schools in Quebec, Canada. School board and school recruitment spanned three academic school years (2016-2019). Data on school and participant characteristics, HPI characteristics, variables related to HPI planning and implementation and perceived success of the HPI were collected in two-part, structured telephone interviews. Descriptive statistics were used to characterize schools and study participants. Twenty-eight potential correlates of perceived HPI success were investigated separately in multivariable linear regression modelling. RESULTS Participants generally perceived HPIs as highly successful. After controlling for number of students, language of instruction, school neighbourhood and school deprivation, we identified five correlates of perceived success, including lower teacher turnover, higher scores for school physical environment, school/teacher commitment to student health, principal leadership and school being a developer (vs. adopter) of the HPI. CONCLUSION If replicated, these factors should be considered by HPI developers and school personnel when planning and implementing HPIs in elementary schools.
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Affiliation(s)
- Erin K O'Loughlin
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada
- Carrefour de l'innovation et de l'évaluation en santé, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montréal, Québec, Canada
| | - Jodi Kalubi
- Carrefour de l'innovation et de l'évaluation en santé, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montréal, Québec, Canada
- Département de médecine sociale et préventive, Université de Montréal, Montréal, Québec, Canada
- Centre de recherche en santé publique (CReSP), Université de Montréal and CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montréal, Québec, Canada
| | - Teodora Riglea
- Carrefour de l'innovation et de l'évaluation en santé, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montréal, Québec, Canada
| | - Annie Pelekanakis
- Carrefour de l'innovation et de l'évaluation en santé, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montréal, Québec, Canada
| | - Jennifer L O'Loughlin
- Carrefour de l'innovation et de l'évaluation en santé, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montréal, Québec, Canada
- Département de médecine sociale et préventive, Université de Montréal, Montréal, Québec, Canada
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Knighton AJ, Bass EJ, McLaurin EJ, Anderson M, Baird JD, Cray S, Destino L, Khan A, Liss I, Markle P, O'Toole JK, Patel A, Srivastava R, Landrigan CP, Spector ND, Patel SJ. Intervention, individual, and contextual determinants to high adherence to structured family-centered rounds: a national multi-site mixed methods study. Implement Sci Commun 2022; 3:74. [PMID: 35842692 PMCID: PMC9287702 DOI: 10.1186/s43058-022-00322-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 06/22/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Effective communication in transitions between healthcare team members is associated with improved patient safety and experience through a clinically meaningful reduction in serious safety events. Family-centered rounds (FCR) can serve a critical role in interprofessional and patient-family communication. Despite widespread support, FCRs are not utilized consistently in many institutions. Structured FCR approaches may prove beneficial in increasing FCR use but should address organizational challenges. The purpose of this study was to identify intervention, individual, and contextual determinants of high adherence to common elements of structured FCR in pediatric inpatient units during the implementation phase of a large multi-site study implementing a structured FCR approach. METHODS We performed an explanatory sequential mixed methods study from September 2019 to October 2020 to evaluate the variation in structured FCR adherence across 21 pediatric inpatient units. We analyzed 24 key informant interviews of supervising physician faculty, physician learners, nurses, site administrators, and project leaders at 3 sites using a qualitative content analysis paradigm to investigate site variation in FCR use. We classified implementation determinants based on the Consolidated Framework for Implementation Research. RESULTS Provisional measurements of adherence demonstrated considerable variation in structured FCR use across sites at a median time of 5 months into the implementation. Consistent findings across all three sites included generally positive clinician beliefs regarding the use of FCR and structured rounding approaches, benefits to learner self-efficacy, and potential efficiency gains derived through greater rounds standardization, as well as persistent challenges with nurse engagement and interaction on rounds and coordination and use of resources for families with limited English proficiency. CONCLUSIONS Studies during implementation to identify determinants to high adherence can provide generalizable knowledge regarding implementation determinants that may be difficult to predict prior to implementation, guide adaptation during the implementation, and inform sustainment strategies.
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Affiliation(s)
- Andrew J Knighton
- Healthcare Delivery Institute, Intermountain Healthcare, Murray, UT, USA.
