Effects of volunteering over six months on loneliness, social and mental health outcomes among older adults: The HEAL-HOA Dual Randomized Controlled Trial

OBJECTIVE

To determine the beneficial effects of volunteering as lay counselor via telephone on own loneliness, social network engagement, perceived social support, stress, anxiety, and depressive symptoms among Chinese older adults in Hong Kong during the COVID-19 pandemic. DESIGN, SETTING, INTERVENTION, AND PARTICIPANTS: "Helping Alleviate Loneliness in Hong Kong Older Adults" (HEAL-HOA), a dual randomized controlled trial, was implemented to test effects of telephone-based psychosocial interventions delivered by older-adult volunteers for low-income lonely older adults. To evaluate the effects of volunteering on loneliness, we randomized 375 individuals ages 50-70 into a volunteering condition versus an active control (psychoeducation with social gatherings). Following a 6-week training, participants in the volunteering condition, delivered tele-interventions to older intervention recipients.

MEASUREMENT

The primary outcome was loneliness measured with the UCLA Loneliness Scale. Secondary outcomes were loneliness measured with the De Jong Gierveld Scale (DJG), social network engagement, perceived social support, perceived stress, anxiety, and depressive symptoms. Assessments were completed before training (baseline) and immediately after the 6-month volunteering period.

RESULTS

Results from linear mixed models show significant positive effects of volunteering (significant interactions of condition × time) on both measures of loneliness (dppc2 = -0.41 ULCA Loneliness score, dppc2 = -0.70 total DJG score), social network engagement, stress and depressive symptoms as compared to control participants.

CONCLUSIONS

The HEAL-HOA trial demonstrates beneficial effects of volunteer-delivered tele-interventions on decreasing loneliness on the volunteer interventionists themselves. Communicating these benefits for volunteers may attract more older adults into volunteering. This effective tele-based volunteer program is scalable for wider implementation.

SUMMARY

This RCT tested effects of volunteering on loneliness in Hong Kong during the COVID-19-pandemic. Three hundred seventy-five individuals ages 50-70 were randomized into volunteering (delivering tele-interventions against loneliness) versus an active control condition. After 6 months, volunteers compared to controls, showed benefits on loneliness, social network engagement, stress and depressive symptoms. A program engaging lonely older adults in loneliness intervention delivery has beneficial effects on volunteers themselves and could be a scalable solution for our loneliness epidemic.

Big Five personality traits predict small but robust differences in civic engagement

OBJECTIVE

This preregistered study provides robust estimates of the links between Big Five personality traits and civic engagement across different samples and life stages.

METHODS

We recruited two samples from the United States and United Kingdom (total N = 1593) and measured Big Five domains, Big Five aspects, and six civic engagement indicators: volunteerism, charitable giving, donating blood, posthumous organ donation, political voting, and vaccination. We compared the links between these measures across samples and tested moderation across life stages and several sociodemographic variables. We explored whether these links replicate between self- and peer-reports.

RESULTS

We found small but robust effects. Agreeable, extraverted, and open/intellectual participants reported more civic engagement, especially volunteerism and charitable giving. Neurotic and conscientious participants mainly reported less civic engagement, especially blood and organ donations. One of the two Big Five aspects often drove these links, such as Compassion in the link between Agreeableness and volunteerism. We found some differences between younger and middle-aged adults.

CONCLUSIONS

Big Five personality traits predict civic engagement modestly but consistently, with adequate study power being critical to detecting these links. Lower-order traits, such as Big Five aspects, clarify the relationships between traits and engagement. Life stages and sociodemographic variables have limited effects.

Impact on persons with disabilities and their families when they are contributors to society through volunteerism and employment

BACKGROUND

Despite various government initiatives, people with disabilities all over the world face some degree of hindrance when they try to contribute to society.

AIM

This project sought to give voice to and understand the perceptions and experiences of persons with disabilities in Singapore when contributing to society through volunteerism and employment and to explore solutions to help access and retain employment and volunteering.

METHOD AND PROCEDURE

This small qualitative study recruited three convenience samples of people with disabilities aged 18-49 years old who met criteria for daily activity over the previous 12 months. Participant recruitment was limited due to the Covid pandemic lockdown. Ten individuals had maintained open employment, six had worked as a volunteer and four were neither working nor volunteering. All 20 participants were briefed online on the use of the photovoice technique. Interviews were then conducted online, beginning with a 5-min demographic survey. Approximately hour long semi-structured interviews followed. Eleven participants used photovoice but nine who were working or volunteering did not as they were unable to take photos in their workplace. Several individuals were supported during the interview by a caregiver or staff member for example a job coach.

FINDINGS

Themes were identified within the four central areas of enquiry: (i) self-perceptions of being a beneficiary or contributor to society; (ii) the benefits to working and volunteering; (iii) enablers and barriers to working and volunteering and (iv) solutions to access and retain employment and volunteering. Several barriers to use of photovoice were encountered. The importance of inclusive and conducive environments was recognised along with the roles of all stakeholders across the ecosystem.

CONCLUSION

Employment and volunteering can significantly impact quality of life for persons with disabilities and their families and benefit the society. Collaboration among all stakeholders is required to better address solutions and improve desired employment and volunteer outcomes.

COVID-19 Pandemic, Physical Distancing Policies, and the Non-Profit Sector Volunteer Force

Although COVID-19-related physical distancing has had large economic consequences, the impact on volunteerism is unclear. Using volunteer position postings data from Canada's largest volunteer center (Volunteer Toronto) from February 3, 2020, to January 4, 2021, we evaluated the impact of different levels of physical distancing on average views, total views, and total number of posts. There was about a 50% decrease in the total number of posts that was sustained throughout the pandemic. Although a more restrictive physical distancing policy was generally associated with fewer views, there was an initial increase in views during the first lockdown where total views were elevated for the first 4 months of the pandemic. This was driven by interest in COVID-19-related and remote work postings. This highlights the community of volunteers may be quite flexible in terms of adapting to new ways of volunteering, but substantial challenges remain for the continued operations of many non-profit organizations.

Exploration and practice of humanistic education for medical students based on volunteerism

Humanistic education aims to promote educated people's practical and conscious activities to enhance their humanity, cultivate ideal personalities, and realize personal and social values, to develop a humanistic spirit. The advancement of higher education in China has led to the proposal to strengthen scientific and humanistic education integration. Medicine is between science and humanities, shouldering the important task of training senior medical personnel, the quality of medical students will affect the quality of future medical and health work; thus, medical students must explore and practice humanistic education. Promoting and practicing volunteerism is a specific act of constructing spiritual civilization in the whole society, and it is also considered beneficial for improving citizens' sense of responsibility and dedication. Medical students' practice of volunteerism and help in society is a precise manifestation of humanistic care. This review summarizes medical students' exploration and practice of humanistic education in volunteering.

For the Good of the People: an interpretive analysis of Chinese volunteerism in the critical matter of care at the start of the pandemic

PURPOSE

China employed a unique volunteerism system where health care providers outside of Hubei Province, the epicentre, travelled to reverse the devastation wrought by coronavirus disease 2019 (COVID-19) at its global onset. The aim is to study the unique circumstances of Chinese volunteerism in the context of continuing pandemic threats, specifically exploring the experiences of 20 Chinese nurse and physician volunteers fighting COVID-19 during the outbreak.

