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Paltiel O, Manor O, Calderon Margalit R, Baron Epel O, Bar Zeev Y, Berry E, Clarfield AM, Dann EJ, Davidovitch N, Donchin M, Green M, Hochner H, Neumark Y, Nitzan D, Paltiel A, Razum O, Rosen B, Rudolf M. Children on the Gaza-Israel Border: Victims of War. Public Health Rev 2024; 45:1607192. [PMID: 38720818 PMCID: PMC11076671 DOI: 10.3389/phrs.2024.1607192] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 04/10/2024] [Indexed: 05/12/2024] Open
Affiliation(s)
- Ora Paltiel
- Hadassah-Hebrew University Braun School of Public Health and Community Medicine, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Orly Manor
- Hadassah-Hebrew University Braun School of Public Health and Community Medicine, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Ronit Calderon Margalit
- Hadassah-Hebrew University Braun School of Public Health and Community Medicine, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Orna Baron Epel
- School of Public Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Mount Carmel, Israel
| | - Yael Bar Zeev
- Hadassah-Hebrew University Braun School of Public Health and Community Medicine, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Elliot Berry
- Hadassah-Hebrew University Braun School of Public Health and Community Medicine, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - A. Mark Clarfield
- Centre of Global Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Eldad J. Dann
- The Ruth and Bruce Rappaport Faculty of Medicine, Technion Israel Institute of Technology, Haifa, Israel
| | - Nadav Davidovitch
- Department of Health Policy and Management, School of Public Health, Ben Gurion University of the Negev, Beer-Sheva, Israel
| | - Milka Donchin
- Hadassah-Hebrew University Braun School of Public Health and Community Medicine, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Manfred Green
- School of Public Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Mount Carmel, Israel
| | - Hagit Hochner
- Hadassah-Hebrew University Braun School of Public Health and Community Medicine, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Yehuda Neumark
- Hadassah-Hebrew University Braun School of Public Health and Community Medicine, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Dorit Nitzan
- School of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- Center for the Study of Preparedness and Response to Emergencies and Disaster, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Ari Paltiel
- Hadassah-Hebrew University Braun School of Public Health and Community Medicine, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Oliver Razum
- Department of Epidemiology and International Public Health, School of Public Health, Bielefeld University, Bielefeld, Germany
| | - Bruce Rosen
- Paul Baerwald School of Social Work and Social Welfare, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Mary Rudolf
- Population Health, Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel
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van der Boor C, Andersen LS, Massazza A, Tol WA, Taban D, Roberts B, Ssebunnya J, Kinyanda E, May C, Nadkarni A, Fuhr D. Using theory of change to plan for the implementation of a psychological intervention addressing alcohol use disorder and psychological distress in Uganda. Glob Ment Health (Camb) 2024; 11:e6. [PMID: 38283880 PMCID: PMC10808976 DOI: 10.1017/gmh.2023.93] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 12/05/2023] [Accepted: 12/18/2023] [Indexed: 01/30/2024] Open
Abstract
In conflict-affected settings, prevalence of alcohol use disorders (AUDs) can be high. However, limited practical information exists on AUD management in low-income settings. Using a theory of change (ToC) approach, we aimed to identify pathways influencing the implementation and maintenance of a new transdiagnostic psychological intervention ("CHANGE"), targeting both psychological distress and AUDs in humanitarian settings. Three half-day workshops in Uganda engaged 41 stakeholders to develop a ToC map. ToC is a participatory program theory approach aiming to create a visual representation of how and why an intervention leads to specific outcomes. Additionally, five semi-structured interviews were conducted to explore experiences of stakeholders that participated in the ToC workshops. Two necessary pathways influencing the implementation and maintenance of CHANGE were identified: policy impact, and mental health service delivery. Barriers identified included policy gaps, limited recognition of social determinants and the need for integrated follow-up care. Interviewed participants valued ToC's participatory approach and expressed concerns about its adaptability in continuously changing contexts (e.g., humanitarian settings). Our study underscores ToC's value in delineating context-specific outcomes and identifies areas requiring further attention. It emphasizes the importance of early planning and stakeholder engagement for sustainable implementation of psychological interventions in humanitarian settings.