| | - Ellen J Bass
- Department of Health Systems and Sciences Research, College of Nursing & Health Professions, Drexel University, Philadelphia, PA, USA
- Department of Information Science, College of Computing and Informatics, Drexel University, Philadelphia, PA, USA
| | - Elease J McLaurin
- Health Systems & Sciences Research, College of Nursing & Health Professions, Drexel University, Philadelphia, PA, USA
| | | | - Jennifer D Baird
- Institute for Nursing and Interprofessional Research, Children's Hospital of Los Angeles, Los Angeles, CA, USA
| | - Sharon Cray
- St. Christopher's Hospital for Children, Philadelphia, PA, USA
| | - Lauren Destino
- Stanford University, Pediatric Hospital Medicine, Palo Alto, CA, USA
| | - Alisa Khan
- Harvard Medical School, Boston Children's Hospital, Boston, MB, USA
| | - Isabella Liss
- Harvard Medical School, Boston Children's Hospital, Boston, MB, USA
| | - Peggy Markle
- Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Jennifer K O'Toole
- Pediatrics and Internal Medicine, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Aarti Patel
- Rady Children's Hospital San Diego, University of California, San Diego, CA, USA
| | - Rajendu Srivastava
- Healthcare Delivery Institute, Intermountain Healthcare, Murray, UT, USA
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Christopher P Landrigan
- Division of General Pediatrics, Boston Children's Hospital, Boston, MB, USA
- Sleep and Patient Safety Program, Brigham and Women's Hospital, Boston, MB, USA
- William Berenberg Professor of Pediatrics, Harvard Medical School, Boston, MB, USA
- Boston Children's Hospital, Boston, MB, USA
| | - Nancy D Spector
- Executive Leadership in Academic Medicine (ELAM) Program, Drexel University College of Medicine, Philadelphia, PA, USA
- Department of Pediatrics, Drexel University College of Medicine, Philadelphia, PA, USA
| | - Shilpa J Patel
- Kapiolani Medical Center for Women & Children, University of Hawaii John A. Burns School of Medicine, Honolulu, HI, USA
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Rink E, Firemoon P, Anastario M, Johnson O, GrowingThunder R, Ricker A, Peterson M, Baldwin J. Rationale, Design, and Methods for Nen Unkumbi/Edahiyedo ("We Are Here Now"): A Multi-Level Randomized Controlled Trial to Improve Sexual and Reproductive Health Outcomes in a Northern Plains American Indian Reservation Community. Front Public Health 2022; 10:823228. [PMID: 35910931 PMCID: PMC9326233 DOI: 10.3389/fpubh.2022.823228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 04/29/2022] [Indexed: 12/01/2022] Open
Abstract
American Indian (AI) youth in the United States experience disproportionate sexual and reproductive health (SRH) disparities relative to their non-Indigenous, white counterparts, including increased rates of sexually transmitted infections (STIs), earlier sexual debut, increased rates of teen birth, and reduced access to SRH services. Past research shows that to improve SRH outcomes for AI youth in reservation communities, interventions must address complex factors and multiple levels of community that influence sexual risk behaviors. Here, we describe development of a multi-level, multi-component randomized controlled trial (RCT) to intervene upon SRH outcomes in a Northern Plains American Indian reservation community. Our intervention is rooted in a community based participatory research framework and is evaluated with a stepped wedge design that integrates 5 reservation high schools into a 5-year, cluster-randomized RCT. Ecological Systems Theory was used to design the intervention that includes (1) an individual level component of culturally specific SRH curriculum in school, (2) a parental component of education to improve parent-child communication about SRH and healthy relationships, (3) a community component of cultural mentorship, and (4) a systems-level component to improve delivery of SRH services from reservation healthcare agencies. In this article we present the rationale and details of our research design, instrumentation, data collection protocol, analytical methods, and community participation in the intervention. Our intervention builds upon existing community strengths and integrates traditional Indigenous knowledge and values with current public health knowledge to reduce SRH disparities.
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Affiliation(s)
- Elizabeth Rink
- Department of Health and Human Development, Montana State University, Bozeman, MT, United States
| | | | - Michael Anastario
- AHC5, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, United States
| | | | - Ramey GrowingThunder
- Language and Culture Department, Fort Peck Assiniboine and Sioux Tribes, Poplar, MT, United States
| | - Adriann Ricker
- School of Nursing, Johns Hopkins University, Baltimore, MD, United States
| | - Malory Peterson
- Department of Health and Human Development, Montana State University, Bozeman, MT, United States
| | - Julie Baldwin
- Center for Health Equity Research, Northern Arizona University, Flagstaff, AZ, United States
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Im H, Swan LET. "We Learn and Teach Each Other": Interactive Training for Cross-Cultural Trauma-Informed Care in the Refugee Community. Community Ment Health J 2022; 58:917-929. [PMID: 34618270 DOI: 10.1007/s10597-021-00899-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 05/24/2021] [Indexed: 11/27/2022]
Abstract
This paper introduces culturally responsive and trauma-informed mental health training modules to build and enhance competences and partnerships among mental health professionals and refugee community leaders, while facilitating intercultural, mutual learning between participants from various cultural and professional backgrounds. Focus group interviews and participant self-reflections with the training participants (N = 54) were analyzed using thematic analysis. Findings revealed an enhanced understanding of culturally unique as well as universal trauma responses and coping in the refugee community, which led to the building and strengthening of a sense of community and an expansion of social networks and support systems. This study highlights the effectiveness of interactive learning and knowledge transference among participants with various cultural and professional backgrounds, showing that face-to-face interactions and mutual learning reportedly facilitated building relationships and trust among participants and especially those between refugee/immigrant community leaders and service providers.
