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Le H, Rew L. Youth-centered Recommendations to Address Social Stigma and Discrimination Against Unhoused Youth: An Integrative Literature Review. J Sch Nurs 2023:10598405231214061. [PMID: 37994006 DOI: 10.1177/10598405231214061] [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: 11/24/2023] Open
Abstract
Youth between ages 13 and 25 who experience homelessness face numerous barriers to excellent health, including social stigma and discrimination. Applying socio-ecological model and intersectionality theory, an integrative literature review was conducted. Peer-reviewed studies (N = 29) representing 808,296 participants extracted from four databases (CINAHL, MEDLINE, PsychINFO, SocINDEX) were analyzed. The studies included sources of discrimination and stigma from interpersonal interactions with support services staff upwards to policy and systemic levels with housing and justice systems. Health outcomes include poorer physical and behavioral health status from increased likeliness of denied access to support services, prolonged time spent being homeless, and higher incidences of experiencing violence. School nursing has power to push for recommended changes and support unhoused youth towards excellent health. Proposed changes include adapting Housing First framework, engaging with unhoused youth in program planning, policy writing, and public education that address the causes of poverty.
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Affiliation(s)
- Huy Le
- The University of Texas at Austin School of Nursing, Honors Program, TX, USA
| | - Lynn Rew
- Denton & Louise Cooley and Family Centennial Professor in Nursing, The University of Texas at Austin, TX, USA
- The University of Texas at Austin School of Nursing, Austin, TX, USA
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2
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Yitbarek S, Chen K, Celestin M, McCary M. Urban mosquito distributions are modulated by socioeconomic status and environmental traits in the USA. Ecol Appl 2023:e2869. [PMID: 37140135 DOI: 10.1002/eap.2869] [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] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 04/25/2023] [Indexed: 05/05/2023]
Abstract
The distribution of mosquitoes and associated vector diseases (e.g., West Nile, dengue, and Zika viruses) is likely a function of environmental conditions in the landscape. Urban environments are highly heterogeneous in the amount of vegetation, standing water, and concrete structures covering the land at a given time, each having the capacity to influence mosquito abundance and disease transmission. Previous research suggests that socioeconomic status is correlated with the ecology of the landscape, with lower-income neighborhoods generally having more concrete structures and standing water via residential abandonment, garbage dumps, and inadequate sewage. Whether these socio-ecological factors affect mosquito distributions across urban environments in the United States (US) remains unclear. Here, we present a meta-analysis of 42 paired observations from 18 articles testing how socioeconomic status relates to overall mosquito burden in urban landscapes in the US. We also analyzed how with socio-ecological covariates (e.g., abandoned buildings, vegetation, education, and garbage containers) varied across socioeconomic status in the same mosquito studies. The meta-analysis revealed that lower-income neighborhoods (regions with median household incomes <$50,000 household-1 year-1 ) are exposed to 63% greater mosquito densities and mosquito-borne illnesses compared to higher-income neighborhoods (≥$50,000 household-1 year-1 ). One common species of urban mosquito (Aedes aegypti) showed the strongest relationship with socioeconomic status, with Ae. aegypti being 126% higher in low-income than high-income neighborhoods. We also found that certain socio-ecological covariates correlated with median household income. Garbage, trash, and plastic containers were found 67% higher in low-income neighborhoods, whereas high-income neighborhoods tended to have higher levels of education. Together, these results indicate that socio-ecological factors can lead to disproportionate impacts of mosquitoes on humans in urban landscapes. Thus, concerted efforts to manage mosquito populations in low-income urban neighborhoods are required to reduce mosquito burden for the communities most vulnerable to human disease.