METHODS

Interviews were done through video calling.

RESULTS

Using content analysis with a hermeneutic perspective, emerging patterns showed the ways in which China's particular manifestation of volunteerism teaches us how to engage global threats of this nature. The overarching lesson, For the Good of the People, was manifested in several dynamic and overlapping themes: 1) Reaching for Professional Standards Even in Crisis; 2) Constantly Caring Through Failures and Successes; and 3) Holding Fast to the Common Good. The devastation was met by the resilience of volunteers, who overcame profound challenges managing patient care.

CONCLUSIONS

Volunteerism required sacrifice and tremendous support in the form of training and administrative direction, family support, and peer collaboration. Volunteers' physical and psychosocial wellbeing was a priority. Recognizing the representative themes can help societies plan for continuing and future events.

Too hot to help or too cold to care? On the links between ambient temperature, volunteerism, and civic engagement

We investigated the relationship between ambient temperature and prosocial behaviour in real-life settings. It was guided by two mechanisms of opposite predictions, namely (1) higher temperatures decrease prosociality by harming well-being, and (2) higher temperatures increase prosociality by promoting the embodied cognition of social warmth. In Study 1, U.S. state-level time-series data (2002-2015) supported the first mechanism, with higher temperatures predicting lower volunteer rates through lower well-being. Study 2 furthered the investigation by probing the relationship between neighbourhood temperature and civic engagement of 2268 U.S. citizens. The data partially supported the well-being mechanism and reported findings contradictory to the social embodiment mechanism. Higher temperatures predicted lower interpersonal trust and subsequently lower civic engagement. The unexpected finding hinted at a cognitive effect of heat and a compensatory mechanism in social thermoregulation. We discussed the findings regarding their methodological strengths and weaknesses, with cautions made on ecological fallacies and alternative models.

Community Dermatology: Current Status and the Way Forward

Community health interventions in dermatology have the potential to deliver healthcare to large populations. Such interventions can bridge the gap between increasing demands from vast populations and limited availability and asymmetric geographical distribution of specialist doctors. This narrative review aims to delineate various areas in which community dermatology initiatives are useful, the different approaches used, and the factors which could determine their effectiveness. We did a PubMed search using the search terms, "Community Health Services"[Mesh]) AND "Dermatology"[Mesh]. A further literature search was performed by cross-referencing these articles. In addition to its primary purpose of increasing access, community involvement can augment medical education, foster research, and help to develop more patient-centered clinical guidelines, understand disease trends and influences of the environment on various diseases, and formulate population-centered health policy. Task shifting, development of culture-sensitive and gender-sensitive community healthcare teams, disease-specific patient support groups, and use of advances in technology such as telemedicine are some of the important methods used in community dermatology. Task shifting may be performed at different levels - general practitioners, pharmacists, nurses, and community health workers. Community interventions harness volunteerism among health professionals as well as various stakeholders in the community. Partnering with non-governmental organizations, involving members of the community, and being a part of a long-term public health program help to sustain community interventions. The interventions should adapt to the ethical and cultural norms of the community. Continuity of care, fidelity, and evidence support are crucial for the success of community interventions in dermatology.

The role of Nigerian medical students in the HIV response: lessons from the COVID-19 pandemic

Background: With the advent of the COVID-19 pandemic, this study seeks to understand how medical students' involvement in the HIV response during the COVID-19 pandemic - as well as before and after it - has influenced their decision to specialise in HIV care and their participation in HIV-related activities in the future.Method: Quantitative and qualitative approaches were utilised among medical students from Ambrose Alli University in their fourth, fifth and sixth years of study respectively. Data from this study was analysed using the SPSS version 21 module for descriptive statistics.Results: Medical students were more involved in community-based HIV awareness campaigns (48.6%) during the pre-COVID era, but then became more involved in online awareness campaigns (55%). Only 8.6% were involved in HIV research and evaluation activities. Over 31.2% of respondents were interested in specialising in HIV-related fields, with 23.6% attributing their decision to the COVID-19 pandemic. 92.3% of the respondents were of the opinion that medical students need to become more involved in HIV-related activities. There was statistical significance between the year of study of respondents and awareness of HIV-related activities (p < 0.007). Focused discussions revealed that all students felt that medical students should be more involved in HIV-related activities.Conclusion: Our results suggest that the COVID-19 pandemic marginally boosted the number of medical students involved in online awareness campaigns for HIV and AIDs, but there was decreased involvement in community campaigns and participation in community HIV testing. The impact of these findings on the lives of people living with HIV needs further investigation.

Corrigendum: A multilevel selection model for prosocial well-being

[This corrects the article DOI: 10.3389/fpsyg.2023.1068119.].

Is Social Participation Associated with Successful Aging among Older Canadians? Findings from the Canadian Longitudinal Study on Aging (CLSA)

The present study examines various activities of social participation (i.e., church or religious activities; educational or cultural activities; service club or fraternal organization activities; neighbourhood, community, or professional association activities; volunteer or charity work; and recreational activities) as contributing factors to successful aging. Successful aging in this study includes the following: adequate social support, no limitations with respect to Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs), no mental illness in the preceding year, no serious cognitive decline or pain that prevents activity, as well as high levels of happiness, and self-reports of good physical health, mental health, and successful aging. Methods: The Canadian Longitudinal Study on Aging (CLSA) is a large, national, longitudinal study on aging. A secondary analysis of the baseline (i.e., 2011-2015) and Time 2 (i.e., 2015-2018) data of the CLSA was conducted on a sample of 7623 older adults who were defined as "aging successfully" at baseline and were aged 60+ at Time 2. Binary logistic regression analyses were employed to examine the association between engaging in various social participation activities at baseline and aging successfully at Time 2. Results: In a subsample (n = 7623) of the Canadian Longitudinal Study on Aging (CLSA) Comprehensive Cohort who were aging successfully at baseline, the prevalence of successful aging at Time 2 was significantly higher among the participants who participated in volunteer or charity work and recreational activities compared to those who were not involved in these activities. After adjusting for 22 potential factors, the results of the binary logistic regression analyses reported that participants who, at baseline, participated in volunteer or charity work and recreational activities had higher age-sex-adjusted odds of achieving successful aging (volunteer or charity work: aOR = 1.17, 95% CI: 1.04, 1.33; recreational activities: aOR = 1.15, 95% CI: 1.00, 1.32). Conclusions: Among six types of social participation activities, people who participated in volunteer or charity work and recreational activities were more likely to achieve successful aging than their counterparts who did not engage in these activities. If these associations are found to be causal, policies and interventions encouraging older adults to participate in volunteer or charity work and recreational activities may support older adults to achieve successful aging in later life.