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Affiliation(s)
- Hyojin Im
- School of Social Work, Virginia Commonwealth University, 1000 Floyd Ave, Richmond, VA, 23804, USA.
| | - Laura E T Swan
- Department of Population Health Sciences, University of Wisconsin-Madison, 610 Walnut St., Madison, WI, 53726, USA
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Im H, Swan LET. “We Learn and Teach Each Other”: Interactive Training for Cross-Cultural Trauma-Informed Care in the Refugee Community. Community Ment Health J 2022; 58:917-929. [DOI: https:/doi.org/10.1007/s10597-021-00899-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 05/24/2021] [Indexed: 06/22/2023]
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Moloi H, Tulloch NL, Watkins D, Perkins S, Engel M, Abdullahi L, Daniels K, Zühlke L. Understanding the local and international stakeholders in rheumatic heart disease field in Tanzania and Uganda: A systematic stakeholder mapping. Int J Cardiol 2022; 353:119-126. [PMID: 35090984 DOI: 10.1016/j.ijcard.2022.01.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 01/12/2022] [Accepted: 01/14/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Our study aimed to systematically identify RHD stakeholders and categories of stakeholders to consider when developing a scorecard that reflects a broad stakeholder input. METHOD We used the Schiller et al.(2013) framework to identify RHD stakeholders and stakeholder categories in Tanzania and Uganda. The process involved identifying stakeholders by searching literature related to incidence, prevalence, morbidity, mortality, health services, or health outcomes of Group A streptococcus, acute rheumatic fever, or rheumatic heart disease in these countries. The strategy was completed for two electronic databases in 2016 and in 2020 to update the results. We also engaged known stakeholders to obtain practice-based insight. We then categorised and visually represented the identified stakeholders. RESULTS We identified 139 stakeholders in Uganda, with 68% being from 15 different countries across 31 locations. In comparison, local Ugandan stakeholders were dispersed in six locations across the country. In Tanzania, we identified 128 stakeholders, with 66% being locally based and dispersed in seven locations across the country and stakeholders from different countries were situated in 18 countries across 28 locations. We categorised all identified stakeholders into one or more of five categories 1) Civil Society and General Public, 2) Education Sector, 3) Research, Training and Capacity Building, 4) Healthcare service delivery, and 5) Health Policy and Administration. CONCLUSION The stakeholder categories identified include multiple sectors and stakeholders from multiple countries, this reflects the complexities of RHD. This also highlights the need for collaboration and partnership as a critical action for preventing and controlling RHD.
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Affiliation(s)
- Hlengiwe Moloi
- Health Systems Research Unit, The South African Medical Research Council, South Africa.
| | - Nathaniel L Tulloch
- Division of General Internal Medicine, Department of Medicine, School of Medicine, University of Washington, Seattle, USA
| | - David Watkins
- Division of General Internal Medicine, Department of Medicine, School of Medicine, University of Washington, Seattle, USA; Department of Global Health, University of Washington, Seattle, USA
| | - Susan Perkins
- Division of Paediatric Cardiology, Department of Paediatrics, Red Cross War Memorial Children's Hospital, University of Cape Town, South Africa
| | - Mark Engel
- Department of Medicine, Groote Schuur Hospital and Faculty of Health Sciences, University of Cape Town, South Africa
| | - Leila Abdullahi
- African Institute for Development Policy (AFIDEP), Nairobi, Kenya
| | - Karen Daniels
- Health Policy and Systems Division, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Liesl Zühlke
- Division of Paediatric Cardiology, Department of Paediatrics, Red Cross War Memorial Children's Hospital, University of Cape Town, South Africa; Division of Cardiology, Department of Medicine, Groote Schuur Hospital and Faculty of Health Sciences, University of Cape Town, South Africa
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Shelton RC, Philbin MM, Ramanadhan S. Qualitative Research Methods in Chronic Disease: Introduction and Opportunities to Promote Health Equity. Annu Rev Public Health 2022; 43:37-57. [PMID: 34936827 PMCID: PMC10580302 DOI: 10.1146/annurev-publhealth-012420-105104] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Public health research that addresses chronic disease has historically underutilized and undervalued qualitative methods. This has limited the field's ability to advance (a) a more in-depth understanding of the factors and processes that shape health behaviors, (b) contextualized explanations of interventions' impacts (e.g., why and how something did or did not work for recipients and systems), and (c) opportunities for building and testing theories. We introduce frameworks and methodological approaches common to qualitative research, discuss how and when to apply them in order to advance health equity, and highlight relevant strengths and challenges. We provide an overview of data collection, sampling, and analysis for qualitative research, and we describe research questions that can be addressed by applying qualitative methods across the continuum of chronic disease research. Finally, we offer recommendations to promote the strategic application of rigorous qualitative methods, with an emphasis on priority areas to enhance health equity across the evidence generation continuum.
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Affiliation(s)
- Rachel C Shelton
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA; ,
| | - Morgan M Philbin
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA; ,
| | - Shoba Ramanadhan
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA;
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Gatesy-Davis A, Koroloff N, Marrone J, Davis M. Collaboration among vocational rehabilitation and mental health leaders: Supporting the vocational success of transition-age youth with serious mental health conditions. JOURNAL OF VOCATIONAL REHABILITATION 2022. [DOI: 10.3233/jvr-221177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: The ability of vocational rehabilitation, adult mental health and child mental health service systems to collaborate regarding the employment and career development goals of transition-age youth has not been explored nor has attention been paid to strategies that would increase this collaboration. OBJECTIVE: This qualitative study asks leaders from these three systems to describe collaborative activities that support better vocational services for transition-age youth with serious mental health conditions and discuss barriers and facilitators to collaboration. METHODS: Qualitative interviews were conducted with 39 formal and informal leaders in vocational rehabilitation (n = 16), child mental health (n = 13), and adult mental health (n = 10) systems as part of a larger study of interorganizational relationships. RESULTS: A primary barrier was lack of knowledge about the services and policies of each other’s systems. Another barrier was differences in philosophy about employment and the special needs of transition-age youth with mental health needs. CONCLUSIONS: In addition to specific activities that would encourage greater interaction across three systems, results underscore the need for the child mental health system and vocational rehabilitation system to increase their involvement with and knowledge about one another. This would include training child mental health providers about employment and career development services, vocational rehabilitation providers about the role of mental health in the youngest workers, and both being involved in transition-planning that directly addresses vocational goals and support needs.
