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Dias T, MacKay D, Canuto K, Boyle JA, D’Antoine H, Hampton D, Martin K, Phillips J, Bartlett N, Mcintyre HD, Graham S, Corpus S, Connors C, McCarthy L, Kirkham R, Maple-Brown LJ. Supporting healthy lifestyles for First Nations women and communities through co-design: lessons and early findings from remote Northern Australia. FRONTIERS IN CLINICAL DIABETES AND HEALTHCARE 2024; 5:1356060. [PMID: 38863516 PMCID: PMC11165116 DOI: 10.3389/fcdhc.2024.1356060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 04/24/2024] [Indexed: 06/13/2024]
Abstract
Background The period before, during, and after pregnancy presents an opportunity to reduce diabetes-related risks, which in Australia disproportionately impact Aboriginal and Torres Strait Islander women. Collaboration with Aboriginal and Torres Strait Islander women/communities is essential to ensure acceptability and sustainability of lifestyle modifications. Using a novel co-design approach, we aimed to identify shared priorities and potential lifestyle strategies. We also reflected on learnings from this approach. Methods We conducted 11 workshops and 8 interviews at two sites in Australia's Northern Territory (Central Australia and Top End), using experience-based co-design (EBCD) and incorporating principles of First Nations participatory research. Workshops/interviews explored participant' experiences and understanding of diabetes in pregnancy, contextual issues, and potential lifestyle strategies. Participants included three groups: 1) Aboriginal and Torres Strait Islander women of reproductive age (defined as aged 16-45 years); 2) Aboriginal and Torres Strait Islander community members; and 3) health/community services professionals. The study methodology sought to amplify the voices of Aboriginal women. Findings Participants included 23 women between ages 16-45 years (9 with known lived experience of diabetes in pregnancy), 5 community members and 23 health professionals. Key findings related to identified priority issues, strategies to address priorities, and reflections on use of EBCD methodology. Priorities were largely consistent across study regions: access to healthy foods and physical activity; connection to traditional practices and culture; communication regarding diabetes and related risks; and the difficulty for women of prioritising their health among competing priorities. Strategies included implementation of a holistic women's program in Central Australia, while Top End participants expressed the desire to improve nutrition, peer support and community awareness of diabetes. EBCD provided a useful structure to explore participants' experiences and collectively determine priorities, while allowing for modifications to ensure co-design methods were contextually appropriate. Challenges included the resource-intensive nature of stakeholder engagement, and collaborating effectively with services and communities when researchers were "outsiders". Conclusions A hybrid methodology using EBCD and First Nations participatory research principles enabled collaboration between Aboriginal women, communities and health services to identify shared priorities and solutions to reduce diabetes-related health risks. Genuine co-design processes support self-determination and enhance acceptability and sustainability of health strategies.
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Affiliation(s)
- Tara Dias
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Diana MacKay
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
- Department of Endocrinology, Royal Darwin Hospital, Darwin, NT, Australia
| | - Karla Canuto
- College of Medicine and Public Health, Flinders University , Melbourne, VIC, Australia
| | - Jacqueline A. Boyle
- Eastern Health Clinical School, Monash University, Melbourne, VIC, Australia
| | - Heather D’Antoine
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
- School of Public Health, University of Queensland, Brisbane, QLD, Australia
| | - Denella Hampton
- Central Australian Aboriginal Congress, Alice Springs, NT, Australia
- Aboriginal and Torres Strait Islander Advisory Group, Diabetes Across the Lifecourse: Northern Australia Partnership, Darwin, NT, Australia
| | - Kim Martin
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Jessica Phillips
- Women’s Cultural Hub, Mala’la Community Wellness Centre, Mala’la Aboriginal Health Corporation, Maningrida, NT, Australia
| | - Norlisha Bartlett
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - H. David Mcintyre
- Mater Research, The University of Queensland, Brisbane, QLD, Australia
| | - Sian Graham
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
- Aboriginal and Torres Strait Islander Advisory Group, Diabetes Across the Lifecourse: Northern Australia Partnership, Darwin, NT, Australia
| | - Sumaria Corpus
- Aboriginal and Torres Strait Islander Advisory Group, Diabetes Across the Lifecourse: Northern Australia Partnership, Darwin, NT, Australia
- Northern Territory Department of Health, Darwin, NT, Australia
| | | | - Leisa McCarthy
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
- Anyinginyi Health Aboriginal Corporation, Tennant Creek, NT, Australia
| | - Renae Kirkham
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Louise J. Maple-Brown
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
- Department of Endocrinology, Royal Darwin Hospital, Darwin, NT, Australia
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Carducci B, Dominguez G, Kidd E, Oh C, Jain R, Khan A, Bhutta ZA. Promoting healthy school food environments and nutrition in Canada: a systematic review of interventions, policies, and programs. Nutr Rev 2024:nuae030. [PMID: 38767979 DOI: 10.1093/nutrit/nuae030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2024] Open
Abstract
CONTEXT The school food environment is a critical interface for child and adolescent nutrition, and there is a need to understand existing literature on Canadian school food environments to identify equity gaps and opportunities, and empower decision-makers to plan for future action. OBJECTIVE Literature on Canadian school food and nutrition interventions, policies, programs, and their effects on diets and nutritional status are synthesized and appraised in this systematic review. DATA SOURCES A search strategy was developed for each database used (Medline, Embase, PsycINFO, ERIC, Cochrane Collaboration, Canadian Electronic Library, BiblioMap), with a combination of free text and controlled vocabulary, for articles published from 1990 to 2021. Unpublished data and grey literature were also searched. DATA EXTRACTION Quantitative and qualitative studies with an observational or intervention study design, reviews, or program evaluations conducted in Canadian schools with participants aged 5-19.9 years were included. Key study characteristics and risk of bias were extracted independently by 2 investigators using a standardized tool. DATA ANALYSIS A total of 298 articles were included (n = 192 peer reviewed and 106 from the grey literature), which were mostly conducted in Ontario (n = 52), British Columbia (n = 43), and Nova Scotia (n = 28). Twenty-four interventions, 5 nonevaluated programs, and 1 policy involved Indigenous populations. Overall, 86 articles measured and reported on effectiveness outcomes, including dietary intake; anthropometry; knowledge, attitudes, and practices; and physical activity. The literature remains largely heterogenous and primarily focused on nutrition education programs that use subjective assessments to infer changes in nutrition. A key facilitator to implementation and sustainability was community engagement, whereas key barriers were staff capacity, access to resources and funding, and consistent leadership. CONCLUSIONS This review provides insight into Canadian school food and nutrition interventions, programs, and policies and uncovers important evidence gaps that require careful examination for future evaluations. Governments must create supportive environments that optimize nutrition for children and adolescents through equitable policies and programs. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42022303255.
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Affiliation(s)
- Bianca Carducci
- Centre for Global Child Health, Hospital for Sick Children, Peter Gilgan Centre for Research, and Learning, Toronto, ON, Canada
- Department of Nutritional Sciences, University of Toronto, Faculty of Medicine, University of Toronto, Medical Sciences Building, Toronto, ON, Canada
| | - Georgia Dominguez
- Centre for Global Child Health, Hospital for Sick Children, Peter Gilgan Centre for Research, and Learning, Toronto, ON, Canada
| | - Emily Kidd
- Centre for Global Child Health, Hospital for Sick Children, Peter Gilgan Centre for Research, and Learning, Toronto, ON, Canada
| | - Christina Oh
- Western University, Schulich School of Medicine and Dentistry, London, ON, Canada
| | - Reena Jain
- Centre for Global Child Health, Hospital for Sick Children, Peter Gilgan Centre for Research, and Learning, Toronto, ON, Canada
| | - Amira Khan
- Centre for Global Child Health, Hospital for Sick Children, Peter Gilgan Centre for Research, and Learning, Toronto, ON, Canada
- Department of Nutritional Sciences, University of Toronto, Faculty of Medicine, University of Toronto, Medical Sciences Building, Toronto, ON, Canada
| | - Zulfiqar A Bhutta
- Centre for Global Child Health, Hospital for Sick Children, Peter Gilgan Centre for Research, and Learning, Toronto, ON, Canada
- Department of Nutritional Sciences, University of Toronto, Faculty of Medicine, University of Toronto, Medical Sciences Building, Toronto, ON, Canada
- Centre of Excellence in Women, and Child Health, Aga Khan University, Karachi, Pakistan
- Dalla Lana School of Public, Health University of Toronto Health Sciences Building, Toronto, ON, Canada
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Stanley RM, McKnight A, Probst Y, O'Flynn G, Tillott S. Strong culture, healthy lifestyles: a mixed methods feasibility study for a co-created afterschool cultural programme for Australian Aboriginal children. Pilot Feasibility Stud 2024; 10:31. [PMID: 38360808 PMCID: PMC10868114 DOI: 10.1186/s40814-023-01422-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 11/21/2023] [Indexed: 02/17/2024] Open
Abstract
BACKGROUND Having a strong connection to culture and Country is fundamental to the health and wellbeing of Australian Aboriginal children. The aim of the research was to evaluate the feasibility of study methods and programme implementation of a co-created afterschool cultural programme, and identify areas for improvement. METHODS Aboriginal Relational Research Methodology and mixed methods were applied to evaluate the feasibility of the implementation of the programme and study methods using a non-randomised single-group study design. Australian Aboriginal children and their siblings aged 5-13 years were recruited within regional New South Wales, Australia. The primary outcomes for feasibility included recruitment rates of children and Aboriginal programme mentors, compliance rates of outcome data collection and of the planned programme activities, programme attendance, retention rates and mean enjoyment scores. Follow-up yarning circles were conducted with the children, their parents/caregivers, programme mentors and teachers to explore aspects of feasibility, and areas for improvement. RESULTS A total of 90 caregivers consented to their children (n = 111) being part of the research. Sixteen Aboriginal mentors were recruited to deliver the programmes across the communities. Overall, 74.4% of all health outcome measures were completed across baseline (86.5%) and follow-up (55.9%). Only 61.0% of the programme activities were delivered as originally planned. The average programme attendance rate was 70.0% with a 92.0% retention rate. Eighty-nine percent of children reported a high level of enjoyment with the programmes. Follow-up yarning identified the importance of relational methodologies and flexibility within the programme design and implementation to ensure programmes were adapted to the local community, conditions and differing age groups. Considerations for future programmes included the timing of the programme and identifying health outcome assessment tools and methods that acknowledge cultural protocols and experiences. CONCLUSIONS Engaging the communities in the development, implementation and evaluation of the programmes were key to community support of the programme and conducting the feasibility study. Future programmes and evaluations need to be built on strong partnerships and embrace flexible and culturally embedded methodologies in order to be adaptive and responsive to research approaches, communities and to Country. TRIAL REGISTRATION ACTRN12619001224112. Retrospectively registered on 05 September 2019.