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Affiliation(s)
- Senay Yitbarek
- University of North Carolina at Chapel Hill, Department of Biology, Chapel Hill, NC
| | - Kelvin Chen
- Rutgers University, Department of Ecology and Evolution, New Brunswick, NJ
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Descarpentrie A, Estevez M, Brabant G, Vandentorren S, Lioret S. Lifestyle Patterns of Children Experiencing Homelessness: Family Socio-Ecological Correlates and Links with Physical and Mental Health. Int J Environ Res Public Health 2022; 19:16276. [PMID: 36498355 PMCID: PMC9737210 DOI: 10.3390/ijerph192316276] [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] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 11/25/2022] [Accepted: 12/01/2022] [Indexed: 06/17/2023]
Abstract
Diet, screen time, physical activity, and sleep combine into lifestyle patterns with synergistic effects on health. This study aimed to identify lifestyle patterns in children without housing and assess their associations with physical and mental health and family socio-ecological factors. In the 2013 ENFAMS cross-sectional survey (children aged 6-12 experiencing homelessness, Greater Paris area, n = 235), parents reported socio-ecological factors, children's behaviours, and mental health (the latter was also child-reported). Nurses measured children's haemoglobin concentrations and body mass index. Principal component analysis was used to derive sex-specific lifestyle patterns. Hierarchical linear regressions and "outcome-wide" analyses assessed, respectively, these patterns' relations to health and family socio-ecological factors. A rather healthy lifestyle pattern-similarly characterized by diverse diet and high sleep time-was identified, with slight differences by sex. Scores for this pattern were higher for children in food-secure or higher-income households, whose parents were proficient in French, who slept longer, or who received more social support compared to their counterparts, with some nuances by sex. Higher scores for this pattern were associated with higher prosocial behaviour scores (girls) and lower anxiety and hyperactivity-inattention symptoms scores (boys), but not with physical health. For this underserved and understudied population, the results highlight the importance of family socio-ecological factors in shaping the lifestyles and mental health of children.
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Affiliation(s)
- Alexandra Descarpentrie
- Université Paris Cité, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), F-75004 Paris, France
| | - Mégane Estevez
- Université de Bordeaux, Inserm, UMR1219, PHARes team, F-33000 Bordeaux, France
| | - Gilles Brabant
- Santé Publique France, French National Public Health Agency, F-94415 Saint-Maurice, France
| | - Stéphanie Vandentorren
- Université de Bordeaux, Inserm, UMR1219, PHARes team, F-33000 Bordeaux, France
- Santé Publique France, French National Public Health Agency, F-94415 Saint-Maurice, France
- Institut Convergences Migration/CNRS, F-93322 Aubervilliers, France
| | - Sandrine Lioret
- Université Paris Cité, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), F-75004 Paris, France
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Cuesta-Briand B, Taran M, Coleman M. A rural ecosystem of recovery: Lessons from substance users' experiences of accessing services in Western Australia's South West. Drug Alcohol Rev 2022; 41:963-973. [PMID: 35315552 DOI: 10.1111/dar.13455] [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: 06/15/2021] [Revised: 11/03/2021] [Accepted: 12/28/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Substance use is a public health issue with a greater burden in rural areas. Barriers to accessing services are exacerbated for rural substance users, with confidentiality concerns, longer travel distances, workforce issues and limited availability of services. This paper presents results from a study exploring substance users' experiences of accessing services in Western Australia's South West. METHODS This qualitative study was informed by phenomenology, and drew from social determinants and socio-ecological theories. Data were collected through 22 semi-structured telephone interviews with current and past substance users residing in the South West. Interviews were audio-recorded and transcripts were subjected to thematic analysis. RESULTS Two themes were identified: readiness to engage as a three-way street; and building an ecosystem of recovery networks. Effective engagement with services required multi-level readiness. Individual readiness was strongly influenced by the social environment, while service readiness required trustworthiness and responsiveness. A number of local access barriers were identified that hindered broader system readiness. Participants experienced recovery as on-going and require an ecosystem of support with peer support at the centre and a network of healthy relationships established through meaningful connections. DISCUSSION AND CONCLUSIONS An effective ecosystem of support for alcohol and other drugs users in the South West should include expanded access to health, community and welfare services, with an emphasis on peer-led support programs, and strong cross-sector collaboration to mitigate the access barriers operating at the broader community level. Lessons from our study can inform the development of rural ecosystems of support for alcohol and other drugs users.