Teledermatology Within Correctional Settings in the United States: A Narrative Review of the Literature

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A multilevel selection model for prosocial well-being

This article proposes an evolutionary model for well-being informed by multilevel selection. We posit that people's subjective assessment of their own quality of life is the sum their happiness, which is related to individual selection, and their sense of having a meaningful life, which is related to group selection. Conceptualizing life quality as "Happiness + Meaning = Well-being" offers insights into how the human well-being system helps people navigate between individual and group needs. We define happiness as the cluster of affects that reward individuals for solving adaptively relevant problems. We approach meaning as a reward individuals experience when contributing to their community. While people derive happiness from cooperation and competition, meaning originates from prosocial (cooperative/altruistic) behavior. Since increased within-group competition often reduces societal well-being, public policy should aim at cooperative means for good living. Our model brings attention to these dynamics. The Nordic countries, which score highest on quality of life, facilitate multilevel well-being, that is, individual prosperity and altruistic opportunity. Our preliminary quantitative study confirmed the correlation between some markers of prosociality and well-being at a national level. To investigate the psychological mechanisms behind this correlation, we conducted in-depth interviews of Nordic and Slavonic helpers of Ukrainian refugees in Norway (n = 32). A primary ambition was to illuminate how the human quest for meaning contributes both to individual flourishing and group selection. In line with Nesse's view on happiness not as an affect meant to be maximized, but an evolutionary signal, we use a qualitative approach that allows for a deeper understanding of how individuals adapt to these signals. Our findings suggest that happiness is transient so that the well-being system's signal sensitivity can be preserved. Meaning is enduring since it assesses and reinforces social belonging. These insights are relevant for our era's turn toward more holistic development policies. Compared to often materialistic, competition-driven happiness pursuits, meaning-driven well-being is a more sustainable alternative for individuals, communities, and the planet.

Continuous voluntary community care services for older people in China: Evidence from Wuhu

Introduction

China has limited formal care services and weak unpaid informal care support for older people, which has caused a care service shortage for them. Voluntary community care services are thus a type of formal care service that aims to meet older people's unmet care needs. However, the continuity of such voluntary community care services is important for the degree to which these unmet care needs of older people can be satisfied. Therefore, this study examines what motivates volunteers to provide voluntary community care services for older people in China. It argues that providing continuous voluntary community care services can be motivated by the interaction of volunteers' internal and external motivations.

Methods

This study employs the grounded theory approach, including open coding, axial coding, selective coding, and saturation testing, and derives the data from 15 semi-structured interviews with volunteers from September to December 2021 in Wuhu, China.

Results

The analysis identifies three internal motivations (altruism, social interaction, and self-fulfillment) and three external motivations (social support, standardized management, and relevant benefits) as well as the interaction between them as factors that impact volunteers' willingness to offer continuous voluntary community care services for older people.

Discussion

The study's findings highlight the impact of continuous volunteering on society, which is significant to provide voluntary community care services for older people. It thus contributes to the development of China's care policy and future care supply services as well as serves as a reference for care development models in other welfare states, particularly in places where both formal and informal care are underdeveloped such as China.

The Culture of Volunteerism: Attitudes and Motivations among Generation 1.5 Former Soviet Union Immigrants versus Native-Born Israelis

The large Former Soviet Union (FSU) immigration of the 1990s, accounting for approximately 15% of the Jewish population in Israel today, plays a significant role in shaping Israeli society. Volunteering, as part of social citizenship and normative culture, is an important element of acculturation among immigrants. The present study compares volunteering attitudes and motivations among Generation 1.5 FSU immigrants in their third decade in Israel to native-born Israelis (NBIs): 576 participants, 50.2% NBIs and 49.8% FSUs. Generation 1.5 FSU immigrants exhibited less favorable attitudes toward volunteerism than NBIs. FSUs also rated career motivations for volunteerism significantly higher than NBIs, and values significantly lower than NBIs. Significant differences were found between motivations for volunteering among each cohort, separately, as well. In the context of mass immigration, re-socialization regarding volunteering among Generation 1.5 FSU immigrants living 2-3 decades in Israel appears relatively weak, possibly attributable to FSU policy and culture in opposition to independent volunteerism.

Which Volunteering Settings Do Medical Students Prefer During a Novel Respiratory Virus Pandemic? A Cross-Sectional Study of Multiple Colleges in Central Saudi Arabia During the COVID-19 Pandemic

Purpose

Novel respiratory virus outbreaks are a recurring public health concern. Volunteering medical students can be a valuable asset during such times. This study investigated the willingness of medical students to volunteer during the coronavirus disease of 2019 (COVID-19) pandemic and the barriers to doing so, considering the possibility of exposure to COVID-19 and mode of contact.

Patients and methods

This cross-sectional study was conducted using a self-administered online questionnaire adapted from the literature. The questionnaire comprised four parts: demographic variables, COVID-19-related variables, willingness scale, and barrier scale. The target population was medical students at four different colleges in Riyadh, Saudi Arabia.

Results

A total of 802 students participated in the study. A small proportion of students (10.6%) were willing to participate in volunteering activities that could involve contact with patients with COVID-19 as compared to other settings (39.4-43.4%). More than one-quarter of students (26.8%) had risk factors for severe COVID-19. The main barrier to volunteering was the concern of transmitting the infection to family members (76.8%). Registration to receive the COVID-19 vaccine was positively associated with more willingness to volunteer (β=0.17, p <0.001), whereas residing in a household with an elderly person was negatively associated (β=-0.13, p <0.001). Female sex was positively associated with higher barrier score (β=0.12, p <0.001).

Conclusion

Medical students were more willing to volunteer in activities that did not involve direct contact with patients with COVID-19. A considerable proportion of participants had risk factors for severe illness. Sharing a household with an elderly person or child was associated with lower willingness to volunteer. Organizers of volunteering activities should offer various volunteering options considering the risk of infection; and be mindful of barriers to volunteering, especially risk factors for severe illness and eldercare and childcare responsibilities.

"It helps me find balance": older adult perspectives on the intersection of caregiving and volunteering

Caregiving is an increasingly prevalent experience that can negatively impact health and well-being. Volunteerism, long associated with positive benefits for older adults, is one potential strategy that can be used to counteract caregiver stress. A national cohort of existing older adult volunteers was engaged to explore the intersection of volunteering and caregiving through qualitative analysis of respondent comments using the lens of role theory. Survey responses from 533 older volunteers were analyzed. Role conflict and role enhancement themes were examined, with time constraints and reduced energy emerging as the perceived causes of conflict between the caregiver and volunteer roles. Caregivers discussed benefits to their caregiving role, including respite, learning, access to information and resources relevant to caregiving, increased socialization and improved physical and cognitive health. Findings indicate that volunteering can be framed as a health and well-being intervention for caregivers.

Managing Compound Hazards: Impact of COVID-19 and Cases of Adaptive Governance during the 2020 Kumamoto Flood in Japan

Japan experienced natural hazards during the COVID-19 pandemic as some other countries did. Kumamoto and Kagoshima prefectures, including many other parts of southern Japan, experienced record-breaking heavy rain on 4th July 2020. While many countries were affected by compound hazards, some cases such as the Kumamoto flood did not cause a spike of the COVID-19 cases even after going through massive evacuation actions. This study aims to understand how COVID-19 made an impact on people’s response actions, learn the challenges and problems during the response and recovery phases, and identify any innovative actions and efforts to overcome various restrictions and challenges through a questionnaire survey and interviews with the affected people. With an increase in the risk of compound hazards, it has become important to take a new, innovative, and non-traditional approach. Proper understanding and application of adaptive governance can make it possible to come up with a solution that can work directly on the complex challenges during disasters. This study identified that a spike of COVID-19 cases after the disaster could be avoided due to various preventive measures taken at the evacuation centers. It shows that it is possible to manage compound hazard risks with effective preparedness. Furthermore, during emergencies, public-private-partnership as well as collaboration among private organizations and local business networks are extremely important. These collaborations generate a new approach, mechanism and platform to tackle unprecedented challenges.