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Affiliation(s)
- Anwyn Gatesy-Davis
- Transitions to Adulthood Center for Research, Systems and Psychosocial Advances Research Center, Department of Psychiatry, University of Massachusetts Medical School, Shrewsbury, MA, USA
| | - Nancy Koroloff
- Regional Research Institute for Human Services, Portland State University, Portland, OR, USA
| | - Joseph Marrone
- Institute for Community Inclusion, University of Massachusetts, Boston, MA, USA
| | - Maryann Davis
- Transitions to Adulthood Center for Research, Systems and Psychosocial Advances Research Center, Department of Psychiatry, University of Massachusetts Medical School, Shrewsbury, MA, USA
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Macgregor Thom RR, Grimes A. Land loss and the intergenerational transmission of wellbeing: The experience of iwi in Aotearoa New Zealand. Soc Sci Med 2022; 296:114804. [PMID: 35180592 DOI: 10.1016/j.socscimed.2022.114804] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 02/05/2022] [Accepted: 02/07/2022] [Indexed: 11/16/2022]
Abstract
We analyse the impact of land loss, through colonisation, on contemporary cultural wellbeing and health outcomes of Māori, the Indigenous population of Aotearoa New Zealand. In 1840, Māori legally owned all land in the country; by 2017, Māori owned just 5% of land. Ties to the land (whenua) have been identified as being critical to spirituality (wairua) and health (hauora). All tribes (iwi) experienced major land loss, but the timing, extent and nature of land loss differed across iwi. In some cases, land was confiscated following the New Zealand wars of the nineteenth century. We draw on recently derived data for historical landholdings of 70 (North Island) iwi to link the extent of historical landholdings, and whether land was confiscated, to contemporary outcomes for five cultural wellbeing and health outcomes for each iwi: te reo Māori (Māori language) proficiency, importance of involvement in Māori culture, visiting an ancestral marae (meeting place), difficulty in finding support for Māori cultural practices, and rates of regular smoking. We find that higher land retention within an iwi's rohe at the end of the nineteenth century is supportive of contemporary cultural wellbeing outcomes, while confiscation is linked to higher contemporary rates of smoking. The evidence is consistent with historical trauma having significant effects on the cultural wellbeing and health outcomes of Aotearoa New Zealand's Indigenous population over a century later.
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Affiliation(s)
| | - Arthur Grimes
- School of Government, Victoria University of Wellington. PO Box 600, Wellington, 6140, New Zealand.
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Maxwell AE, Vargas C, Santifer R, Chang LC, Crespi CM, Lucas-Wright A. Facilitators and Challenges to Health Promotion in Black and Latino Churches. J Racial Ethn Health Disparities 2022; 9:59-67. [PMID: 33230738 PMCID: PMC8141063 DOI: 10.1007/s40615-020-00929-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 11/10/2020] [Accepted: 11/12/2020] [Indexed: 02/03/2023]
Abstract
BACKGROUND Churches are important assets for the African American and Latino communities. They can play a critical role in health promotion, especially in areas that are under-resourced and in which residents have limited access to health care. A better understanding of health promotion in churches is needed to support and maintain church collaborations and health initiatives that are integrated, data-driven, and culturally appropriate. The purpose of this study is to identify churches' facilitators and challenges to health promotion and to contrast and compare Black and Latino churches of different sizes (< 200 members versus > 200 members). METHODS We interviewed leaders of 100 Black and 42 Latino churches in South Los Angeles to assess their history of wellness activities, resources, facilitators, and challenges to conduct health promotion activities. RESULTS Eighty-three percent of African American and 86% of Latino church leaders reported at least one health activity in the last 12 months. Black and Latino churches of different sizes have similar interests in implementing specific health promotion strategies and face similar challenges. However, we found significant differences in the composition of their congregations, number of paid staff, and the proportions of churches that have a health or wellness ministry and that implement specific wellness strategies. Fifty-seven percent of African American and 43% of Latino church leaders stated that they needed both financial support and professional expertise for health promotion. DISCUSSION Our findings highlight the importance of conducting a readiness assessment for identifying intervention content and strategies that fit the intervention context of a church.
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Affiliation(s)
- Annette E Maxwell
- University of California Los Angeles Fielding School of Public Health & Jonsson Comprehensive Cancer Center, 650 Charles Young Dr. South, A2-125 CHS, Box 956900, Los Angeles, CA, 90095-6900, USA.