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Affiliation(s)
- Beatriz Cuesta-Briand
- The Rural Clinical School of Western Australia, University of Western Australia, Albany, Australia
| | - Michael Taran
- Great Southern Mental Health Service, WA Country Health Service, Albany, Australia
| | - Mathew Coleman
- The Rural Clinical School of Western Australia, University of Western Australia, Albany, Australia.,Great Southern Mental Health Service, WA Country Health Service, Albany, Australia.,Telethon Kids Institute, Perth, Australia
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Edney SM, Park SH, Tan L, Chua XH, Dickens BSL, Rebello SA, Petrunoff N, Müller AM, Tan CS, Müller-Riemenschneider F, van Dam RM. Advancing understanding of dietary and movement behaviours in an Asian population through real-time monitoring: Protocol of the Continuous Observations of Behavioural Risk Factors in Asia study (COBRA). Digit Health 2022; 8:20552076221110534. [PMID: 35795338 PMCID: PMC9251970 DOI: 10.1177/20552076221110534] [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: 06/07/2022] [Accepted: 06/13/2022] [Indexed: 11/17/2022] Open
Abstract
Background Modifiable risk factors for non-communicable diseases, including eating an unhealthy diet and being physically inactive, are influenced by complex and dynamic interactions between people and their social and physical environment. Therefore, understanding patterns and determinants of these risk factors as they occur in real life is essential to enable the design of precision public health interventions. Objective This paper describes the protocol for the Continuous Observations of Behavioural Risk Factors in Asia study (COBRA). The study uses real-time data capture methods to gain a comprehensive understanding of eating and movement behaviours, including how these differ by socio-demographic characteristics and are shaped by people's interaction with their social and physical environment. Methods COBRA is an observational study in free-living conditions. We will recruit 1500 adults aged 21-69 years from a large prospective cohort study. Real-time data capture methods will be used for nine consecutive days: an ecological momentary assessment app with a global positioning system enabled to collect location data, accelerometers to measure movement, and wearable sensors to monitor blood glucose levels. Participants receive six EMA surveys per day between 8 a.m. and 9.30 p.m. to capture information on behavioural risk factors including eating behaviours and diet composition movement behaviours (physical activity, sedentary behaviour, sleep), and related contextual factors. The second wave of ecological momentary assessment surveys with a global positioning system enabled will be sent 6 months later. Data will be analysed using generalised linear models to examine associations between behavioural risk factors and contextual determinants. Discussion Findings from this study will advance our understanding of dietary and movement behaviours as they occur in real-life and inform the development of personalised interventions to prevent chronic diseases.
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Affiliation(s)
- Sarah Martine Edney
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Su Hyun Park
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Linda Tan
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Xin Hui Chua
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Borame Sue Lee Dickens
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Salome A Rebello
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Nick Petrunoff
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Andre Matthias Müller
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Cheun Seng Tan
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Falk Müller-Riemenschneider
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Digital Health Center, Berlin Institute of Health, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Rob M van Dam
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
- Departments of Exercise and Nutrition Sciences and Epidemiology, Milken Institute of Public Health, The George Washington University, Washington, DC, USA
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6
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Gallegos D, Eivers A, Sondergeld P, Pattinson C. Food Insecurity and Child Development: A State-of-the-Art Review. Int J Environ Res Public Health 2021; 18:8990. [PMID: 34501578 DOI: 10.3390/ijerph18178990] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 08/22/2021] [Accepted: 08/22/2021] [Indexed: 02/07/2023]
Abstract
Converging research indicates that household food insecurity impedes children from reaching their full physical, cognitive, and psychosocial potential. This state-of-the-art review examines the last decade of research to: (1) describe the impact of the severity and persistence of food insecurity on child development; (2) use a socio-ecological framework to examine significant proximal and distal factors which may interplay; and (3) outline directions for future research. We conducted a systematic review of six databases of published papers from 2011 to June 2021. The search was limited to high-income countries and children aged from birth to 12 years. From 17,457 papers, 17 studies were included in the final review. Transitioning between food security and food insecurity had a significant and lasting effect on academic/cognitive function and behavior (i.e., externalizing), however less clear relationships were seen for psychosocial outcomes and other behaviors examined (i.e., internalizing). There was significant variation in the measurement and thresholds used to define both food insecurity and child development outcomes. Subsequently, comparisons across studies are difficult. Several future recommendations, including incorporation of socio-ecological factors, is provided. In conclusion, this review supports the link between food insecurity and sub-optimal child development; however, there is an imperative to improve and extend current understanding to ameliorate the causes of food insecurity.