The national identity on the border: Indonesian language awareness and attitudes through multi-ethnic community involvement

State borders are the areas that are vulnerable to the degradation of national identity. The purpose of this study was to investigate the attitudes and the behavior of language use among the multi-ethnic Indonesian of predominantly Dayak, Malay, and Chinese who resided on the Indonesia-Malaysia border. The present research applied a qualitative ethnographic approach to document and to describe how a group of multi-ethnic communities participated in building their awareness, attitudes and practices of language as a national identity. The data were taken from 20 informants. They were teachers, students, local people, entrepreneurs, and state civil apparatus. The research found out that the ethnic groups on the border were highly aware of using Indonesian language as evidenced through a form of community involvement, volunteerism and social attitudes in civilizing Indonesian as the dominant language at the border. Their awareness was shown through their involvement, volunteerism, and social attitudes in developing Indonesian language as the dominant language in the border. It is argued that the involvement of all ethnic groups on the border affects positively on strengthening their attitudes and awareness in using Indonesian language.

No mission? No motivation. On hospitals' organizational form and charity care provision

A healthcare provider faces two decision problems. On the one hand, it chooses its organizational form: a hospital can be a for-profit institution providing compensated care only, or it can be a nonprofit organization whose mission is enhancing access to care for uninsured, low-income patients. On the other hand, the provider chooses which health professionals to hire, without observing their heterogeneous skills and their pro-social motivation. These decisions are related because an increase in the percentage of revenues, that the nonprofit hospital sacrifices for charity care, might enhance the motivation of its workers and induce some of them to donate their labor, that is, to volunteer. Accordingly, this article analyzes the provider's optimal screening contracts, which are contingent on workers' ability and satisfy limited liability, and relates them to the optimal choice of its mission-orientation. The results provide a new rationale for: a the emergence of different organizational forms for hospitals, such as for-profits and nonprofits, which complement public hospitals in the provision of health care, b the heterogeneity in the degree of charity care chosen by different nonprofit hospitals.

Short-term medical service trips: what is the cost of patient care and student training?

Background

Evaluations of the costs and effects of medical service trips (MSTs) are increasingly necessary. Estimates of costs can inform decision making to determine if participation is likely to be a wise use of resources.

Methods

This study estimates the costs and effects of a 1-week MST for 20 health professions students and seven providers to the Dominican Republic. Costs were defined as direct costs for students and providers and opportunity costs for providers. Effects were defined as the cost to treat one patient and the cost to train one student. Students were surveyed about their costs before and after the MST. Most provider costs were assumed to be the same as those of the students.

Results

The mean direct cost per student was US\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{upgreek} \usepackage{mathrsfs} \setlength{\oddsidemargin}{-69pt} \begin{document} }{}${\$}$\end{document}1764 and US\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{upgreek} \usepackage{mathrsfs} \setlength{\oddsidemargin}{-69pt} \begin{document} }{}${\$}$\end{document}2066 for providers. Total opportunity costs for seven providers was US\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{upgreek} \usepackage{mathrsfs} \setlength{\oddsidemargin}{-69pt} \begin{document} }{}${\$}$\end{document}19 869. The total cost for the trip was US\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{upgreek} \usepackage{mathrsfs} \setlength{\oddsidemargin}{-69pt} \begin{document} }{}${\$}$\end{document}69 612 to treat 464 patients. With and without provider opportunity costs, the cost to treat one patient was US\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{upgreek} \usepackage{mathrsfs} \setlength{\oddsidemargin}{-69pt} \begin{document} }{}${\$}$\end{document}150 and US\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{upgreek} \usepackage{mathrsfs} \setlength{\oddsidemargin}{-69pt} \begin{document} }{}${\$}$\end{document}107, and the cost to train one student was US\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{upgreek} \usepackage{mathrsfs} \setlength{\oddsidemargin}{-69pt} \begin{document} }{}${\$}$\end{document}3481 and US\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{upgreek} \usepackage{mathrsfs} \setlength{\oddsidemargin}{-69pt} \begin{document} }{}${\$}$\end{document}2487, respectively.

Conclusions

Short-term MSTs may be more expensive than previously thought. The cost to treat one patient was similar to a medical office visit in the USA.

The Anesthesiologist's Perspective and Experience in Global Congenital Cardiac Surgery: Results of a Survey of the Congenital Cardiac Anesthesia Society Membership

Anesthesiologists are important components of volunteer teams which perform congenital cardiac surgery in low-resource settings throughout the world, but limited data exist to characterize the nature and breadth of their work. A survey of Congenital Cardiac Anesthesia Society (CCAS) members was conducted with the objective of understanding the type of voluntary care being provided, its geographic reach, the frequency of volunteer activities, and factors which may encourage or limit anesthesiologists' involvement in this work. The survey was completed by 108 participants. Respondents reported a total of 115 volunteer trips during the study period, including work in 41 countries on 5 continents. Frequent motivating factors to begin volunteering included invitations from charitable groups, encouragement from senior colleagues, and direct connections to individual locations. Discouraging factors included familial responsibilities, the need to use vacation time, and a lack of support from home institutions. The year 2020 saw a marked decrease in reported volunteer activity, and respondents reported multiple pandemic-related factors which might discourage future volunteer activities. The results of this study demonstrate the global reach of anesthesiologists in providing care for children having cardiac surgery. It also offers insights into the challenges faced by interested individuals, many of which are related to a lack of institutional support. These challenges have only mounted under the COVID-pandemic, leading to a dramatic downturn in volunteer activities. Finally, the survey reinforces the need for better coordination of volunteer activities to optimize clinical impact.

Does Global Surgery Interest Influence the Choice of Surgical Residency Program?

OBJECTIVE

Medical students actively seek global health opportunities. Surgical residents also show great enthusiasm for international missions, rotations and global surgery. Unfortunately, only 18% to 34% of all surgery residency programs offer such international opportunities. We surveyed fourth year medical students applying for surgery residency to determine if international surgery opportunities offered by a program would influence their match rank list.

DESIGN

A 20 question survey was given to interviewees at our surgery residency program. Survey was optional and anonymous. We queried prior volunteerism, interest in global surgery and importance of international opportunities offered during residency.

SETTING

Hackensack University Medical Center, Hackensack New Jersey PARTICIPANTS: All candidates interviewing for general surgery residency at Hackensack University Medical Center from October 2019 to January 2020.

RESULTS

A total of 97 fourth year medical students interviewed, with a 66% response rate to the survey. Mean age was 27 years. 92% of students had volunteered during college and/or medical school. 41% of students had volunteered internationally. Majority of students were interested in a surgery residency program offering international opportunity. 78% of students planned to volunteer internationally after residency, and two-thirds planned to include global surgery in future career. Half of the students reported they would rank a residency program higher if it offered an international opportunity. Students who were immigrants were significantly more likely to rank a program higher in the match if an international opportunity was offered, compared to students born in the US (p < 0.05).

CONCLUSIONS

There is great interest in global surgery and international volunteer opportunities amongst fourth year medical students who apply for surgery residency. The majority of applicants have prior volunteer experience either locally or abroad. Majority of students plan to volunteer internationally after residency and are interested in academic global surgery careers. Students will rank surgery residency programs that offer international opportunities higher in the match.