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Affiliation(s)
- Rebecca M Stanley
- Early Start, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, NSW, 2522, Australia.
- Illawarra Health and Medical Research Institute, Wollongong, NSW, 2500, Australia.
- School of Health and Society, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, NSW, 2522, Australia.
| | - Anthony McKnight
- School of Education, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, NSW, 2522, Australia
| | - Yasmine Probst
- Illawarra Health and Medical Research Institute, Wollongong, NSW, 2500, Australia
- Faculty of Health, Southern Cross University, Gold Coast Campus, Bilinga, QLD, 4225, Australia
| | - Gabrielle O'Flynn
- School of Education, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, NSW, 2522, Australia
| | - Sarah Tillott
- Faculty of Health, Southern Cross University, Gold Coast Campus, Bilinga, QLD, 4225, Australia
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Jordan KA, Mackintosh KA, Davies GA, Griffiths CJ, Lewis PD, McNarry MA. Perceptions surrounding the possible interaction between physical activity, pollution and asthma in children and adolescents with and without asthma. BMC Public Health 2023; 23:2416. [PMID: 38053057 PMCID: PMC10696824 DOI: 10.1186/s12889-023-17174-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 11/07/2023] [Indexed: 12/07/2023] Open
Abstract
A cornerstone of asthma management is maintaining physical activity (PA), but this may lead to increased exposure to, and deeper inhalation of, pollutants. Furthermore, children and adolescents may be more susceptible to the deleterious impacts of such exposures. Despite the recent air quality campaigns and media coverage surrounding the dangers of air pollution to respiratory health, few target children and their understanding of such issues.Using semi structured interviews, understanding of PA, air pollution and their interaction was explored with 25 youth aged 7-17 years. Utilising NVIVO 12 software, an atheoretical, inductive thematic analysis was conducted to identify key themes which were subsequently presented as pen profiles with the number of common responses within a theme indicative of its strength.The majority (88%) of youth's indicated traffic-related air pollution and global manufacturing as key sources of air pollution. Whilst all youths were aware of outdoor pollution, only 52% were aware of indoor air pollutants, of which 62% had asthma. Despite some uncertainty, all youths described pollution in a negative fashion, with 52% linking air pollution to undesirable effects on health, specifically respiratory health. PA in a polluted area was thought to be more dangerous than beneficial by 44%, although 24% suggested the benefits of PA would outweigh any detriment from pollution.Youth are aware of, and potentially compensate for, the interaction between air pollution and PA. Strategies are needed to allow youth to make more informed decisions regarding how to promote PA whilst minimising exposure to air pollution.
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Affiliation(s)
- Kathryn A Jordan
- Department of Sport and Health Sciences, Applied Sports, Technology, Exercise and Medicine (A-STEM) Research Centre, Swansea University, Swansea, Wales, UK
| | - Kelly A Mackintosh
- Department of Sport and Health Sciences, Applied Sports, Technology, Exercise and Medicine (A-STEM) Research Centre, Swansea University, Swansea, Wales, UK
| | - Gwyneth A Davies
- Swansea University Medical School, Swansea University, Swansea, Wales, UK
| | - Chris J Griffiths
- Barts Institute of Population Health Sciences, Queen Mary University of London, London, UK
| | - Paul D Lewis
- School of Management, Swansea University and Vindico ICS, Swansea, UK
| | - Melitta A McNarry
- Department of Sport and Health Sciences, Applied Sports, Technology, Exercise and Medicine (A-STEM) Research Centre, Swansea University, Swansea, Wales, UK.
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Domingo A, Yessis J, Charles KA, Skinner K, Hanning RM. Integrating knowledge and action: learnings from an implementation program for food security and food sovereignty with First Nations communities within Canada. Implement Sci 2023; 18:34. [PMID: 37573323 PMCID: PMC10422772 DOI: 10.1186/s13012-023-01291-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 07/31/2023] [Indexed: 08/14/2023] Open
Abstract
BACKGROUND Collaborative approaches to knowledge translation (KT) are important for advancing community-engaged research. However, there is a need for examples of participatory approaches that have effectively supported public health research, program development, and implementation with First Nations communities. To strengthen KT with communities, we proposed a set of guiding principles for participatory planning and action for local food system change. Principles emerged from a cross-community analysis of Learning Circles: Local Healthy Food to School (LC:LHF2S) a participatory program (2015-2019) for Indigenous food system action. The objective was to identify guiding principles for participatory planning and action from key learnings and successes on scaling-up of the Learning Circles (LC) model vertically in Haida Nation, British Columbia (BC), and horizontally in three distinct community contexts: Gitxsan Nation, Hazelton /Upper Skeena, BC; Ministikwan Lake. The application of these principles is discussed in the context of our ongoing partnership with Williams Treaties First Nations to support community planning to enhance food security and sovereignty. METHODS A cross-community thematic analysis was conducted and guided by an implementation science framework, Foster-Fishman and Watson's (2012) ABLe Change Framework, to identify key learnings and successes from adapting the LC approach. Information gathered from interviews (n = 55) and meeting reports (n = 37) was thematically analyzed to inform the development of guiding principles. Community sense-making of findings informed applicability in a new community context embarking on food systems work. RESULTS Emergent guiding principles for participatory food system planning and action are described within four main areas: (1) create safe and ethical spaces for dialog by establishing trust and commitment from the ground up, (2) understand the context for change through community engagement, (3) foster relationships to strengthen and sustain impact, and (4) reflect and embrace program flexibility to integrate learnings. CONCLUSIONS Emergent principles offer guidance to supporting Indigenous community-led research and mobilization of knowledge into action. Principles are intended to support researchers and health system administrators with taking a collaborative approach that fosters relationships and integration of community leadership, knowledge, and action for food system change. Application of principles with implementation frameworks can strengthen KT in Indigenous contexts by incorporating community protocols and perspectives in support of Indigenous self-determined priorities.
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Affiliation(s)
- Ashleigh Domingo
- Faculty of Health, School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada.
| | - Jennifer Yessis
- Faculty of Health, School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada
| | | | - Kelly Skinner
- Faculty of Health, School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada
| | - Rhona M Hanning
- Faculty of Health, School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada
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Laurisz N, Ćwiklicki M, Żabiński M, Canestrino R, Magliocca P. Co-Creation in Health 4.0 as a New Solution for a New Era. Healthcare (Basel) 2023; 11:healthcare11030363. [PMID: 36766938 PMCID: PMC9913923 DOI: 10.3390/healthcare11030363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 01/14/2023] [Accepted: 01/20/2023] [Indexed: 02/03/2023] Open
Abstract
Previous research on co-creation in healthcare indicates that the use of co-creation in the design process of health solutions influences their greater acceptance and adaptation, resulting in greater efficiency of health services and higher usability of implemented health solutions. Analysis of adaptation and acceptance of new technologies reveals the problem of misunderstanding and the need for more trust in modern tools implemented in the healthcare system. The remedy may be the use of co-creation in the process of developing modern medical products and services. This article's main purpose is to explore the co-creation process in Health 4.0, which is understood as the development of healthcare through the application of methods and tools of the Fourth Industrial Revolution. The literature review provided insights for an analytical framework-the co-creation matrix. We analyzed the case of the Italian medical platform Paginemediche.it to reveal the actors' engagement in co-creation. The results demonstrated different levels of engagement in improving the efficiency of implementing medical and technological solutions. Both theoretical and practical analysis proved that the co-creation matrix helps more precisely define the scale and scope of co-creation in Health 4.0.
