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Wheldon CW, Skurka C, Eng N. Inoculating Black/African American and LGBTQ Communities Against the Tobacco Industry: The Role of Community Connectedness and Tobacco Denormalization Beliefs. Health Promot Pract 2024; 25:445-454. [PMID: 36648060 DOI: 10.1177/15248399221146553] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
The purpose of this study was to explore how connectedness to Black/African American or lesbian, gay, bisexual, transgender and queer (LGBTQ) communities can promote anti-tobacco industry beliefs and to examine the role of targeted anti-tobacco industry messaging (i.e., tobacco industry denormalization [TID] messages).We hypothesized that community connectedness would predict anti-tobacco industry motivation (H1) and that this effect would be mediated by community-specific anti-industry beliefs (H2). We also hypothesized that these effects would be greater (i.e., moderated) for individuals exposed to targeted TID messages (H3). This study was a secondary analysis of data from a web-based experiment focused on the effects of counter-industry messages (data collected in 2020). The sample consisted of 430 Black/African Americans and 458 LGBTQ young adults. Hypotheses were tested using structural equation modeling. In support of hypothesis 1, community connectedness was associated with anti-tobacco industry motivation for both the LGBTQ and Black/African American subsamples. Hypothesis 2 was also supported. The associations between community connectedness and anti-industry motivations were partially mediated by anti-industry beliefs. Hypothesis 3 was not supported. Exposure to counter-industry messages did not modify the structural model; however, counter-industry messages increased anti-industry beliefs in both subsamples. Fostering community connectedness may help to mobilize community-based tobacco control efforts. Furthermore, interventions targeting anti-tobacco industry beliefs may be effective at reducing tobacco-related disparities. Anti-tobacco industry beliefs can be increased using brief targeted TID messages. Collectively, these findings suggest that community-based approaches rooted in consciousness-raising action may provide a useful model for future tobacco control interventions.
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Ayhan Başer D, Gümüştakim RŞ. Addressing the Urgent Concerns of Disaster-Related Hypertension After the 2023 Turkey Earthquake: Letter to Editor. Disaster Med Public Health Prep 2024; 18:e51. [PMID: 38557450 DOI: 10.1017/dmp.2024.51] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Affiliation(s)
- Duygu Ayhan Başer
- Hacettepe, University, Faculty of Medicine, Department of Family Medicine, Ankara, Turkey
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Amalraj SK, Pittman SP, Patel S, Thompson JA, Nangia AK. Urologist Access for the Male Population: An 18-Year Study on Population Trends. Urol Pract 2024; 11:324-332. [PMID: 38277176 DOI: 10.1097/upj.0000000000000508] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Accepted: 11/29/2023] [Indexed: 01/27/2024]
Abstract
INTRODUCTION Our study examines the factors associated with urologist availability for younger and older men across the country over a period of 18 years from 2000 to 2018. METHODS The Area Health Resource Files and US Census Data were analyzed from 2000, 2010, and 2018. The younger male population was defined as men aged 20 to 49, and the older male population was defined as ages 50 to 79. Urologist availability was determined by county at all time points. Logistic regression analysis and geographically weighted regression was completed. RESULTS Over an 18-year period, overall urologist availability decreased for men by 19.6%. Access to urologist availability for men in metropolitan and rural counties decreased by 9.4% and 29.5%, respectively. Among the younger male cohort, urologist availability increased in metropolitan counties by 4%, but decreased by 16% in rural counties. There was an overall decrease in urologist availability of 28% and 43% in metropolitan and rural counties in the older male population. Multiple logistic regression analysis demonstrated that metropolitan status was the most significant factor associated with urologist availability for both male populations. The odds of each independent factor predicting urologist availability for the younger and older male population is dependent on geography. CONCLUSIONS The majority of the male population has seen a decline in urologist availability. This is especially true for the older male residing in a rural county. Predictors of urologist availability depend on geographical regions, and understanding these regional drivers may allow us to better address disparities in urological care.
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Affiliation(s)
- Sarah K Amalraj
- Department of Urology, University of Kansas Medical Center, Kansas City, Kansas
| | - Stephen P Pittman
- Department of Urology, University of Kansas Medical Center, Kansas City, Kansas
| | - Shachi Patel
- Department of Biostatistics and Data Sciences, University of Kansas Medical Center, Kansas City, Kansas
| | - Jeffrey A Thompson
- Department of Biostatistics and Data Sciences, University of Kansas Medical Center, Kansas City, Kansas
| | - Ajay K Nangia
- Department of Urology, University of Kansas Medical Center, Kansas City, Kansas
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Roberts LS, James TG. Inclusion of People With Disabilities in Community Health Needs Assessments in Florida, United States. Health Promot Pract 2024:15248399231225642. [PMID: 38235695 DOI: 10.1177/15248399231225642] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
Community health needs assessments (CHNAs) play a crucial role in identifying health needs of communities. Yet, unique health needs of people with disabilities (PWDs) are often underrecognized in public health practice. In 2010, the Patient Protection and Affordable Care Act (ACA) required the implementation of standardized data collection guidelines, including disability status, among federal agencies. The extent to which guidance from ACA and the U.S. Centers for Disease Control and Prevention has impacted disability inclusion in CHNAs is unknown. This study used a content analysis approach to review CHNAs conducted by local health councils and the top 11 nonprofit hospitals in Florida (n = 77). We coded CHNAs based on mentioning disability in CHNA reports, involving disability-related stakeholders, and incorporating data on disability indicators. Findings indicate that PWDs are widely not included in CHNAs in Florida, emphasizing the need for equitable representation and comprehensive understanding of PWDs in community health planning.
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Ramírez AS, Houston K, Bateman C, Campos-Melendez Z, Estrada E, Grassi K, Greenberg E, Johnson K, Nathan S, Perez-Zuniga R. Communicating about the social determinants of health: development of a local brand. J Commun Healthc 2023; 16:231-238. [PMID: 36946864 PMCID: PMC10514231 DOI: 10.1080/17538068.2023.2192579] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
BACKGROUND Successful comprehensive population-based approaches to chronic disease prevention leverage mass media to amplify messages and support a culture of health. We report on a community-engaged formative evaluation to segment audiences and identify major themes to guide campaign message development for a transformative health communication campaign. METHODS Four key phases of campaign development: (I) Formative evaluation to identify priorities, guiding themes, and audience segments (interviews/focus groups with residents, N = 85; representatives of community-based partner organizations, N = 10); (II) Brand development (focus groups and closed-ended surveys; N = 56); (III) Message testing approaches to verbal and visual appeals (N = 50 resident intercept interviews); (IV) Workshop (N = 26 participants representing 15 organizations). RESULTS Residents were engaged throughout campaign development and the resulting campaign materials, including the campaign name and visual aesthetic (logo, color schemes, overall look and feel) reflect the diversity of the community and were accepted and valued by diverse groups in the community. Campaign materials featuring photos of county residents were created in English, Spanish, and Hmong. Plain language messages on social determinants of health resonate with residents. The county was described as a sort of idyllic environment burdened by inequality and structural challenges. Residents demonstrated enthusiasm for the campaign and provided specific suggestions for content (education about disease risks, prevention, management; information about accessing resources; testimonials from similar people) and tone. CONCLUSIONS Communication to support a policy, systems, and environmental change approach to chronic disease prevention must carefully match messages with appropriate audiences. We discuss challenges in such messaging and effectiveness across multiple, diverse audiences.
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Beidler LB, Colvin JD, Winterer CM, Fraze TK. Addressing Social Needs in Clinical Settings: Early Lessons from Accountable Health Communities. Popul Health Manag 2023; 26:283-293. [PMID: 37824818 DOI: 10.1089/pop.2023.0119] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2023] Open
Abstract
The Centers for Medicare and Medicaid Services recently adopted quality metrics that require hospitals to screen for health-related social risks. The hope is that these requirements will encourage health care organizations to refer patients with social needs to community resources and, as possible, offer navigation services. This approach-screening, referrals, and navigation-is based, in part, on the Accountable Health Communities (AHC) model. Twenty-two of 31 participants in the AHC model in 2019 were interviewed to generate guidance for health care organizations as they implement screening, referral, and navigation activities to improve patients' health-related social risks. From these interviews, the team identified 4 key program design elements that facilitated AHC implementation: (1) centralized management office, (2) accountability milestones, (3) prescriptive requirements, and (4) technology support. The structure and requirements of the AHC model spurred participating organizations to rapidly implement social care activities, but the model did not allow for the flexibility necessary to ensure sustained adoption of AHC activities. The AHC model required a designated centralized management office, which was instrumental in ensuring AHC activities were implemented effectively. The centralized management office was typically external from participating clinical sites that impacted the AHC model's integration within clinical workflows. The reliance on the centralized management office to implement AHC activities limited the sustainability of the model. As payers, policymakers, and delivery system leaders aim to develop sustainable and effective social care programs, insights from these interviews can help guide and shape policy and program design elements.
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Affiliation(s)
- Laura B Beidler
- The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire, USA
| | - Jeffery D Colvin
- Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri, USA
| | - Courtney M Winterer
- Department of Pediatrics, Children's Mercy Kansas City, Kansas City, Missouri, USA
| | - Taressa K Fraze
- Department of Family and Community Medicine, University of California, San Francisco, San Francisco, California, USA
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, California, USA
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Stucchi R, Ripoll-Gallardo A, Sechi GM, Weinstein ES, Villa GF, Frigerio C, Federighi F, Grasselli G, Zoli A, Bonora R, Fumagalli R. Severe Acute Respiratory Syndrome Coronavirus 2 and Medical Evacuation in Lombardy: Lessons Learned from an Unprecedented Pandemic. Disaster Med Public Health Prep 2023; 17:e480. [PMID: 37667885 DOI: 10.1017/dmp.2023.145] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/06/2023]
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerging infectious disease pandemic developed in Lombardy (northern Italy) during the last week of February 2020 with a progressive increase of patients presenting with serious clinical findings. Despite the efforts of the Central Italian Government, regional resources were rapidly at capacity. The solution was to plan the medical evacuation (MEDEVAC) of 119 critically ill patients (median age 61 years) to in-patient intensive care units in other Italian regions (77) and Germany (42). Once surviving patients were deemed suitable, the repatriation process concluded the assignment. The aim of this report is to underline the importance of a rapid organization and coordination process between different nodes of an effective national and international network during an emerging infectious disease outbreak and draw lessons learned from similar published reports.
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Affiliation(s)
- Riccardo Stucchi
- SSD AAT Milano, Agenzia Regionale Emergenza Urgenza (AREU), Dipartimento di Emergenza e Accettazione, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Alba Ripoll-Gallardo
- SSD AAT Milano, Agenzia Regionale Emergenza Urgenza (AREU), Dipartimento di Emergenza e Accettazione, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
- CRIMEDIM-Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Università del Piemonte Orientale, Novara, Italy
| | | | - Eric S Weinstein
- CRIMEDIM-Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Università del Piemonte Orientale, Novara, Italy
| | | | - Cristina Frigerio
- Dipartimento di Anestesia e Rianimazione, ASST Melegnano Martesana, Cernusco sul Naviglio, Italy
| | | | - Giacomo Grasselli
- Department of Anesthesia and Intensive Care, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milano, Italy
| | - Alberto Zoli
- Agenzia Regionale Emergenza Urgenza (AREU), Milan, Italy
| | - Rodolfo Bonora
- Agenzia Regionale Emergenza Urgenza (AREU), Milan, Italy
| | - Roberto Fumagalli
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
- Dipartimento di Anestesia e Rianimazione, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
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Nakamura N, Mitsuhashi T, Nakashima Y, Matsumoto N, Yorifuji T. Effect of 2-week postpartum check-ups on screening positive for postpartum depression: a population-based cohort study using instrumental variable estimation in Japan. Fam Pract 2023:cmad074. [PMID: 37467366 DOI: 10.1093/fampra/cmad074] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/21/2023] Open
Abstract
BACKGROUND Postpartum depression is experienced by approximately 10% of women and affects the health and development of their children. Although it is recommended that all mothers have the opportunity for early detection and intervention for postpartum depression, it is unclear whether early postpartum check-ups help to reduce postpartum depression. OBJECTIVE The aim of this study was to assess the effect of 2-week postpartum check-ups on screening positive for postpartum depression in Japan. METHODS This was a population-based cohort study that used the administrative database of Tsuyama, Japan. Participants were women who received postpartum home visits from a public health nurse in Tsuyama during the fiscal years 2017-2019. Data were obtained on participant's attendance at a 2-week postpartum check-up and their responses on the Edinburgh Postpartum Depression Scale. Owing to the initiation of a publicly funded postpartum check-up programme, participants were pseudo-randomly assigned to receive/not receive a 2-week postpartum check-up. We conducted instrumental variable estimation to assess the causal effects of the check-up on screening positive for postpartum depression. RESULTS The characteristics of the 1,382 participants did not differ by fiscal year of childbirth. We found a 6.7% (95% confidence interval 2.2-11.2) reduction in the prevalence of screening positive for postpartum depression as an effect of 2-week postpartum check-ups among women received 1-month postpartum home visits. CONCLUSION The results suggest that 2-week postpartum check-ups are effective in reducing the prevalence of screening positive for postpartum depression among 1-month postpartum women. Despite some limitations, early postpartum care could reduce postpartum depression.
