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Yamamoto K, Nasu K, Nakayoshi Y, Takase M. Sustaining the nursing workforce - exploring enabling and motivating factors for the retention of returning nurses: a qualitative descriptive design. BMC Nurs 2024; 23:248. [PMID: 38627792 PMCID: PMC11022350 DOI: 10.1186/s12912-024-01900-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 03/29/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND The nursing shortage represents a persistent and urgent challenge within the healthcare industry. One of the most cost-effective and time-efficient solutions to address this issue is the recruitment of inactive nurses to rejoin the nursing workforce, while simultaneously ensuring the long-term sustainability of their careers following their return to work. The aim of this study is to explore the factors that facilitate the retention of nurses who have returned to work, from their perspective. METHODS To achieve this aim, a qualitative descriptive design was employed. A total of 15 registered nurses who had not practiced nursing for a minimum of three years prior to their return to work, and had been working as nurses for at least three months following their return, were selected from seven healthcare institutions using convenience sampling. Face-to-face or online semi-structured interviews were conducted, and qualitative inductive analysis was employed to analyze the collected data. RESULTS The analysis revealed five key themes, two of which were related to the enabling factors making it possible for the nurses to continue their work, while the remaining three pertained to the motivating factors driving the pursuit of professional careers. The two themes associated with enabling factors were identified as "Conditions and support that sustain work-life balance" and "A workplace that acknowledges my career, and encourages my growth as an experienced nurse". The three themes related to motivating factors were entitled "Pride in reconnecting with and contributing to society," "Cultivating confidence through incremental professional development and future envisioning," and "Enrichment of my own and my family's life". CONCLUSIONS Returning nurses constitute a valuable asset for healthcare institutions. To effectively retain these nurses, it is crucial to implement multi-dimensional approaches that enable and motivate them to sustain and enrich their professional and personal lives while continuing their work in the nursing field.
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Affiliation(s)
- Kumiko Yamamoto
- School of Nursing, Yasuda Women's University, 6-13-1, Yasuhigashi, Asaminami-ku, 731-0153, Hiroshima, Japan
| | - Katsumi Nasu
- School of Nursing, Yasuda Women's University, 6-13-1, Yasuhigashi, Asaminami-ku, 731-0153, Hiroshima, Japan
| | - Yoko Nakayoshi
- School of Nursing, Yasuda Women's University, 6-13-1, Yasuhigashi, Asaminami-ku, 731-0153, Hiroshima, Japan
| | - Miyuki Takase
- School of Nursing, Yasuda Women's University, 6-13-1, Yasuhigashi, Asaminami-ku, 731-0153, Hiroshima, Japan.
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Lestari PW, Agestika L, Dewi GK. Predisposing, Enabling, and Reinforcing Factors of COVID-19 Prevention Behavior in Indonesia: A Mixed-methods Study. J Prev Med Public Health 2023; 56:21-30. [PMID: 36746419 PMCID: PMC9925286 DOI: 10.3961/jpmph.22.340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 11/14/2022] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES To prevent the spread of coronavirus disease 2019 (COVID-19), behaviors such as mask-wearing, social distancing, decreasing mobility, and avoiding crowds have been suggested, especially in high-risk countries such as Indonesia. Unfortunately, the level of compliance with those practices has been low. This study was conducted to determine the predisposing, enabling, and reinforcing factors of COVID-19 prevention behavior in Indonesia. METHODS This cross-sectional study used a mixed-methods approach. The participants were 264 adults from 21 provinces in Indonesia recruited through convenience sampling. Data were collected using a Google Form and in-depth interviews. Statistical analysis included univariate, bivariate, and multivariate logistic regression. Furthermore, qualitative data analysis was done through content analysis and qualitative data management using Atlas.ti software. RESULTS Overall, 44.32% of respondents were non-compliant with recommended COVID-19 prevention behaviors. In multivariate logistic regression analysis, low-to-medium education level, poor attitude, insufficient involvement of leaders, and insufficient regulation were also associated with decreased community compliance. Based on in-depth interviews with informants, the negligence of the Indonesian government in the initial stages of the COVID-19 pandemic may have contributed to the unpreparedness of the community to face the pandemic, as people were not aware of the importance of preventive practices. CONCLUSIONS Education level is not the only factor influencing community compliance with recommended COVID-19 prevention behaviors. Changing attitudes through health promotion to increase public awareness and encouraging voluntary community participation through active risk communication are necessary. Regulations and role leaders are also required to improve COVID-19 prevention behavior.
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Affiliation(s)
- Putri Winda Lestari
- Corresponding author: Putri Winda Lestari, Faculty of Health Sciences and Technology, Binawan University, Kalibata City Street No. 25-30, East Jakarta 13630, Indonesia E-mail:
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Morgan AK, Adei D, Agyemang-Duah W, Mensah AA. An integrative review on individual determinants of enrolment in National Health Insurance Scheme among older adults in Ghana. BMC Prim Care 2022; 23:190. [PMID: 35907799 PMCID: PMC9338578 DOI: 10.1186/s12875-022-01797-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 07/13/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND We conducted an integrative review in an attempt to methodically and systematically understand the individual (personal factors) that influence National Health Insurance Scheme [NHIS] enrolment among older adults aged 50 years and above. The study was premised on evidence pointing to a state of little or no change in the enrolment rates [especially among older adults], which contrasts with the initial euphoria that greeted the launch of the scheme - which culminated in high enrolment rates. METHODS The integrative literature review was conducted to synthesise the available evidence on individual determinants of NHIS among older adults. The methodological approach of the integrative literature review follows a five-stage interdependent and interconnected procedure of problem identification, literature search, data evaluation, data analysis and results presentation. Studies that met the inclusion criteria were peer-reviewed articles published in the English Language, from January 2010 to July 2020 and have Ghana as its setting or study area. The Andersen's Behavioural Model was used to categorize the predictor variables. RESULTS Predisposing factors [gender, age, level of education and marital status], enabling factors [income] and need factors [health conditions or health attributes of older adults] were identified as individual predictors of NHIS enrolment among older adults. The findings support argument of Andersen's Behavioural Model [where predisposing, enabling and need factors are considered as individual determinants of health behaviour]. CONCLUSIONS The findings call for policy reforms that take into account the aforementioned individual predictors of NHIS enrolment, especially among the aged.