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de Koning J, Richards SH, Wood GER, Stathi A. Profiles of Loneliness and Social Isolation in Physically Active and Inactive Older Adults in Rural England. Int J Environ Res Public Health 2021; 18:3971. [PMID: 33918808 PMCID: PMC8070246 DOI: 10.3390/ijerph18083971] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 03/30/2021] [Accepted: 04/07/2021] [Indexed: 11/16/2022]
Abstract
Objective: Loneliness and social isolation are associated with higher risk of morbidity and mortality and physical inactivity in older age. This study explored the socioecological context in which both physically active and inactive older adults experience loneliness and/or social isolation in a UK rural setting. Design: A mixed-methods design employed semi structured interviews and accelerometer-measured moderate-to-vigorous physical activity (MVPA). Interviews explored the personal, social and environmental factors influencing engagement with physical activities, guided by an adapted-socioecological model of physical activity behaviour. Findings: Twenty-four older adults (Mean Age = 73 (5.8 SD); 12 women) were interviewed. Transcripts were thematically analysed and seven profiles of physical activity, social isolation and loneliness were identified. The high-MVPA group had established PA habits, reported several sources of social contact and evaluated their physical environment as activity friendly. The low MVPA group had diverse experiences of past engagement in social activities. Similar to the high MVPA, they reported a range of sources of social contact but they did not perceive the physical environment as activity friendly. Conclusions: Loneliness and/or social isolation was reported by both physically active and inactive older adults. There is wide diversity and complexity in types and intensity of PA, loneliness and social isolation profiles and personal, social and environmental contexts.
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Affiliation(s)
| | - Suzanne H Richards
- Leeds Institute of Health Sciences, University of Leeds, Leeds LS2 9NL, UK;
| | - Grace E R Wood
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham B15 2TT, UK;
| | - Afroditi Stathi
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham B15 2TT, UK;
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Arakelyan S, Karat AS, Jones ASK, Vidal N, Stagg HR, Darvell M, Horne R, Lipman MCI, Kielmann K. Relational Dynamics of Treatment Behavior Among Individuals with Tuberculosis in High-Income Countries: A Scoping Review. Patient Prefer Adherence 2021; 15:2137-2154. [PMID: 34584407 PMCID: PMC8464367 DOI: 10.2147/ppa.s313633] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 08/18/2021] [Indexed: 12/28/2022] Open
Abstract
Although tuberculosis (TB) incidence has significantly declined in high-income, low-incidence (HILI) countries, challenges remain in managing TB in vulnerable populations who may struggle to stay on anti-TB treatment (ATT). Factors associated with non-adherence to ATT are well documented; however, adherence is often narrowly conceived as a fixed binary variable that places emphasis on individual agency and the act of taking medicines, rather than on the demands of being on treatment more broadly. Further, the mechanisms through which documented factors act upon the experience of being on treatment are poorly understood. Adopting a relational approach that emphasizes the embeddedness of individuals within dynamic social, structural, and health systems contexts, this scoping review aims to synthesize qualitative evidence on experiences of being on ATT and mechanisms through which socio-ecological factors influence adherence in HILI countries. Six electronic databases were searched for peer-reviewed literature published in English between January 1990 and May 2020. Additional studies were obtained by searching references of included studies. Narrative synthesis was used to analyze qualitative data extracted from included studies. Of 28 included studies, the majority (86%) reported on health systems factors, followed by personal characteristics (82%), structural influences (61%), social factors (57%), and treatment-related factors (50%). Included studies highlighted three points that underpin a relational approach to ATT behavior: 1) individual motivation and capacity to take ATT is dynamic and intertwined with, rather than separate from, social, health systems, and structural factors; 2) individuals' pre-existing experiences of health-seeking influence their views on treatment and their ability to commit to long-term regular medicine-taking; and 3) social, cultural, and political contexts play an important role in mediating how specific factors work to support or hinder ATT adherence behavior in different settings. Based on our analysis, we suggest that person-centered clinical management of tuberculosis should 1) acknowledge the ways in which ATT both disrupts and is managed within the everyday lives of individuals with TB; 2) appreciate that individuals' circumstances and the support and resources they can access may change over the course of treatment; and 3) display sensitivity towards context-specific social and cultural norms affecting individual and collective experiences of being on ATT.