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Affiliation(s)
- Naoko Nakamura
- Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Toshiharu Mitsuhashi
- Center for Innovative Clinical Medicine, Okayama University Hospital, Okayama, Japan
| | - Yasuko Nakashima
- Health Promotion Division, Tsuyama City Department of Children's Health, Tsuyama, Japan
| | - Naomi Matsumoto
- Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Takashi Yorifuji
- Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
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Kujawa H, Pinto RS, Leles FAG, Machado FV. [Community participation in health as an essential element for health system strengthening in the AmericasLa participación en salud como elemento indispensable para el fortalecimiento de los sistemas de atención de salud en las Américas]. Rev Panam Salud Publica 2023; 47:e109. [PMID: 37457759 PMCID: PMC10337638 DOI: 10.26633/rpsp.2023.109] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 04/28/2023] [Indexed: 07/18/2023] Open
Abstract
The present narrative review discusses the relevance and challenges of community participation in health for health system strengthening. Based on a definition of community participation in health as a dynamic process that gives people access and control over health resources through involvement and experience, the article summarizes information obtained from documents and debate at an international event (Seminario Internacional: Experiencias y Modelos de Participación en Salud en América Latina y el Caribe). In addition, the SciELO, PubMed and Google Scholar databases were searched using the terms "community participation", "community engagement", "social control" and "community health planning" to identify national or transnational review and opinion articles. Community participation in health is a current concept, acknowledged in the recommendations for health policies described in recent documents and publications. Around the world, the number of studies on the subject is growing; however, in the Americas, three countries (United States, Canada and Brazil) accounted for most of the scientific publications identified in the databases. The studies address timely questions and show consensus among investigators within each individual research group. However, the area lacks exchanges and comparative analyses that contrast different experiences transcending national borders and expanding knowledge on community participation in health. The creation of more spaces for the sharing of experiences and research is advised, as well as the establishment of professional and research networks in the field of community participation in health.
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Affiliation(s)
- Henrique Kujawa
- Centro de Educação e Assessoramento Popular (Organização da Sociedade Civil)Passo Fundo (RS)BrasilCentro de Educação e Assessoramento Popular (Organização da Sociedade Civil), Passo Fundo (RS), Brasil.
| | - Rodrigo Silveira Pinto
- Centro de Educação e Assessoramento Popular (Organização da Sociedade Civil)Passo Fundo (RS)BrasilCentro de Educação e Assessoramento Popular (Organização da Sociedade Civil), Passo Fundo (RS), Brasil.
| | - Fernando Antônio Gomes Leles
- Organização Pan-Americana da Saúde (OPAS)Organização Mundial da Saúde (OMS)Brasília (DF)BrasilOrganização Pan-Americana da Saúde (OPAS), Organização Mundial da Saúde (OMS), Brasília (DF), Brasil.
| | - Frederico Viana Machado
- Universidade Federal do Rio Grande do Sul (UFRGS)Programa de Pós-Graduação em Saúde ColetivaPorto Alegre (RS)BrasilUniversidade Federal do Rio Grande do Sul (UFRGS), Programa de Pós-Graduação em Saúde Coletiva, Porto Alegre (RS), Brasil.
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Dintrans PV, Valenzuela P, Castillo C, Granizo Y, Maddaleno M. Bottom-up innovative responses to COVID-19 in Latin America and the Caribbean: addressing deprioritized populations. Rev Panam Salud Publica 2023; 47:e92. [PMID: 37324197 PMCID: PMC10261555 DOI: 10.26633/rpsp.2023.92] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 02/02/2023] [Indexed: 06/17/2023] Open
Abstract
Objective To identify and describe innovative initiatives implemented as a response to the interruption of health services during the COVID-19 pandemic in Latin America and the Caribbean (LAC). Methods This was a descriptive study that reviewed 34 initiatives implemented during the COVID-19 pandemic in LAC to address health services needs among deprioritized groups. The review of initiatives included four phases: a call for submissions of innovative initiatives from LAC countries; a selection of initiatives that had the ability to address health services gaps and that were innovative and effective; systematization and cataloging of the selected initiatives; and a content analysis of the information collected. Data were analyzed from September to October 2021. Results The 34 initiatives show important variations regarding the target populations, the stakeholders involved, level of implementation, strategies, scope, and relevance of the innovative initiative. There was also evidence of the emergence of a bottom-up set of actions in the absence of top-down actions. Conclusion The findings of this descriptive review of 34 initiatives implemented during the COVID-19 pandemic in LAC suggest that systematizing the strategies and lessons learned has the potential to expand learning for re-establishing and improving post-pandemic health services.
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Affiliation(s)
- Pablo Villalobos Dintrans
- Programa Centro Salud PúblicaFacultad de Ciencias MédicasUniversidad de SantiagoSantiagoChilePrograma Centro Salud Pública, Facultad de Ciencias Médicas, Universidad de Santiago, Santiago, Chile.
| | - Paula Valenzuela
- Independent consultantSantiagoChileIndependent consultant, Santiago, Chile
| | - Claudio Castillo
- Programa Centro Salud PúblicaFacultad de Ciencias MédicasUniversidad de SantiagoSantiagoChilePrograma Centro Salud Pública, Facultad de Ciencias Médicas, Universidad de Santiago, Santiago, Chile.
| | - Yamileth Granizo
- Independent consultantSantiagoChileIndependent consultant, Santiago, Chile
| | - Matilde Maddaleno
- Programa Centro Salud PúblicaFacultad de Ciencias MédicasUniversidad de SantiagoSantiagoChilePrograma Centro Salud Pública, Facultad de Ciencias Médicas, Universidad de Santiago, Santiago, Chile.
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Gutiérrez Tyler C, Salinas A, Guevara A, Alva H, Ruiz M, Prot EY. Assessing 2019 Hurricane Harvey Recovery in Aransas County, Texas Through Community Assessment for Public Health Emergency Response (CASPER). Disaster Med Public Health Prep 2023; 17:e366. [PMID: 36950876 DOI: 10.1017/dmp.2023.12] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/24/2023]
Abstract
OBJECTIVES The objective of this study was to assess recovery of Aransas County, Texas households 2 years after Category 4 Hurricane Harvey made landfall. METHODS A 2-stage cluster sampling method used to conduct a Community Assessment for Public Health Emergency Response (CASPER) on May 3 - 4 and May 18 - 19, 2019. A household-based survey was administered through face-to-face interviews, selected through systematic random sampling using weighted analysis of the county population. Field teams collected 175 surveys (83.3% completion rate). RESULTS Approximately 57% households experienced repairable damage, 23% had destroyed homes, and 19% had minimal damage. 38% stated having 'no need,' 18% needed financial assistance, 16% needed household repairs, and over 8% had behavioral health needs. 17% experiencing a behavioral health concern were seeking services. Of the 35% of households who did not seek services, 14% felt there was no need, and 4% were not aware of the resources available. CONCLUSIONS Households reported high levels of preparedness, but gaps remain in evacuation intention and behavioral health care access. CASPERs are effective in assessing long-term recovery of communities impacted by major disasters.
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Affiliation(s)
- Carla Gutiérrez Tyler
- Texas Department of State Health Services. Public Health Region 11, Harlingen, TX, United States
| | - Albesa Salinas
- Texas Department of State Health Services. Public Health Region 11, Harlingen, TX, United States
| | - Angel Guevara
- Texas Department of State Health Services. Public Health Region 11, Harlingen, TX, United States
| | - Herminia Alva
- Texas Department of State Health Services. Center for Health Emergency Preparedness and Response, Austin, TX, United States
| | - Mauro Ruiz
- Texas Department of State Health Services. Public Health Region 11, Harlingen, TX, United States
| | - Emilie Y Prot
- Texas Department of State Health Services. Public Health Region 11, Harlingen, TX, United States
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Cortez LR, da Silva IP, Freitas LS, do Nascimento RM, Mesquita SKDC, da Silva JA, Costa IKF. Effectiveness of a course on family health in the knowledge of doctors of the Mais Médicos program. Rev Assoc Med Bras (1992) 2023; 69:131-135. [PMID: 36629652 PMCID: PMC9937603 DOI: 10.1590/1806-9282.20220966] [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] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 09/30/2022] [Indexed: 01/11/2023]
Abstract
OBJECTIVE The aim of this study was to analyze the effectiveness of the distance education course in family health in the knowledge of physicians from the Mais Médicos program. METHOD This is a quantitative, quasi-experimental study, without a pretest and posttest control group, carried out from August 2019 to September 2021. In all modules, physicians responded to a pretest and posttest to verify their knowledge of the subject. RESULTS There was a statistically significant difference in all modules with higher average scores in the posttests; the modules with the greatest emphasis are child health care: growth and development; approach to cancer in primary health care; and family health strategy and territorialization. CONCLUSION The effectiveness of the distance education course was verified, as evidenced by the significant improvement of knowledge in all the modules studied.
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Affiliation(s)
- Lyane Ramalho Cortez
- Universidade Federal do Rio Grande do Norte, Departamento de Saúde Coletiva – Natal (RN), Brazil
| | - Isabelle Pereira da Silva
- Universidade Federal do Rio Grande do Norte, Departamento de Enfermagem – Natal (RN), Brazil.,Corresponding author:
| | - Luana Souza Freitas
- Universidade Federal do Rio Grande do Norte, Departamento de Enfermagem – Natal (RN), Brazil
| | | | | | - José Adailton da Silva
- Universidade Federal do Rio Grande do Norte, Departamento de Saúde Coletiva – Santa Cruz (RN), Brazil
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Nwanja E, Akpan U, Toyo O, Nwaokoro P, Badru T, Gana B, Nwanja I, Ayabi O, Ayeni B, Xavier E, Idemudia A, Sanwo O, Khamofu H, Bateganya M. Improving access to HIV testing for pregnant women in community birth centres in Nigeria: an evaluation of the Prevention of Mother-to-Child Transmission program. Ther Adv Infect Dis 2023; 10:20499361231172088. [PMID: 37152184 PMCID: PMC10155002 DOI: 10.1177/20499361231172088] [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: 07/11/2022] [Accepted: 04/11/2023] [Indexed: 05/09/2023] Open
Abstract
Background The elimination of mother-to-child HIV transmission requires access to HIV testing services (HTS) for pregnant women. In Akwa Ibom, Nigeria, 76% of pregnant women receive antenatal care from traditional birth attendants and may not have access to HIV testing. Objectives This study examines the contribution of traditional birth attendants and other healthcare workers in community birth centres in improving access to HTS among pregnant women and their HIV-exposed infants. Design A retrospective cross-sectional study of previously collected programme data at two points in time to evaluate the prevention of mother-to-child transmission (PMTCT) programme. Methods We assessed programme records before and after introducing an intervention that engaged traditional birth attendants and other healthcare workers in community birth centres to expand access to HTS among pregnant women and their HIV-exposed infants in Akwa Ibom State, Nigeria. Data were abstracted from the programme database for the preintervention period (April 2019 to September 2020) and the intervention period (October 2020 to March 2022). Data abstracted include the number of pregnant women tested for HIV, those diagnosed with HIV, the number of HIV-exposed infants who had samples collected for early infant diagnosis and those diagnosed with HIV. The data were analysed descriptively and inferentially. Results Before the intervention, 39,305 pregnant women and 2248 HIV-exposed infants were tested for HIV. After the intervention, the number of pregnant women tested increased to 127,005 and the number of HIV-exposed infants tested increased to 2490. Among pregnant women, the postintervention testing increased by 3.2-fold, with community birth centres reporting 63% of all tests. The intervention also resulted in an 11% increase in HIV-exposed infants benefitting from early infant diagnosis with community birth centres reporting 5% of all tests. Of those diagnosed with HIV, 24% of pregnant women and 12% of infants were diagnosed at community birth centres. Conclusion Community-based HIV testing for pregnant women can reduce mother-to-child transmission and improve early diagnosis and treatment of exposed infants. Collaboration with birth attendants is crucial to ensure testing opportunities are not missed. Prospective research is needed to understand the clinical outcomes of intervention programmes in the community.