- UCLA Kaiser Permanente Center for Health Equity, 650 Charles Young Dr. South, A2-125 CHS, Box 956900, Los Angeles, CA, 90095-6900, USA.
| | - Claudia Vargas
- Division of Cancer Research and Training, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
| | - Rhonda Santifer
- Division of Cancer Research and Training, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
| | - L Cindy Chang
- University of California Los Angeles Fielding School of Public Health & Jonsson Comprehensive Cancer Center, 650 Charles Young Dr. South, A2-125 CHS, Box 956900, Los Angeles, CA, 90095-6900, USA
- UCLA Kaiser Permanente Center for Health Equity, 650 Charles Young Dr. South, A2-125 CHS, Box 956900, Los Angeles, CA, 90095-6900, USA
| | - Catherine M Crespi
- University of California Los Angeles Fielding School of Public Health & Jonsson Comprehensive Cancer Center, 650 Charles Young Dr. South, A2-125 CHS, Box 956900, Los Angeles, CA, 90095-6900, USA
- UCLA Kaiser Permanente Center for Health Equity, 650 Charles Young Dr. South, A2-125 CHS, Box 956900, Los Angeles, CA, 90095-6900, USA
| | - Aziza Lucas-Wright
- Division of Cancer Research and Training, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
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Greiman L, Ravesloot C, S Goddard K, Ward B. Effects of a consumer driven home modification intervention on community participation for people with mobility disabilities. Disabil Health J 2022; 15:101210. [PMID: 34521604 PMCID: PMC10798581 DOI: 10.1016/j.dhjo.2021.101210] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 08/04/2021] [Accepted: 08/05/2021] [Indexed: 11/03/2022]
Abstract
BACKGROUND Community participation has become a key outcome measure for people with disabilities. This has resulted in a shift in researchers focus from the individual to the environment. However, research has focused primarily on participation barriers in the community with limited research examining the role of the home environment. For people with mobility disabilities the home environment is the starting place for community participation and research is needed to understand the relationship between the home and participation outcomes. OBJECTIVE This study explores the effects of a consumer-driven home modification intervention on community participation for people with mobility disabilities. METHODS We conducted a randomized control trial (from June 2017-April 2019) of the effects of a consumer-directed home modification intervention on community participation. The intervention, the Home Usability Program, was implemented with consumers at two different Centers for Independent Living (N = 195) and included a self-assessment of their home environment and implementation of a home usability change. RESULTS The Home Usability program positively affected the community participation of people with mobility disabilities. Overall, intervention participants reported a 39.5% (p < .05) increase in social and recreational activities immediately following the intervention relative to the control group after controlling for health status and month when outcome data were collected. Six months after the intervention, this effect returned to baseline. CONCLUSIONS Community-based, consumer-driven home modification programs show promise for improving community participation outcomes among people with disabilities, however, more research is needed to understand why results did not persist.
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Affiliation(s)
- Lillie Greiman
- The University of Montana Research and Training Center on Disability in Rural Communities, United States.
| | - Craig Ravesloot
- The University of Montana Research and Training Center on Disability in Rural Communities, United States
| | - Kelsey S Goddard
- The University of Kansas Research and Training Center on Independent Living (KU-RTCIL), United States
| | - Bryce Ward
- The University of Montana Research and Training Center on Disability in Rural Communities, United States
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Evans C. Community-Level Vulnerabilities and Political Field Experiments. CANADIAN JOURNAL OF BIOETHICS 2022. [DOI: 10.7202/1087203ar] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Allen J, Wexler L, Rasmus S. Protective Factors as a Unifying Framework for Strength-Based Intervention and Culturally Responsive American Indian and Alaska Native Suicide Prevention. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2022; 23:59-72. [PMID: 34169406 DOI: 10.1007/s11121-021-01265-0] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2021] [Indexed: 12/14/2022]
Abstract
The ongoing challenge of American Indian and Alaska Native (AIAN) youth suicide is a public health crisis of relatively recent historical origin inadequately addressed by contemporary prevention science. A promising development in AIAN suicide prevention highlights the role of protective factors. A protective factor framework adopts a social ecological perspective and community-level intervention paradigm. Emphasis on protection highlights strength-based AIAN cultural strategies in prevention of youth suicide. Attention to multiple intersecting levels incorporates strategies promoting community as well as individual resilience processes, seeking to influence larger contexts as well as individuals within them. This approach expands the scope of suicide prevention strategies beyond the individual level and tertiary prevention strategies. Interventions that focus on mechanisms of protection offer a rigorous, replicable, and complementary prevention science alternative to risk reduction approaches. This selected review critically examines recent AIAN protective factor suicide prevention science. One aim is to clarify key concepts including protection, resilience, and cultural continuity. A broader aim is to describe the evolution of this promising new framework for conducting primary research about AIAN suicide, and for designing and testing more effective intervention. Recommendations emphasize focus on mechanisms, multilevel interactions, more precise use of theory and terms, implications for new intervention development, alertness to unanticipated impacts, and culture as fundamental in a protective factors framework for AIAN suicide prevention. A protective factor framework holds significant potential for advancing AIAN suicide prevention and for work with other culturally distinct suicide disparity groups, with broad implications for other areas of prevention science.