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Affiliation(s)
- Norbert Laurisz
- Department of Public Management, Cracow University of Economics; 31-510 Krakow, Poland
- Correspondence: ; Tel.: +48-12-293-5963
| | - Marek Ćwiklicki
- Department of Public Management, Cracow University of Economics; 31-510 Krakow, Poland
| | - Michał Żabiński
- Department of Public Management, Cracow University of Economics; 31-510 Krakow, Poland
| | - Rossella Canestrino
- Department of Management and Quantitative Studies, Parthenope University of Naples, 80133 Naples, Italy
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Bonin L, Levasseur-Puhach S, Guimond M, Gabbs M, Wicklow B, Vandenbroeck B, Copenace S, Delaronde M, Mosienko L, McGavock J, Katz LY, Roos LE, Diffey L, Dart A. Walking in two worlds with type 2 diabetes: a scoping review of prevention and management practices incorporating traditional indigenous approaches. Int J Circumpolar Health 2022; 81:2141182. [DOI: 10.1080/22423982.2022.2141182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Lynette Bonin
- University of Manitoba, Faculty of Arts, Department of Psychology Winnipeg, Manitoba Canada
| | - Sydney Levasseur-Puhach
- University of Manitoba, Faculty of Arts, Department of Psychology Winnipeg, Manitoba Canada
- Children’s Hospital Research Institute of Manitoba, and DREAM Theme, Diabetes Research Envisioned and Accomplished in Manitoba, Winnipeg, Manitoba, Canada
| | - Michelle Guimond
- Children’s Hospital Research Institute of Manitoba, and DREAM Theme, Diabetes Research Envisioned and Accomplished in Manitoba, Winnipeg, Manitoba, Canada
| | - Melissa Gabbs
- Children’s Hospital Research Institute of Manitoba, and DREAM Theme, Diabetes Research Envisioned and Accomplished in Manitoba, Winnipeg, Manitoba, Canada
- University of Manitoba, Max Rady College of Medicine, Department of Pediatric and Child Health, Winnipeg, Manitoba, Canada
| | - Brandy Wicklow
- Children’s Hospital Research Institute of Manitoba, and DREAM Theme, Diabetes Research Envisioned and Accomplished in Manitoba, Winnipeg, Manitoba, Canada
- University of Manitoba, Max Rady College of Medicine, Department of Pediatric and Child Health, Winnipeg, Manitoba, Canada
| | - Belinda Vandenbroeck
- University of Manitoba, Faculty of Arts, Department of Psychology Winnipeg, Manitoba Canada
| | - Sherry Copenace
- University of Manitoba, Faculty of Arts, Department of Psychology Winnipeg, Manitoba Canada
| | - Meagan Delaronde
- Children’s Hospital Research Institute of Manitoba, and DREAM Theme, Diabetes Research Envisioned and Accomplished in Manitoba, Winnipeg, Manitoba, Canada
| | - Lucas Mosienko
- Children’s Hospital Research Institute of Manitoba, and DREAM Theme, Diabetes Research Envisioned and Accomplished in Manitoba, Winnipeg, Manitoba, Canada
| | - Jonathan McGavock
- Children’s Hospital Research Institute of Manitoba, and DREAM Theme, Diabetes Research Envisioned and Accomplished in Manitoba, Winnipeg, Manitoba, Canada
- University of Manitoba, Max Rady College of Medicine, Department of Pediatric and Child Health, Winnipeg, Manitoba, Canada
| | - Laurence Y. Katz
- University of Manitoba, Max Rady College of Medicine, Department of Psychiatry, Winnipeg, Manitoba, Canada
| | - Leslie E. Roos
- University of Manitoba, Faculty of Arts, Department of Psychology Winnipeg, Manitoba Canada
- Children’s Hospital Research Institute of Manitoba, and DREAM Theme, Diabetes Research Envisioned and Accomplished in Manitoba, Winnipeg, Manitoba, Canada
| | - Linda Diffey
- Children’s Hospital Research Institute of Manitoba, and DREAM Theme, Diabetes Research Envisioned and Accomplished in Manitoba, Winnipeg, Manitoba, Canada
- University of Manitoba, Max Rady College of Medicine, Department of Community Health Sciences, Winnipeg, Manitoba, Canada
| | - Allison Dart
- Children’s Hospital Research Institute of Manitoba, and DREAM Theme, Diabetes Research Envisioned and Accomplished in Manitoba, Winnipeg, Manitoba, Canada
- University of Manitoba, Max Rady College of Medicine, Department of Pediatric and Child Health, Winnipeg, Manitoba, Canada
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Cultural Greenspaces: Synthesizing Knowledge and Experience in Nova Scotia’s African-Canadian Communities through Participatory Research and SoftGIS. SOCIAL SCIENCES-BASEL 2022. [DOI: 10.3390/socsci11070281] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Greenspaces are integral components of communities and provide numerous benefits. However, human development threatens these spaces, particularly in communities of color where histories of racial injustice persist and environmental vulnerabilities remain. A step towards preventing the loss of important cultural greenspaces is documenting knowledge and experience. This research employed community-based participatory techniques to study the relationship between the landscape and African-Canadian communities around Preston, Nova Scotia, the oldest and largest in Canada. Community-directed meetings created collaborative-based knowledge about perceptions surrounding land use change while identifying valued greenspaces. This paper studies the relationships between the community’s greenspaces and the benefits to psychological, social, and physical aspects of human wellbeing. This relationship is operationalized through the use of a public participation geographic information system (PPGIS), SoftGIS, which activates the greenspace–human wellbeing relationship through interaction and its map-based survey data collection. Results indicate residents predominately visited greenspaces near a church or community center for social wellbeing benefits to interact with neighbors and friends, to cookout, or to bring children outside. This research contributes to a greater understanding of the Preston area’s greenspace identification and qualification, resident behavior, and cultural perspectives to inform strategies and goals for engaging government agencies surrounding policy and land use planning. This research illustrates frameworks for improving building capacity and promoting racial equity within the urbanization process in other communities.
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The essential conditions needed to implement the Indigenous Youth Mentorship Program: a focused ethnography. BMC Public Health 2022; 22:213. [PMID: 35105323 PMCID: PMC8808991 DOI: 10.1186/s12889-021-12412-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 12/08/2021] [Indexed: 11/15/2022] Open
Abstract
Background The Indigenous Youth Mentorship Program (IYMP) is a 20-week communal, relationship-based afterschool healthy living program for Indigenous youth in Canada. IYMP embraces the Anishnaabe/Nehiyawak concepts of Mino-Bimaadiziwin/miyo-pimâtisiwin (“living in a good way”) via its core components of physical activities/games, healthy snacks, and relationship-building. A strength of IYMP is that it values autonomy, adaptability, and the school community context. However, this presents challenges when evaluating its implementation, given that traditional implementation science methods tend to oversimplify the process. In response, essential conditions for the implementation of school-based healthy living programs across diverse contexts have been developed. The purpose of this research was to understand the applicability of these essential conditions within the context of IYMP. Methods 15 participants (n = 10 Young Adult Health Leaders; n = 5 coordinators) with experience implementing IYMP in the provinces of Alberta, Saskatchewan, Manitoba, and Quebec were purposefully sampled. Focused ethnography was the guiding method and one-on-one semi-structured interviews were used as the data generation strategy. The purpose of the interviews was to understand what conditions are needed to implement IYMP. The interview guide was based on previously established essential conditions developed by the research team. Interviews were audio-recorded and transcribed, and content analysis was used to identify patterns in the data. Results The overarching theme that emerged from the interviews was the applicability of the essential conditions when implementing IYMP. Participants felt the eight core conditions (students as change agents, school/community-specific autonomy, demonstrated administrative leadership, higher-level support, dedicated champion(s) to engage school community, community support, quality and use of evidence, and professional development) and four contextual conditions (time, funding and project support, readiness and understanding, and prior community connectivity) were necessary, but made suggestions to modify two conditions (youth led and learning opportunities) to better reflect their experiences implementing IYMP. In addition, a new core condition, rooted in relationship, emerged as necessary for implementation. Conclusions This research adds to the literature by identifying and describing what is needed in practice to implement a communal, relationship-based afterschool healthy living program. The essential conditions may support other researchers and communities interested in implementing and rippling similar programs. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-12412-1.
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Ko LK, Scarinci IC, Bouchard EG, Drake BF, Rodriguez EM, Chen MS, Kepka D, Kruse-Diehr AJ, Befort C, Shannon J, Farris PE, Trentham-Dietz A, Onega T. OUP accepted manuscript. JNCI Cancer Spectr 2022; 6:6529549. [PMID: 35603844 PMCID: PMC8997116 DOI: 10.1093/jncics/pkac017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 12/29/2021] [Accepted: 01/05/2022] [Indexed: 11/24/2022] Open
Abstract
Rural populations continue to experience persistent cancer disparities compared with urban populations particularly in cancers that can be prevented or detected early through screening and vaccination. Although the National Cancer Institute and the larger cancer research community have identified rural community partnerships as the foundation for reducing the disparities, we have identified limited application of community-based participatory research in cancer prevention and control research. Guided by the Community-Based Participatory Research Conceptual Model and our collective experience, we provide a framework for a community–cancer center partnership that focuses on promoting health equity. In this commentary, we articulate that the partnership process must foster capacity for communities and cancer centers, strive for rural representation in clinical trials and biobanking, build a pipeline for dissemination and implementation research, and create a bidirectional flow of knowledge between communities and academic institutions. Authentic partnerships with rural communities should be the ultimate goal of cancer centers, and the process described in this commentary can serve as an initial platform to build capacity and continue to strive toward that goal.