Nursing Students' Willingness and Confidence to Volunteer in a Pandemic

Introduction

The current coronavirus disease 2019 pandemic may result in shortages of health care workers in some areas of the health care system. With adequate support, nursing students could potentially play a role in easing health worker shortages.

Objective

To describe and explore nursing students' willingness and confidence to contribute to the health care workforce during a pandemic.

Methods

A mixed-methods descriptive survey design was used to explore the perspectives of second-year nursing students at an Australian University. Quantitative data were analyzed using descriptive statistics. Qualitative data were analyzed using directed content analysis.

Results

A total of 280 nursing students were invited to complete the survey with a response rate of 32%. The majority of the participants showed moderate to high levels of willingness to volunteer in a pandemic. Of the participants, 50% reported slight confidence that their knowledge and skills would assist them during their volunteering. Reasons that influenced students' willingness to volunteer included perception of lack of personal protective equipment, need for incentives, fear of transmitting infection to family members, barriers to volunteering, inadequate knowledge and skills to handle a pandemic situation, study and clinical placement arrangements, and disease hazardousness.

Conclusion

Most nursing students have a level of willingness to volunteer but low confidence that their knowledge and skills would assist them while volunteering in pandemic situations. Universities and health care organizations can benefit from these findings by developing strategies to increase students' willingness to volunteer, as well as their confidence in their knowledge and skills.

Comparing the family characteristics, professional profile, and personality traits of COVID-19 volunteer and nonvolunteer frontline healthcare workers at the epicenter in Nigeria

BACKGROUND

Emergency volunteering becomes a necessity in the face of unprecedented disasters like the coronavirus disease 2019 (COVID-19) pandemic. There is a paucity of empirical data on volunteerism not imported from the developed countries. It became necessary to evaluate the local-bred volunteerism with its peculiarity, as it emerged within the public health sector of Nigeria's COVID-19 epicenter.

OBJECTIVES

To compare the family characteristics, professional profiles, and personality traits of volunteer and nonvolunteer COVID-19 frontline healthcare workers (HCWs). To determine the significant predictors of volunteering as well as the deterrents to and motivation for volunteering.

METHOD

A comparative cross-sectional study was conducted between May and August 2020 among COVID-19 volunteer and nonvolunteer HCWs serving at the six dedicated COVID-19 isolation/treatment centers and the 27 general hospitals, respectively. Using a stratified sampling technique, three professional categories of HCWs (doctors, nurses, and medical laboratory scientists) were randomly selected from the nonvolunteers while total enumeration of volunteers was done. The survey employed pilot-tested self-administered questionnaires. The univariate, bivariate, and multivariate analyses were carried out with IBM Statistical Package for Social Sciences (SPSS) version 23.0. The level of statistical significance was determined by a P-value of <.05.

RESULTS

A total of 244 volunteers and 736 nonvolunteers HCWs participated in this survey. Sex, ethnicity, professional level, income level, number of years of practice, and traits of agreeableness and conscientiousness were significantly different between volunteers and nonvolunteers (P < .05). Inadequate personal protective equipment (PPE), lack of insurance, and inadequate hazard allowance deterred nonvolunteers. After regression analysis, the significant predictors of volunteerism included sex (odds ratio [OR] = 2.644; confidence interval [CI]: 1.725-4.051), ethnicity (OR = 2.557; CI: 1.551-4.214), and professional level (matrons: OR = 0.417; CI: 0.254-0.684, consultants: OR = 0.171; CI: 0.038-0.757).

CONCLUSION

HRH crisis in the face of high-danger situations such as the COVID-19 pandemic makes it urgent for health policymakers to address the identified barriers to volunteerism in order to optimize the health outcomes of the population.

Willingness of university nursing students to volunteer during the COVID-19 pandemic in Brunei Darussalam

Background

Volunteering among nursing students has become a valuable resource during an outbreak to help alleviate the strain in nursing staff shortages. However, evidence of willingness to volunteer is scarce, particularly in Asian countries.

Objective

To study Bruneian university nursing students' willingness to volunteer during a pandemic in Brunei.

Methods

An online cross-sectional study was conducted at Universiti Brunei Darussalam from January to February 2021. A self-administered questionnaire was used to measure willingness factors, including motivational factors, barriers, enablers, and level of agreement to volunteer during the COVID-19 pandemic. Sub-group inferential analysis was applied.

Results

72 participants were included in this study. 75.0% of whom were willing to volunteer during the COVID-19 pandemic. Factors that influenced the willingness of nursing students to volunteer were marital status (p <0.001), year of study (p <0.001), altruism (p <0.001), personal safety (p <0.001), and knowledge level (p <0.001).

Conclusion

Nursing students are an invaluable resource, and they are highly willing to be part of disaster management. Training and planning should prepare the nursing students for disaster or pandemic readiness and integrated them into the undergraduate nursing curriculum. Align with this, safety aspects of nursing students during volunteering should also be considered, including the provision of childcare assistance, sufficient personal protective equipment, vaccination, and prophylaxis to the volunteers.

Volunteerism in the last year as a moderator between empathy and altruistic social value orientation: an exploratory study

BACKGROUND

Volunteerism is a sustained prosocial activity, and young adults are one of the most important targets for organizations recruiting volunteers. Empathy and altruistic social value orientation measured by a decomposed game are dispositional traits that might foster engagement in volunteerism.

PARTICIPANTS AND PROCEDURE

Using a self-report online-based questionnaire study on two groups of young adults (aged 18-35, N = 224 non-volunteers and N = 178 volunteers in the last year) the relationship between empathy and altruistic social value orientation in both of these groups was explored.

RESULTS

The results showed that volunteers scored significantly higher on empathy and altruistic social value orientation than non-volunteers. In non-volunteers, empathy is positively linked to altruistic social value orientation, whereas for volunteers the relationship is inversed.

CONCLUSIONS

The results provide evidence that volunteers, when high on empathy, might not necessarily be ready to share financial resources with others, as operationalized by a decomposed game.

[ACTIVITIES OF MEDICAL VOLUNTEERS DURING THE REPORTING PERIOD PANDEMICS COVID-19 (ON THE EXAMPLE OF THE WORK OF THE HEADQUARTERS OF THE VOLUNTEER DETACHMENTS OF THE KURSK STATE MEDICAL UNIVERSITY)]

This article presents the results of a study of the activities of volunteer detachments to support medical organizations during the COVID-19 pandemic in the Kursk region. The organizational and managerial mechanisms of the formation of the volunteer movement of the Kursk region are defined. The specifics of the work of the volunteer movement in conditions of high readiness at the regional level are revealed. The assessment of the level of professional training of medical volunteers is given.