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Affiliation(s)
- James Allen
- Department of Family Medicine and Biobehavioral Health and Memory Keepers Medical Discovery Team-American Indian and Rural Health Equity, University of Minnesota Medical School, Duluth Campus, Duluth, MN, 55812, USA.
| | - Lisa Wexler
- Department of Social Work and Research Center for Group Dynamics, Institute for Social Research, Univeristy of Michigan, Ann Arbor, MI, 48104, USA
| | - Stacy Rasmus
- Center for Alaska Native Health Research, Institute for Arctic Biology, University of Alaska Fairbanks, Fairbanks, AK, 99775, USA
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How can we promote co-creation in communities? The perspective of health promoting professionals in four European countries. HEALTH EDUCATION 2021. [DOI: 10.1108/he-02-2021-0033] [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 aim was to identify the competencies professionals need to promote co-creation engagement within communities.
Design/methodology/approach
Co-creation could contribute to building community capacity to promote health. Professional development is key to support co-creative practices. Participants were professionals in a position to promote co-creation processes in health-promoting welfare settings across Denmark, Portugal, France and United Kingdom. An overarching unstructured topic guide was used within interviews, focus groups, questionnaires and creative activities.
Findings
The need to develop competencies to promote co-creation was high across all countries. Creating a common understanding of co-creation and the processes involved to increase inclusivity, engagement and shared understanding was also necessary. Competencies included: How to run co-creation from the beginning of the process right through to evaluation, using feedback and communication throughout using an open action-oriented approach; initiating a perspective change and committing to the transformation of co-creation into a real-life process.
Practical implications
Overall, learning about underlying principles, process initiation, implementation and facilitation of co-creation were areas identified to be included within a co-creation training programme. This can be applied through the framework of enabling change, advocating for co-creative processes, mediating through partnership, communication, leadership, assessment, planning, implementation, evaluation and research, ethical values and knowledge of co-creative processes.
Originality/value
This study provides novel findings on the competencies needed for health promoting professionals to embed co-creative processes within their practice, and the key concerns that professionals with a position to mediate co-creation have in transferring the abstract term of co-creation into a real-world practice.
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Pardoel ZE, Reijneveld SA, Lensink R, Widyaningsih V, Probandari A, Stein C, Hoang GN, Koot JAR, Fenenga CJ, Postma M, Landsman JA. Core health-components, contextual factors and program elements of community-based interventions in Southeast Asia - a realist synthesis regarding hypertension and diabetes. BMC Public Health 2021; 21:1917. [PMID: 34686171 PMCID: PMC8539840 DOI: 10.1186/s12889-021-11244-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 06/09/2021] [Indexed: 11/30/2022] Open
Abstract
Background In Southeast Asia, diabetes and hypertension are on the rise and have become major causes of death. Community-based interventions can achieve the required behavioural change for better prevention. The aims of this review are 1) to assess the core health-components of community-based interventions and 2) to assess which contextual factors and program elements affect their impact in Southeast Asia. Methods A realist review was conducted, combining empirical evidence with theoretical understanding. Documents published between 2009 and 2019 were systematically searched in PubMed/Medline, Web of Science, Cochrane Library, Google Scholar and PsycINFO and local databases. Documents were included if they reported on community-based interventions aimed at hypertension and/or diabetes in Southeast Asian context; and had a health-related outcome; and/or described contextual factors and/or program elements. Results We retrieved 67 scientific documents and 12 grey literature documents. We identified twelve core health-components: community health workers, family support, educational activities, comprehensive programs, physical exercise, telehealth, peer support, empowerment, activities to achieve self-efficacy, lifestyle advice, activities aimed at establishing trust, and storytelling. In addition, we found ten contextual factors and program elements that may affect the impact: implementation problems, organized in groups, cultural sensitivity, synergy, access, family health/worker support, gender, involvement of stakeholders, and referral and education services when giving lifestyle advice. Conclusions We identified a considerable number of core health-components, contextual influences and program elements of community-based interventions to improve diabetes and hypertension prevention. The main innovative outcomes were, that telehealth can substitute primary healthcare in rural areas, storytelling is a useful context-adaptable component, and comprehensive interventions can improve health-related outcomes. This extends the understanding of promising core health-components, including which elements and in what Southeast Asian context. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11244-3.
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Affiliation(s)
- Zinzi E Pardoel
- Department of Health Sciences, University of Groningen, University Medical Center Groningen, Hanzeplein 1, Building 3217, 9700 RB, Groningen, The Netherlands.
| | - Sijmen A Reijneveld
- Department of Health Sciences, University of Groningen, University Medical Center Groningen, Hanzeplein 1, Building 3217, 9700 RB, Groningen, The Netherlands
| | - Robert Lensink
- Faculty of Economics and Business, University of Groningen, Groningen, The Netherlands
| | - Vitri Widyaningsih
- Department of Public Health, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia
| | - Ari Probandari
- Department of Public Health, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia
| | | | | | - Jaap A R Koot
- Department of Health Sciences, University of Groningen, University Medical Center Groningen, Hanzeplein 1, Building 3217, 9700 RB, Groningen, The Netherlands
| | - Christine J Fenenga
- Department of Health Sciences, University of Groningen, University Medical Center Groningen, Hanzeplein 1, Building 3217, 9700 RB, Groningen, The Netherlands
| | - Maarten Postma
- Department of Health Sciences, University of Groningen, University Medical Center Groningen, Hanzeplein 1, Building 3217, 9700 RB, Groningen, The Netherlands.,Faculty of Economics and Business, University of Groningen, Groningen, The Netherlands.,Department of Pharmacology and Therapy, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia.,Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Bandung, Indonesia
| | - Johanna A Landsman
- Department of Health Sciences, University of Groningen, University Medical Center Groningen, Hanzeplein 1, Building 3217, 9700 RB, Groningen, The Netherlands
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Lester P, Mogil C, Milburn N, Murthy G, Sherin J. A Public Partnership to Support Well-Being: Population Health Implementation of Trauma and Resilience Informed Care Across Child and Family Ecosystems. Child Adolesc Psychiatr Clin N Am 2021; 30:737-750. [PMID: 34538445 DOI: 10.1016/j.chc.2021.07.002] [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] [Indexed: 10/20/2022]
Abstract
Early life adversity and trauma can jeopardize child and family well-being. Mitigating the effects of early adversity and trauma requires a tiered, public health approach that includes trauma-informed mental health promotion, prevention, screening, early intervention, and effective and equitable treatment across community ecosystems and service systems. This article describes the development of a partnership between a public academic (University of California at Los Angeles) and community mental health system (Los Angeles County Department of Mental Health) and provides a roadmap for core principles and actionable steps to implement coherent, comprehensive, and adaptive trauma-informed community systems of support for children.