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Affiliation(s)
- Linda K Ko
- Department of Health Systems and Population Health, University of Washington, Hans Rosling Center for Population Health, Seattle, WA, USA
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Correspondence to: Linda K. Ko, PhD, Department of Health Systems and Population Health, University of Washington, Hans Rosling Center for Population Health, 3980 15th Ave NE, UW Mailbox 351621, Seattle, WA 98195, USA (e-mail: )
| | - Isabel C Scarinci
- Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Elizabeth G Bouchard
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Bettina F Drake
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, Alvin J. Siteman Cancer Center, St. Louis, MO, USA
| | - Elisa M Rodriguez
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Moon S Chen
- Division of Hematology and Oncology, School of Medicine, UC Davis and UC Davis Comprehensive Cancer Center, Sacramento, CA, USA
| | - Deanna Kepka
- College of Nursing, University of Utah, Huntsman Cancer Institute, Salt Lake City, UT, USA
| | - Aaron J Kruse-Diehr
- Markey Cancer Center, Cancer Prevention and Control Program, University of Kentucky College of Public Health, Lexington, KY, USA
| | - Christie Befort
- University of Kansas Medical Center, Cancer Prevention and Control, University of Kansas Cancer Center, Kansas City, KS, USA
| | - Jackilen Shannon
- Oregon Health & Science University-Portland State University School of Public Health, Knight Cancer Institute, Portland, OR, USA
| | - Paige E Farris
- Oregon Health & Science University-Portland State University School of Public Health, Knight Cancer Institute, Portland, OR, USA
| | - Amy Trentham-Dietz
- Department of Population Health Sciences and Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI, USA
| | - Tracy Onega
- Department of Population Health Sciences, University of Utah, Huntsman Cancer Institute, Salt Lake City, UT, USA
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Stotz SA, McNealy K, Begay RL, DeSanto K, Manson SM, Moore KR. Multi-level Diabetes Prevention and Treatment Interventions for Native People in the USA and Canada: a Scoping Review. Curr Diab Rep 2021; 21:46. [PMID: 34743261 PMCID: PMC8572533 DOI: 10.1007/s11892-021-01414-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/02/2021] [Indexed: 10/26/2022]
Abstract
PURPOSE OF REVIEW This scoping literature review seeks to answer the question "What is known in the existing literature about multi-level diabetes prevention and treatment interventions for Native people living in the United States and Canada?" RECENT FINDINGS Multi-level interventions to prevent and/or treat chronic diseases, such as diabetes, promise to help individuals who experience health disparities related to social determinants of health. As described by the socio-ecological model, such interventions mobilize support through a combination of individual, interpersonal, organizational, community, and policy levels of activity. This review revealed little literature about multi-level diabetes prevention and/or treatment programs for US and Canada-based Native peoples. Ten interventions were identified; all focused on diabetes prevention; eight were specific to youth. Multi-level intervention design elements were largely individual-, school-, and community-based. Only three interventions included environmental or policy-level components.
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Affiliation(s)
- Sarah A. Stotz
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, 13055 East 17thAve, Aurora, CO 80045 USA
| | | | - Rene L. Begay
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, 13055 East 17thAve, Aurora, CO 80045 USA
| | - Kristen DeSanto
- Strauss Health Sciences Library, University of Colorado Anschutz Medical Campus, 13055 East 17th Ave, Aurora, CO 80045 USA
| | - Spero M. Manson
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, 13055 East 17thAve, Aurora, CO 80045 USA
| | - Kelly R. Moore
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, 13055 East 17thAve, Aurora, CO 80045 USA
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Key performance indicators of cooperative planning processes: Case study results from German sport science and physical activity promotion projects. GERMAN JOURNAL OF EXERCISE AND SPORT RESEARCH 2021. [DOI: 10.1007/s12662-021-00745-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Abstract
Objective
The aim of this study was to map the phases and individual steps of the cooperative planning process, a specific participatory approach frequently used in German sports and physical activity promotion, and to explore facilitators, barriers, and challenges experienced by those leading its implementation in selected projects.
Background
More than half of the global population is not physically active enough. Therefore, the demand for more effective physical activity programs is growing. Participatory-based interventions, using the cooperative planning process, offer the potential to plan new programs that match population group and setting characteristics. This approach was extensively applied in German sports and physical activity fields, serving as a mechanism to develop and implement specific measures to change the population’s behaviour. We analysed four German empirical projects promoting sports and physical activity to identify how the approach was adapted to each project, which phases were considered, and which key performance indicators enhanced (facilitators), exacerbated (barriers), or challenged the process.
Methods
This study used a mixed-methods approach, including a systematic analysis of documents (n = 10) and in-depth, semi-structured interviews (n = 4) with the empirical projects’ scientific members.
Results
The cooperative planning process was shaped across its phases by several facilitators, challenges, and barriers. Diverse assessment procedures and recruitment tools can facilitate preparation of the process, while moderation requires particular attention during the development phase. Identifying a champion in the transition subphase and providing ongoing scientific counselling can assure the implementation of an action plan with tailored measures for sports and physical activity promotion.
Conclusions
This study contributes to a better understanding of the complexity of the cooperative planning approach and, therefore, flexibility in sports and physical activity promotion projects. Many preparation actions, several challenges in the planning process, and a critical transition in implementation responsibilities should be considered by future projects intending to adopt the approach.
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Lopresti S, Willows ND, Storey KE, McHugh TLF. Indigenous Youth Mentorship Program: key implementation characteristics of a school peer mentorship program in Canada. Health Promot Int 2021; 36:913-923. [PMID: 33166996 DOI: 10.1093/heapro/daaa090] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The Indigenous Youth Mentorship Program (IYMP) is a peer-led health promotion program developed for elementary school students in Indigenous school communities in Canada. A local young adult health leader (YAHL) and high school mentors offer students healthy snacks, physical activity games, relationship building activities and cultural teachings. IYMP aims to improve children's health and wellbeing and empower Indigenous youth and communities. The purpose of this focused ethnography was to describe the key characteristics of successful IYMP delivery. Two focus groups were conducted with 16 participants (8 YAHLS and 8 youth mentors) from 7 schools followed by 4 individual interviews (3 YAHLs, 1 youth peer mentor). Transcripts were analyzed using content analysis. Findings were triangulated with IYMP program field observations and notes from IYMP national team meetings. The five characteristics identified as important for IYMP delivery were a sense of ownership by those delivering the program, inclusion of Indigenous Elders/knowledge keepers, establishing trusting relationships, open communication among all stakeholder groups, including community and academic partners, and adequate program supports in the form of program funding, manuals that described program activities, and local and national gatherings between academic and community partners for sharing ideas about the program and its components. This study indicates the importance of respectful partnerships between community and academic leads for program success and sustainability. As IYMP is implemented in more communities and becomes community autonomous, program sustainability may be ensured and implementation challenges mitigated by embedding the identified five essential characteristics within the fabric of IYMP.
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Affiliation(s)
- Sabrina Lopresti
- Faculty of Agricultural, Life & Environmental Sciences, University of Alberta, 11405 87 Avenue, Edmonton, Alberta, Canada T6G 2P5
| | - Noreen D Willows
- Faculty of Agricultural, Life & Environmental Sciences, University of Alberta, 11405 87 Avenue, Edmonton, Alberta, Canada T6G 2P5
| | - Kate E Storey
- School of Public Health, University of Alberta, 8303 - 112 Street, Edmonton, Alberta, Canada T6G 2P5
| | - Tara-Leigh F McHugh
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, 1-111 University Hall, Edmonton, Alberta, Canada T6G 2P5
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14
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Johnston R, Norman J, Furber S, Parkinson J. The barriers and enablers to implementing the NSW Healthy School Canteen Strategy in secondary schools in the Illawarra and Shoalhaven region - A qualitative study. Health Promot J Austr 2021; 33:686-695. [PMID: 34382275 DOI: 10.1002/hpja.528] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 07/20/2021] [Accepted: 08/08/2021] [Indexed: 11/11/2022] Open
Abstract
ISSUE ADDRESSED In 2017, the New South Wales Healthy School Canteen Strategy (Strategy) was introduced into primary and secondary schools. Studies have reported that secondary schools have a lower level of compliance with healthy canteen policies compared with primary schools. This study aims to identify and describe the barriers and enablers to implementing the Strategy in Department of Education (DoE) secondary schools in the Illawarra and Shoalhaven regions. METHODS The framework underpinning the study was the systems theory. Canteen managers (CM) and principals from the 21 DoE secondary schools in the Illawarra and Shoalhaven regions were invited to participate in semi-structured interviews. The interviews were structured around the five focus areas of the Strategy, including questions on school nutrition policies and the role of the canteen. Data were collated using the interview guides as a framework and qualitative content analysis, using manual coding, was undertaken. RESULTS Eight (38%) schools participated with seven CMs and six principals interviewed. Barriers to implementing the Strategy included the changing role of the canteen, the increased demands placed on CMs and inconsistencies between the school food environment and the Strategy. Enablers included monitoring implementation, and internal and external support. This study also recognised that previously identified barriers to healthy canteen strategy implementation are ongoing. CONCLUSIONS The school canteen is an integral part of the school environment and therefore needs whole-of-school support if successful implementation of the Strategy is to occur. SO WHAT Addressing the barriers and promoting the enablers identified in this study will support better nutrition policy implementation in secondary schools.
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Affiliation(s)
- Rosi Johnston
- Health Promotion Service, Illawarra Shoalhaven Local Health District, Warrawong, NSW, 2502, Australia
| | - Jennifer Norman
- Health Promotion Service, Illawarra Shoalhaven Local Health District, Warrawong, NSW, 2502, Australia.,Illawarra Health and Medical Research Institute, Wollongong, NSW, 2522, Australia.,Early Start, University of Wollongong, NSW, 2522, Australia
| | - Susan Furber
- Health Promotion Service, Illawarra Shoalhaven Local Health District, Warrawong, NSW, 2502, Australia.,Illawarra Health and Medical Research Institute, Wollongong, NSW, 2522, Australia.,Early Start, University of Wollongong, NSW, 2522, Australia
| | - Julie Parkinson
- Health Promotion Service, Illawarra Shoalhaven Local Health District, Warrawong, NSW, 2502, Australia
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15
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Lopresti S, Willows ND, Storey KE, McHugh TLF. Indigenous Youth Mentorship Program: essential characteristics of a Canadian multi-site community-university partnership with Indigenous communities. Health Promot Int 2021; 37:6278427. [PMID: 34010391 DOI: 10.1093/heapro/daab039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The Indigenous Youth Mentorship Program (IYMP) is a peer-led health promotion program grounded in the teachings of Indigenous scholars. IYMP is delivered as a multi-sited community-university partnership (CUP) with Indigenous communities across Canada for elementary students. A local young adult health leader and high school youth mentors offer students healthy snacks, physical activity games, relationship building activities and traditional cultural teachings. IYMP aims to improve children's health and wellbeing and empower Indigenous youth and communities. The purpose of this descriptive qualitative study was to describe the essential characteristics of this multi-sited CUP as perceived by the IYMP principal investigators (PIs). Key informant interviews were conducted with 5 IYMP PIs (2 Indigenous) and analysed using content analysis. The overarching theme was forming a community of practice (CoP), where people with a common interest share best practices as they interact regularly. Four sub-themes were shared interest for Indigenous health/wellbeing and social justice, relationships, mentorship and taking a decolonizing research approach. The IYMP CoP allowed mentorship to occur across regions. The essential characteristics that made the IYMP CUPs successful could be used to inform other multi-sited CUPs with Indigenous communities. Those with mutual interests in Indigenous health and partnership with Indigenous communities could consider forming a CoP. Within a newly formed CoP, relationships and mentorship can be developed through discussion and activities. It is imperative within the CoP to take a decolonizing approach to research and acknowledge the impact that colonial policies and practices have had on generations of Indigenous peoples.