I Wanna help, but my Hands can be a Little Tied: The Challenges and Benefits of Formal Volunteering among Low-Income Diverse Older Adults

Volunteering is often considered an important component of productive and active aging. Although there is a rich body of literature on the predictors and outcomes of volunteering among the general older adults in the United States (U.S.), few studies have explored the unique volunteering experiences of culturally and linguistically diverse older adults. Given the growing number of diverse older adults and the importance of optimizing their contributions to society, this study investigates the challenges and benefits of volunteering among low-income diverse older adults. We conducted eight 90-minute focus groups in six languages (English, Nepali, Khmer, Somali, Russian, and Chinese) with 70 older volunteers attending a Senior Companions monthly training in a U.S. Midwestern metropolitan area. Data analysis followed the Rapid and Rigorous Qualitative Data Analysis (RADaR) technique and thematic analysis through an interactive team approach. Three overarching themes highlighted the challenges of volunteering: (1) transportation, (2) community emergencies and workload, and (3) family caregiving; and three themes reflected the benefits of volunteering: (1) stress-relief, (2) training and information, and (3) peer support and socialization. Study findings shed light on diverse older adults' unique volunteering experiences with implications for recruitment and retention.

Retirement and Social Activities in Japan: Does Age Moderate the Association?

Although retirement age is increasing in aging societies, its impact on individuals and communities is unclear. This study examined how age moderates the linkage between transition into retirement and participation in productive and non-productive social activities after retirement, using a nationwide longitudinal survey with a probability sample of Japanese aged 60 and over (n = 3,493). Multinomial logistic regression analyses were performed to predict changes in volunteering and hobbies/learning during 3-5 years of follow-up and their participation level at the follow-up. The significant interactions between change in work status (remained working as reference, full/partial retirement, remained not-working) and age at baseline showed that fully retired persons were more likely to increase these activities than remained workers only when they retired by their early seventies. Thus it is important to encourage engagement in social activities before retirement and remove psychological and environmental barriers that hinder starting new activities at old age.

Development of a scale assessing retired older adults' attitudes to volunteering

OBJECTIVE

Given positive attitudes to volunteering are likely to be associated with support for volunteering and individual participation, this study aimed to develop and test a 10-item 'attitudes to formal volunteering' scale for retired older adults that could be used to inform intervention efforts.

METHOD

A sample of 801 Australian retirees (62% female; mean age: 71.9 years) completed a survey that included the attitude scale, demographic items and questions assessing engagement in volunteering.

RESULTS

A principal component analysis identified two factors (general attitude to volunteering and attitude to participating in volunteering) that together accounted for 64% of the variance in attitude scores. A confirmatory factor analysis indicated the two-factor model was an excellent fit to the data. Cronbach's alphas for both factors were >0.80, and both were positively associated with volunteering engagement.

CONCLUSION

The proposed scale is a potentially useful instrument for measuring attitudes to volunteering among retired older adults.

Volunteerism and Cardiovascular Health: The HCHS/SOL Sociocultural Ancillary Study

Objectives

The objective of this study was to examine the association between volunteerism and favorable cardiovascular health (CVH) among Hispanics/Latinos living in the US.

Methods

Data from the Hispanic Community Health Study/Study of Latinos (2008-2011) Sociocultural Ancillary Study were used (N = 4,926; ages 18-74 years). Favorable CVH was defined as positive profiles of all major CVD risk factors: low total serum cholesterol, blood pressure, and body mass index; not having diabetes; and not smoking. Survey-weighted logistic regression models were adjusted for sociodemographic, lifestyle, and psychological factors. In secondary analyses, we tested whether the volunteerism-CVH association was modified by sex, age, or years lived in the US (<10 vs. ≥10 years; a proxy acculturation measure).

Results

Prevalence of volunteerism was 14.5%. Compared to non-volunteers, volunteers had 1.67 higher odds of favorable CVH in the fully-adjusted model (Odds Ratio [OR] = 1.67, 95% Confidence Interval [CI] = 1.11, 2.52). There was evidence of effect modification by acculturation; only volunteers who had lived in the US ≥10 years had 2.41 higher odds of favorable CVH (OR = 2.41, 95% CI=1.53, 3.80). There was no evidence of effect modification by sex or age.

Conclusions

Volunteerism was associated with favorable CVH among US Hispanics/Latinos.

The Benefits of Being a "Buddy": Exploring the Medical Student Experience As Mentor to Minority High-School Students

Purpose:The Aspiring Doctors Precollege Program at Ohio University Heritage College of Osteopathic Medicine serves to introduce underrepresented minority (URM) high-school students to careers in health care as well as introducing URM high-school students to medical student mentors. Each month, medical students and their student mentees connect through a variety of activities on the medical college campus. While the program has significant benefit for the mentees, it also provides professional development opportunities for the medical students as mentors. Many researchers have written on the value of mentored relationships between medical students and established physicians; however, exploring the benefits of medical student mentorship has yet to be discussed in the literature.

Objectives: The primary objectives of this study are to understand medical student perceptions of being a mentor and describe the contributions to their medical education.

Methods: Semistructured interviews were conducted with student mentors regarding their experiences serving in this program. These interviews were inductively coded for significant ideas, themes, and patterns.

Results: A series of 12 research interviews were conducted with medical students who have participated in The Aspiring Doctors program for at least three semesters. Major themes that emerged from the analysis include the following: the importance of guidance in medicine through person-to-person mentoring, and identification of future career aspirations.

Summary/Conclusions: Medical student mentors found this program to be a valuable addition to their educational experience. Mentoring URM high-school students offers pre-clinical medical students the opportunity to connect with their community and envision themselves serving as physicians in underresourced communities. Simultaneously, it provides a meaningful way of paying-it-forward during their education. Further studies can be done to track the outcomes of the medical students with respect to their designations stated while participating in this program, the role of mentorship on professional identity development, and possible effects on preventing/mitigating burnout.

Empathy of Medical Students and Compassionate Care for Dying Patients: An Assessment of "No One Dies Alone" Program

The "No One Dies Alone" (NODA) program was initiated to provide compassionate companions to the bedside of dying patients. This study was designed to test the following hypotheses: (1) Empathy scores would be higher among medical students who volunteered to participate in the NODA program than nonvolunteers; (2) Spending time with dying patients would enhance empathy in medical students. Study sample included 525 first- and second-year medical students, 54 of whom volunteered to participate in the NODA program. Of these volunteers, 26 had the opportunity to visit a dying patient (experimental group), and 28 did not, due to scheduling conflicts (volunteer control group). The rest of the sample (n = 471) comprised the "nonvolunteer control group." Comparisons of the aforementioned groups on scores of the Jefferson Scale of Empathy confirmed the first research hypothesis (P < .05, Cohen d = 0.37); the second hypothesis was not confirmed. This study has implications for the assessment of empathy in physicians-in-training, and timely for recruiting compassionate companion volunteers (armed with personal protective equipment) at the bedside of lonely dying patients infected by COVID-19.

How Full Is Your Tank? A Qualitative Exploration of Faculty Volunteerism in a National Professional Development Program

OBJECTIVE

Professional development programs (PDPs) within academic professional organizations rely on faculty volunteers, but little is known about the volunteering process and experience. Our aim was to gain insights into the initial decision to volunteer, the experience of volunteering and the decision to re-volunteer or not (ie, remain or leave as a volunteer). The study setting was a PDP of the Academic Pediatric Association, the Educational Scholars Program.

METHODS

In 2014, 13 Educational Scholars Program faculty members participated in semistructured phone interviews. The authors performed a general inductive analysis of the data, inductively created codes, and analyzed coded data for emergent themes that led to the creation of a model for recruiting and sustaining volunteers.