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Affiliation(s)
- Patricia Lester
- UCLA Department of Psychiatry and Biobehavioral Sciences, 760 Westwood Plaza, A8-159, Los Angeles, CA 90024, USA
| | - Catherine Mogil
- UCLA Department of Psychiatry and Biobehavioral Sciences, 760 Westwood Plaza, A8-159, Los Angeles, CA 90024, USA.
| | - Norweeta Milburn
- UCLA Department of Psychiatry and Biobehavioral Sciences, 760 Westwood Plaza, A8-159, Los Angeles, CA 90024, USA
| | - Gita Murthy
- Los Angeles County Department of Mental Health + UCLA Strike Team, 3261 Lincoln Avenue, Altadena, CA 91001, USA
| | - Jonathan Sherin
- Los Angeles County Department of Mental Health, 11301 Wilshire Boulevard, Los Angeles, CA 90073, USA
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Cox GR, Anastario M, FireMoon P, Ricker A, Rink E. Narrative frames as choice over structure of American Indian sexual and reproductive health consequences of historical trauma. SOCIOLOGY OF HEALTH & ILLNESS 2021; 43:1774-1788. [PMID: 34293204 PMCID: PMC8767647 DOI: 10.1111/1467-9566.13355] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 06/08/2021] [Accepted: 06/21/2021] [Indexed: 06/13/2023]
Abstract
Emerging evidence suggests that the historical trauma associated with settler colonialism affects the sexual and reproductive health (SRH) of American Indian (AI) communities today. This article examines how one AI community narratively frames the influence of historical trauma within the context of community-based participatory research (CBPR) and the implications of this framing for health behaviours, internalized oppression, SRH outcomes, and future CBPR interventions. We found that AIs framed the SRH consequences of historical trauma with renderings that favoured personal choice over structural explanations. Our findings suggest future interventions could: (1) include educational components on historical trauma and the continued role settler colonialism plays in structural violence against AI bodies and communities; and (2) recognize the role that the individualized logic of westernized/white culture may play in the erasure of traditional collectivist AI culture, internalized oppression, and SRH.
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Affiliation(s)
| | | | | | - Adriann Ricker
- Fort Peck Public Health Consultant, Poplar, Montana, USA
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Ahmedien DAM. New-media arts-based public engagement projects could reshape the future of the generative biology. MEDICAL HUMANITIES 2021; 47:283-291. [PMID: 32467304 DOI: 10.1136/medhum-2020-011862] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/24/2020] [Indexed: 06/11/2023]
Abstract
Research in the sciences of new-media arts aims to develop original research questions and borrows many different interdisciplinary research methodologies that often involve collaboration with professionals from non-art fields to provide real investigations. Over the last four decades, new-media arts provided unlimited strategies to integrate the laypeople into real interactive conversations allowing them to express their opinions and reflect their concerns regarding boundless scientific, environmental, political and ethical issues. Within this context, this article illustrates the parallel and growing attention to perform effective joint public engagement projects between both new-media arts and biological science domains and how biological science could benefit from the new-media arts projects to allow the laypeople to actively participate in decision-making processes regarding critical biological issues that seek more open and democratic biological investigations. This article, therefore, monitors the developments of public engagement as a concept in biological sciences and its practical principles, which they have been enhanced under the influence of today's new-media arts strategies of engagement. As an extension of the existed efforts, the article, finally, highlighted one of the most recent international conversation led by the author regarding an assumed new-media arts protocol to use stem cells in new-media arts labs and the role of such protocol to secure the highest standard level of public engagement, by which the laypeople could control and reshape the future of generative biology and personalised medicine.