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Affiliation(s)
- Sabrina Lopresti
- Department of Agricultural, Food & Nutritional Science, Faculty of Agricultural, Life & Environmental Sciences, University of Alberta, 4-378 Edmonton Clinic Health Academy, Mailbox #54, 11405 87 Avenue, Edmonton, AB T6G 2P5, Canada
| | - Noreen D Willows
- Department of Agricultural, Food & Nutritional Science, Faculty of Agricultural, Life & Environmental Sciences, University of Alberta, 4-378 Edmonton Clinic Health Academy, Mailbox #54, 11405 87 Avenue, Edmonton, AB T6G 2P5, Canada
| | - Kate E Storey
- School of Public Health, University of Alberta, 4-378 Edmonton Clinic Health Academy, Mailbox #54, 11405 87 Avenue, Edmonton, AB T6G 2P5, Canada
| | - Tara-Leigh F McHugh
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, 4-378 Edmonton Clinic Health Academy, Mailbox #54, 11405 87 Avenue, Edmonton, AB T6G 2P5, Canada
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16
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Spagnolo J, Gautier L, Seppey M, D'souza NA. Re-thinking global and public health projects during the COVID-19 pandemic context: Considerations and recommendations for early- and not-so-early-career researchers. SOCIAL SCIENCES & HUMANITIES OPEN 2020; 2:100075. [PMID: 34173503 PMCID: PMC7577678 DOI: 10.1016/j.ssaho.2020.100075] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 09/25/2020] [Accepted: 10/17/2020] [Indexed: 11/24/2022]
Abstract
This commentary aims to provide a glimpse into some of the early and continuing impacts of the COVID-19 pandemic on our global and public health projects: research in low-resourced settings; research with vulnerable populations, such as asylum seekers, Indigenous communities, children, and mental health service users; and research with healthcare professionals, frontline workers, and health planners. In the early context of restrictions caused by COVID-19, this commentary highlights our research setbacks and challenges, and the ways in which we are adapting research methodologies, while considering ethical implications related to the pandemic and their impacts on conducting global and public health research. As we learn to become increasingly aware of some of our limitations in the face of the pandemic, some positives are also worth highlighting: we are mobilizing our training and research skills to participate in COVID-19 projects and to disseminate knowledge on COVID-19, including through papers such as this one. However, we do acknowledge that these opportunities have not been equitable. Each thematic section of this commentary concludes with key recommendations related to research in the early and continuing context of the COVID-19 pandemic that we believe to be applicable to early- and not-so-early-career researchers working in the global and public health fields.
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Affiliation(s)
- Jessica Spagnolo
- Département des sciences de la santé communautaire, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Canada
- Centre de recherche Charles-Le-Moyne-Saguenay-Lac-St-Jean sur les innovations en santé, Campus de Longueuil, Université de Sherbrooke, Canada
| | - Lara Gautier
- Département de Gestion, Évaluation et Politique de Santé, École de Santé Publique, Université de Montréal, Canada
- Centre de recherche en santé publique, Université de Montréal et CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Canada
- Department of Sociology McGill University, Canada
| | - Mathieu Seppey
- Centre de recherche en santé publique, Université de Montréal et CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Canada
- Département de Médecine Sociale et Préventive, École de Santé Publique, Université de Montréal, Canada
| | - Nicole Anne D'souza
- Division of Social & Transcultural Psychiatry, Department of Psychiatry, McGill University, Canada
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David JL, Thomas SL, Randle M, Pitt H, Daube M. Parent and child perceptions of gambling promotions in Australian sport. Health Promot Int 2020; 35:362-372. [PMID: 30982902 DOI: 10.1093/heapro/daz028] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Gambling is recognized as a significant public health problem. However, there is little research exploring community attitudes towards gambling and the development of advocacy initiatives. Engaging adults and young people in advocacy efforts is recognized as being beneficial to the successful implementation of harm prevention and reduction strategies. This study explored the attitudes of young people and their parents towards the alignment of gambling with sport, and the strategies they perceive could be used to prevent and reduce gambling related harm. Using a Constructivist Grounded Theory approach, 30 family groups from Melbourne, Australia participated in semi-structured interviews. Parents and young people were asked about gambling and its promotion, alignment with sporting codes, the potential impact on young people and strategies that may prevent or reduce gambling harm. Thematic analysis was undertaken to interpret the data. The sample comprised 29 parents, one grandparent and 48 young people. Themes emerging from the data related to the use of imagery and appeal strategies in advertisements, the normalization of betting in advertisements and the alignment of betting with sport. Parents and young people also identified a number of potential gambling harm prevention and reduction initiatives. Parents and young people were able to describe a range of strategies used by gambling companies to promote their products, understand the potential impact of these strategies, and recommend strategies to reduce harm. Given this level of understanding there is clearly an opportunity to engage young people and stakeholders in advocacy initiatives aimed at reducing and preventing gambling harm.
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Affiliation(s)
- Jennifer L David
- Centre for Population Health Research, Faculty of Health, Deakin University, Geelong, VIC, Australia
| | - Samantha L Thomas
- Centre for Population Health Research, Faculty of Health, Deakin University, Geelong, VIC, Australia
| | - Melanie Randle
- School of Management, Operations and Marketing, Faculty of Business, University of Wollongong, Wollongong, NSW, Australia
| | - Hannah Pitt
- Centre for Population Health Research, Faculty of Health, Deakin University, Geelong, VIC, Australia
| | - Mike Daube
- Faculty of Health Sciences, Curtin University, Perth, WA, Australia
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18
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Levac L, Ronis S, Cowper‐Smith Y, Vaccarino O. A scoping review: The utility of participatory research approaches in psychology. JOURNAL OF COMMUNITY PSYCHOLOGY 2019; 47:1865-1892. [PMID: 31441516 PMCID: PMC6852237 DOI: 10.1002/jcop.22231] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 06/11/2019] [Accepted: 07/24/2019] [Indexed: 05/31/2023]
Abstract
Consistent with community psychology's focus on addressing societal problems by accurately and comprehensively capturing individuals' relationships in broader contexts, participatory research approaches aim to incorporate individuals' voices and knowledge into understanding, and responding to challenges and opportunities facing them and their communities. Although investigators in psychology have engaged in participatory research, overall, these approaches have been underutilized. The purpose of this review was to examine areas of research focus that have included participatory research methods and, in turn, highlight the strengths and ways that such methods could be better used by researchers. Nearly 750 articles about research with Indigenous Peoples, children/adolescents, forensic populations, people with HIV/AIDS, older adults, and in the area of industrial-organizational psychology were coded for their use of participatory research principles across all research stages (i.e., research design, participant recruitment and data collection, analysis and interpretation of results, and dissemination). Although we found few examples of studies that were fully committed to participatory approaches to research, and notable challenges with applying and reporting on this type of work, many investigators have developed creative ways to engage respectfully and reciprocally with participants. Based on our findings, recommendations and suggestions for researchers are discussed.
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Affiliation(s)
- Leah Levac
- Department of Political ScienceUniversity of GuelphGuelphONCanada
| | - Scott Ronis
- Department of PsychologyUniversity of New BrunswickFrederictonNBCanada
| | - Yuriko Cowper‐Smith
- Political Science and International DevelopmentUniversity of GuelphGuelphONCanada
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Harris J, Haltbakk J, Dunning T, Austrheim G, Kirkevold M, Johnson M, Graue M. How patient and community involvement in diabetes research influences health outcomes: A realist review. Health Expect 2019; 22:907-920. [PMID: 31286639 PMCID: PMC6803418 DOI: 10.1111/hex.12935] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 05/24/2019] [Accepted: 05/26/2019] [Indexed: 11/30/2022] Open
Abstract
Background Patient and public involvement in diabetes research is an international requirement, but little is known about the relationship between the process of involvement and health outcomes. Objective This realist review identifies who benefits from different types of involvement across different contexts and circumstances. Search strategies Medline, CINAHL and EMBASE were searched to identify interventions using targeted, embedded or collaborative involvement to reduce risk and promote self‐management of diabetes. People at risk/with diabetes, providers and community organizations with an interest in addressing diabetes were included. There were no limitations on date, language or study type. Data extraction and synthesis Data were extracted from 29 projects using elements from involvement frameworks. A conceptual analysis of involvement types was used to complete the synthesis. Main results Projects used targeted (4), embedded (8) and collaborative (17) involvement. Productive interaction facilitated over a sufficient period of time enabled people to set priorities for research. Partnerships that committed to collaboration increased awareness of diabetes risk and mobilized people to co‐design and co‐deliver diabetes interventions. Cultural adaptation increased relevance and acceptance of the intervention because they trusted local delivery approaches. Local implementation produced high levels of recruitment and retention, which project teams associated with achieving diabetes health outcomes. Discussion and Conclusions Achieving understanding of community context, developing trusting relationships across sectors and developing productive partnerships were prerequisites for designing research that was feasible and locally relevant. The proportion of diabetes studies incorporating these elements is surprisingly low. Barriers to resourcing partnerships need to be systematically addressed.