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Houser R. Expanding Access to Naloxone: A Necessary Step to Curb the Opioid Epidemic. Disaster Med Public Health Prep 2022; 17:e245. [PMID: 36172901 DOI: 10.1017/dmp.2022.199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The COVID-19 Pandemic has exacerbated the already worsening opioid epidemic within the United States. With a continuing increase in opioid overdose deaths, measures are needed to halt the needless number of deaths and begin on a path of recovery to address all the factors that impact the epidemic. The CDC has provided various recommendations to combat the increases in opioid overdose deaths. These recommendations have included expanded distribution and use of naloxone and overdose prevention education as essential services for people most at risk of overdose. While strategies should include the increase in community resources for those with opioid disorder and shifting the perspectives of healthcare to view opioid disorder as a chronic illness that can be treated with medication such as buprenorphine, these methods are not immediate enough to stop the trend in deaths. The United States must take immediate action to expand access to and use of Naloxone for the public and first responders. Naloxone alone cannot address the magnitude of this epidemic, but it is an essential first step in preventing immediate death while a multimodal strategy is enacted to fully protect those most at risk.
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15
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Pittman SP, Patel S, Thompson JA, Nangia AK. 18-Year Population Trends Determine Factors Associated with Future Access to Urologists. Urol Pract 2022; 9:441-450. [PMID: 37145724 DOI: 10.1097/upj.0000000000000313] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 04/11/2022] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Our study evaluated urologist availability by United States county since 2000 relative to regional changes in the general population to identify factors associated with access to care. METHODS County-level data from 2000, 2010 and 2018 from the Department of Health and Human Services, U.S. Census and American Community Survey were analyzed. Availability of urologists by county was defined as urologists per 10,000 adults. Multiple logistic and geographically weighted regression were performed. A predictive model was formulated with tenfold cross-validation (AUC=0.75). RESULTS Despite a 6.95% increase in urologists over 18 years, local urologist availability declined 13% (-0.03 urologists/10,000 individuals, 95% CI 0.02-0.04, p <0.0001). On multiple logistic regression, metropolitan status was the greatest predictor of urologist availability (OR 1.86, 95% CI 1.47-2.34), followed by prior urologist presence (OR 1.49, 95% CI 1.16-1.89), defined as a higher number of urologists in 2000. The predictive weight of these factors varied by U.S. region. All regions experienced worsening overall urologist availability, with rural areas suffering the most. Large population shifts away from the Northeast to the West and South were outpaced by urologists leaving the Northeast, the only region with a decreasing number of total urologists (-1.36%). CONCLUSIONS Urologist availability declined in every region over nearly 2 decades likely due to an increasing general population and inequitable regional migration. Predictors of urologist availability differed by region, and thus it will be necessary to investigate regional drivers influencing population shifts and urologist concentration to prevent worsening disparities in care.
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Affiliation(s)
- Stephen P Pittman
- Department of Urology, University of Kansas Medical Center, Kansas City, Kansas
| | - Shachi Patel
- Department of Biostatistics and Data Sciences, University of Kansas Medical Center, Kansas City, Kansas
| | - Jeffrey A Thompson
- Department of Biostatistics and Data Sciences, University of Kansas Medical Center, Kansas City, Kansas
| | - Ajay K Nangia
- Department of Urology, University of Kansas Medical Center, Kansas City, Kansas
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16
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Myra RS, Koerich MHADL, Gregório EC, Swarowsky A. Primary care for people with Parkinson's disease in Brazil: A referral flowchart based on risk of falls. Front Public Health 2022; 10:836633. [PMID: 35991031 PMCID: PMC9387551 DOI: 10.3389/fpubh.2022.836633] [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: 12/15/2021] [Accepted: 06/29/2022] [Indexed: 11/13/2022] Open
Abstract
Background People with Parkinson's disease (PD) need to exercise to have a better quality of life. The risk of falling needs to be considered when choosing and implementing exercise interventions. Flowcharts are used to facilitate referrals in Brazilian primary care network, but there is no specific one for PD. Aim To develop a referral flowchart for people with PD in Brazilian primary care based on the risk of falls and scientific evidence in the context of a multidisciplinary approach. Methods The development of the referral flowchart was accomplished in three steps; (1) relevant literature was reviewed (2) semi-structured interviews (in focus groups) were conducted with primary health care professionals to investigate the current care for people with Parkinson's disease, and (3) the information obtained from the previous steps were analyzed to inform the development of the referral flowchart. Results The fall risk-based flowchart uses the 3-step-fall-prediction tool. The primary health care professional should refer the person with a low risk of falls to activities with minimal supervision and those with a higher risk of falls to specialized neurology services. Neurology services are also the referral target for persons presenting significant mobility restrictions (i.e., restricted to a wheelchair or bed). The referral occurs according to what is available in Brazilian primary care. Conclusion This flowchart might be the first step to build a multidisciplinary approach for people with Parkinson's disease in Brazilian primary care. The next stage of this study is the validation and subsequent implementation of the flowchart through the primary care at Unified Health System in Brazil.
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Affiliation(s)
- Rafaela Simon Myra
- Brazilian Parkinson's Disease Rehabilitation Initiative (BPaRkI), Center for Health and Sports Sciences (CEFID), Santa Catarina State University (UDESC), Florianópolis, Brazil
| | | | - Elaine Cristina Gregório
- Brazilian Parkinson's Disease Rehabilitation Initiative (BPaRkI), Center for Health and Sports Sciences (CEFID), Santa Catarina State University (UDESC), Florianópolis, Brazil
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17
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Evans CA, Perks J, O'Kane L. Decision-Making During a Disaster-Scenario Tabletop Exercise by Prelicensure Student Nurses - A Replication Study. Disaster Med Public Health Prep 2022; 17:e152. [PMID: 35535761 DOI: 10.1017/dmp.2022.69] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE "Determine which clients to recommend for discharge in a disaster situation" is a Registered Nurse Activity Statement on the National Council Licensing Exam test plan. The activity statement raised the nursing education research question: could senior student nurses transfer their learning to a novel circumstance, with a high degree of risk, making decisions using patient assessments and determining resource needs? A study with a descriptive quantitative approach was designed with 2 aims. The first was to describe students' transfer of learning for basic disaster and medical-surgical knowledge and make recommendations for patient dispositions. The second aim was to describe students' attitudes about their transfer of learning during the tabletop exercise. METHODS A researcher-designed disaster-scenario tabletop exercise and 3 instruments with subject-matter-expert feedback captured participants' decisions. Eligible senior student nurses volunteered to participate in the replicated study that was extended to 2 universities. Participant decisions and attitude responses were statistically analyzed. RESULTS Descriptive and difficulty index statistics described students' transfer of learning for basic disaster and medical-surgical topics, patient disposition recommendations, and attitudes. The cut-score for optimal transfer of learning was difficulty index (DI) ≤ .49. CONCLUSIONS Students had positive attitudes and transferred learning to most decisions. Decision DIs ≤ .49 were remediated.
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18
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Yoo SH, Jung SH, Shin SJ. Evaluation of an Oral Health Management Project in Connection to a Non-Communicable Disease Prevention and Management Project: A Case Study in South Korea. Int J Environ Res Public Health 2022; 19:5209. [PMID: 35564607 DOI: 10.3390/ijerph19095209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 04/21/2022] [Accepted: 04/24/2022] [Indexed: 11/23/2022]
Abstract
This study aimed to develop, pilot, and evaluate a three-year integrated preventive management project focused on chronic diseases and oral health prevalence. A total of 1148 users of the health care office of the G Public Health Center with dental risk factors were selected for this study and connected to the dental counseling department. Respondents were classified into a group that would receive counseling-type self-education on oral care and a second group that needed dental care. To evaluate the dental care utilization and satisfaction, a telephone survey was conducted with the 263 people. Oral health behavioral changes were analyzed in 97 comparable subjects who responded to both the oral health basic survey and telephone survey. More than 90% of the subjects who visited the dental clinics were positively satisfied with the system for requesting care and with being referred to dental clinics at the public health center or community dental clinics. Measures of oral health perception and of behavior need showed positive changes. This study was effective in inducing positive changes in the oral health management behavior of chronically ill patients and in promoting the use of preventive management-centered dental care.
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Lawson B, Clark S, Geraghty K, Poggetti J, Stewart J, Tarling P. More Shots in Arms: Scalable Learnings From a Continuous Improvement Effort to Deliver COVID-19 Vaccinations in Small Community-Based Clinics. Disaster Med Public Health Prep 2022; 17:e190. [PMID: 35361305 DOI: 10.1017/dmp.2022.94] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Existing mass vaccination clinic guidance calls for staffing and resource requirements that may not be achievable in smaller settings. Practical and scalable solutions to these problems were developed by a volunteer group of continuous improvement professionals, working to assist 2 non-governmental organizations engaged in coordinating refugee health services: the Somali Health Board of Seattle, WA and Community Health Services Inc. of Rochester, MN. Our shared goal was to get more shots in arms by bringing vaccines to small communities through pop-up clinics that are quick to set-up and require minimal resources. The clinics were developed using continuous improvement methods, thereby yielding a 2-minute vaccine administration time and an 8-fold improvement in productivity as a result of Federal Emergency Management Agency (FEMA) guidance. This report details our field-tested methods and achieved results. The relevance and benefits of this approach deserve attention as pandemic response needs continue to evolve and vaccines become more globally available.
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20
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Koschmann E, Jacob R, Robinson K, Foster Friedman M, Foster A, Rodriguez-Quintana N, Vichich J, Smith M, Rajaram H. Mental health needs in a large urban school district: Findings from a web-based survey. Health Serv Res 2022; 57:830-841. [PMID: 35243624 PMCID: PMC9264464 DOI: 10.1111/1475-6773.13924] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 12/02/2021] [Accepted: 12/03/2021] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To explore the mental health needs of students, and the professional development and support needs of teachers and school health professionals, as a way to foster community engagement and help set priorities for a comprehensive school mental health system in the Detroit Public Schools Community District (DPSCD). SETTING The study team surveyed all DPSCD staff in June 2019 and all students in grades 8-12 between October and December 2019. STUDY DESIGN A descriptive study based on anonymous, web-based surveys focused on student trauma exposure and mental health symptoms, student mental health resource utilization, staff burnout, and professional development needs. DATA COLLECTION All students (grades 8-12) and district staff were eligible to participate; the student survey was made available in six languages. Parents/guardians could opt children out; schools could exclude children unable to complete the survey independently. Student surveys were administered in school; staff surveys were sent via email. PRINCIPAL FINDINGS Thirty-four percent of DPSCD students reported moderate/severe depression symptoms; 22% had seriously considered suicide in the past year. Rates exceed national averages; 37% of students with severe depression and 34% of those with suicidal ideation had not accessed mental health supports. Staff indicated high levels of burnout and substantial interest in learning about self-care strategies or coping with vicarious trauma. Over 75% of teachers and school mental health professionals expressed interest in learning about best practices for supporting students impacted by trauma or mental illness. CONCLUSIONS A large number of DPSCD students are experiencing symptoms of depression and anxiety, and many students who need care are not accessing it. Addressing the mental health needs of students is a high priority for staff, but they need more training and support, as well as support for their own vicarious trauma and high levels of burnout.