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Affiliation(s)
- Stella Arakelyan
- Institute for Global Health and Development, Queen Margaret University, Edinburgh, UK
| | - Aaron S Karat
- Institute for Global Health and Development, Queen Margaret University, Edinburgh, UK
- TB Centre, London School of Hygiene & Tropical Medicine, London, UK
| | - Annie S K Jones
- Centre for Behavioural Medicine, Research Department of Practice and Policy, UCL School of Pharmacy, London, UK
| | - Nicole Vidal
- Institute for Global Health and Development, Queen Margaret University, Edinburgh, UK
| | - Helen R Stagg
- Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Marcia Darvell
- UCL Respiratory, Division of Medicine, University College London, London, UK
| | - Robert Horne
- Centre for Behavioural Medicine, Research Department of Practice and Policy, UCL School of Pharmacy, London, UK
| | - Marc C I Lipman
- UCL Respiratory, Division of Medicine, University College London, London, UK
- Royal Free London NHS Foundation Trust, London, UK
| | - Karina Kielmann
- Institute for Global Health and Development, Queen Margaret University, Edinburgh, UK
- Correspondence: Karina Kielmann Queen Margaret University, Queen Margaret University Way, Edinburgh, EH216UU, UKTel +44 131 474 0000 Email
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Rao R, Hawkins M, Ulrich T, Gatlin G, Mabry G, Mishra C. The Evolving Role of Public Health in Medical Education. Front Public Health 2020; 8:251. [PMID: 32714890 PMCID: PMC7344251 DOI: 10.3389/fpubh.2020.00251] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [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] [Received: 08/17/2019] [Accepted: 05/20/2020] [Indexed: 11/15/2022] Open
Abstract
Medical education in the twentieth century was largely influenced by the Flexner Report, with significant proportions of instruction dedicated to the molecular underpinnings of the pathologic pathways and minimal mention of the socio-ecological determinants of health. When examining the predominant diseases of the twenty first century landscape, widening health disparities, and significant changes in the United States healthcare system, it is imperative to view wellness and sickness in a broader public health context rather than a singular focus of the biomedical model. While undergraduate opportunities to study public health are on the rise in the United States, there is a parallel urgency for medical curricula to recognize the importance of the complex interrelated socio-ecological root causes of health, well-being, and illness. In order to reduce the risk of non-communicable diseases and increase health equity, it is necessary for medical education to integrate core public health knowledge and competencies. Contemporary health challenges require a public health approach, in addition to clinical skills, for physicians to provide equitable care. The COVID-19 pandemic further underscores the necessity to mitigate the effects of socio-ecological determinants of health. Seven key recommendations are presented from a training to practice timeline emphasizing the important linkages between medical education, socio-ecological influences on health, and public health. As the health challenges in society and communities shift, so too must training of future physicians. There is a need and an opportunity for medicine and public health to address the shared health challenges of our global society.
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Affiliation(s)
- Ravi Rao
- Independent Researcher, Los Angeles, CA, United States
| | - Melissa Hawkins
- Department of Health Studies, College of Arts and Sciences, American University, Washington, DC, United States
| | - Trina Ulrich
- Department of Health Studies, College of Arts and Sciences, American University, Washington, DC, United States
| | - Greta Gatlin
- Department of Health Studies, College of Arts and Sciences, American University, Washington, DC, United States
| | - Guadalupe Mabry
- Department of Health Studies, College of Arts and Sciences, American University, Washington, DC, United States
| | - Chaitanya Mishra
- Department of Health Studies, College of Arts and Sciences, American University, Washington, DC, United States
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Learmonth YC, Chan Z, Correia H, Hathorn D, Kermode A, Smith C, Walker D. Exercise participation and promotion in the multiple sclerosis community; perspectives across varying socio-ecological levels. Disabil Rehabil 2020; 43:3623-3638. [PMID: 32393076 DOI: 10.1080/09638288.2020.1743778] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 12/24/2022]
Abstract
Purpose: We undertook a qualitative study that explored exercise participation and exercise promotion in the multiple sclerosis (MS) community who live in regional or remote areas of Australia. By simultaneously gathering views from persons with MS, carers, healthcare providers and healthcare managers we aimed to gather unique perspectives which represented views from across socio-ecological levels of MS healthcare.Methods: We used interpretive description methodology, and conducted semi-structured interviews or focus groups with people with MS (n = 28), carers (n = 8), healthcare providers (n = 12) and managers/supervisors of MS healthcare systems (n = 16). Data were analysed using thematic analysis.Results: We identified three themes with 10 subthemes. The first theme was "Factors associated with exercise engagement" for the people with MS, from individual, interpersonal, organisational and community/public policy perspectives. The second theme was "Factors influencing the MS community's promotion of exercise" focusing on carers, healthcare providers and healthcare systems. The third theme was "Motivators to increase exercise promotion" which should be delivered by the MS community across varying socio-ecological levels of healthcare to encourage exercise participation.Conclusion: We identified new evidence on the factors which influence the MS community's promotion of exercise and we now better understand that training on exercise should be provided to the wider MS community, and exercise services should be considered locally and perhaps delivered via teleheath.IMPLICATIONS FOR REHABILITATIONCohesive healthcare campaigns, and clinical guidelines based on empirical evidence should be established for symptom management in MS with a focus on the role of exercise.Symptom management strategies should consider the whole MS community, including patients, carers, healthcare professional and healthcare co-ordinators.Internal factors (e.g., emotion and motivation) and broader factors (e.g., funding and location) must be considered when designing exercise interventions in persons with MS.