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Affiliation(s)
- Janet Harris
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Johannes Haltbakk
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Trisha Dunning
- Centre for Quality and Patient Safety Research, Deakin University and Barwon Health Partnership, Geelong, Victoria, Australia
| | - Gunhild Austrheim
- Library, Western Norway University of Applied Sciences, Bergen, Norway
| | - Marit Kirkevold
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway.,Department of Nursing Science, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Maxine Johnson
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Marit Graue
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
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20
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Velardo S, Drummond M. Australian children's discourses of health, nutrition and fatness. Appetite 2019; 138:17-22. [PMID: 30880084 DOI: 10.1016/j.appet.2019.03.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 03/08/2019] [Accepted: 03/08/2019] [Indexed: 11/17/2022]
Abstract
Talking to children about their health-related understandings and experiences can provide valuable information for public health practitioners who seek to improve children's dietary behaviours. To date, however, research on children's food consumption has generally prioritized the views of parents and caregivers, rather than children themselves. This paper reports results from a qualitative study that explored preadolescent children's attitudes and perceptions towards health and nutrition. 38 children aged 11-12 years, across three state government schools, took part in an individual interview or group interview. Interviews were recorded, transcribed verbatim and analysed using thematic analysis techniques. Our results indicate that children inextricably linked the concept of health to diet and physical activity. They pondered the connection between different types of foods and physical implications for the body, emphasising nutrition and physical activity as a resource for preventing the onset of chronic disease and specifically the state of 'fatness'. Children collectively overemphasised the correlation between body size and health, and expressed that people should take responsibility for healthy choices to prevent fatness. In their discussions, they referred to aesthetic elements of the body and negative consequences of obesity. Overall, we argue that children's discourses of health and nutrition are potentially problematic. Results suggest that it is important to reshape these ideas to encourage children to develop more positive relationships with food and physical activity.
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Affiliation(s)
- Stefania Velardo
- College of Education, Psychology and Social Work, Flinders University, Adelaide, Australia; Sport, Health, Activity, Performance and Exercise Research Centre, Flinders University, Adelaide, Australia.
| | - Murray Drummond
- College of Education, Psychology and Social Work, Flinders University, Adelaide, Australia; Sport, Health, Activity, Performance and Exercise Research Centre, Flinders University, Adelaide, Australia
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21
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Gray C, Crawford G, Lobo R, Maycock B. Co-Designing an Intervention to Increase HIV Testing Uptake with Women from Indonesia At-Risk of HIV: Protocol for a Participatory Action Research Study. Methods Protoc 2019; 2:E41. [PMID: 31164620 PMCID: PMC6632167 DOI: 10.3390/mps2020041] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 05/20/2019] [Accepted: 05/20/2019] [Indexed: 01/05/2023] Open
Abstract
Early diagnosis is a critical component of the global response to the human immunodeficiency virus (HIV). In Australia, more than two-thirds of women from Southeast Asia are diagnosed late with HIV. There is limited evidence regarding the barriers to HIV testing and which interventions work to increase an uptake among migrants living in high-income countries. This participatory action research (PAR) project will work with women from Indonesia to co-design an intervention to increase HIV testing uptake in Western Australia. The project will involve trained community researchers, representatives from relevant organizations, and community women born in Indonesia. We will conduct three PAR cycles. Phase one will use focus groups to understand enablers for HIV testing among community members. In phase two, data will be presented back to members of the participating communities who will be invited to co-design an intervention to increase HIV testing. The final cycle will focus on implementing and evaluating the resulting intervention. This project will add to the small body of literature on pathways and enablers to HIV testing, and to new insights regarding interventions that work for women from migrant communities and why.
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Affiliation(s)
- Corie Gray
- Collaboration for Evidence, Research and Impact in Public Health, School of Public Health, Curtin University, 6102 Bentley, Australia.
| | - Gemma Crawford
- Collaboration for Evidence, Research and Impact in Public Health, School of Public Health, Curtin University, 6102 Bentley, Australia.
| | - Roanna Lobo
- Collaboration for Evidence, Research and Impact in Public Health, School of Public Health, Curtin University, 6102 Bentley, Australia.
| | - Bruce Maycock
- Collaboration for Evidence, Research and Impact in Public Health, School of Public Health, Curtin University, 6102 Bentley, Australia.
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Pedersen M, Brown B, Harris K, France S, Tryon M, Cooksley A. Rural Parent Support of Child Health Behavior in the Home Environment: A Qualitative Study on an American Indian Reservation. Glob Pediatr Health 2019; 6:2333794X19847451. [PMID: 31106246 PMCID: PMC6506919 DOI: 10.1177/2333794x19847451] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 04/09/2019] [Accepted: 04/09/2019] [Indexed: 01/31/2023] Open
Abstract
Background. Obesity rates are disproportionately high among
rural and American Indian (AI) children. Health behaviors contributing to child
obesity are influenced by parents at home. Engaging parents remains a challenge,
particularly among low-income and ethnic minority families.
Aims. The aim of this study was to learn how AI parents
living on a rural AI reservation support and engage with their children’s
nutrition and physical activity behaviors at home. Methods.
Parents with children ages 6 to 12 years living on one, rural AI reservation
participated. Focus groups and interviews were conducted, using a 14-question
moderator’s guide. A systematic, iterative content analysis was applied to the
transcripts. Results. Twenty-five parents (52% AI or Alaska
Native) participated in 3 focus groups (n = 17) and interviews (n = 8). Themes
related to enhancers included role modeling and whole family and child-initiated
activities. Barriers included resources, child safety concerns, driving
distances, and competing family priorities. Themes related to strategies for
change included opportunities for peer learning from other local families,
creating fun, program support for all supplies and incentives, and incorporation
of storytelling and multicultural activities. Discussion. This
study advances knowledge to promote parental engagement with child health
behavior in the home, including unique themes of inclusiveness, culture-focused,
and intergenerational activities. Conclusion. Results may
inform interventions seeking to engage parents living in rural and AI
reservation communities in home-based child behavior change efforts.
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Affiliation(s)
| | | | | | | | - Mike Tryon
- Summit Medical Fitness Center, Kalispell, MT, USA
| | - Aric Cooksley
- Boys and Girls Club of the Flathead Reservation and Flathead County, Ronan, MT, USA
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Murdoch-Flowers J, Tremblay MC, Hovey R, Delormier T, Gray-Donald K, Delaronde E, Macaulay AC. Understanding how Indigenous culturally-based interventions can improve participants' health in Canada. Health Promot Int 2019; 34:154-165. [PMID: 28973378 DOI: 10.1093/heapro/dax059] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
There is increasing recognition that culturally-based diabetes prevention programs can facilitate the adoption and maintenance of healthy behaviours in the communities in which they are implemented. The Kahnawake School Diabetes Prevention Project (KSDPP) is a health promotion, community-based participatory research project aiming to reduce the incidence of Type 2 diabetes in the community of Kahnawake (Mohawk territory, Canada), with a large range of interventions integrating a Haudenosaunee perspective of health. Building on a qualitative, naturalistic and interpretative inquiry, this study aimed to assess the outcomes of a suite of culturally-based interventions on participants' life and experience of health. Data were collected through semi-structured qualitative interviews of 1 key informant and 17 adult, female Kahnawake community members who participated in KSDPP's suite of interventions from 2007 to 2010. Grounded theory was chosen as an analytical strategy. A theoretical framework that covered the experiences of all study participants was developed from the grounded theory analysis. KSDPP's suite of interventions provided opportunities for participants to experience five different change processes: (i) Learning traditional cooking and healthy eating; (ii) Learning physical activity; (iii) Learning mind focusing and breathing techniques; (iv) Learning cultural traditions and spirituality; (v) Socializing and interacting with other participants during activities. These processes improved participants' health in four aspects: mental, physical, spiritual and social. Results of this study show how culturally-based health promotion can bring about healthy changes addressing the mental, physical, spiritual and social dimensions of a holistic concept of health, relevant to the Indigenous perspective of well-being.