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Affiliation(s)
- Anthony Kwame Morgan
- Department of Planning, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Dina Adei
- Department of Planning, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | - Anthony Acquah Mensah
- Department of Planning, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Mann C, Loft L, Hernández-Morcillo M, Primmer E, Bussola F, Falco E, Geneletti D, Dobrowolska E, Grossmann CM, Bottaro G, Schleyer C, Kluvankova T, Garcia G, Lovrić M, Torralba M, Plieninger T, Winkel G. Governance Innovations for forest ecosystem service provision - Insights from an EU-wide survey. Environ Sci Policy 2022; 132:282-295. [PMID: 35663433 PMCID: PMC8996823 DOI: 10.1016/j.envsci.2022.02.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 01/27/2022] [Accepted: 02/28/2022] [Indexed: 06/15/2023]
Abstract
This paper analyses the occurrence of governance innovations for forest ecosystem service (FES) provision in the forestry sector in Europe and the factors that influence innovation development. Based on a European-wide online survey, public and private forest owners and managers representing different property sizes indicate what type of governance innovation activities they engage in, and why. To investigate forestry innovations as systems, the analysis focuses on biophysical, social and technical factors influencing innovation development. The results of our exploratory quantitative analysis show that most innovation activities identified are largely oriented towards biomass production. Accordingly, most forest owners implement efficiency-driven optimisation strategies for forest management and technological improvement for provisioning service supply, to generate income. In contrast, the provision of regulating and cultural services is not yet a prominent part of forestry innovation activities.Reasons are rooted in a market-oriented economic rationale focusing on timber production, a lack of financial resources to compensate for other FES provisions or institutions to provide backup and security to forest owners and managers for engaging in innovation development. Given that the provision of a wide range of FES is a politically well-established objective for forest management in Europe, a strategy is needed that helps to align actors and sectors for supporting and co-financing related forest management approaches and business models. The current revision of the forest related policy framework on EU level under the EU Green deal poses a window of opportunity for better fostering novel governance approaches for more sustainable FES provision.
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Affiliation(s)
- Carsten Mann
- Eberswalde University for Sustainable Development, Chair for Sustainable Forest Resource Economics, Schicklerstrasse 5, Eberswalde 16225, Germany
| | - Lasse Loft
- Leibniz Centre for Agricultural Landscape Research (ZALF), Eberswalder Str. 84, Müncheberg 15374, Germany
| | - Mónica Hernández-Morcillo
- Eberswalde University for Sustainable Development, Chair for Sustainable Forest Resource Economics, Schicklerstrasse 5, Eberswalde 16225, Germany
| | - Eeva Primmer
- Finnish Environment Institute, Latokartanonkaari 11, Helsinki 00790, Finland
| | - Francesca Bussola
- Forest Service of the Autonomous Province of Trento, via Trener 3, Trento 38121, Italy
| | - Enzo Falco
- Department of Civil, Environmental, and Mechanical Engineering, University of Trento, Via Mesiano 77, Trento 38123, Italy
| | - Davide Geneletti
- Department of Civil, Environmental, and Mechanical Engineering, University of Trento, Via Mesiano 77, Trento 38123, Italy
| | - Ewelina Dobrowolska
- Eberswalde University for Sustainable Development, Faculty of Forest and Environment, Schicklerstrasse 5, Eberswalde 16225, Germany
| | - Carol M. Grossmann
- Forest Research Institute Baden-Wuerttemberg (FVA), Department of Societal Change, Wonnhaldestr. 4, Freiburg 79100, Germany
| | - Giorgia Bottaro
- Land Environment Agriculture and Forestry Department (TeSAF), University of Padova, Viale dell’Università 16, Legnaro, Padova 35020, Italy
| | - Christian Schleyer
- Institute of Geography, University of Innsbruck, Innrain 52f, Innsbruck 6020, Austria
- Faculty of Organic Agricultural Sciences, University of Kassel, Steinstraße 19, Witzenhausen 37213, Germany
| | - Tatiana Kluvankova
- SlovakGlobe: Slovak University of Technology and Slovak Academy of Sciences, Vazovova5, Bratislava 81243, Slovakia
| | - Gino Garcia
- Eberswalde University for Sustainable Development, Schicklerstrasse 5, Eberswalde 16225, Germany
| | - Marko Lovrić
- European Forest Institute, Yliopistokatu 6B, Joensuu 80100, Finland
| | - Mario Torralba
- Faculty of Organic Agricultural Sciences, University of Kassel, Steinstraße 19, Witzenhausen 37213, Germany
| | - Tobias Plieninger
- Faculty of Organic Agricultural Sciences, Universität Kassel, Germany
- Department of Agricultural Economics and Rural Development, Georg-August-Universität Göttingen, Platz der Göttinger Sieben 5, Göttingen 37073, Germany
| | - Georg Winkel
- European Forest Institute, Governance Programme, Platz der Vereinten Nationen 7, Bonn 53113, Germany