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Affiliation(s)
- Elizabeth Koschmann
- Transforming Research into Action to Improve the Lives of Students (TRAILS), Department of Psychiatry, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Robin Jacob
- Youth Policy Lab, University of Michigan Institute for Social Research and Gerald R. Ford School of Public Policy, Ann Arbor, Michigan, USA
| | - Katja Robinson
- Youth Policy Lab, University of Michigan Institute for Social Research and Gerald R. Ford School of Public Policy, Ann Arbor, Michigan, USA
| | - Megan Foster Friedman
- Youth Policy Lab, University of Michigan Institute for Social Research and Gerald R. Ford School of Public Policy, Ann Arbor, Michigan, USA
| | - Anna Foster
- Youth Policy Lab, University of Michigan Institute for Social Research and Gerald R. Ford School of Public Policy, Ann Arbor, Michigan, USA
| | - Natalie Rodriguez-Quintana
- Transforming Research into Action to Improve the Lives of Students (TRAILS), Department of Psychiatry, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Jennifer Vichich
- Transforming Research into Action to Improve the Lives of Students (TRAILS), Department of Psychiatry, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Maureen Smith
- Transforming Research into Action to Improve the Lives of Students (TRAILS), Department of Psychiatry, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Hersheena Rajaram
- Youth Policy Lab, University of Michigan Institute for Social Research and Gerald R. Ford School of Public Policy, Ann Arbor, Michigan, USA
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21
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Gilbert LR, Mak R, Lovejoy P, Adepoju O. Framing the COVID-19 Pandemic for Minority Older Adults Through a Family Lens: Results of a Qualitative Thematic Analysis of Survey Responses. J Patient Exp 2022; 9:23743735221106587. [PMID: 35707769 PMCID: PMC9189517 DOI: 10.1177/23743735221106587] [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] [Indexed: 11/23/2022] Open
Abstract
This study assessed COVID-19 experiences among minority older adults in Houston, Texas. An electronic survey was administered to community-dwelling older adults, and the open-ended responses of 458 minority adults were analyzed using thematic analysis. Through an inductive coding approach, 2 unexpected main themes emerged regarding family: fear of COVID-19 spreading among their family and modifications to family and community interactions. These older minority adults framed their personal COVID-19 experiences through the lens of family and their community, demonstrating the importance of integrating family considerations into pandemic planning, response, and recovery efforts for minority older adults.
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Affiliation(s)
- Lauren R Gilbert
- Department of Health Systems and Population Health Sciences, College of Medicine, University of Houston, Houston, TX, USA.,Humana Integrated Health System Sciences Institute, University of Houston, Houston, TX, USA
| | - Rebecca Mak
- Humana Integrated Health System Sciences Institute, University of Houston, Houston, TX, USA
| | - Phoebe Lovejoy
- Humana Integrated Health System Sciences Institute, University of Houston, Houston, TX, USA
| | - Omolola Adepoju
- Department of Health Systems and Population Health Sciences, College of Medicine, University of Houston, Houston, TX, USA.,Humana Integrated Health System Sciences Institute, University of Houston, Houston, TX, USA
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22
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Roman SB, Whitmire L, Reynolds L, Pasha S, Brockman A, Oldfield BJ. Demographic and Clinical Correlates of the Cost of Potentially Preventable Hospital Encounters in a Community Health Center Cohort. Popul Health Manag 2021; 25:625-631. [PMID: 34468228 DOI: 10.1089/pop.2021.0169] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
This study sought to describe the cost of hospital care for ambulatory care-sensitive conditions (ACSCs) and to identify independent predictors of high-cost hospital encounters related to an ACSC among an urban community health center cohort. The authors conducted a retrospective cohort study of individuals engaged in care in a large, multisite community health center in New Haven, Connecticut, with any Medicaid claims between June 1, 2018 and March 31, 2020. Prevention Quality Indicators of the Agency for Healthcare Research and Quality were used to identify ACSCs. The primary outcome was a high-cost episode of care for an ACSC (in the top quartile within a 7-day period). Multivariable logistic regression was used to identify independent predictors of high-cost episodes by ACSCs among sociodemographic and clinical variables as covariates. Among 8019 included individuals, a total of 751 episodes of hospital care involving ACSCs were identified. The median episode cost was $793, with the highest median cost of care related to heart failure ($4992), followed by diabetes ($1162), and chronic obstructive pulmonary disease ($1141). In adjusted analyses, male gender (P < 0.01), increasing age (P = 0.02), and ACSC type (P < 0.01) were associated with higher costs of care; race/ethnicity was not. Community health centers in urban settings seeking to reduce the cost of care of potentially preventable hospitalizations may target disease-/condition-specific groups, particularly individuals of increasing age with congestive heart failure and diabetes mellitus. These findings may inform return-on-investment calculations for care coordination and other enabling services programming.
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Affiliation(s)
- Susan B Roman
- Fair Haven Community Health Care, New Haven, Connecticut, USA
| | - Lacey Whitmire
- Fair Haven Community Health Care, New Haven, Connecticut, USA
| | - Lori Reynolds
- Fair Haven Community Health Care, New Haven, Connecticut, USA
| | - Saamir Pasha
- Fair Haven Community Health Care, New Haven, Connecticut, USA.,Yale School of Public Health, New Haven, Connecticut, USA.,IQVIA, Inc., Stamford, Connecticut, USA
| | | | - Benjamin J Oldfield
- Fair Haven Community Health Care, New Haven, Connecticut, USA.,Departments of Medicine and Pediatrics, Yale School of Medicine, New Haven, Connecticut, USA
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23
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Burns SP, Mendonca R, Pickens ND, Smith RO. America's housing affordability crisis: Perpetuating disparities among people with disability. Disabil Soc 2021; 36:10.1080/09687599.2021.1960276. [PMID: 35919542 PMCID: PMC9340793 DOI: 10.1080/09687599.2021.1960276] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 06/15/2021] [Accepted: 07/10/2021] [Indexed: 06/15/2023]
Abstract
America's housing affordability crisis has had various indirect costs on health and safety among people living with disability. The skyrocketing housing prices have exponentially increased with the onset of the COVID-19 pandemic leaving many people at risk for eviction after federal and local moratoriums providing protection during the pandemic expire. Americans with disabilities have been particularly affected by the affordability crisis and it is expected that this major public health problem will only grow as government-provided protections and supports wane. It is critical that both government and various housing organizations consider ways to support affordability, quality, and accessibility in this particularly hard-hit population.
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Affiliation(s)
| | - Rochelle Mendonca
- Rehabilitation and Regenerative Medicine, Columbia University, New York City, USA
| | | | - Roger O Smith
- Department of Occupational Science and Technology, University of Wisconsin-Milwaukee, Milwaukee, USA
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24
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del Castillo FA. Community Pantries: Responding to COVID-19 Food Insecurity. Disaster Med Public Health Prep 2021; 16:1. [PMID: 34099094 PMCID: PMC8314045 DOI: 10.1017/dmp.2021.186] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 05/03/2021] [Accepted: 05/07/2021] [Indexed: 11/07/2022]
Affiliation(s)
- Fides A. del Castillo
- Theology and Religious Education Department, De La Salle University, Malate, Manila, Philippines
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25
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Piltch-Loeb R, Bernard D, Quiñones Vallejo B, Harriman N, Savoia E. Engaging Community Leaders in Sharing Local Knowledge for Emergency Preparedness to Leverage Communication and Trusted Assets for Vulnerable Populations. Disaster Med Public Health Prep 2021;:1-7. [PMID: 34016210 DOI: 10.1017/dmp.2021.103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Public health and emergency management agencies play a critical role in addressing the needs of vulnerable populations in preparation for and in response to emergencies. Identifying and leveraging community assets is a way to address such needs. This study focuses on the development of a process and tools to engage community leaders in sharing their knowledge about their community characteristics and assets useful for emergency planning. METHODS We conducted interviews with community leaders across five study sites with the goal of understanding what type of local knowledge community leaders are able to share in regard to emergency preparedness. Based on the interview results we developed and tested a mobile application as a mobile friendly directory of community assets. RESULTS We identified two main types of local knowledge about community assets for emergency preparedness: communication-based and trust-based local knowledge. We created an application to facilitate the sharing of such knowledge. Community leaders were able to share local knowledge across four areas: communication-based assets, trust-based assets, spatial-based assets and personal-preparedness assets. CONCLUSION Community leaders' engagement in preparedness efforts is important to identify community assets that can be leveraged to address the needs of the most vulnerable segments of a community.
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26
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Hakala JO, Pahkala K, Juonala M, Salo P, Kähönen M, Hutri-Kähönen N, Lehtimäki T, Laitinen TP, Jokinen E, Taittonen L, Tossavainen P, Viikari JSA, Raitakari OT, Rovio SP. Cardiovascular Risk Factor Trajectories Since Childhood and Cognitive Performance in Midlife: The Cardiovascular Risk in Young Finns Study. Circulation 2021; 143:1949-1961. [PMID: 33966448 DOI: 10.1161/circulationaha.120.052358] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Cardiovascular risk factors, such as high blood pressure, adverse serum lipids, and elevated body mass index in midlife, may harm cognitive performance. It is important to note that longitudinal accumulation of cardiovascular risk factors since childhood may be associated with cognitive performance already since childhood, but the previous evidence is scarce. We studied the associations of cardiovascular risk factors from childhood to midlife, their accumulation, and midlife cognitive performance. METHODS From 1980, a population-based cohort of 3596 children (3-18 years of age) have been repeatedly followed up for 31 years. Blood pressure, serum lipids, and body mass index were assessed in all follow-ups. Cardiovascular risk factor trajectories from childhood to midlife were identified using latent class growth mixture modeling. Cognitive testing was performed in 2026 participants 34 to 49 years of age using a computerized test. The associations of the cardiovascular risk factor trajectories and cognitive performance were studied for individual cardiovascular risk factors and cardiovascular risk factor accumulation. RESULTS Consistently high systolic blood pressure (β=-0.262 SD [95% CI, -0.520 to -0.005]) and serum total cholesterol (β=-0.214 SD [95% CI, -0.365 to -0.064]) were associated with worse midlife episodic memory and associative learning compared with consistently low values. Obesity since childhood was associated with worse visual processing and sustained attention (β=-0.407 SD [95% CI, -0.708 to -0.105]) compared with normal weight. An inverse association was observed for the cardiovascular risk factor accumulation with episodic memory and associative learning (P for trend=0.008; 3 cardiovascular risk factors: β=-0.390 SD [95% CI, -0.691 to -0.088]), with visual processing and sustained attention (P for trend<0.0001; 3 cardiovascular risk factors: β=-0.443 SD [95% CI, -0.730 to -0.157]), and with reaction and movement time (P for trend=0.048; 2 cardiovascular risk factors: β=-0.164 SD [95% CI, -0.318 to -0.010]). CONCLUSIONS Longitudinal elevated systolic blood pressure, high serum total cholesterol, and obesity from childhood to midlife were inversely associated with midlife cognitive performance. It is important to note that the higher the number of cardiovascular risk factors, the worse was the observed cognitive performance. Therefore, launching preventive strategies against cardiovascular risk factors beginning from childhood might benefit primordial promotion of cognitive health in adulthood.
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Affiliation(s)
- Juuso O Hakala
- Research Centre of Applied and Preventive Cardiovascular Medicine (J.O.H., K.P., P.S., O.T.R., S.P.R.), University of Turku, Finland.,Paavo Nurmi Centre, Sports and Exercise Medicine Unit, Department of Physical Activity and Health (J.O.H., K.P.), University of Turku, Finland.,Centre for Population Health Research (J.O.H., K.P., P.S., O.T.R., S.P.R.), University of Turku and Turku University Hospital, Turku, Finland
| | - Katja Pahkala
- Research Centre of Applied and Preventive Cardiovascular Medicine (J.O.H., K.P., P.S., O.T.R., S.P.R.), University of Turku, Finland.,Paavo Nurmi Centre, Sports and Exercise Medicine Unit, Department of Physical Activity and Health (J.O.H., K.P.), University of Turku, Finland.,Centre for Population Health Research (J.O.H., K.P., P.S., O.T.R., S.P.R.), University of Turku and Turku University Hospital, Turku, Finland
| | - Markus Juonala
- Department of Medicine (M.J., J.S.A.V.), University of Turku, Finland.,Division of Medicine (M.J., J.S.A.V.), Turku University Hospital, Finland
| | - Pia Salo
- Research Centre of Applied and Preventive Cardiovascular Medicine (J.O.H., K.P., P.S., O.T.R., S.P.R.), University of Turku, Finland.,Centre for Population Health Research (J.O.H., K.P., P.S., O.T.R., S.P.R.), University of Turku and Turku University Hospital, Turku, Finland
| | - Mika Kähönen
- Department of Clinical Physiology (M.K.), Tampere University Hospital, Finland.,DFaculty of Medicine and Health Technology (M.K., N.H.-K., T.L.), Tampere University, Finland
| | - Nina Hutri-Kähönen
- Department of Pediatrics (N.H.-K.), Tampere University Hospital, Finland.,DFaculty of Medicine and Health Technology (M.K., N.H.-K., T.L.), Tampere University, Finland
| | - Terho Lehtimäki
- DFaculty of Medicine and Health Technology (M.K., N.H.-K., T.L.), Tampere University, Finland.,Department of Clinical Chemistry, Fimlab Laboratories and Finnish Cardiovascular Research Center, Tampere (T.L.)