RESULTS

Four themes related to the initial volunteer decision and the decision to re-volunteer or not (self-interest and altruism, reputation of the program, relevant skill set, and doability), and 4 themes related to the experience of volunteering (emotional impact, career advancement and professional recognition, professional growth, and doability) emerged. The relationship among the themes led to the creation of a model of volunteering, involving a metaphorical volunteerism "tank" that is full when faculty initially volunteer and subsequently fills or empties as a result of dynamic interplay between the themes for each individual.

CONCLUSIONS

Leaders of PDPs may find our model of volunteering beneficial for enhancing the emotional and tangible benefits and minimizing the logistical issues of volunteering. This information should contribute to success in recruiting and retaining the volunteers who are essential for developing and sustaining PDPs.

Factors that motivate individuals to volunteer to be dispatched as first responders in the event of a medical emergency: A systematic review protocol

Background: Voluntary First Response is an important component of prehospital care for medical emergencies, particularly cardiac arrest, in many countries. This intervention entails the mobilisation of volunteers, known as Community First Responders (CFRs), by the Emergency Medical Services to respond to medical emergencies in their locality. They include lay responders and/or professional responders (e.g. police officers, fire fighters, and general practitioners). A wide variety of factors are thought to motivate CFRs to join and remain engaged in Voluntary First Response schemes, such as the availability of learning opportunities, recognition, counselling, and leadership. The aim of this review is to develop an in-depth understanding of CFR motivation, including the factors that influence the initial decision to volunteer as a CFR and the factors that sustain involvement in Voluntary First Response over time. Any factors relevant to CFR de-motivation and turnover will also be examined. Methods: This is a protocol for a qualitative systematic review of the factors that influence the motivation of individuals to participate in Voluntary First Response. A systematic search will be carried out on seven electronic databases. Qualitative studies, mixed-methods studies, and any other studies producing data relating to the review question will be eligible for inclusion. Title and abstract screening, as well as full text screening, will be completed independently by two authors. A narrative synthesis, which is an established qualitative synthesis methodology, will be performed. The quality of each of the included studies will be critically appraised. Discussion: The findings of this review will be used to optimise the intervention of Voluntary First Response. Specifically, the results will inform the design and organisation of Voluntary First Response schemes, including their recruitment, training, and psychological support processes. This could benefit a range of stakeholders, including CFRs, paramedics, emergency physicians, patients, and the public.

Volunteerism during COVID-19

Health care workers have been asked to do their part to make a difference and give back to their community. This personal reflection is a result of an experience as a medical reserve corps nurse volunteer for a local health department in the northeastern United States. Volunteering resulted in positive social and personal benefits for me. It inspired a sense of pride in helping others and knowing that someone's well-being may be enhanced. The individuals whom I spoke with via the phone appreciated the concern for their health, and some individuals seemed to enjoy the interaction with another person, possibly due to their isolation. Descriptions of interactions via phone calls with coronavirus positive individuals are provided that support the benefits of volunteering. Volunteerism has personal value in its ability to inspire someone to continue to make an impact. Volunteerism allowed me to give to others and to gain a sense of purpose.

Perceived Usefulness and Easiness of Information and Communication Technologies and Volunteering among Older Adults

This study investigates the association between older adults' perception of usefulness and easiness (PUE) of Information Communication and Technologies (ICTs) and volunteering, and if this association differs across their income status. Data were obtained from the 2012 wave of the Health and Retirement Study (HRS), and the sample was restricted to respondents aged between 60 and 84 (N = 901) and who completed the 2012 HRS technology module. Multinomial logistic regression was employed to examine the independent and joint influence of PUE of ICTs and of low-income status on volunteering. The results show that only people with high PUE engaged in more than 100 hours of volunteering among older adults after controlling for covariates. The positive effect of high PUE was found to be more significant in the low-income group. This is the first known research to investigate the PUE of ICTs and volunteering among older adults. This study expands the knowledge of volunteering among older adults by exploring ICTs which can be considered as one of the most influential macrosocial changes in the current society. Moreover, our findings provide some insights and an empirical foundation in volunteering programs for older adults of different PUE levels.

Volunteering in older adulthood is associated with activity engagement and cognitive functioning

Introduction: Given evidence that activity engagement in older adulthood can have protective effects on the aging brain, we investigated the idea that volunteering in the community, which often encompasses social, cognitive, and physical activity, might benefit cognition. Method: Ninety-one retired 65- to 75-year-olds reported their sociodemographic characteristics, wellbeing, volunteering, and activity engagement. They also completed computerized cognitive tests that tapped specific functions known to decline disproportionately with age. Results: Volunteering at least monthly was associated with better working memory and more social and cognitive activity. Mediation analyses indicated that volunteering was indirectly related to switching performance via cognitive activity. However, the volunteering-working memory association did not depend on activity engagement, leaving the underpinning mechanisms unclear. Conclusions: These findings provide new insight into positive associations between older people's volunteering, activity engagement, and cognitive functioning. However, further work is needed to understand the mechanisms that drive volunteering-cognition links, and to establish causality.

Reexamining dental outreach programs: A model for local empowerment and sustainable development

BACKGROUND

To address the inadequacy of oral health care in developing nations, outreach programs have facilitated the provision of dental services by foreign volunteers to areas of need. However, the effectiveness of the current aid model on the long-term well-being of the recipient population and sustainability of efforts remains uncertain. The authors examine the strengths and areas of improvement of outreach initiatives to inform a reorientation of the aid model.

METHODS

The authors conducted a PubMed search and reviewed included articles to assess the current limitations and recommended strategies for outreach programs. The identified limitations and strategies were sorted into 4 key areas of change and organized using the Theory of Change framework to inform an improved aid model.

RESULTS

The current aid models were found to have limitations in scope and coverage, interventions that were not applicable or integrated into local systems, and an inadequate evidence base. To address these limitations, efforts should be directed at the capacity building of local workers through individual training and evidence-based interventions, improved understanding of local contexts, and integration and alignment with local systems.

CONCLUSIONS

The empowerment of local communities is critical in ensuring an effective and sustainable aid model in developing nations.

PRACTICAL IMPLICATIONS

By adopting an improved aid model, outreach programs can enhance the long-term access and availability of quality oral health care that is delivered by local providers and communities.

Factors that motivate individuals to volunteer to be dispatched as first responders in the event of a medical emergency: A systematic review protocol

Background: Voluntary First Response is an important component of prehospital care for medical emergencies, particularly cardiac arrest, in many countries. This intervention entails the mobilisation of volunteers, known as Community First Responders (CFRs), by the Emergency Medical Services to respond to medical emergencies in their locality. They include lay responders and/or professional responders (e.g. police officers, fire fighters, and general practitioners). A wide variety of factors are thought to motivate CFRs to join and remain engaged in Voluntary First Response schemes, such as the availability of learning opportunities, recognition, counselling, and leadership. The aim of this review is to develop an in-depth understanding of CFR motivation, including the factors that influence the initial decision to volunteer as a CFR and the factors that sustain involvement in Voluntary First Response over time. Any factors relevant to CFR de-motivation and turnover will also be examined. Methods: This is a protocol for a qualitative systematic review of the factors that influence the motivation of individuals to participate in Voluntary First Response. A systematic search will be carried out on seven electronic databases. Qualitative studies, mixed-methods studies, and any other studies producing data relating to the review question will be eligible for inclusion. Title and abstract screening, as well as full text screening, will be completed independently by two authors. A narrative synthesis, which is an established qualitative synthesis methodology, will be performed. The quality of each of the included studies will be critically appraised. Discussion: The findings of this review will be used to optimise the intervention of Voluntary First Response. Specifically, the results will inform the design and organisation of Voluntary First Response schemes, including their recruitment, training, and psychological support processes. This could benefit a range of stakeholders, including CFRs, paramedics, emergency physicians, patients, and the public.