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Kumera M, Haidar J. Level of exclusive breastfeeding and its enabling factors among lactating women who delivered in health facilities of Asosa town, Ethiopia: a cross sectional study. BMC Womens Health 2021; 21:432. [PMID: 34961489 PMCID: PMC8714435 DOI: 10.1186/s12905-021-01580-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 12/15/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite the enormous benefit of exclusive breastfeeding (EBF) to mothers and infants, the practice of exclusive breastfeeding is globally low. In sub-Saharan Africa and Ethiopia, the prevalence of EBF stands at 35% and 59%, respectively. The low EBF practice in Ethiopia as well as in the studied region calls for further study and thus we studied the EBF practice in the study area since little is known about its current magnitude and factors influencing its practice for some programmatic improvements. METHODS A facility based cross-sectional study linked to a community was conducted from June-July 2019 among 412 mothers who had antenatal follow-up and delivered in health facilities of Asosa town over a period of one year prior to the study. Data on socio demographic characteristics and other important variables were collected through face to face interview while gestational age in weeks was recorded from their medical chart by trained health extension workers in accordance with relevant ethical guidelines and regulations. The collected data were then cleaned and entered into Epi-data software version 3.02. Analysis was done by SPSS version 20. Binary and multivariate logistic regression were performed to identify the contributing factors. P-value of less than 0.05 and 95% confidence interval was considered to determine statistical significance. RESULTS Of the 412 respondents, the majority (88.1%) were multi-gravida and above. Slightly higher than a quarter (26.0%) and over half (55.4%) had neither received antenatal nor postnatal care. The proportion of mothers who exclusively breastfed their children was 76.0% and the overall aggregated good practice of EBF score was 64.1%. Mothers who completed primary school [AOR = 4.5; 95% CI = 1.1,18.2], had four or more ANC [AOR = 1.8;95CI = 0.79-0.98], and postnatal follow-up [AOR = 0.21;95% CI = 0.07-0.67], and had male infants [AOR = 2.3; 95% CI = 1.0-4.95] were among the factors influencing the exclusive breastfeeding practice score. CONCLUSION While three in four mothers exclusively breastfed their newborns and about two-thirds had good EBF score, the observed women's retention on the continuum of the maternal care pathway is low with one in four had no antenatal and over half had no postnatal care which are important derivers for EBF practice. To improve the EBF score and narrow the observed maternal and child health disparities, it is essential to promote maternal education and increase the recomended coverage of antenatal and postnatal care for mothers.
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Affiliation(s)
| | - Jemal Haidar
- College of Health Sciences, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
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Shrestha A, Thapa TB, Giri M, Kumar S, Dhobi S, Thapa H, Dhami PP, Shahi A, Ghimire A, Rathaur ES. Knowledge and attitude on prevention of COVID-19 among community health workers in Nepal-a cross-sectional study. BMC Public Health 2021; 21:1424. [PMID: 34281512 PMCID: PMC8287280 DOI: 10.1186/s12889-021-11400-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 06/28/2021] [Indexed: 01/20/2023] Open
Abstract
Background Emerging and reemerging pathogens are global challenges for public health and the pandemic of Coronavirus disease 2019is a reemerging case of an infectious disease caused by Severe Acute Respiratory Syndrome-Corornavirus-2. Health care worker worldwide are at higher risk worldwide and the situation is the same in Nepal. The knowledge and attitude of health workers will certainly mark the outcome towards this pandemic. So, this study aims to assess the knowledge and attitude of community health workers towards the prevention of COVID-19 virus. Methods A descriptive cross-sectional study was carried out among the community health workers of various provinces of Nepal. A semi-structured, self-administered questionnaire was prepared in Google form and circulated to the sampled health workers through various social media platforms like face book, messenger, Instagram and g-mails. A total of 650 invitations were send and among them 420 responded and among them only 399 provided complete response. Responses containing anonymized data was collected analyzed in using SPSS-version-20. The results were interpreted and was checked with various demographic and enabling factors using chi-square test and logistic regression model. Also, ethical approval was taken from NHRC (Nepal Health Research Council (protocol registration number: 360/2020P) prior to the conduction of study. Results Out the total sample size of 450, we took 399 responses taking into consideration all the inclusion criteria. So, from 399 valid response, 230 (47.6%) were males and 169 (42.4%) were females. 380 (95.2%) employed participants thought that wearing PPE will reduce the chances of getting COVID-19, majority of the participants 80.5% (321) responded that COVID-19 will successfully be controlled and staffs receiving excellent support from palika had high knowledge level. Knowledge level was significantly associated with the enabling factor “support from palika” (P = 0.045).45.9% of the respondents had no availability of COVID-19 response medical items for prevention of COVID-19 at their respective health facilities. Also the logistic regression analysis revealed that the odds of knowledge level was 2 times higher (AOR=1.913 at 95% CI: 1.266-2.891) compared to the female participants (Ref- female). Conclusions Proper and adequate knowledge and attitude towards COVID-19 is a paramount in the prevention and control of SARS-COV-2. Health care workers are knowledgeable about COVID-19 and are proactively practicing the preventive measures to minimize the spread of infection but some lack optimistic attitude. Hence, the constantly updated educational programs related to COVID-19 will surely contribute to improving the healthcare workers knowledge and attitude towards COVID-19. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11400-9.