| | - Tomi P Laitinen
- Department of Clinical Physiology, University of Eastern Finland and Kuopio University Hospital, Finland (T.P.L.)
| | - Eero Jokinen
- Department of Paediatric Cardiology, Hospital for Children and Adolescents, University of Helsinki, Finland (E.J.)
| | - Leena Taittonen
- Vaasa Central Hospital, Finland (L.T.).,Department of Pediatrics, University of Oulu, Finland (L.T., P.T.)
| | | | - Jorma S A Viikari
- Department of Medicine (M.J., J.S.A.V.), University of Turku, Finland.,Division of Medicine (M.J., J.S.A.V.), Turku University Hospital, Finland
| | - Olli T Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine (J.O.H., K.P., P.S., O.T.R., S.P.R.), University of Turku, Finland.,Centre for Population Health Research (J.O.H., K.P., P.S., O.T.R., S.P.R.), University of Turku and Turku University Hospital, Turku, Finland.,Department of Clinical Physiology and Nuclear Medicine (O.T.R.), Turku University Hospital, Finland
| | - Suvi P Rovio
- Research Centre of Applied and Preventive Cardiovascular Medicine (J.O.H., K.P., P.S., O.T.R., S.P.R.), University of Turku, Finland.,Centre for Population Health Research (J.O.H., K.P., P.S., O.T.R., S.P.R.), University of Turku and Turku University Hospital, Turku, Finland
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Kinney RG, Zakumumpa H, Rujumba J, Gibbons K, Heard A, Galárraga O. Community-funded integrated care outreach clinics as a capacity building strategy to expand access to health care in remote areas of Uganda. Glob Health Action 2021; 14:1988280. [PMID: 34720066 PMCID: PMC8567937 DOI: 10.1080/16549716.2021.1988280] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
Most Ugandans live in rural, medically underserved communities where geography and poverty lead to reduced access to healthcare. We present a novel low-cost approach for supplemental primary care financing through 1) pooling community wealth to cover overhead costs for outreach clinic activities and 2) issuing microfinance loans to motorcycle taxi entrepreneurs to overcome gaps in access to transportation. The intervention described here, which leverages community participation as a means to extend the reach of government health service delivery, was developed and implemented by Health Access Connect (HAC), a non-governmental organization based in Uganda. HAC began its work in August 2015 in the Lake Victoria region and now serves over 40 sites in Uganda across 5 districts, helping government health-care workers to provide over 1,300 patient services per month (and over 35,000 since the program's inception) with an average administrative cost of $6.24 per patient service in 2020. In this article, we demonstrate how integrated and appropriately resourced monthly outreach clinics, based on a microfinance-linked model of wealth pooling and government cooperation, can expand the capacity of government-provided healthcare to reach more patients living in remote communities. This scalable, sustainable, and flexible model is responsive to shifting needs of patients and health systems and presents an alternative approach to healthcare financing in low-resource settings. More rigorous evaluation of health outcomes stemming from such community-based models of service delivery is warranted.
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Affiliation(s)
| | - Henry Zakumumpa
- School of Public Health, Makerere University, Kampala, Uganda
| | - Joseph Rujumba
- Department of Paediatrics and Child Health, School of Medicine, Makerere University, Kampala, Uganda
| | | | - Anna Heard
- Independent Consultant, Washington, DC, USA
| | - Omar Galárraga
- School of Public Health, Brown University, Providence, RI, USA
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Samadipour E, Ghardashi F, Aghaei N. Evaluation of Risk Perception of COVID-19 Disease: A Community-Based Participatory Study. Disaster Med Public Health Prep 2020; 17:e10. [PMID: 32873355 PMCID: PMC7642912 DOI: 10.1017/dmp.2020.311] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [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: 04/07/2020] [Revised: 07/22/2020] [Accepted: 08/16/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVE How people behave in a crisis depends on their understanding and evaluation of risk and vulnerability. Therefore, this study was conducted to investigate the Iranians' risk perception of coronavirus disease (COVID-19). METHODS An online survey was applied, which resulted in the collection of information on demographics, the 5 dimensions of risk perception (cognitive, political, social, cultural, and emotional), and trust in the government among the Iranian users of social networks. Data were analyzed by descriptive and analytical tests of SPSS (IBM Corp, Armonk, NY) software, and confirmatory factor analysis of Amos software. RESULTS A total of 364 persons from 20 provinces completed the questionnaire during February 25 to March 2, 2020. More than 80% of the participants believed that negligence and lack of close supervision of the authorities have led to the spread of COVID-19. The mean (SD) risk perception was 58.77 (± 10.11), indicating the medium level of risk perception of people. The second-order confirmatory factor analysis also indicated that cultural dimension had the highest positive correlation (0.96), emotional dimension had the highest negative correlation (-0.65), and social dimension had the least correlation with the risk perception model (0.08). CONCLUSION Iranians' risk perception of the COVID-19 outbreak is not optimal, and it seems necessary to improve it.
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Affiliation(s)
- Ezat Samadipour
- Non-Communicable Diseases Research Center, School Paramedical, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Fatemeh Ghardashi
- Non-Communicable Diseases Research Center, School Paramedical, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Nahid Aghaei
- School of Nasibeh Nursing and Midwifery, Mazandaran University of Medical Sciences, Mazandaran, Iran
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Doolittle BR, Richards B, Tarabar A, Ellman M, Tobin D. The day the residents left: lessons learnt from COVID-19 for ambulatory clinics. Fam Med Community Health 2020; 8:fmch-2020-000513. [PMID: 32737058 PMCID: PMC7398102 DOI: 10.1136/fmch-2020-000513] [Citation(s) in RCA: 2] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
As the COVID-19 pandemic began, the residents from our ambulatory clinics were pulled to cover the increasing numbers of hospitalised patients. To provide care for our 40 000 patients, without resident support, we needed to develop quickly a new culture of communication and innovation. We accomplished this by regular, transparent meetings with senior leadership and key stakeholders who were empowered to make rapid decisions. We then convened regular meetings with clinic leadership and frontline providers to receive feedback and implement new practices. These rapid meeting cycles allowed for a nimble response to a changing landscape. We optimised our video-conferencing and telehealth services, reached out to our most vulnerable patients and engaged other providers and medical students who were not engaged in patient care due to social isolation practices. We discuss the implications of these innovations on our future practice.
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Affiliation(s)
- Benjamin R Doolittle
- Department of Internal Medicine & Pediatrics, Yale University, New Haven, Connecticut, USA
| | - Bradley Richards
- Department of Internal Medicine, Yale University, New Haven, Connecticut, USA
| | - Amerisa Tarabar
- Department of Internal Medicine, Yale University, New Haven, Connecticut, USA
| | - Matthew Ellman
- Department of Internal Medicine, Yale University, New Haven, Connecticut, USA
| | - Daniel Tobin
- Department of Internal Medicine, Yale University, New Haven, Connecticut, USA
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Burma AD, Mishra V, Das SK, Parivallal MB, Amudhan S, Rao GN. Monitoring and Surveillance of COVID-19 Survival and Stay Characteristics: A Need for Hospital Preparedness in India. Disaster Med Public Health Prep 2020; 14:e15-e16. [PMID: 32666914 PMCID: PMC7438623 DOI: 10.1017/dmp.2020.251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 06/25/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Ajit Deo Burma
- Department of Epidemiology, National Institute of Mental Health and Neuro Sciences, Bangalore, India
| | - Vinayak Mishra
- Department of Epidemiology, National Institute of Mental Health and Neuro Sciences, Bangalore, India
| | - Sumit Kumar Das
- Department of Biostatistics, National Institute of Mental Health And Neuro Sciences, Bangalore, India
| | - Mohana Balan Parivallal
- Department of Epidemiology, National Institute of Mental Health and Neuro Sciences, Bangalore, India
| | - Senthil Amudhan
- Department of Epidemiology, National Institute of Mental Health and Neuro Sciences, Bangalore, India
| | - Girish N. Rao
- Department of Epidemiology, National Institute of Mental Health and Neuro Sciences, Bangalore, India
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31
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Carlsson G, Slaug B, Månsson Lexell E. Assessing environmental barriers by means of the swedish craig hospital inventory of environmental factors among people post-stroke. Scand J Occup Ther 2020; 28:366-374. [PMID: 32544352 DOI: 10.1080/11038128.2020.1775885] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND When occupational therapists address environmental barriers to occupational engagement, some barriers might not be possible to reduce for single individuals, because decisions have to be taken at community or societal level, for example changes in public transport. Investigating environmental barriers by means of the Swedish Craig Hospital Inventory of Environmental Factors (CHIEF-S) may increase our understanding of the environmental impact on occupation engagement and the methodological challenges to assess environmental barriers. AIMS To investigate and describe the magnitude of encountered environmental barriers in a group of people post-stroke and to assess psychometric properties of the CHIEF-S. MATERIAL AND METHODS In total, 34 participants, who had sustained a stroke in Sweden were recruited. RESULTS The participants reported in average 2,7 barriers and the total frequency-magnitude score of barriers (CHIEF-S score) was 0.45. The Cronbach's α for the total CHIEF-S was 0.80 and the analysis of test-retest reliability revealed ICC = 0.86. The entire instrument demonstrated better psychometric properties than the single sub-scales. CONCLUSION In this study, the frequency-magnitude of environmental barriers encountered by people post-stroke are reported at a group level and adds information to the cumulative knowledge generation on perceived environmental barriers in the society. However, to inform which interventions are needed at a more detailed level, other data collection methods have to be added.
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Affiliation(s)
| | - Björn Slaug
- Department of Health Sciences, Lund University, Lund, Sweden
| | - Eva Månsson Lexell
- Department of Health Sciences, Lund University, Lund, Sweden.,Department of Neurology and Rehabilitation Medicine, Skåne University Hospital, Lund-Malmö, Sweden
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Forchuk C, Martin ML, Sherman D, Corring D, Srivastava R, O'Regan T, Gyamfi S, Harerimana B. Healthcare professionals' perceptions of the implementation of the transitional discharge model for community integration of psychiatric clients. Int J Ment Health Nurs 2020; 29:498-507. [PMID: 31863520 DOI: 10.1111/inm.12687] [Citation(s) in RCA: 2] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/25/2019] [Indexed: 12/17/2022]
Abstract
Research has demonstrated the benefits of mental healthcare interventions that ensure a safe transition of clients throughout the discharge and community integration process. This paper reports on qualitative data from focus groups with health professionals collected as part of a larger a mixed method study designed to examine the effectiveness and sustainability of implementing the transitional discharge model. Data collection involved two sets of focus groups, which were held at six months and one-year post-implementation. There were 216 health professional participants from nine (9) hospitals across the Province of Ontario, Canada. Data analysis used a four-step ethnographic framework by Leininger (1985) to identify descriptors and recurrent and major themes. The study identified four major themes, including healthcare professionals' roles and positive experiences in implementing the transitional discharge model; perceived benefits of the model; challenges to implementing the model; and suggestions for sustaining the model's implementation. Healthcare professionals felt that the implementation of the transitional discharge model has the potential for increasing their awareness of the process of clients' integration, serving as a framework for discharge planning, and reducing hospital readmissions. The study findings may provide healthcare providers with information on pragmatic ways to plan clients' discharge, to bridge the gap between hospital and community care, and to positively impact client health outcomes.