Higher levels of self-efficacy and readiness for a future career of Spanish speaking physician assistant students after their volunteer work in a student-run free clinic in the United States

Volunteering at a free clinic may influence career choice amongst health profession students. The purpose of this research is to explore knowledge, skill, attitudes, self-efficacy, interest in future work with the underserved, and interest in primary care amongst physician assistant (PA) students through the analysis of demographic characteristics of PA students at a student-run free clinic in the United States. Data were collected from 56 PA students with a quantitative survey collection in October 2018 after their participation at a student-run free clinic in Intermountain West, Salt Lake City, Utah, USA. Out of three sub-scales i. e. attitudes, effect, and readiness, students responded most positively to effect of experience of participating in free clinic. Students who spoke Spanish showed higher levels of self-efficacy and readiness for a future career in comparison to non-Spanish speakers.

Developing undergraduate community psychology pedagogy and research practice

In this study two community psychology students describe their experiences in participating in different types of "green" volunteer sustainable programs. In the first scenario, Anthonie Collins describes his experiences in working with young men in a youth detention facility and how the participants discovered the intrinsic value of maintaining a vegetable community garden. In the second scenario, Jordan Seitz describes her experiences in organizing a community apple harvest at a local fruit tree orchard in Wyoming, MN. At the conclusion of their community service projects, participants were interviewed regarding their overall subjective experiences in participating in an outdoor "green space" community service project and how superordinate programs that provide increased positive contact helped improve understanding of persons from ethnically diverse cultures and appreciate the value of outdoor "green" voluntary programs.

Humanitarian Mission in Pediatric Cardiothoracic Surgery: A Recipient's Perspective

Introduction: Pediatric cardiac surgical mission programs are deemed as common practice, especially in developing nations funded by international non-governmental organizations (NGOs). This article presents and discusses the results and strategies implemented by this partnership, aiming at achieving the autonomy of the local center by this collaboration. Materials and Methods: A retrospective review was conducted on patients with congenital heart disease who underwent surgical intervention from the beginning of the NGO collaboration (September 2015) until November 2018 in an existing cardiac center. In between those visits, any congenital heart disease patient with Risk Adjustment Congenital Heart Surgery (RACHS)-1 Category 1-3 would be discussed in a local multi-disciplinary meeting with regards to the feasibility of the surgery being performed by the local members. Results: A total of 60 operations were performed during the trips. Throughout the visit, 46% (28) of the operations were performed by the local surgeon, with or without assistance from the visiting surgeon. Between September 2015 and November 2018, 27 cases were also performed by the local team independently. For the 27 cases performed by the local team independently, the median age of the patient was 42 days (ranging from 14 days to 20 years old), with median body weight of 3.2 kg (ranging from 2.8 to 64 kg). Conclusion: Humanitarian pediatric cardiac surgical missions are safe to be done for the population in need. In order to achieve autonomy, continuous efforts by both teams are crucial, as the cooperation by the two parties ensures that the objectives are achieved.

"It's Not Just a Simple Meal. It's So Much More": Interactions Between Meals on Wheels Clients and Drivers

Background and Objectives: Meals on Wheels (MOW) programs provide home-delivered meals to over 1.5 million older adults; yet, very little is known about the drivers who make meal deliveries possible. Specifically, we do not have clear insight into their interaction with clients or the benefits that they may receive through their service. The objective of this article is to describe the characteristics of MOW drivers, the interactions among drivers and clients, and the benefits of the program to both. Research Design and Method: This qualitative research study reports on interviews with 84 MOW staff (leadership, case managers/client assessors, volunteer coordinators) and drivers at six geographically and operationally distinct programs across the United States. Results: Qualitative analysis of the interviews with MOW staff and drivers revealed the following key themes: (a) clients have multiple vulnerabilities; (b) clients appear to derive social, as well as nutritional benefit from receiving meals; (c) drivers report they provide additional support to their clients beyond delivering the meal; (d) social bonds between drivers and clients were reported to strengthen over time; (e) drivers claim that they, too, derive validation and personal benefit through their meal delivery. Discussion and Implications: This research highlights the significant contributions that meal delivery drivers made in the lives of MOW clients beyond the actual meal itself. This research also spotlights the perceived benefits experienced by the drivers and points to the importance of conducting further research to determine the effects of meal delivery on client and drivers' outcomes, more broadly.

A Helping Hand: The Case for Volunteerism

Medical professionals are often regarded as influential community figures, yet their actual civic engagement may not match these expectations. Physicians certainly have a commitment to their own patients, but principles of medical ethics and professionalism suggest that physicians are also responsible for treating patients who lack access to care. Physician volunteerism is beneficial for entire communities, but can be particularly transformative for uninsured, underinsured, or geographically isolated patients. Volunteerism also yields countless benefits for physicians themselves, including professional development, skill building, and reduction of burnout. Despite evidence for the positive results of volunteerism, some physicians are discouraged by the time commitments, working conditions, and ethical controversies. Yet for interested physicians, diverse opportunities exist in medical and nonmedical activities and domestic and international areas.

Understanding Motivations and Barriers of CRNAs Involved in Global Health: A Qualitative Descriptive Study

Surgical care provided through short-term medical missions (STMMs) is an important component of global healthcare. Certified Registered Nurse Anesthetists (CRNAs) are equipped with valuable knowledge and skills to help those lacking access to healthcare. Understanding the motivations and barriers to the participation of CRNAs in STMMs is vital to increasing their participation in these trips, which positively influence global healthcare. A descriptive qualitative design to understand motivations underlying volunteerism was used to gain this understanding. Clary's use of Functionalist Theory was the theoretical framework informing this study. Semistructured interviews were conducted with 6 CRNAs who had participated in at least one STMM. Colaizzi's qualitative method of inquiry was used for data analysis. The study's main objective was to identify motivations and barriers specific to CRNAs' participation in STMMs. Major categories for motivation included humanitarian values, personal and professional growth, readiness to serve, and strong teamwork. Barriers of participation in STMMs were divided into categories of internal (eg, personal discomfort, obligations) and external (weakness of the organization). The study results yield greater understanding of what can draw increased participation in STMMs from CRNAs. Improved understanding may lead to more effective recruitment and better satisfaction of CRNA participants in STMM work.

The role of community health workers in supporting South Africa's HIV/ AIDS treatment programme

Community health workers deployed around South Africa's primary health care clinics, supply indispensable support for the world's largest HIV/AIDS treatment programme. Interviews with these workers illuminated the contribution they make to anti-retroviral treatment (ART) of HIV/AIDS patients and the motivations that sustain their engagement. Their testimony highlights points of stress in the programme and supplies insights into the quality of its implementation. Finally, the paper addresses issues about the sustainability of a programme that depends on a group of workers who are not yet fully incorporated into the public sector.