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Affiliation(s)
- Amul Shrestha
- IFHR (Innovative Foundation for Health and Research), Kathmandu, Nepal. .,Department of Public Health, Health Office, Lalitpur, Bagmati Province, Nepal.
| | - Tek Bahadur Thapa
- IFHR (Innovative Foundation for Health and Research), Kathmandu, Nepal.,Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Nepal
| | - Mahendra Giri
- IFHR (Innovative Foundation for Health and Research), Kathmandu, Nepal.,Department of Social Welfare Health Section, Lalitpur Metropolitan City, Pulchowk, Lalitpur, Nepal
| | - Sanjiv Kumar
- IFHR (Innovative Foundation for Health and Research), Kathmandu, Nepal
| | - Sakil Dhobi
- IFHR (Innovative Foundation for Health and Research), Kathmandu, Nepal.,Department of Public Health, Tarkeshwor Municipality, Kathmandu, Nepal
| | - Haikali Thapa
- IFHR (Innovative Foundation for Health and Research), Kathmandu, Nepal.,Department of Public Health, Health Office, Lalitpur, Bagmati Province, Nepal
| | | | - Arun Shahi
- IFHR (Innovative Foundation for Health and Research), Kathmandu, Nepal.,Consultant of medical oncology, Patan Academy of Health Sciences, Lalitpur, Nepal
| | - Ajita Ghimire
- IFHR (Innovative Foundation for Health and Research), Kathmandu, Nepal
| | - Ela Singh Rathaur
- IFHR (Innovative Foundation for Health and Research), Kathmandu, Nepal.,Consultant-Disease Surveillance for emergency response- Strengthening System for Better Health, Lalitpur, Nepal
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Osinowo K, Ekholuenetale M, Ojomo O, Hassan A, Ladipo OA. Patterns of triggers, ideation and motivational factors of contraceptive utilization among women and gate-keepers in Nigeria: a scoping study on the resilient and accelerated scale up of DMPA-SC in Nigeria (RASUDIN). Contracept Reprod Med 2020; 5:38. [PMID: 33292709 PMCID: PMC7709337 DOI: 10.1186/s40834-020-00141-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 11/25/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Women have unfair share in the burden of unintended pregnancy outcome and unhealthy interpregnancy intervals. An understanding of the triggers, ideation and motivational factors influencing utilization of modern contraceptives is relevant for efforts aimed at increasing utilization among the general public, specifically sexually active women. The objective of this study is to explore the triggers, ideation and motivational factors influencing the use of modern family planning methods including depot-medroxyprogesterone acetate subcutaneous (DMPA-SC). METHODS Qualitative methods which include; Focus Group Discussions (FGDs) and In-depth Interviews (IDIs) were used to elicit information from women of reproductive age and gate-keepers in selected Nigerian states; Rivers, Ogun, Kwara, Niger, Anambra, Delta, Lagos, Enugu and Oyo. The categories of respondents include; unmarried women aged 18-25 years, women in union aged 18-24 years using modern family planning (FP), women in union aged 25-49 years using modern FP, women in union aged 26-49 years non-users of modern FP, community leaders, health facility focal person, husbands of current users of modern FP, husbands of non-users of modern FP, religious leaders, state FP coordinators and women aged 18-49 years who currently use DMPA-SC. Maximum variation sampling techniques was used to enlist participants to participate in both FGDs and IDIs. RESULTS Respondents reported being motivated to use FP for reasons such as benefits of the method, economic situation, suitability of the methods, fear of unwanted pregnancy and its convenience. Further analysis showed that the unmarried respondents discussed more about fear of unwanted pregnancy and accessibility and affordability as a key motivator; while women in union discussed more on economic situations, encouragement from partners and benefits of FP when compared with the unmarried. In addition, respondents reported that their partners, health workers and friends influenced their decisions to use FP. Partners' encouragement, personal experience, accessibility and availability, awareness of FP and its benefits; willingness to space children and costs were notable enablers of FP use. The triggers for FP use were; appointment cards, phone calls from health workers, reminders (text messages, phone alarms and partners' support). CONCLUSION Increasing utilization therefore requires a well-planned horizontal approach that considers all enabling factors influencing utilization including women's empowerment. Family planning programmes that are client centered, address socio-cultural and gender norms and ensure access to contraceptive mix methods are recommended to improve utilization rate. This study recommends improved care-seeking behaviour through community-based awareness creation to address myths and misconceptions of family planning use, establishment of contraceptive delivery teams to prevent challenges of availability and accessibility, value clarification and tasks shifting among others to deal with the issue of inadequate family planning utilization.
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Affiliation(s)
- Kehinde Osinowo
- Association for Reproductive and Family Health, 1st Floor, Block C, Millennium Builders Plaza, Abuja, Nigeria.
| | - Michael Ekholuenetale
- Association for Reproductive and Family Health, 1st Floor, Block C, Millennium Builders Plaza, Abuja, Nigeria
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Oluwaseun Ojomo
- Association for Reproductive and Family Health, 1st Floor, Block C, Millennium Builders Plaza, Abuja, Nigeria
| | - Abiodun Hassan
- Association for Reproductive and Family Health, 1st Floor, Block C, Millennium Builders Plaza, Abuja, Nigeria
- Family Health International (FHI360), Godab Plaza, J. S. Tarkar St, Garki, Abuja, Nigeria
| | - Oladapo Alabi Ladipo
- Association for Reproductive and Family Health, 1st Floor, Block C, Millennium Builders Plaza, Abuja, Nigeria
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Pourhaji F, Delshad MH, Tavafian SS, Niknami S, Pourhaji F. Effects of educational program based on Precede-Proceed model in promoting low back pain behaviors (EPPLBP) in health care workers Shahid Beheshti University of medical sciences: randomized trial. Heliyon 2020; 6:e05236. [PMID: 33163641 PMCID: PMC7610227 DOI: 10.1016/j.heliyon.2020.e05236] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 09/02/2020] [Accepted: 10/08/2020] [Indexed: 01/01/2023] Open
Abstract
The PRECEDE-PROCEED model is an adaptable planning model that could be served in public health issues. The purpose of this study is to investigate the effects of an educational program based on Precede-Proceed model on promoting Low Back Pain (LBP) behaviors among health care workers (HCWs). This Double-blinded randomized trial study was conducted on 112 from 120 HCWs aged from 30 to 55 years The eligible HCWs were randomly divided to intervention group 1 (N = 38), respectively intervention group 2 and control group (N = 37) for which the Precede-Proceed - based educational program was implemented and control group (N = 37). The random multi-stage cluster sampling method was used to recruit HCWs. HCWs completed a self-reported questionnaire on their Low Back Pain Behaviors assessment questionnaire based on the Precede-Proceed Model and a visual analogue scale (VAS) was also used. The data were gathered at initial of the study, 6 and 12 months follow-ups from three groups and were analyzed through SPSS version 19. There was a significant interaction between the factors “group” and “test time” (p < 0.05, p < 0.001) of knowledge, perceived self-efficacy, and attitude, reinforcing factors, enabling factors, public health, quality of life and LBP preventive behaviors of the intervention group., although, no significant alternate became located in the mean score of above structures of the control group. The findings of the present study confirmed the effectiveness of the PRECEDE-PROCEED model-based educational program on preventing LBP by enhancing scores of model constructs. However, these results should be repeated in further studies to be able to apply this program in health system.