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Affiliation(s)
- Jayne Murdoch-Flowers
- Kahnawake Schools Diabetes Prevention Project, Kahnawake Territory, Kanien'keha, Mohawk Nation, QC, Canada.,School of Dietetics and Human Nutrition, McGill University, Montréal, QC, Canada
| | - Marie-Claude Tremblay
- Department of Family Medicine and Emergency Medicine, Office of Education and Continuing Professional Development, Université Laval, QC, Canada
| | - Richard Hovey
- Kahnawake Schools Diabetes Prevention Project, Kahnawake Territory, Kanien'keha, Mohawk Nation, QC, Canada.,Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montréal, QC, Canada
| | - Treena Delormier
- Kahnawake Schools Diabetes Prevention Project, Kahnawake Territory, Kanien'keha, Mohawk Nation, QC, Canada.,Office of Public Health Studies, University of Hawai'i, Honolulu, HI, USA
| | - Katherine Gray-Donald
- Kahnawake Schools Diabetes Prevention Project, Kahnawake Territory, Kanien'keha, Mohawk Nation, QC, Canada.,School of Dietetics and Human Nutrition, McGill University, Montréal, QC, Canada
| | - Elaine Delaronde
- Kahnawake Schools Diabetes Prevention Project, Kahnawake Territory, Kanien'keha, Mohawk Nation, QC, Canada
| | - Ann C Macaulay
- Kahnawake Schools Diabetes Prevention Project, Kahnawake Territory, Kanien'keha, Mohawk Nation, QC, Canada.,Participatory Research at McGill, Department of Family Medicine, McGill University, Montréal, QC, Canada
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24
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Leask CF, Sandlund M, Skelton DA, Altenburg TM, Cardon G, Chinapaw MJM, De Bourdeaudhuij I, Verloigne M, Chastin SFM. Framework, principles and recommendations for utilising participatory methodologies in the co-creation and evaluation of public health interventions. RESEARCH INVOLVEMENT AND ENGAGEMENT 2019; 5:2. [PMID: 30652027 PMCID: PMC6327557 DOI: 10.1186/s40900-018-0136-9] [Citation(s) in RCA: 169] [Impact Index Per Article: 33.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 12/10/2018] [Indexed: 05/23/2023]
Abstract
PLAIN ENGLISH SUMMARY Background: Society has to cope with a large burden of health issues. There is need to find solutions to prevent diseases and help individuals live healthier lifestyles. Individual needs and circumstances vary greatly and one size fit all solutions do not tend to work well. More tailored solutions centred on individuals' needs and circumstances can be developed in collaboration with these individuals. This process, known as co-creation, has shown promise but it requires guiding principles to improve its effectiveness. The aim of this study was to identify a key set of principles and recommendations for co-creating public health interventions.Methods: These principles were collaboratively developed through analysing a set of case studies targeting different health behaviours (such as reducing sitting and improving strength and balance) in different groups of people (such as adolescent schoolgirls and older adults living in the community).Results: The key principles of co-creation are presented in four stages: Planning (what is the purpose of the co-creation; and who should be involved?); Conducting (what activities can be used during co-creation; and how to ensure buy-in and commitment?); Evaluating (how do we know the process and the outcome are valid and effective?) and Reporting (how to report the findings?). Three models are proposed to show how co-created solutions can be scaled up to a population level.Conclusions: These recommendations aim to help the co-creation of public health interventions by providing a framework and governance to guide the process. ABSTRACT Background: Due to the chronic disease burden on society, there is a need for preventive public health interventions to stimulate society towards a healthier lifestyle. To deal with the complex variability between individual lifestyles and settings, collaborating with end-users to develop interventions tailored to their unique circumstances has been suggested as a potential way to improve effectiveness and adherence. Co-creation of public health interventions using participatory methodologies has shown promise but lacks a framework to make this process systematic. The aim of this paper was to identify and set key principles and recommendations for systematically applying participatory methodologies to co-create and evaluate public health interventions. Methods: These principles and recommendations were derived using an iterative reflection process, combining key learning from published literature in addition to critical reflection on three case studies conducted by research groups in three European institutions, all of whom have expertise in co-creating public health interventions using different participatory methodologies. Results: Key principles and recommendations for using participatory methodologies in public health intervention co-creation are presented for the stages of: Planning (framing the aim of the study and identifying the appropriate sampling strategy); Conducting (defining the procedure, in addition to manifesting ownership); Evaluating (the process and the effectiveness) and Reporting (providing guidelines to report the findings). Three scaling models are proposed to demonstrate how to scale locally developed interventions to a population level. Conclusions: These recommendations aim to facilitate public health intervention co-creation and evaluation utilising participatory methodologies by ensuring the process is systematic and reproducible.
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Affiliation(s)
- Calum F. Leask
- Glasgow Caledonian University, School of Health and Life Sciences, Institute of Applied Health Research, Glasgow, UK
- NHS Grampian, Health Intelligence Department, Aberdeen, UK
| | - Marlene Sandlund
- Department of Community Medicine and Rehabilitation, Umea University, Umea, Sweden
| | - Dawn A. Skelton
- Glasgow Caledonian University, School of Health and Life Sciences, Institute of Applied Health Research, Glasgow, UK
| | - Teatske M. Altenburg
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Greet Cardon
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Mai J. M. Chinapaw
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Ilse De Bourdeaudhuij
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Maite Verloigne
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Sebastien F. M. Chastin
- Glasgow Caledonian University, School of Health and Life Sciences, Institute of Applied Health Research, Glasgow, UK
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - on behalf of the GrandStand, Safe Step and Teenage Girls on the Move Research Groups
- Glasgow Caledonian University, School of Health and Life Sciences, Institute of Applied Health Research, Glasgow, UK
- NHS Grampian, Health Intelligence Department, Aberdeen, UK
- Department of Community Medicine and Rehabilitation, Umea University, Umea, Sweden
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
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25
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Tremblay MC, Martin DH, McComber AM, McGregor A, Macaulay AC. Understanding community-based participatory research through a social movement framework: a case study of the Kahnawake Schools Diabetes Prevention Project. BMC Public Health 2018; 18:487. [PMID: 29650020 PMCID: PMC5897940 DOI: 10.1186/s12889-018-5412-y] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 04/05/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A longstanding challenge of community-based participatory research (CBPR) has been to anchor evaluation and practice in a relevant theoretical framework of community change, which articulates specific and concrete evaluative benchmarks. Social movement theories provide a broad range of theoretical tools to understand and facilitate social change processes, such as those involved in CBPR. Social movement theories have the potential to provide a coherent representation of how mobilization and collective action is gradually developed and leads to systemic change in the context of CBPR. The current study builds on a social movement perspective to assess the processes and intermediate outcomes of a longstanding health promotion CBPR project with an Indigenous community, the Kahnawake Schools Diabetes Prevention Project (KDSPP). METHODS This research uses a case study design layered on a movement-building evaluation framework, which allows progress to be tracked over time. Data collection strategies included document (scientific and organizational) review (n = 51) and talking circles with four important community stakeholder groups (n = 24). RESULTS Findings provide an innovative and chronological perspective of the evolution of KSDPP as seen through a social movement lens, and identify intermediate outcomes associated with different dimensions of movement building achieved by the project over time (mobilization, leadership, vision and frames, alliance and partnerships, as well as advocacy and action strategies). It also points to areas of improvement for KSDPP in building its potential for action. CONCLUSION While this study's results are directly relevant and applicable to the local context of KSDPP, they also highlight useful lessons and conclusions for the planning and evaluation of other long-standing and sustainable CBPR initiatives. The conceptual framework provides meaningful benchmarks to track evidence of progress in the context of CBPR. Findings from the study offer new ways of thinking about the evaluation of CBPR projects and their progress by drawing on frameworks that guide other forms of collective action.
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Affiliation(s)
- Marie-Claude Tremblay
- Department of Family Medicine and Emergency Medicine, Office of Education and Continuing Professional Development, Université Laval, 1050, de la Médecine, Pavillon Ferdinand-Vandry, 2881-F, Québec, QC, G1V 0A6, Canada.
| | - Debbie H Martin
- School of Health and Human Performance, Dalhousie University, Halifax, NS, Canada
| | - Alex M McComber
- Kahnawake Schools Diabetes Prevention Project, Kahnawake, QC, Canada.,Department of Family Medicine, McGill University, Montreal, QC, Canada
| | - Amelia McGregor
- Kahnawake Schools Diabetes Prevention Project, Kahnawake, QC, Canada
| | - Ann C Macaulay
- Department of Family Medicine, McGill University, Montreal, QC, Canada
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26
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Mohindra KS. Research and the health of indigenous populations in low- and middle-income countries. Health Promot Int 2018; 32:581-586. [PMID: 26511944 DOI: 10.1093/heapro/dav106] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
In low- and middle-income countries (LMICs)-when there are available data-a 'health divide' exists between indigenous and non-indigenous populations living in the same society. Despite the limited available evidence suggesting that indigenous populations have high levels of health needs, there is scant research on indigenous health, especially in Africa, China and South Asia. Pursuing research, however, is clouded by the prior negative experiences that indigenous populations have had with researchers. In this paper, we describe the current evidence base on indigenous health in LMICs, propose practical strategies for undertaking future research, and conclude by describing how global health researchers can contribute to improving the health of indigenous populations.
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Affiliation(s)
- K S Mohindra
- Institute of Population Health, University of Ottawa, 1 Stewart Street, Ottawa, CanadaON K1N 6N5
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27
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Bteich M, da Silva Miranda E, El Khoury C, Gautier L, Lacouture A, Yankoty LI. A proposed core model of the new public health for a healthier collectivity: how to sustain transdisciplinary and intersectoral partnerships. CRITICAL PUBLIC HEALTH 2017. [DOI: 10.1080/09581596.2017.1419167] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Michel Bteich
- École de santé publique, Université de Montréal, Montréal, Canada
- Department of Environmental and Occupational Health, Université de Montréal, Montréal, Canada
| | - Erica da Silva Miranda
- École de santé publique, Université de Montréal, Montréal, Canada
- Department of Social and Preventive Medicine, Université de Montréal, Montréal, Canada
| | - Caline El Khoury
- École de santé publique, Université de Montréal, Montréal, Canada
- Department of Management, Evaluation and Health Policy, Université de Montréal, Montréal, Canada
| | - Lara Gautier
- École de santé publique, Université de Montréal, Montréal, Canada
- Department of Social and Preventive Medicine, Université de Montréal, Montréal, Canada
| | - Anthony Lacouture
- École de santé publique, Université de Montréal, Montréal, Canada
- Department of Social and Preventive Medicine, Université de Montréal, Montréal, Canada
| | - Larisa Ines Yankoty
- École de santé publique, Université de Montréal, Montréal, Canada
- Department of Environmental and Occupational Health, Université de Montréal, Montréal, Canada
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28
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Teevale T, Kaholokula JK. Using appreciative inquiry methodology to develop a weight management program for obese children in New Zealand. Aust N Z J Public Health 2017; 42:7-11. [PMID: 28898503 DOI: 10.1111/1753-6405.12719] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2017] [Revised: 05/01/2017] [Accepted: 07/01/2017] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES Paediatric obesity predicts adult obesity, and alarming new data in New Zealand reveals that obesity among the young continues to rise. In this study, we used a novel solution-focused paradigm, or appreciative inquiry perspective, to explore the factors that influence not just obese but non-obese states (that is, healthy weight as well as obesity), in Pacific adolescents (aged 13-17) living in socioeconomically deprived neighbourhoods. METHODS Sixty-eight parents and adolescents from 30 families were recruited and interviewed, resulting in 15 obese and 15 healthy weight adolescents participating in the study. RESULTS Our findings showed that, despite living in low socioeconomic circumstances, parents were able to alter their micro-environments to prevent obesity in their children. Parents with healthy weight adolescents had food rules in the home and monitored their children's eating and television viewing time. CONCLUSIONS An appreciative inquiry approach to obesity research can uncover resiliency factors within families that can be applied to obesity prevention and treatment programs. Implications for public health: Appreciative inquiry methodology is a promising alternative qualitative research strategy for developing health interventions for low-income ethnic minority communities.