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Affiliation(s)
- Cheryl Forchuk
- Lawson Health Research Institute, London, Ontario, Canada.,Arthur Labatt School of Nursing, Western University, London, Ontario, Canada
| | - Mary-Lou Martin
- St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada.,School of Nursing, McMaster University, Hamilton, Ontario, Canada
| | | | - Deborah Corring
- Division of Psychiatry, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Rani Srivastava
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Tony O'Regan
- Lawson Health Research Institute, London, Ontario, Canada.,Arthur Labatt School of Nursing, Western University, London, Ontario, Canada
| | - Sebastian Gyamfi
- Lawson Health Research Institute, London, Ontario, Canada.,Arthur Labatt School of Nursing, Western University, London, Ontario, Canada
| | - Boniface Harerimana
- Lawson Health Research Institute, London, Ontario, Canada.,Arthur Labatt School of Nursing, Western University, London, Ontario, Canada
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Moth G, Binderup AT. Community-based homecare nursing in Denmark: exploring factors related to substitution of nurses by ancillary health professionals. Scand J Caring Sci 2020; 35:559-566. [PMID: 32434286 DOI: 10.1111/scs.12871] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 03/03/2020] [Accepted: 04/20/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Demographic changes and shorter hospital stays have made community-based homecare nursing an increasingly important part of the healthcare organisation. This development may also impact the secondary healthcare system. Optimal use of resources is key to meeting the future challenges. Nevertheless, the research-based knowledge on homecare nursing is scarce. The aim of this study was to examine factors related to homecare nursing tasks that could have been performed by ancillary health professionals. METHODS A population-based survey involving all homecare nurses in the homecare services in one municipality in Denmark was performed. The nurses registered all contacts during daytime for one week using a registration form with a series of items to identify factors related to possible substitution of nurse-performed tasks. Statistical analyses were used to identify associations between specific factors and potential substitution of the performing type of healthcare professional. The study was approved by and is registered at VIA University College in accordance with the General Data Protection Regulation of the EU. RESULTS Homecare nurses registered 941 representative visits in the municipality. Substitution by ancillary health professionals was considered a possibility by the nurses in 28.3% of the cases. When adjusting for age, gender, type of visit, need for extra healthcare services and vulnerability, we established that the nurses more often found that ancillary health professionals could have provided the care in unplanned visits and in visits to patients above 90 years of age. CONCLUSIONS The results indicate potential for optimising the available nursing resources as substitution by ancillary health professionals was considered possible in numerous visits. In view of the increasing demands for community-based homecare nursing, it is important to make the most of the available resources in the future. Substitution of nurses for some tasks could be a feasible solution.
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Affiliation(s)
- Grete Moth
- Program for Health Technology, Methodology Development and Ethics, VIA Research Centre for Health and Welfare Technology, VIA University College, Denmark.,Research Unit for General Practice, Aarhus University, Aarhus, Denmark
| | - Asbjørn Thalund Binderup
- Program for Health Technology, Methodology Development and Ethics, VIA Research Centre for Health and Welfare Technology, VIA University College, Denmark
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Buck BH, Cowan L, Smith L, Duncan E, Bazemore J, Schwind JS. Effective Practices and Recommendations for Drive-Through Clinic Points of Dispensing: A Systematic Review. Disaster Med Public Health Prep 2021; 15:374-88. [PMID: 32234111 DOI: 10.1017/dmp.2020.15] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Drive-through clinics (DTCs) are a novel type of point of dispensing where participants drive to a designated location and receive prophylaxis while remaining inside their vehicle. The objective of this review was to identify effective practices and recommendations for implementing DTCs for mass prophylaxis dispensing during emergency events. METHODS A systematic review was conducted for articles covering DTCs published between 1990 and 2019. Inclusion criteria were peer-reviewed, written in English, and addressed DTCs sufficiently. Effective practices and recommendations identified in the literature were presented by theme. RESULTS A total of 13 articles met inclusion criteria. The themes identified were (1) optimal DTC design and planning via decision support systems and decision support tools; (2) clinic layouts, locations, and design aspects; (3) staffing, training, and DTC communication; (4) throughput time; (5) community outreach methods; (6) DTC equipment; (7) infection prevention and personal protective equipment; and (8) adverse events prevention and traffic management. CONCLUSIONS DTCs are an essential component of emergency preparedness and must be optimally designed and implemented to successfully dispense mass prophylaxis to a community within 48 hours. The effective practices and recommendations presented can be used for the development, implementation, and improvement of DTCs for their target populations.
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Rezaei F, Maracy MR, Yarmohammadian MH, Ardalan A, Keyvanara M. Preparedness of community-based organisations in biohazard: reliability and validity of an assessment tool. Fam Med Community Health 2020; 7:e000124. [PMID: 32148714 PMCID: PMC6910748 DOI: 10.1136/fmch-2019-000124] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Revised: 05/31/2019] [Accepted: 06/01/2019] [Indexed: 11/16/2022] Open
Abstract
The purpose of this study was to develop a tool for community-based health organisations (CBHOs) to evaluate the preparedness in biohazards concerning epidemics or bioterrorism. We searched concepts on partnerships of CBHOs with health systems in guidelines of the Centers for Disease Control and Prevention and literature. Then, we validated the researcher-made tool by face validity, content validity, exploratory factor analysis (EFA), confirmatory factor analysis (CFA) and criterion validity. Data were collected by sending the tool to 620 CBHOs serving under supervision of Iran’s ministry of health. Opinions of health professionals and stakeholders in CBHOs were used to assess face and content validity. Factor loads in EFA were based on three-factor structure that verified by CFA. We used SPSS V.18 and Mplus7 software for statistical analysis. About 105 health-based CBHOs participated. After conducting face validity and calculating content validity ratio and content validity index, we reached 54 items in the field of planning, training and infrastructure. We conducted construct validity using 105 CBHOs. Three items exchanged between the fields according to factor loads in EFA, and CFA verified the model fit as Comparative Fit Index, Tucker-Lewis index and root mean square error of approximation were 0.921, 0918 and 0.052, respectively. The Cronbach’s of the whole tool was 0.944. Spearman correlation coefficient confirmed criterion validity as coefficient was 0.736. Planning, training and infrastructure fields are the most important aspects of preparedness in health-based CBHOs. Applying the new assessment tool in future studies will show the weaknesses and capabilities of health-based CBHOs in biohazard and clear necessary intervention actions for health authorities.
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Affiliation(s)
- Fatemeh Rezaei
- Department of health in emergencies and disasters, Isfahan University of Meical science, Isfahan, Iran (the Islamic Republic of)
| | - Mohammad R Maracy
- School of Public Health, Department of Epidemiology & Biostatistics, Isfahan University of Medical Sciences, Isfahan, Iran (the Islamic Republic of)
| | - Mohammad H Yarmohammadian
- Health Management and Economics Research Center, Isfahan University of Medical Sciences, Isfahan, Iran (the Islamic Republic of)
| | - Ali Ardalan
- Department of Health in Emergencies and Disasters, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
| | - Mahmood Keyvanara
- Faculty of Management and Medical Informatics, Isfahan University of Medical Sciences, Isfahan, Iran (the Islamic Republic of)
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Wojkowski S, Ahluwalia P, Radassao K, Wharin C, Walker G, Rushford N. Role-Emerging Clinical Placements in a Community-Based HIV Organization - Opportunities for Interprofessional Collaboration: A Case Report. Physiother Can 2019. [PMID: 31762548 DOI: 10.3138/ptc.2018-57.e] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Purpose: We describe the development, implementation, and outcomes of role-emerging (RE) clinical placements at Positive Living Niagara (PLN), a community-based HIV organization (CBHIVO), for two second-year, entry-level Master of Science (Physiotherapy) (MSc[PT]) students from McMaster University. Client Description: A national, not-for-profit organization, Realize, conducted outreach to identify CBHIVOs interested in developing physiotherapy (PT) student placements. Intervention: PLN responded to the outreach and worked with McMaster's MSc(PT) programme and Realize to establish two part-time RE PT student placements. The placement description and expectations were developed collaboratively by PLN, Realize, and the MSc(PT) programme. All PT students participating in their third 6-week clinical placement were eligible to apply. A registered occupational therapist and physiotherapist and PLN's programme services manager participated in a shared model to supervise the students' clinical and administrative activities. Measures and Outcome: These first RE PT placements in a Canadian CBHIVO were completed between November and December 2016. The evaluation of the student and placement included a learning contract and the Canadian Physiotherapy Assessment of Clinical Performance. Over 6 weeks, the students collaborated with people living with HIV (PLWHIV) who were members of PLN to identify a role for physiotherapists at PLN and led two health promotion workshops for PLN's members and staff. Implications: The RE PT placement identified future opportunities for physiotherapists at PLN. The experience also influenced one student's decision to apply after graduation for a newly created PT position that included working with PLWHIV.
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Affiliation(s)
- Sarah Wojkowski
- School of Rehabilitation Science, McMaster University, Hamilton
| | | | | | - Caitlin Wharin
- University Health Network, Toronto Rehabilitation Institute - Lyndhurst Centre, Toronto
| | - Glen Walker
- Positive Living Niagara, St. Catharines, Ont
| | - Nancy Rushford
- School of Rehabilitation Science, McMaster University, Hamilton
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Wojkowski S, Ahluwalia P, Radassao K, Wharin C, Walker G, Rushford N. Role-Emerging Clinical Placements in a Community-Based HIV Organization - Opportunities for Interprofessional Collaboration: A Case Report. Physiother Can 2019; 71:384-390. [PMID: 31762548 DOI: 10.3138/ptc-2018-57.e] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Purpose: We describe the development, implementation, and outcomes of role-emerging (RE) clinical placements at Positive Living Niagara (PLN), a community-based HIV organization (CBHIVO), for two second-year, entry-level Master of Science (Physiotherapy) (MSc[PT]) students from McMaster University. Client Description: A national, not-for-profit organization, Realize, conducted outreach to identify CBHIVOs interested in developing physiotherapy (PT) student placements. Intervention: PLN responded to the outreach and worked with McMaster's MSc(PT) programme and Realize to establish two part-time RE PT student placements. The placement description and expectations were developed collaboratively by PLN, Realize, and the MSc(PT) programme. All PT students participating in their third 6-week clinical placement were eligible to apply. A registered occupational therapist and physiotherapist and PLN's programme services manager participated in a shared model to supervise the students' clinical and administrative activities. Measures and Outcome: These first RE PT placements in a Canadian CBHIVO were completed between November and December 2016. The evaluation of the student and placement included a learning contract and the Canadian Physiotherapy Assessment of Clinical Performance. Over 6 weeks, the students collaborated with people living with HIV (PLWHIV) who were members of PLN to identify a role for physiotherapists at PLN and led two health promotion workshops for PLN's members and staff. Implications: The RE PT placement identified future opportunities for physiotherapists at PLN. The experience also influenced one student's decision to apply after graduation for a newly created PT position that included working with PLWHIV.
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Affiliation(s)
- Sarah Wojkowski
- School of Rehabilitation Science, McMaster University, Hamilton
| | | | | | - Caitlin Wharin
- University Health Network, Toronto Rehabilitation Institute - Lyndhurst Centre, Toronto
| | - Glen Walker
- Positive Living Niagara, St. Catharines, Ont
| | - Nancy Rushford
- School of Rehabilitation Science, McMaster University, Hamilton
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Sreedhara M, Valentine Goins K, Frisard C, Rosal MC, Lemon SC. Stepping Up Active Transportation in Community Health Improvement Plans: Findings From a National Probability Survey of Local Health Departments. J Phys Act Health 2019; 16:772-9. [PMID: 31365900 DOI: 10.1123/jpah.2018-0623] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Revised: 03/11/2019] [Accepted: 05/17/2019] [Indexed: 01/19/2023]
Abstract
BACKGROUND Local health departments (LHDs) are increasingly involved in Community Health Improvement Plans (CHIPs), a collaborative planning process that represents an opportunity for prioritizing physical activity. We determined the proportion of LHDs reporting active transportation strategies in CHIPs and associations between LHD characteristics and such strategies. METHODS A national probability survey of US LHDs (<500,000 residents; 30.2% response rate) was conducted in 2017 (n = 162). LHDs reported the inclusion of 8 active transportation strategies in a CHIP. We calculated the proportion of LHDs reporting each strategy. Multivariate logistic regression models determined the associations between LHD characteristics and inclusion of strategies in a CHIP. Inverse probability weights were applied for each stratum. RESULTS 45.6% of US LHDs reported participating in a CHIP with ≥1 active transportation strategy. Proportions for specific strategies ranged from 22.3% (Safe Routes to School) to 4.1% (Transit-Oriented Development). Achieving national accreditation (odds ratio [OR] = 3.67; 95% confidence interval [CI], 1.11-12.05), pursuing accreditation (OR = 3.40; 95% CI, 1.25-9.22), using credible resources (OR = 5.25; 95% CI, 1.77-15.56), and collaborating on a Community Health Assessment (OR = 4.48; 95% CI, 1.23-16.29) were associated with including a strategy in a CHIP after adjusting for covariates. CONCLUSIONS CHIPs are untapped tools, but national accreditation, using credible resources, and Community Health Assessment collaboration may support strategic planning efforts to improve physical activity.