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Affiliation(s)
- Fatemeh Pourhaji
- Department of Public Health Department, School of Health, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran.,Health Sciences Research Center, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | - Mohammad Hossein Delshad
- Department of Public Health Department, School of Health, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran.,Health Sciences Research Center, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran.,PhD of Health Education and Health Promotion, Shemiranat Health Network, Health Deputy Department, Shahid Beheshti University, Tehran, Iran
| | - Sedigheh Sadat Tavafian
- Department of Health Education and Health Promotion, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Shamsodin Niknami
- Department of Health Education and Health Promotion, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Fahimeh Pourhaji
- Department of Health Education and Health Promotion, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
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Penzenstadler L, Gentil L, Grenier G, Khazaal Y, Fleury MJ. Risk factors of hospitalization for any medical condition among patients with prior emergency department visits for mental health conditions. BMC Psychiatry 2020; 20:431. [PMID: 32883239 PMCID: PMC7469095 DOI: 10.1186/s12888-020-02835-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 08/24/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND This longitudinal study identified risk factors for frequency of hospitalization among patients with any medical condition who had previously visited one of six Quebec (Canada) emergency departments (ED) at least once for mental health (MH) conditions as the primary diagnosis. METHODS Records of n = 11,367 patients were investigated using administrative databanks (2012-13/2014-15). Hospitalization rates in the 12 months after a first ED visit in 2014-15 were categorized as no hospitalizations (0 times), moderate hospitalizations (1-2 times), and frequent hospitalizations (3+ times). Based on the Andersen Behavioral Model, data on risk factors were gathered for the 2 years prior to the first visit in 2014-15, and were identified as predisposing, enabling or needs factors. They were tested using a hierarchical multinomial logistic regression according to the three groups of hospitalization rate. RESULTS Enabling factors accounted for the largest percentage of total variance explained in the study model, followed by needs and predisposing factors. Co-occurring mental disorders (MD)/substance-related disorders (SRD), alcohol-related disorders, depressive disorders, frequency of consultations with outpatient psychiatrists, prior ED visits for any medical condition and number of physicians consulted in specialized care, were risk factors for both moderate and frequent hospitalizations. Schizophrenia spectrum and other psychotic disorders, bipolar disorders, and age (except 12-17 years) were risk factors for moderate hospitalizations, while higher numbers (4+) of overall interventions in local community health service centers were a risk factor for frequent hospitalizations only. Patients with personality disorders, drug-related disorders, suicidal behaviors, and those who visited a psychiatric ED integrated with a general ED in a separate site, or who visited a general ED without psychiatric services were also less likely to be hospitalized. Less urgent and non-urgent illness acuity prevented moderate hospitalizations only. CONCLUSIONS Patients with severe and complex health conditions, and higher numbers of both prior outpatient psychiatrist consultations and ED visits for medical conditions had more moderate and frequent hospitalizations as compared with non-hospitalized patients. Patients at risk for frequent hospitalizations were more vulnerable overall and had important biopsychosocial problems. Improved primary care and integrated outpatient services may prevent post-ED hospitalization.
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Affiliation(s)
- Louise Penzenstadler
- grid.14709.3b0000 0004 1936 8649Douglas Hospital Research Center, Douglas Mental Health University Institute, McGill University, 6875 LaSalle Boulevard, Montréal, Québec, H4H 1R3 Canada ,grid.150338.c0000 0001 0721 9812Hôpitaux Universitaires Genève, Département de psychiatrie, Service d’addictologie, Rue du Grand-Pré 70c, 1202 Geneva, Switzerland
| | - Lia Gentil
- grid.14709.3b0000 0004 1936 8649Douglas Hospital Research Center, Douglas Mental Health University Institute, McGill University, 6875 LaSalle Boulevard, Montréal, Québec, H4H 1R3 Canada ,Institut universitaire sur les dépendances du Centre intégré universitaire de santé et des services sociaux du Centre-Sud-de-l’Île-de-Montréal, 950 Louvain East, Montréal, Québec, H2M 2E8 Canada
| | - Guy Grenier
- grid.14709.3b0000 0004 1936 8649Douglas Hospital Research Center, Douglas Mental Health University Institute, McGill University, 6875 LaSalle Boulevard, Montréal, Québec, H4H 1R3 Canada
| | - Yasser Khazaal
- grid.8515.90000 0001 0423 4662Centre hospitalier universitaire vaudois, Département de psychiatrie, Service de médecine des addictions, Policlinique d’addictologie, Rue du Bugnon 23, 1011 Lausanne, Switzerland ,grid.14848.310000 0001 2292 3357Département de psychiatrie et d’addictologie, Université de Montréal, 2900 bld Eduard-Montpetit, Montréal, Québec, H3T1J4 Canada
| | - Marie-Josée Fleury
- Douglas Hospital Research Center, Douglas Mental Health University Institute, McGill University, 6875 LaSalle Boulevard, Montréal, Québec, H4H 1R3, Canada. .,Institut universitaire sur les dépendances du Centre intégré universitaire de santé et des services sociaux du Centre-Sud-de-l'Île-de-Montréal, 950 Louvain East, Montréal, Québec, H2M 2E8, Canada.