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Affiliation(s)
- Yvonne C Learmonth
- College of Science, Health, Engineering and Education, Murdoch University, Murdoch, WA, Australia
| | - Zita Chan
- College of Science, Health, Engineering and Education, Murdoch University, Murdoch, WA, Australia
| | - Helen Correia
- College of Science, Health, Engineering and Education, Murdoch University, Murdoch, WA, Australia
| | - Dave Hathorn
- Multiple Sclerosis Western Australia, Wilson, WA, Australia
| | - Allan Kermode
- Perron Institute for Neurological and Translational Science, Perth, WA, Australia.,University of Western Australia, Crawley, WA, Australia.,Institution of Immunology and Infectious Diseases Murdoch University, Murdoch, WA, Australia.,Sir Charles Gairdner Hospital, Nedlands, WA, Australia
| | - Catherine Smith
- School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Diana Walker
- University of Western Australia, Crawley, WA, Australia
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11
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Jacobs W, Barry AE, Merianos AL, Becker KJ, Valente TW. Gender Differences in Socio-ecological Determinants of Alcohol Use Among Hispanic Adolescents. J Sch Health 2020; 90:99-106. [PMID: 31813163 DOI: 10.1111/josh.12860] [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] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 06/28/2019] [Accepted: 06/30/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Compared to other racial groups, Hispanic/Latino(a) adolescents experience higher rates of alcohol (ab)use and alcohol-related problems. Evidence suggests there are gender differences in alcohol use patterns indicating the likelihood of gender differences in how various determinants influence alcohol use among the genders. Assessing the mechanisms that contribute to Hispanic adolescents' alcohol use requires an understanding of the multidimensional social and environmental processes that operate together to impact their alcohol use. In this study, we examined socio-ecological determinants of Hispanic adolescent alcohol use by gender. METHODS Data from 10th grade Hispanic/Latino(a) students (N = 781) from four high schools in Los Angeles were used to examine associations between socio-ecological characteristics and adolescent alcohol use by gender. RESULTS Overall, 37.5% of participants reported past 30-day alcohol use. Among boys, alcohol use was associated with intrapersonal (not qualifying for reduced lunch), interpersonal (mother's education and peer drinking), and institutional (alcohol-prone school club membership) determinants. Among girls, alcohol use was associated with intrapersonal (academic achievement) and interpersonal (parent and peer alcohol use behavior) determinants. CONCLUSIONS Prevention and intervention efforts need to take into consideration the gender differences in social-ecological risk and protective factors when designing educational or intervention programs and services targeted at Hispanic adolescents. This is crucial to addressing multi-component factors that influence their substance use behavior.
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Affiliation(s)
- Wura Jacobs
- Department of Kinesiology, California State University, Stanislaus, One University Circle, Turlock, CA
| | - Adam E Barry
- Department of Health & Kinesiology, Texas A&M University, Blocker Bldg., Office 332C, College Station, TX
| | - Ashley L Merianos
- Department of Health Promotion and Education, University of Cincinnati, Teachers College 460NC, Cincinnati, OH
| | - Kelsi J Becker
- Department of Health Promotion and Education, University of Cincinnati, 2160 McMicken Circle, Cincinnati, OH
| | - Thomas W Valente
- Department of Preventive Medicine, University of Southern California, 2001 N. Soto Street, SSB 302W, Los Angeles, CA
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Ssewanyana D, van Baar A, Mwangala PN, Newton CR, Abubakar A. Inter-relatedness of underlying factors for injury and violence among adolescents in rural coastal Kenya: A qualitative study. Health Psychol Open 2019; 6:2055102919849399. [PMID: 31205735 PMCID: PMC6537266 DOI: 10.1177/2055102919849399] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
We utilized a socio-ecological model to explore views from 85 young people and 10
local stakeholders on forms and underlying factors for unintentional injury,
violence, self-harm, and suicidal behavior of adolescents in Kilifi County,
Kenya. Young people took part in 11 focus group discussions, whereas 10 in-depth
interviews were conducted with the local stakeholders. Road traffic accidents,
falls, fights, sexual and gender-based violence, theft, and vandalism were
viewed as common. There was an overlap of risk factors, especially at intra- and
interpersonal levels (gender, poverty, substance use, parenting behavior, school
drop-out). Some broader-level risk factors were insecure neighborhoods and risky
sources of livelihood. Research is needed to quantify burden and to pilot
feasible injury prevention interventions in this setting.