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Affiliation(s)
- Catharina van der Boor
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Lena S. Andersen
- Section of Global Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Alessandro Massazza
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Wietse A. Tol
- Section of Global Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Athena Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | | | - Bayard Roberts
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Joshua Ssebunnya
- Mental Health Focus Area, MRC/UVRI & LSHTM Uganda Research Unit/MRC Investigator, Entebbe, Uganda
| | - Eugene Kinyanda
- Mental Health Focus Area, MRC/UVRI & LSHTM Uganda Research Unit/MRC Investigator, Entebbe, Uganda
| | - Carl May
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Abhijit Nadkarni
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK
- Addictions and Related Research Group, Sangath, Goa, India
| | - Daniela Fuhr
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
- Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology, Bremen, Germany
- Health Sciences, University of Bremen, Bremen, Germany
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Cha J, Noh JW, Robinson C, Kwon YD, Kim J. Challenges of COVID-19 prevention during protracted conflicts: differential adherence to preventive measures in "contact line" regions in eastern Ukraine. Front Public Health 2023; 11:1151452. [PMID: 37213618 PMCID: PMC10195995 DOI: 10.3389/fpubh.2023.1151452] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 04/05/2023] [Indexed: 05/23/2023] Open
Abstract
Objectives Despite the epidemiological importance of social vulnerabilities in compliance with preventive measures, little is known about the disproportional nature of preventive behaviors in crisis-affected populations. We examined adherence to COVID-19 preventive behaviors, focusing on social distancing measures in the conflict-affected regions in eastern Ukraine. Methods From a multisectoral needs assessment conducted in 2020 using a household interview of a stratified simple random sample, we included 1,617 rural and urban households located in the government-controlled area. We performed multivariable binary logistic regression analysis with latent class analysis (LCA) to identify unmeasured patterns of classification of preventive measures using data from a cross-sectional survey. Results The conflict-affected populations showed difficulty in complying with COVID-19 preventive measures due to losses of housing, partners, and access to food resources due to conflicts. Among the various preventive measures, wearing a face mask (88.1%) and washing hands more regularly (71.4%) were the most frequently reported. Compliance with social distancing was significantly lower in those who experienced the direct impacts of conflicts indicated by damaged accommodation or being widowed. Three different groups who showed distinctive patterns of employing COVID-19 preventive measures were identified via the LCA model, which were "highly complying group", "moderately complying group", and "face masks only group". The group membership was associated with a respondent's poverty status. Conclusion The findings show the difficulty in compliance with COVID-19 preventive measures among conflict-affected populations indicating secondary impacts of the conflicts on preventive health behaviors. To mitigate the health impacts of conflicts, immediate attention is needed to address barriers to COVID-19 preventive measures among conflict-affected populations in Ukraine. This study suggests the need for public health strategies to improve preventive health behaviors in conflict-affected populations under pandemics or large-scale outbreaks.
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Affiliation(s)
- Jiho Cha
- Moonsoul Graduate School of Future Strategy, Korea Advanced Institute of Science and Technology, Daejeon, Republic of Korea
| | - Jin-Won Noh
- Division of Health Administration, College of Software and Digital Healthcare Convergence, Yonsei University, Wonju, Republic of Korea
| | - Courtland Robinson
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States
| | - Young Dae Kwon
- Department of Humanities and Social Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Cathoilc Institute for Public Health and Healthcare Management, The Catholic University of Korea, Seoul, Republic of Korea
- *Correspondence: Young Dae Kwon, ; Jinseok Kim,
| | - Jinseok Kim
- Department of Social Welfare, Seoul Women’s University, Seoul, Republic of Korea
- *Correspondence: Young Dae Kwon, ; Jinseok Kim,
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Sommer M, Munoz-Laboy M, Wilkinson Salamea E, Arp J, Falb KL, Rudahindwa N, Stark L. How Narratives of Fear Shape Girls' Participation in Community Life in Two Conflict-Affected Populations. Violence Against Women 2017; 24:565-585. [PMID: 29332551 DOI: 10.1177/1077801217710000] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [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: 11/15/2022]
Abstract
Numerous social factors shape girls' lives in conflict-affected settings, affecting their vulnerability to gender-based violence (GBV). Qualitative research methods were used to examine spaces of perceived safety and risk for girls living in two conflict-affected populations: camps in Ethiopia hosting primarily South Sudanese and Sudanese refugees and communities in eastern Democratic Republic of Congo. Three major themes emerged: (a) challenges around caregiver-child communication regarding development, sex, and sexual violence; (b) a typology of safe/risky spaces; and (c) the influence of male-dominated spaces on experiences and fear of GBV. The findings have implications for programs focused on reducing adolescent girls' vulnerability to violence within conflict-affected contexts.
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Affiliation(s)
- Marni Sommer
- 1 Columbia University Mailman School of Public Health, New York, NY, USA
| | | | | | - Johanna Arp
- 3 International Rescue Committee, Community Wellbeing Initiative, Addis Ababa, Ethiopia
| | - Kathryn L Falb
- 4 International Rescue Committee, Research, Evaluation, and Learning, New York, NY, USA
| | - Nadine Rudahindwa
- 5 International Rescue Committee, Women's Protection and Empowerment, Goma, Democratic Republic of Congo
| | - Lindsay Stark
- 1 Columbia University Mailman School of Public Health, New York, NY, USA
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