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10
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Tesfaye G, Chojenta C, Smith R, Loxton D. Predisposing, enabling and need factors associated with skilled delivery care utilization among reproductive-aged women in Kersa district, eastern Ethiopia. Reprod Health 2019; 16:167. [PMID: 31729986 PMCID: PMC6858740 DOI: 10.1186/s12978-019-0829-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Accepted: 10/28/2019] [Indexed: 11/10/2022] Open
Abstract
Background Skilled delivery care utilization in Ethiopia is still very low compared with the goal set by the global community for countries with the highest maternal mortality. As a result, the country is overburdened with high maternal morbidity and mortality. We aimed to explore the predisposing, enabling, and need factors associated with skilled delivery care utilization among reproductive-aged women in Kersa district, eastern Ethiopia. Methods A community-based cross-sectional study was conducted with a total of 1294 women. The participants were selected using systematic sampling techniques. An interviewer-administered structured questionnaire aided by an electronic survey tool was used to collect data. Univariate analyses were conducted to describe the study sample. Bivariate and multivariate logistic regression analyses were carried out to elicit the association of predisposing, enabling, and need factors associated with skilled delivery care utilization. Separate multivariate models were fitted for primiparous and multiparous women categories. Odds ratios with 95% confidence intervals were used to assess statistical significance. Results More than a quarter (30.8%) of the women surveyed used skilled delivery care for their most recent birth. Significant predisposing factors were as follows: presence of educated family member; receiving education on maternal health; previous use of skilled delivery care; and best friend’s use of maternal care. Place of residence was the enabling factor that predicted skilled delivery care use. Antenatal care attendance and pregnancy intention were significant need factors associated with skilled delivery care utilization. Conclusion The findings of the study highlight the need for a concerted effort to establish community-based peer education programs; improve access to family planning services (to reduce unintended pregnancies); increase antenatal care uptake; and facilitate access to skilled delivery care in rural areas.
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Affiliation(s)
- Gezahegn Tesfaye
- School of Public Health, College of Health and Medical Sciences, Haramaya University, P.O Box: 235, Harar, Ethiopia. .,Research Centre for Generational Health and Ageing, Faculty of Health and Medicine University of Newcastle, Newcastle upon Tyne, NSW, Australia.
| | - Catherine Chojenta
- Research Centre for Generational Health and Ageing, Faculty of Health and Medicine University of Newcastle, Newcastle upon Tyne, NSW, Australia
| | - Roger Smith
- Mothers and Babies Research Centre, Faculty of Health and Medicine, University of Newcastle, Newcastle, NSW, Australia
| | - Deborah Loxton
- Research Centre for Generational Health and Ageing, Faculty of Health and Medicine University of Newcastle, Newcastle upon Tyne, NSW, Australia
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11
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Khani Jeihooni A, Moradi M. The Effect of Educational Intervention Based on PRECEDE Model on Promoting Skin Cancer Preventive Behaviors in High School Students. J Cancer Educ 2019; 34:796-802. [PMID: 29926433 DOI: 10.1007/s13187-018-1376-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
School-based education programs can be an effective way of educating adolescents about the dangers of exposure to sunlight and about preventive measures against this exposure and its relation to skin cancer. The aim of this study is to survey the effect of educational intervention based on the PRECEDE model on promoting skin cancer preventive behaviors in high school students of Fasa City, Fars Province, Iran. In this quasi-experimental study, 300 students (150 in experimental group and 150 in control group) in Fasa City, Fars Province, Iran, were selected in 2016-2017. The educational intervention for the experimental group consisted of six training sessions. A questionnaire consisting of demographic information, PRECEDE constructs (knowledge, attitude, self-efficacy, enabling factors, and social support), was used to measure skin cancer preventive behaviors before and 4 months after the intervention. Data were analyzed using SPSS 22 and paired t test, independent t test, and chi-square test at a significance level of p < 0.05. The mean age of the students was 16.05 ± 1.76 years in the experimental group and 16.20 ± 1.71 years in the control group. Four months after the intervention, the experimental group showed a significant increase in the knowledge, attitude, self-efficacy, enabling factors, social support, and skin cancer preventive behaviors compared to the control group. This study showed the effectiveness of the intervention based on the PRECEDE constructs in adoption of skin cancer preventive behaviors in 4 months post-intervention in students. Hence, this model can act as a framework for designing and implementing educational intervention for the prevention of skin cancer.