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Adini B, Israeli A, Bodas M, Peleg K. Increasing Perceived Emergency Preparedness by Participatory Policy-Making (Think-Tanks). Disaster Med Public Health Prep 2019; 13:152-7. [PMID: 29458451 DOI: 10.1017/dmp.2018.8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The study aimed to examine impact of think-tanks designed to create policies for emerging threats on medical teams' perceptions of individual and systemic emergency preparedness. METHODS Multi-professional think-tanks were established to design policies for potential attacks on civilian communities. In total, 59 multi-sector health care managers participated in think-tanks focused on: (a) primary care services in risk zones; (b) hospital care; (c) casualty evacuation policies; (d) medical services to special-needs populations; and (e) services in a "temporary military-closed zone." Participants rotated systematically between think-tanks. Perceived individual and systemic emergency preparedness was reviewed pre-post participation in think-tanks. RESULTS A significant increase in perceived emergency preparedness pre-post-think-tanks was found in 8/10 elements including in perceived individual role proficiency (3.71±0.67 vs 4.60±0.53, respectively; P<0.001) and confidence in colleagues' proficiency during crisis (3.56±0.75 vs 4.37±0.61, respectively; P<0.001). Individual preparedness and role perception correlates with systemic preparedness and proficiency in risk assessment. CONCLUSIONS Participation in policy-making impacts on individuals' perceptions of empowerment including trust in colleagues' capacities, but does not increase confidence in a system's preparedness. Field and managerial officials should be involved in policy-making processes, as a means to empower health care managers and improve interfaces and self-efficacy that are relevant to preparedness and response for crises. (Disaster Med Public Health Prepardness. 2019;13:152-157).
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Jeffery AD, Hewner S, Pruinelli L, Lekan D, Lee M, Gao G, Holbrook L, Sylvia M. Risk prediction and segmentation models used in the United States for assessing risk in whole populations: a critical literature review with implications for nurses' role in population health management. JAMIA Open 2019; 2:205-214. [PMID: 31984354 DOI: 10.1093/jamiaopen/ooy053] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 10/03/2018] [Accepted: 11/23/2018] [Indexed: 01/17/2023] Open
Abstract
Objective We sought to assess the current state of risk prediction and segmentation models (RPSM) that focus on whole populations. Materials Academic literature databases (ie MEDLINE, Embase, Cochrane Library, PROSPERO, and CINAHL), environmental scan, and Google search engine. Methods We conducted a critical review of the literature focused on RPSMs predicting hospitalizations, emergency department visits, or health care costs. Results We identified 35 distinct RPSMs among 37 different journal articles (n = 31), websites (n = 4), and abstracts (n = 2). Most RPSMs (57%) defined their population as health plan enrollees while fewer RPSMs (26%) included an age-defined population (26%) and/or geographic boundary (26%). Most RPSMs (51%) focused on predicting hospital admissions, followed by costs (43%) and emergency department visits (31%), with some models predicting more than one outcome. The most common predictors were age, gender, and diagnostic codes included in 82%, 77%, and 69% of models, respectively. Discussion Our critical review of existing RPSMs has identified a lack of comprehensive models that integrate data from multiple sources for application to whole populations. Highly depending on diagnostic codes to define high-risk populations overlooks the functional, social, and behavioral factors that are of great significance to health. Conclusion More emphasis on including nonbilling data and providing holistic perspectives of individuals is needed in RPSMs. Nursing-generated data could be beneficial in addressing this gap, as they are structured, frequently generated, and tend to focus on key health status elements like functional status and social/behavioral determinants of health.
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Affiliation(s)
- Alvin D Jeffery
- Department of Veterans Affairs and Vanderbilt University Department of Biomedical Informatics, Nashville, Tennessee, USA
| | - Sharon Hewner
- Family, Community and Health Systems Science Department, University at Buffalo School of Nursing, Buffalo, New York, USA
| | - Lisiane Pruinelli
- School of Nursing, University of Minnesota, Minneapolis, Minnesota, USA
| | - Deborah Lekan
- School of Nursing, University of North Carolina, Greensboro, North Carolina, USA
| | - Mikyoung Lee
- College of Nursing, Texas Woman's University, Denton, Texas, USA
| | - Grace Gao
- Department of Nursing, St. Catherine University, St. Paul, Minnesota, USA
| | | | - Martha Sylvia
- College of Nursing, Medical University of South Carolina, Charleston, South Carolina, USA
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Herity LB, Upchurch G, Schenck AP. Senior PharmAssist: Less Hospital Use with Enrollment in an Innovative Community-Based Program. J Am Geriatr Soc 2018; 66:2394-2400. [PMID: 30306540 DOI: 10.1111/jgs.15617] [Citation(s) in RCA: 3] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 08/20/2018] [Accepted: 08/21/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To evaluate changes in acute health services use of Senior PharmAssist participants. DESIGN Retrospective analysis. SETTING Community-based, nonprofit program in Durham County, North Carolina. PARTICIPANTS Adults aged 60 and older with income of 200% of the federal poverty level or less who enrolled in the Senior PharmAssist program (N = 191) between August 1, 2011, and March 15, 2017. INTERVENTION Medication therapy management (MTM), customized community referrals, Medicare insurance counseling, and medication copayment assistance provided by Senior PharmAssist. MEASUREMENTS Primary outcomes were self-reported emergency department (ED) visits and hospital admissions in the previous year, assessed at baseline and every 6 months for up to 2 years. RESULTS Mean number of ED visits declined over time (0.83 visits per year at baseline to 0.53 visits per year at 24 months, P = .002), as did the percentage of participants reporting an ED visit in the past year (49% at baseline to 31% at 24 months, P = .003). Mean hospital admissions also decreased (0.56 admissions per year at baseline to 0.4 admissions per year at 24 months, P = .02). There was no significant change in percentage of participants reporting a hospital admission in the past year (33% at baseline to 25% at 24 months, P = .23). CONCLUSION Older adults who enrolled in a community-based program that helps them manage medications, connect with community resources, and overcome barriers to medication access experienced reductions in acute health services use. J Am Geriatr Soc 66:2394-2400, 2018.
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Affiliation(s)
- Leah B Herity
- Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina.,Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, North Carolina.,Virginia Commonwealth University Health System, Richmond, Virginia
| | - Gina Upchurch
- Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina.,Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, North Carolina.,Geriatric Workforce Enhancement Program, Duke University, Durham, North Carolina.,Senior PharmAssist, Durham, North Carolina
| | - Anna P Schenck
- Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
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Barry T, González A, Conroy N, Watters P, Masterson S, Rigby J, Bury G. Mapping the potential of community first responders to increase cardiac arrest survival. Open Heart 2018; 5:e000912. [PMID: 30402259 PMCID: PMC6203054 DOI: 10.1136/openhrt-2018-000912] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 09/05/2018] [Accepted: 09/26/2018] [Indexed: 11/04/2022] Open
Abstract
Objective Resuscitation from out-of-hospital cardiac arrest (OHCA) is largely determined by the availability of cardiopulmonary resuscitation (CPR) and defibrillation within 5-10 min of collapse. The potential contribution of organised groups of volunteers to delivery of CPR and defibrillation in their communities has been little studied. Ireland has extensive networks of such volunteers; this study develops and tests a model to examine the potential impact at national level of these networks on early delivery of care. Methods A geographical information systems study considering all statutory ambulance resource locations and all centre point locations for community first responder (CFR) schemes that operate in Ireland were undertaken. ESRI ArcGIS Desktop 10.4 was used to map CFR and ambulance base locations. ArcGIS Online proximity analysis function was used to model 5-10 min drive time response areas under sample peak and off-peak conditions. Response areas were linked to Irish population census data so as to establish the proportion of the population that have the potential to receive a timely cardiac arrest emergency response. Results This study found that CFRs are present in many communities throughout Ireland and have the potential to reach a million additional citizens before the ambulance service and within a timeframe where CPR and defibrillation are likely to be effective treatments. Conclusion CFRs have significant potential to contribute to survival following OHCA in Ireland. Further research that examines the processes, experiences and outcomes of CFR involvement in OHCA resuscitation should be a scientific priority.
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Affiliation(s)
- Tomás Barry
- School of Medicine, University College Dublin, Dublin, Ireland
| | - Ainhoa González
- School of Geography, University College Dublin, Dublin, Ireland
| | - Niall Conroy
- School of Medicine, University College Dublin, Dublin, Ireland
| | - Paddy Watters
- National Emergency Operations Centre, National Ambulance Service, Dublin, Ireland
| | - Siobhán Masterson
- School of Medicine, National University of Ireland Galway, Discipline of General Practice, Galway, Ireland
- Out of Hospital Cardiac Arrest Strategy, National Ambulance Service, Dublin, Ireland
| | - Jan Rigby
- Department of Geography, Maynooth University, Maynooth, Ireland
| | - Gerard Bury
- Professor of General Practice, University College Dublin, Dublin, Ireland
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Asgary R, Price JT. Socio-Cultural Challenges of Family Planning Initiatives for Displaced Populations in Conflict Situations and Humanitarian Settings. Disaster Med Public Health Prep 2018; 12:670-4. [PMID: 29622049 DOI: 10.1017/dmp.2017.146] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Provision of family planning services for refugee populations in conflict and humanitarian settings has been improving. Availability of services, however, does not translate into acceptability and uptake; understanding socio-cultural settings and barriers is critical to ensure utilization of services. Misconceptions and apprehensions surrounding family planning services are common. Populations may see limiting pregnancies as counterproductive in light of high child mortality or suspicious in the context of ethnic violence; larger family size has the perceived advantage of additional security for the community or ethnic group, assistance with family duties in a subsistence structure, and a social service investment for parents as they age; and there may be religious and moral objections to contraception. Any service planning and implementation must take into account community perceptions and address socio-cultural contextual subtleties. Ongoing community education via local initiatives from within the refugee community, region-wide structural strategies for service implementation and sustainability, and efforts to reconcile reproductive rights and family planning services within the religious and social context are crucial. (Disaster Med Public Health Preparedness. 2018;12:670-674).
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Tai CG, Hiatt RA. The Population Burden of Cancer: Research Driven by the Catchment Area of a Cancer Center. Epidemiol Rev 2018; 39:108-122. [PMID: 28472310 DOI: 10.1093/epirev/mxx001] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Accepted: 01/09/2017] [Indexed: 11/14/2022] Open
Abstract
Cancer centers, particularly those supported by the National Cancer Institute, are charged with reducing the cancer burden in their catchment area. However, methods to define both the catchment area and the cancer burden are diverse and range in complexity often based on data availability, staff resources, or confusion about what is required. This article presents a review of the current literature identifying 4 studies that have defined various aspects of the cancer burden in a defined geographical area and highlights examples of how some cancer centers and other health institutions have defined their catchment area and characterized the cancer burden within it. We then present a detailed case study of an approach applied by the University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center to define its catchment area and its population cancer burden. We cite examples of how the Cancer Center research portfolio addresses the defined cancer burden. Our case study outlines a systematic approach to using publicly available data, such as cancer registry data, that are accessible by all cancer centers. By identifying gaps and formulating future research directions based on the needs of the population within the catchment area, epidemiologic studies and other types of cancer research can be directed to the population served. This review can help guide cancer centers in developing an approach to defining their own catchment area as mandated and applying research findings to this defined population.
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Abstract
OBJECTIVE Like the general population, the military is experiencing an increase in the number of obese personnel. This study aimed to identify predictors of obesity by assessing social determinants of health and behaviors in relation to Body Mass Index (BMI), and to use these variables to build a model to predict obesity in Active Duty Military Personnel (ADMP). Predicting obesity would allow early intervention of at risk personnel, potentially reducing the number of ADMP who are separated from the service for failing to meet weight standards. DESIGN A secondary data analysis of the 2011 Survey of Health-Related Behaviors of Active Duty Military Personnel was performed. The survey included 39,197 responders. MEASURES Descriptive statistics, bivariate analyses, and logistic regression analysis were conducted to examine the relationship between social determinants of health, behaviors in relation to Healthy People 2020 recommendations, and obesity. Moderator variables were used to determine what affects the direction and/or strength of the relationship between the independent variables (e.g., social determinants and behaviors) and the outcome variable of obesity. RESULTS At the bivariate level, these variables mirror existing research. However, logistic regression identified few statistically significant obesogenic lifestyle behaviors in relation to Healthy People 2020 recommendations and a weak interactive effect between the variables. CONCLUSION The low number of significant variables identified to predict obesity highlights the multifactorial nature of obesity making it difficult for weight-loss interventions to be effective if limited to one group or one specific behavior.