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Affiliation(s)
- Derrick Ssewanyana
- Kenya Medical Research Institute
(KEMRI), Kenya
- Utrecht University, The
Netherlands
- Derrick Ssewanyana, Centre for Geographic
Medicine Research-Coast, Kenya Medical Research Institute (KEMRI), Box 230,
Kilifi 80108, Kenya.
| | | | | | - Charles R Newton
- Kenya Medical Research Institute
(KEMRI), Kenya
- Pwani University, Kenya
- University of Oxford, UK
| | - Amina Abubakar
- Kenya Medical Research Institute
(KEMRI), Kenya
- Utrecht University, The
Netherlands
- Pwani University, Kenya
- Aga Khan University, Kenya
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Little E, Biehler D, Leisnham PT, Jordan R, Wilson S, LaDeau SL. Socio-Ecological Mechanisms Supporting High Densities of Aedes albopictus (Diptera: Culicidae) in Baltimore, MD. J Med Entomol 2017; 54:1183-1192. [PMID: 28605549 PMCID: PMC5850657 DOI: 10.1093/jme/tjx103] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [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] [Received: 01/05/2017] [Indexed: 06/07/2023]
Abstract
Social, ecological, and climatic factors interact creating a heterogeneous matrix that determines the spatiotemporal distribution of mosquitoes and human risks of exposure to the diseases they transmit. We explore linkages between the social and institutional processes behind residential abandonment, urban ecology, and the interactions of socio-ecological processes with abiotic drivers of mosquito production. Specifically, we test the relative roles of infrastructure degradation and vegetation for explaining the presence of Aedes albopictus Skuse 1894 to better predict spatial heterogeneity in mosquito exposure risk within urban environments. We further examine how precipitation interacts with these socially underpinned biophysical variables. We use a hierarchical statistical modeling approach to assess how environmental and climatic conditions over 3 years influence mosquito ecology across a socioeconomic gradient in Baltimore, MD. We show that decaying infrastructure and vegetation are important determinants of Ae. albopictus infestation. We demonstrate that both precipitation and vegetation influence mosquito production in ways that are mediated by the level of infrastructural decay on a given block. Mosquitoes were more common on blocks with greater abandonment, but when precipitation was low, mosquitoes were more likely to be found in higher-income neighborhoods with managed container habitat. Likewise, although increased vegetation was a negative predictor of mosquito infestation, more vegetation on blocks with high abandonment was associated with the largest mosquito populations. These findings indicate that fine spatial scale modeling of mosquito habitat within urban areas is needed to more accurately target vector control.
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Affiliation(s)
- E. Little
- Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY ()
- Corresponding author, e-mail:
| | - D. Biehler
- Department of Geography and Environmental Systems, University of Maryland, Baltimore County, Baltimore, MD ()
| | - P. T. Leisnham
- Department of Environmental Science and Technology, University of Maryland, College Park, MD ()
| | - R. Jordan
- Departments of Human Ecology & Ecology, Evolution, and Natural Resources, School of Environmental and Biological Sciences, Rutgers University, New Brunswick, NJ ()
| | - S. Wilson
- Maryland Institute for Applied Environmental Health, University of Maryland, College Park, MD ()
| | - S. L. LaDeau
- Cary Institute of Ecosystem Studies, Millbrook, NY ()
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Haynes-Maslow L, Auvergne L, Mark B, Ammerman A, Weiner BJ. Low-Income Individuals' Perceptions About Fruit and Vegetable Access Programs: A Qualitative Study. J Nutr Educ Behav 2015; 47:317-24.e1. [PMID: 25910929 PMCID: PMC4500669 DOI: 10.1016/j.jneb.2015.03.005] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [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] [Received: 07/10/2014] [Revised: 02/21/2015] [Accepted: 03/14/2015] [Indexed: 05/11/2023]
Abstract
OBJECTIVE To examine how fruit and vegetable (FV) programs address barriers to FV access and consumption as perceived by low-income individuals. DESIGN From 2011 to 2012, the researchers used 13 focus groups to better understand low-income individuals' perceptions about FV programs. SETTING Five North Carolina counties at community-serving organizations. PARTICIPANTS Low-income participants aged ≥ 18 years were included in the study. A majority were African American women with a high school education or less, and received government assistance. PHENOMENON OF INTEREST Low-income individuals' perceptions about how FV access programs can reduce barriers and increase consumption. ANALYSIS A socio-ecological framework guided data analysis, and 2 trained researchers coded transcripts, identified major themes, and summarized findings. RESULTS A total of 105 participants discussed how mobile markets could overcome barriers such as availability, convenience, transportation, and quality/variety. Some were worried about safety in higher-crime communities. Participants' opinions about how successful food assistance programs were at overcoming cost barriers were mixed. Participants agreed that community gardens could increase access to affordable, conveniently located produce but worried about feasibility and implementation issues. IMPLICATIONS FOR RESEARCH AND PRACTICE Addressing access barriers through FV programs could improve consumption. Programs have the potential to be successful if they address multiple access barriers.