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Affiliation(s)
- Ali Khani Jeihooni
- Department of Public Health, School of Health, Fasa University of Medical Sciences, Fasa Ibn Sina square, Fasa, 7461686688, Iran.
| | - Milad Moradi
- Department of Public Health, School of Health, Fasa University of Medical Sciences, Fasa Ibn Sina square, Fasa, 7461686688, Iran
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12
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Danhoundo G, Nasiri K, Wiktorowicz ME. Improving social accountability processes in the health sector in sub-Saharan Africa: a systematic review. BMC Public Health 2018; 18:497. [PMID: 29653531 PMCID: PMC5899409 DOI: 10.1186/s12889-018-5407-8] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Accepted: 04/04/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Social accountability is a participatory process in which citizens are engaged to hold politicians, policy makers and public officials accountable for the services that they provide. In the Fifteenth Ordinary Session of the Assembly of the African Union, African leaders recognized the need for strong, decentralized health programs with linkages to civil society and private sector entities, full community participation in program design and implementation, and adaptive approaches to local political, socio-cultural and administrative environments. Despite the increasing use of social accountability, there is limited evidence on how it has been used in the health sector. The objective of this systematic review was to identify the conditions that facilitate effective social accountability in sub-Saharan Africa. METHODS Electronic databases (MEDLINE, PsycINFO, Sociological Abstracts, Social Sciences Abstracts) were searched for relevant articles published between 2000 and August 2017. Studies were eligible for inclusion if they were peer-reviewed English language publications describing a social accountability intervention in sub-Saharan Africa. Qualitative and quantitative study designs were eligible. RESULTS Fourteen relevant studies were included in the review. The findings indicate that effective social accountability interventions involve leveraging partnerships and building coalitions; being context-appropriate; integrating data and information collection and analysis; clearly defined roles, standards, and responsibilities of leaders; and meaningful citizen engagement. Health system barriers, corruption, fear of reprisal, and limited funding appear to be major challenges to effective social accountability interventions. CONCLUSION Although global accountability standards play an important guiding role, the successful implementation of global health initiatives depend on national contexts.
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Affiliation(s)
- Georges Danhoundo
- Faculty of Health (York University), 435 Health, Nursing & Environmental Studies Bldg, 4700 Keele St., Toronto, ON, M3J 1P3, Canada.
| | - Khalidha Nasiri
- Faculty of Health (York University), 435 Health, Nursing & Environmental Studies Bldg, 4700 Keele St., Toronto, ON, M3J 1P3, Canada
| | - Mary E Wiktorowicz
- Dahdaleh Institute for Global Health Research, Community and Global Health, Health Policy and Management, Faculty of Health, York University, Toronto, Canada
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13
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Radmerikhi S, Tabatabaei SVA, Jahani Y, Mohseni M. Predicting effective factors on eating behaviors in the prevention of cardiovascular disease based on the PRECEDE model. Electron Physician 2017; 9:5894-5901. [PMID: 29560139 PMCID: PMC5843413 DOI: 10.19082/5894] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 09/06/2017] [Indexed: 11/20/2022] Open
Abstract
Background and aim Changes in eating behavior can reduce the risk of developing cardiovascular disease. The aim of this study was to predict the effective factors of eating behaviors in the prevention of cardiovascular disease using the PRECEDE model. Methods This cross-sectional study was performed on 400 subjects aged from 20 to 60 years old in Kerman, Iran in 2016. The participants were selected using a multistage random sampling method. A self-administered questionnaire including questions regarding demographic characteristics, eating behavior, and PRECEDE model constructs were completed by the participants. Data were analyzed using SPSS 22 and STATA 12. For data analysis, Spearman correlation coefficient, univariate and multiple median regression were applied. The predictive power of the model constructs was determined by analysis of artificial neural networks. Results Among participants, the score of knowledge was high (84.15±10.7), and the scores of perceived self-efficacy (59.1±16.57), reinforcing factors (60.66±14.01), enabling factors (56.5±12.91), and eating behavior (62.1±14.7) were intermediate, and the score of attitude was low (47.84±7.67). Attitude, self-perceived efficacy, enabling factors, and knowledge predicted 32%, 30%, 26%, and 0.93% of participants' eating behavior respectively. The relationship between all variables and eating behavior was positive and significant (p<0.0001). Perceived self-efficacy had the most, and reinforcing factors the least correlation with eating behavior. Conclusion According to the results of this study, self-efficacy, attitude, and enabling factors were the main predicting factors for eating behaviors; therefore, to prevent cardiovascular disease and enhance healthy eating behavior, it is recommended to change attitude, and enhance self-efficacy and enabling factors in the community.