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Charney RL, Rebmann T, Endrizal A, Dalawari P. The General Public's Attitudes and Beliefs Regarding Resource Management, Collaboration, and Community Assistance Centers During Disasters. Disaster Med Public Health Prep 2018; 12:446-9. [PMID: 28965525 DOI: 10.1017/dmp.2017.108] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND The key to resilience after disasters is the provision of coordinated care and resource distribution to the affected community. Past research indicates that the general public lacks an understanding regarding agencies' roles and responsibilities during disaster response.Study ObjectivesThis study's purpose was to explore the general public's beliefs regarding agencies or organizations' responsibilities related to resource management during disasters. In addition, the public's attitudes towards the management and use of community disaster assistance centers were explored. METHODS Qualitative interviews were conducted with members of the general public. Interviews were audio-recorded and transcribed verbatim. Content analysis was used to analyze the data and identify themes that describe the public's expectations of disaster response agencies and the use of community disaster assistance centers. RESULTS A total of 28 interviews were conducted. Half of the participants (n=14) were black, 57% (n=16) were female, and the mean age was 49 years. The general public has developed trust and distrust toward response organizations and governmental agencies based on past experiences during disasters. The public wishes to have local agencies to help lead disaster response, but expects a collaboration between all response organizations, including the government. The managing agency overseeing community disaster assistance centers was not perceived as important, but the proximity of these centers to community members was considered critical. CONCLUSIONS The general public prefers that local agencies and leaders manage disaster response, and they expect collaboration among response agencies. Community assistance centers need to be located close to those in need, and be managed by agencies trusted by the general public. (Disaster Med Public Health Preparedness. 2018;12:446-449).
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Wong GCY, Lee KY, Lam KF, Fan SYS. Community-based survey of knowledge of, attitudes to and practice of colorectal cancer screening in Hong Kong. J Dig Dis 2017; 18:582-590. [PMID: 28945312 DOI: 10.1111/1751-2980.12544] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Revised: 09/06/2017] [Accepted: 09/20/2017] [Indexed: 12/11/2022]
Abstract
OBJECTIVE We aimed to investigate the knowledge, attitudes and practice of colorectal cancer (CRC) and screening in the community to complement the introduction of population-based CRC screening in Hong Kong SAR, China. METHODS Clients attending the Family Planning Association of Hong Kong clinics from March to June 2016 were randomly invited to participate in this questionnaire survey. RESULTS Knowledge of CRC and screening for it was still deficient in the community. Respondents scored less than half on their knowledge of the symptoms and screening methods of CRC as well as on the local screening policy. Fewer than 30% knew that CRC can be asymptomatic and they had insufficient knowledge of primary lifestyle prevention of CRC. However, most (86.0%) would like to participate in CRC screening. The cost and trouble involved were the two main reasons given for not wanting to do so. Only 14.0% of the whole sample and 27.0% of those aged 50 years or above had undergone CRC screening irrespective of screening method. One-fifth of those who had been screened had some abnormality, with a cancer detection rate of 2.2%. Employment, income, knowledge and perception of risk were major determinants of their decision to undergo screening. CONCLUSIONS To reduce the morbidity and mortality of CRC significantly, average risk and high-risk groups should be encouraged to come forward for screening even if they are asymptomatic. Educating the population, simplifying the screening procedure and offering financial support by the government are keys to success.
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Affiliation(s)
- Grace Ching Yin Wong
- Wan Chai Clinic, Hong Kong, China.,Ma Tau Chung Clinic, Hong Kong, China.,Wong Tai Sin Clinic, Hong Kong, China.,Tsuen Wan Centre, Hong Kong, China.,Tai Wai Clinic, Hong Kong, China.,Yuen Long Clinic, The Family Planning Association of Hong Kong, Hong Kong SAR, China
| | - Ka Yu Lee
- Wan Chai Clinic, Hong Kong, China.,Ma Tau Chung Clinic, Hong Kong, China.,Wong Tai Sin Clinic, Hong Kong, China.,Tsuen Wan Centre, Hong Kong, China.,Tai Wai Clinic, Hong Kong, China.,Yuen Long Clinic, The Family Planning Association of Hong Kong, Hong Kong SAR, China
| | - Kwok Fai Lam
- Wan Chai Clinic, Hong Kong, China.,Ma Tau Chung Clinic, Hong Kong, China.,Wong Tai Sin Clinic, Hong Kong, China.,Tsuen Wan Centre, Hong Kong, China.,Tai Wai Clinic, Hong Kong, China.,Yuen Long Clinic, The Family Planning Association of Hong Kong, Hong Kong SAR, China
| | - Susan Yun Sun Fan
- Wan Chai Clinic, Hong Kong, China.,Ma Tau Chung Clinic, Hong Kong, China.,Wong Tai Sin Clinic, Hong Kong, China.,Tsuen Wan Centre, Hong Kong, China.,Tai Wai Clinic, Hong Kong, China.,Yuen Long Clinic, The Family Planning Association of Hong Kong, Hong Kong SAR, China
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Bareket R, Schonberg MA, Comaneshter D, Schonmann Y, Shani M, Cohen A, Vinker S. Cancer Screening of Older Adults in Israel According to Life Expectancy: Cross Sectional Study. J Am Geriatr Soc 2017; 65:2539-2544. [PMID: 28875497 DOI: 10.1111/jgs.15035] [Citation(s) in RCA: 2] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVES To examine over-screening of older Israelis for colon and breast cancer. DESIGN Cross sectional. SETTING Clalit Health Services (CHS), Israel's largest health maintenance organization (HMO), provides care for more than half of the country's population and operates a national age-based programs for cancer screening. PARTICIPANTS All community-dwelling members aged 65 to 79 in 2014 (N = 370,876). MEASUREMENTS We used CHS data warehouse to evaluate cancer screening during 2014. Life expectancy (LE) was estimated using the validated Schonberg index. RESULTS Almost one-quarter (23.1%; 15.6% of adults aged 65-74, 42.7% of adults aged 75-79) of the study population had an estimated LE of less than 10 years. Annual fecal occult blood test and biannual mammography rates among adults aged 65 to 74 with a LE of 10 years or longer were 37.1% and 70.0%, respectively. Rates dropped after age 75 (4.0%, 19.5%) and to a lesser extent with a LE of less than 10 years (31.6%, 56.4%). Prostate-specific antigen testing is not part of the national screening program, and the proportion of people tested (42.6%), did not vary similarly with age of 75 and older (43.2%) or LE of less than 10 years (38.1%). CONCLUSION The cancer screening inclusion criteria of the national referral system have a strong effect on receipt of screening; LE considerations are less influential. Some method of estimating LE could be incorporated into algorithms to improve individualized cancer screening to reduce over- and underscreening of older adults.
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Affiliation(s)
- Ronen Bareket
- Quality Indicators and Research Department, Chief Physician Office, Clalit Health Services, Tel Aviv, Israel.,Department of Family Medicine, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Mara A Schonberg
- Division of General Medicine and Primary Care, Department of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Doron Comaneshter
- Quality Indicators and Research Department, Chief Physician Office, Clalit Health Services, Tel Aviv, Israel
| | - Yochai Schonmann
- Quality Indicators and Research Department, Chief Physician Office, Clalit Health Services, Tel Aviv, Israel.,Department of Family Medicine, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Michal Shani
- Quality Indicators and Research Department, Chief Physician Office, Clalit Health Services, Tel Aviv, Israel.,Department of Family Medicine, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Arnon Cohen
- Quality Indicators and Research Department, Chief Physician Office, Clalit Health Services, Tel Aviv, Israel.,Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheba, Israel
| | - Shlomo Vinker
- Department of Family Medicine, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
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Kaufman A, Boren J, Koukel S, Ronquillo F, Davies C, Nkouaga C. Agriculture and Health Sectors Collaborate in Addressing Population Health. Ann Fam Med 2017; 15:475-480. [PMID: 28893819 PMCID: PMC5593732 DOI: 10.1370/afm.2087] [Citation(s) in RCA: 10] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Revised: 02/20/2017] [Accepted: 03/22/2017] [Indexed: 11/09/2022] Open
Abstract
PURPOSE Population health is of growing importance in the changing health care environment. The Cooperative Extension Service, housed in each state's land grant university, has a major impact on population health through its many community-based efforts, including the Supplemental Nutrition Assistance Program - Education (SNAP-Ed) nutrition programs, 4-H youth engagement, health and wellness education, and community development. Can the agricultural and health sectors, which usually operate in parallel, mostly unknown to each other, collaborate to address population health? We set out to provide an overview of the collaboration between the Cooperative Extension Service and the health sector in various states and describe a case study of 1 model as it developed in New Mexico. METHODS We conducted a literature review and personally contacted states in which the Cooperative Extension Service is collaborating on a "Health Extension" model with academic health centers or their health systems. We surveyed 6 states in which Health Extension models are being piloted as to their different approaches. For a case study of collaboration in New Mexico, we drew on interviews with the leadership of New Mexico State University's Cooperative Extension Service in the College of Agricultural, Consumer and Environmental Sciences; the University of New Mexico (UNM) Health Science Center's Office for Community Health; and the personal experiences of frontline Cooperative Extension agents and UNM Health Extension officers who collaborated on community projects. RESULTS A growing number of states are linking the agricultural Cooperative Extension Service with academic health centers and with the health care system. In New Mexico, the UNM academic health center has created "Health Extension Rural Offices" based on principles of the Cooperative Extension model. Today, these 2 systems are working collaboratively to address unmet population health needs in their communities. Nationally, the Cooperative Extension Service has formed a steering committee to guide its movement into the health arena. CONCLUSION Resources of the agricultural and health sectors offer communities complementary expertise and resources to address adverse population health outcomes. The collaboration between Cooperative Extension and the health sector is 1 manifestation of this emerging collaboration model termed Health Extension. Initial skepticism and protection of funding sources and leadership roles can be overcome with shared funding from new sources, shared priority setting and decision making, and the initiation of practical, collaborative projects that build personal relationships and trust.
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Affiliation(s)
- Arthur Kaufman
- University of New Mexico Health Sciences Center, University of New Mexico, Albuquerque, New Mexico
| | - Jon Boren
- College of Agricultural, Consumer and Environmental Sciences, New Mexico State University, Las Cruces, New Mexico
| | - Sonja Koukel
- Extension Family and Consumer Sciences Department, New Mexico State University, Las Cruces, New Mexico
| | - Francisco Ronquillo
- University of New Mexico Health Sciences Center, University of New Mexico, Albuquerque, New Mexico
| | - Cindy Davies
- Bernalillo County Cooperative Extension Service, New Mexico State University, Las Cruces, New Mexico
| | - Carolina Nkouaga
- University of New Mexico Health Sciences Center, University of New Mexico, Albuquerque, New Mexico
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Tataw DB, Ekúndayò OT. Mixed Methods in Prostate Cancer Prevention and Service Utilization Planning: Combining Focus Groups, Survey Research, and Community Engagement. Soc Work Public Health 2017; 32:254-272. [PMID: 28276892 DOI: 10.1080/19371918.2016.1275914] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 06/06/2023]
Abstract
This article reports on the use of sequential and integrated mixed-methods approach in a focused population and small-area analysis. The study framework integrates focus groups, survey research, and community engagement strategies in a search for evidence related to prostate cancer screening services utilization as a component of cancer prevention planning in a marginalized African American community in the United States. Research and data analysis methods are synthesized by aggregation, configuration, and interpretive analysis. The results of synthesis show that qualitative and quantitative data validate and complement each other in advancing our knowledge of population characteristics, variable associations, the complex context in which variables exist, and the best options for prevention and service planning. Synthesis of findings and interpretive analysis provided two important explanations which seemed inexplicable in regression outputs: (a) Focus group data on the limitations of the church as an educational source explain the negative association between preferred educational channels and screening behavior found in quantitative analysis. (b) Focus group data on unwelcoming provider environments explain the inconsistent relationship between knowledge of local sites and screening services utilization found in quantitative analysis. The findings suggest that planners, evaluators, and scientists should grow their planning and evaluation evidence from the community they serve.
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Affiliation(s)
- David Besong Tataw
- a College of Health Professions , Northern Kentucky University , Highland Heights , Kentucky , USA
| | - Olúgbémiga T Ekúndayò
- b Department of Public Health and Health Care Administration , College of Health Science and Public Health, Eastern Washington University , Spokane , Washington , USA
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