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Affiliation(s)
| | - Lauriane Auvergne
- Department of Anesthesiology, University of Michigan at Ann Arbor, Ann Arbor, MI
| | - Barbara Mark
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Alice Ammerman
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Bryan J Weiner
- Department of Health Policy and Management, University of North Carolina at Chapel Hill, Chapel Hill, NC
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Giallo R, Seymour M, Matthews J, Gavidia-Payne S, Hudson A, Cameron C. Risk factors associated with the mental health of fathers of children with an intellectual disability in Australia. J Intellect Disabil Res 2015; 59:193-207. [PMID: 24645779 DOI: 10.1111/jir.12127] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/24/2014] [Indexed: 06/03/2023]
Abstract
BACKGROUND Raising a child with a disability places considerable demands and stress on parents, which can contribute to mental health difficulties. Research has primarily focused on mothers' mental health, and our understanding of the effects on fathers remains limited. The factors that place fathers at increased risk of mental health difficulties are also poorly understood. This study aimed to redress these gaps by reporting on the mental health of a large sample of fathers of children with an intellectual disability (ID) (aged 3-15 years), comparing this to published Australian norms and mothers of children with ID. The second aim of the study was to explore risk factors associated with fathers' mental health. METHOD The data for this study come from 315 Australian fathers of children (aged 3-15 years) with ID, who participated in the large-scale evaluation of the Signposts for building better behaviour programme. Fathers completed a range of self-report questionnaires at baseline including the Depression Anxiety Stress Scale (DASS). RESULTS Fathers in the present sample reported significantly more symptoms of depression and stress than the Australian normative data, with approximately 6-8% reporting symptoms in the severe to extremely severe range. The strongest predictors of fathers' mental health difficulties were children's behaviour problems, daily stress arising from fathers' own needs and children's care needs, and low parenting satisfaction. Socio-economic factors did not predict mental health difficulties. CONCLUSION This study is among one of the first to report the mental health of fathers of children with a disability in Australia. Findings highlight that some fathers of children with ID are at heightened risk of experiencing mental health difficulties, underscoring the importance of the provision of information and interventions to promote their mental health.
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Affiliation(s)
- R Giallo
- Parenting Research Centre, East Melbourne, Vic., Australia; RMIT University, Bundoora, Vic., Australia; Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Vic., Australia
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King C, Salem B. A socio-ecological investigation of options to manage groundwater degradation in the Western Desert, Egypt. Ambio 2012; 41:490-503. [PMID: 22569842 PMCID: PMC3390576 DOI: 10.1007/s13280-012-0255-8] [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] [Received: 02/25/2011] [Revised: 08/31/2011] [Accepted: 01/27/2012] [Indexed: 05/31/2023]
Abstract
Under increasing water scarcity, collective groundwater management is a global concern. This article presents an interdisciplinary analysis of this challenge drawing on a survey including 50 large and small farms and gardens in a village in an agricultural land reclamation area on the edge of the Western Desert of Egypt. Findings revealed that smallholders rely on a practice of shallow groundwater use, through which drainage water from adjacent irrigation areas is effectively recycled within the surface aquifer. Expanding agroindustrial activities in the surrounding area are socio-economically important, but by mining non-renewable water in the surrounding area, they set in motion a degradation process with social and ecological consequences for all users in the multi-layered aquifer system. Based on the findings of our investigation, we identify opportunities for local authorities to more systematically connect available environmental information sources and common pool resource management precedents, to counterbalance the degradation threat.
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Affiliation(s)
- Caroline King
- Oxford University Centre for the Environment, University of Oxford, South Parks Road, Oxford, UK
| | - Boshra Salem
- Department of Environmental Sciences, Faculty of Science, University of Alexandria, Alexandria, Egypt
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