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Affiliation(s)
- Samera Radmerikhi
- MSc. of Health Education, Social Determinants of Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Seyed Vahid Ahmady Tabatabaei
- M.D-MPH-Ph.D., Assistant Professor, Social Determinants of Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Yunes Jahani
- Ph.D. of Biostatistics, Assistant Professor, Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohabbat Mohseni
- Ph.D. of Public Health and Health Promotion, Assistant Professor, Social Determinants of Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
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14
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Arabyat RM, Raisch DW, Bakhireva L. Influenza vaccination for patients with chronic obstructive pulmonary disease: Implications for pharmacists. Res Social Adm Pharm 2018; 14:162-9. [PMID: 28533080 DOI: 10.1016/j.sapharm.2017.02.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 02/13/2017] [Indexed: 11/20/2022]
Abstract
BACKGROUND Influenza virus is responsible for substantial morbidity and mortality. Specific populations are at higher risk for exacerbations from influenza virus, such as patients with chronic obstructive pulmonary disease (COPD). Influenza vaccination coverage among COPD patients is low. Pharmacists can improve influenza vaccination among COPD patients by recognizing factors that influence vaccination and addressing these factors. OBJECTIVES To (1) determine the recent influenza vaccination coverage among patients with COPD, (2) identify factors that were associated with immunization, and (3) interpret the results based upon Andersen's healthcare utilization model. METHODS The 2012 Behavioral Risk Factor Surveillance System (BRFSS) was accessed for the study. Among respondents age ≥ 25 years with COPD, presence of influenza vaccination was captured along with demographic, provider, insurance, and clinical variables. Weighted multiple logistic regression was used to identify significant factors associated with receiving influenza vaccination. The findings were interpreted according to predisposing, enabling, and need factors relevant to Anderson's model. RESULTS Influenza vaccination rate was 53% among COPD patients. Older age was a significant predisposing factor that increased vaccination (adjusted odds ratio [AOR] = 2.4; 95% CI:2.02-2.88). Predisposing factors that decreased vaccination were being Black or Hispanic (AOR = 0.72, 95% CI:0.59-0.86, and AOR = 0.78, 95% CI:0.61-0.98 respectively), and being a non smoker (former and never smokers had higher vaccination rates [AOR = 1.53, 95% CI = 1.3-1.72, and AOR = 1.36, 95% CI = 1.19-1.55 respectively]). Significant enabling factors included having health insurance (AOR = 1.68, 95% CI = 1.37-2.06), a primary physician (AOR = 1.63, 95% CI = 1.30-2.02), and the ability to see a physician regardless of cost (AOR = 1.33, 95% CI = 1.17-1.52). Significant need factors included the presence of comorbidities such as asthma (AOR = 1.18, 95% CI = 1.1-1.3), or diabetes (AOR = 1.36, 95% CI = 1.20-1.53), activity limitation (AOR = 1.16, 95% CI = 1.04-1.29), and having the last medical checkup within less than one year (AOR = 1.49, 95% CI = 1.31-1.70). CONCLUSION Influenza vaccination coverage among COPD patients is far below the Healthy People 2020 national goal. Several predisposing, enabling, and need factors influenced vaccination rate among COPD patients. Pharmacists can improve vaccination rate among COPD patients by recognizing these influencing factors and by acting as advocates, counselors, and administrators of influenza vaccine. Ultimately, with the collaborative efforts of other healthcare providers and public health initiatives, pharmacists can help achieve Healthy People 2020 objectives related to influenza vaccination.
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Abstract
Fishing using explosives is common in Tanzanian waters; it is considered to be more widely practised now than at any other point in history. Mwambao Coastal Community Network, a Tanzanian NGO carried out a multi-stakeholder consultation in April 2014 initiated through the concern of private investors and tourism operators. Consultations were held with villagers, fisheries officers, government officers, hoteliers, dive operators, fish processors, NGOs and other key individuals, and shed some light on key factors enabling this practice to flourish. Key areas identified for attention include engendering political will at all levels, upholding of the law through a non-corrupt enforcement and judicial system, and defining clear roles and responsibilities for monitoring and surveillance. The work identified other successful initiatives which have tackled this pervasive practice including projects that build local capacity for marine governance, villages that have declared themselves intolerant of blast-fishing, and private-public partnerships for patrol and protection.
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Affiliation(s)
- Lorna M Slade
- Mwambao Coastal Community Network, P.O. Box 3810, Zanzibar, Tanzania.
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Borhani M, Rastgarimehr B, Shafieyan Z, Mansourian M, Hoseini SM, Arzaghi SM, Qorbani M, Rezapoor A, Asayesh H, Charkazi A, Ansari H. Effects of predisposing, reinforcing and enabling factors on self-care behaviors of the patients with diabetes mellitus in the Minoodasht city, Iran. J Diabetes Metab Disord 2015; 14:27. [PMID: 25897420 PMCID: PMC4403720 DOI: 10.1186/s40200-015-0139-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Accepted: 02/21/2015] [Indexed: 12/21/2022]
Abstract
Background To control diabetes mellitus (DM) it is necessary to make overall changes in the life style of the patients. The aim of this study was to determine the effects of predisposing, reinforcing and enabling factors on self-care behaviors of the patients with DM in the Minoodasht city, Iran in 2012. Methods In this quasi-experimental study, 78 people with DM were selected by convenience sampling method. In the first stage of study, the educational program was compiled and executed on six information sessions. To present the informative content, a video projector and different lecturing methods including questions and answers, dynamic group discussion and different educational materials such as pamphlets and CDs were employed. After one month, the efficiency of the educational program was determined by using the same questioner. Data were analyzed using paired sample T-test and McNemar test. Results The mean age of participants was 49 (SD: 3.27.) years old, 87.2% were married, and 19.2% were illiterate. The results showed that the enabling factors like adopting to go on a diet and the educational classes facilitated by the staff had significant effects on health care behavior of the patients. Furthermore 69.2% of the participants adopted to go on a diet before the educational sessions; that figure increased to 94.9% after the educational sessions. According to the results the mean scores for the knowledge, attitude, and behavior, reinforcement factors and enabling factors increased significantly after of the educational intervention (p- value >0.001). Conclusion Predisposing, enabling and reinforcement factors affected in taking self-care behavior in the patient with DM.
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Affiliation(s)
- Mahboobeh Borhani
- Health Education and Promotion Department, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Zahra Shafieyan
- Student Research Committee, Ilam University of Medical Sciences, Ilam, Iran
| | - Morteza Mansourian
- Public Health Department, Ilam University of Medical Sciences, Ilam, Iran
| | - Seyed Mojtaba Hoseini
- Phd Student in Exercise Physiology, Mazandaran University of Physical Education and Sport Sciences, Babolsar, Iran
| | - Seyed Masoud Arzaghi
- Elderly Health Research Center, Endocrinology and Metabolism Population Science Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mostafa Qorbani
- Departments of Community Medicine, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran.,Non-Communicable Diseases Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Aziz Rezapoor
- Department of Health Economics, School of Health Management and Information Sciences and Health Management & Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Hamid Asayesh
- Department of Medical Emergencies, Qom University of Medical Sciences, Qom, Iran
| | - Abdurrahman Charkazi
- Department of Public Health, Golestan University of Medical Sciences, Gorgan, Iran
| | - Hossein Ansari
- Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
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