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Affiliation(s)
- Diaa Ahmed Mohamed Ahmedien
- Science of New-Media Arts and Technology, Drawing & Painting Department, Faculty of Art Education, Helwan University, Cairo, Egypt
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48
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The Co-Evolution of Network Structure and PrEP Adoption among a Large Cohort of PrEP Peer Leaders: Implications for Intervention Evaluation and Community Capacity-Building. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18116051. [PMID: 34199829 PMCID: PMC8200056 DOI: 10.3390/ijerph18116051] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 05/16/2021] [Accepted: 06/03/2021] [Indexed: 11/17/2022]
Abstract
Background: Peer leader interventions are effective strategies for promoting prevention behaviors in communities at risk for HIV, yet little is known about their effects on the social and behavioral dynamics of peer leaders themselves. Methods: Using data from PrEP Chicago, an RCT PrEP for prevention intervention for young Black MSM (YBMSM), we apply stochastic actor-based models to longitudinally model the impact of study participation on the online friendship and PrEP adoption dynamics among a network of peer leaders (n = 174) and a network of control group counterparts (n = 166). Results: Peer leaders assigned to the same leadership training workshop were more likely to form new Facebook friendships with one another, whereas control participants assigned to the same attention control workshop were no more or less likely to form new friendships. Further, peer leaders with greater PrEP intentions and those living with HIV were more active in forming new friendships with other peer leaders, effects not found in the control network. PrEP adoption was not influenced by network dynamics in either group. Conclusions: The implications of these findings are discussed through the lens of community-capacity building and the role that peer leader interventions and the networks they engage can impact public health.
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Derose KP, Wallace DD, Han B, Cohen DA. Effects of park-based interventions on health-related outcomes: A systematic review. Prev Med 2021; 147:106528. [PMID: 33745954 PMCID: PMC8096710 DOI: 10.1016/j.ypmed.2021.106528] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 02/10/2021] [Accepted: 03/16/2021] [Indexed: 12/26/2022]
Abstract
Increasing use of parks for physical activity has been proposed for improving population health, including mental health. Interventions that aim to increase park use and park-based physical activity include place-based interventions (e.g., park renovations) and person-based interventions (e.g., park-based walking or exercise classes). Using adapted methods from the Community Guide, a systematic review (search period through September 2019) was conducted to evaluate the effectiveness of park-based interventions among adults. The primary outcomes of interest were health-related, including physical and mental health and moderate-to-vigorous physical activity. Twenty-seven studies that met review criteria were analyzed in 2019 and 2020. Seven person-based studies included generally small samples of specific populations and interventions involved mostly exercise programming in parks; all but one had an average quality rating as "high" and all had at least one statistically significant outcome. Of the 20 place-based interventions, 7 involved only 1 or 2 parks; however, 7 involved from 9 to 78 parks. Types of interventions were predominantly park renovations; only 5 involved park-based exercise programming. Most of the renovations were associated with increased park-level use and physical activity, however among those implementing programming, park-level effects were more modest. Less than half of the place-based intervention studies had an average quality rating of "high." The study of parks as sites for physical activity interventions is nascent. Hybrid methods that combine placed-based evaluations and cohort studies could inform how to best optimize policy, programming, design and management to promote health and well-being.
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Affiliation(s)
- Kathryn P Derose
- RAND Corporation, 1776 Main Street, Santa Monica, CA 90401, United States.
| | - Deshira D Wallace
- Carolina Population Center, University of North Carolina, Chapel Hill, United States.
| | - Bing Han
- RAND Corporation, 1776 Main Street, Santa Monica, CA 90401, United States.
| | - Deborah A Cohen
- RAND Corporation, 1776 Main Street, Santa Monica, CA 90401, United States.
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50
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Algarin AB, Hee Shrader C, Hackworth BT, Varas-Diaz N, Fennie KP, Sheehan DM, Ibañez GE. Development and Validation of the Community PrEP-Related Stigma Scale (Community-PSS). AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2021; 33:120-128. [PMID: 33821676 PMCID: PMC8054770 DOI: 10.1521/aeap.2021.33.2.120] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Despite increasing availability of pre-exposure prophylaxis (PrEP), HIV prevention efforts have stalled. It is important to study potential barriers to HIV prevention methods, such as pre-exposure prophylaxis stigma. This study aims to develop and validate the Community PrEP-related Stigma Scale (Community-PSS) to address gaps in the literature. Participants were 108 sexual and gender minority men recruited through virtual and community-posted advertisements in Florida. The authors assessed reliability using Cronbach's alpha analysis, determined scale components using principal component analysis, and assessed construct validity based on five a priori hypotheses. The scale had high internal consistency (α = 0.86) and four components (stigma of actions outside of sex, stigma of sexual actions, extreme stigma perceptions, and positive community perception). The Community-PSS was valid, supporting four out of five hypotheses and in the expected directions. The Community-PSS was a valid and reliable tool in the sample and correlates with a previously validated PrEP stigma scale, HIV knowledge, PrEP knowledge, and likelihood of condom use with a partner on PrEP.
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Affiliation(s)
- Angel B Algarin
- Division of Infectious Diseases and Global Public Health, University of California San Diego, La Jolla, California
| | - Cho Hee Shrader
- Department of Public Health Sciences, University of Miami, Miami, Florida
| | | | - Nelson Varas-Diaz
- Department of Global & Sociocultural Studies, Florida International University, Miami, Florida
| | | | - Diana M Sheehan
- Department of Epidemiology, Center for Research on U.S. Latino HIV/AIDS and Drug Abuse (CRUSADA), and the FIU Research Center in Minority Institutions (FIU-RCMI), Florida International University, Miami, Florida
| | - Gladys E Ibañez
- Department of Epidemiology, Florida International University, Miami, Florida
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