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Affiliation(s)
| | - Joseph K Kaholokula
- Department of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawai'i, USA
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29
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Greenhalgh T, Jackson C, Shaw S, Janamian T. Achieving Research Impact Through Co-creation in Community-Based Health Services: Literature Review and Case Study. Milbank Q 2017; 94:392-429. [PMID: 27265562 PMCID: PMC4911728 DOI: 10.1111/1468-0009.12197] [Citation(s) in RCA: 443] [Impact Index Per Article: 63.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Policy Points: Co‐creation—collaborative knowledge generation by academics working
alongside other stakeholders—is an increasingly popular approach to
aligning research and service development. It has potential for “moving beyond the ivory towers” to deliver
significant societal impact via dynamic, locally adaptive
community‐academic partnerships. Principles of successful co‐creation include a systems perspective,
a creative approach to research focused on improving human
experience, and careful attention to governance and process. If these principles are not followed, co‐creation efforts may
fail.
Context Co‐creation—collaborative knowledge generation by academics working
alongside other stakeholders—reflects a “Mode 2” relationship (knowledge
production rather than knowledge translation) between universities and society.
Co‐creation is widely believed to increase research impact. Methods We undertook a narrative review of different models of co‐creation
relevant to community‐based health services. We contrasted their diverse
disciplinary roots and highlighted their common philosophical assumptions,
principles of success, and explanations for failures. We applied these to an
empirical case study of a community‐based research‐service partnership led by the
Centre of Research Excellence in Quality and Safety in Integrated
Primary‐Secondary Care at the University of Queensland, Australia. Findings Co‐creation emerged independently in several fields, including
business studies (“value co‐creation”), design science (“experience‐based
co‐design”), computer science (“technology co‐design”), and community development
(“participatory research”). These diverse models share some common features, which
were also evident in the case study. Key success principles included (1) a systems
perspective (assuming emergence, local adaptation, and nonlinearity); (2) the
framing of research as a creative enterprise with human experience at its core;
and (3) an emphasis on process (the framing of the program, the nature of
relationships, and governance and facilitation arrangements, especially the style
of leadership and how conflict is managed). In both the literature review and the
case study, co‐creation “failures” could often be tracked back to abandoning (or
never adopting) these principles. All co‐creation models made strong claims for
significant and sustainable societal impacts as a result of the adaptive and
developmental research process; these were illustrated in the case study. Conclusions Co‐creation models have high potential for societal impact but
depend critically on key success principles. To capture the nonlinear chains of
causation in the co‐creation pathway, impact metrics must reflect the dynamic
nature and complex interdependencies of health research systems and address
processes as well as outcomes.
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Affiliation(s)
- Trisha Greenhalgh
- Nuffield Department of Primary Care Health Sciences, University of Oxford
| | - Claire Jackson
- Discipline of General Practice, School of Medicine, University of Queensland
| | - Sara Shaw
- Nuffield Department of Primary Care Health Sciences, University of Oxford
| | - Tina Janamian
- Discipline of General Practice, School of Medicine, University of Queensland
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30
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Huang YM, Wang HP, Yang YHK, Lin SJ, Lin HW, Chen CS, Wu FLL. Effects of a National Health Education Program on the Medication Knowledge of the Public in Taiwan. Ann Pharmacother 2016; 40:102-8. [PMID: 16368924 DOI: 10.1345/aph.1g312] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background: The inappropriate use of medication and inadequate medication knowledge among the general population has long been a concern in Taiwan. One reason for the deficiencies might be the lack of an active role of pharmacists in educating the public. To rectify the situation, in 2002, the Bureau of Pharmaceutical Affairs, Department of Health of Taiwan, began to sponsor a national effort, titled Community Education Program on Medication Use, to involve the expertise of pharmacists in public education. Objective: To evaluate the effects of this education program by analyzing the changes in knowledge of drug therapy among the participating public. Methods: This was a single-group pre- and post-comparison study. Between September 2003 and January 2004, a total of 955 community residents enrolled in the pharmacist-facilitated education program offered at 31 community universities. The medication knowledge of the participants was evaluated before and after the program. Demographic variables that might affect the education outcomes of the program were also examined. Results: Medication knowledge at baseline was positively correlated with education level and negatively correlated with age. Females were more aware of drug-related information than were males. The participants showed a significant improvement in medication knowledge (p < 0.001) at the end of the program. The baseline knowledge score was the most important determinant of the improvement of the posttest score. Conclusions: A national education program facilitated by pharmacists can improve the medication knowledge of the participants. Pharmacists should be encouraged to play a proactive role in large-scale health education programs.
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Affiliation(s)
- Yen-Ming Huang
- School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan
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31
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Ghaumi R, Aminee T, Aminaee A, Dastoury M. An Analysis of the Structural Factors Affecting the Public Participation in Health Promotion. Glob J Health Sci 2016; 8:53129. [PMID: 27045401 PMCID: PMC5016344 DOI: 10.5539/gjhs.v8n8p94] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2015] [Accepted: 12/13/2015] [Indexed: 11/12/2022] Open
Abstract
The present study focuses on analyzing national and international Community-Based Participatory Research (CBPR) studies published from 2000 to 2012 in order to identify and categorize the possible factors that affect social participation for improving the public health. Clearly, improving the public health necessitates a combination of the participation and responsibility by the social members and the attempts by public health policy-makers and planners. CBPR studies are selected as the corpus since they seek to encourage active and informed participation of the social members in fulfilling the health related goals. The present study is conducted through meta-synthesis within a qualitative framework. The results revealed a set of factors within the structural capacities which were employed by the CBPR researchers for achieving the health promotion goals. The structural capacities employed in the interventions could be considered on the cultural and social grounds. The cultural grounds were divided into scientific and religious attempts. For the scientific attempts, the results highlighted the participation of higher education institutes including universities and research centers as well as educational institutes such as schools and the relevant institutions. And regarding the religious attempts, the results indicated that the cooptation of religious centers played the greatest role in enhancing the public participation.
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Affiliation(s)
- Raheleh Ghaumi
- Research & Publication Institute of Peace Culture Charter, Tehran, Iran.
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32
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Fennell K, Turnbull D, Bidargaddi N, McWha J, Davies M, Olver I. The consumer-driven development and acceptability testing of a website designed to connect rural cancer patients and their families, carers and health professionals with appropriate information and psychosocial support. Eur J Cancer Care (Engl) 2016; 26. [DOI: 10.1111/ecc.12533] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2016] [Indexed: 11/30/2022]
Affiliation(s)
- K.M. Fennell
- Cancer Council SA; Unley BC SA Australia
- Flinders Centre for Innovation in Cancer; School of Medicine; Flinders University; Adelaide SA Australia
- School of Psychology; The University of Adelaide; Adelaide SA Australia
- Sansom Institute for Health Research; University of South Australia; Adelaide SA Australia
| | - D.A. Turnbull
- School of Psychology; The University of Adelaide; Adelaide SA Australia
| | - N. Bidargaddi
- Mental Health Observatory Research Unit; Country Health SA; Adelaide SA Australia
- eHealth Systems Research; School of Medicine; Flinders University; Bedford Park SA Australia
| | - J.L. McWha
- School of Psychology; The University of Adelaide; Adelaide SA Australia
| | - M. Davies
- Davies & Robertson Psychology Practice; Golden Grove SA Australia
| | - I. Olver
- Sansom Institute for Health Research; University of South Australia; Adelaide SA Australia
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33
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Bryant CA, Brown KRM, McDermott RJ, Forthofer MS, Bumpus EC, Calkins SA, Zapata LB. Community-Based Prevention Marketing. Health Promot Pract 2016; 8:154-63. [PMID: 16923844 DOI: 10.1177/1524839906290089] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This article describes the application and refinement of community-based prevention marketing (CBPM), an example of community-based participatory research that blends social marketing theories and techniques and community organization principles to guide voluntary health behavior change. The Florida Prevention Research Center has worked with a community coalition in Sarasota County, Florida to define locally important health problems and issues and to develop responsive health-promotion interventions. The CBPM framework has evolved as academic and community-based researchers have gained experience applying it. Community boards can use marketing principles to design evidence-based strategies for addressing local public health concerns. Based on 6 years of experience with the “Believe in All Your Possibilities” program, lessons learned that have led to revision and improvement of the CBPM framework are described.
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Rice K, Te Hiwi B, Zwarenstein M, Lavallee B, Barre DE, Harris SB. Best Practices for the Prevention and Management of Diabetes and Obesity-Related Chronic Disease among Indigenous Peoples in Canada: A Review. Can J Diabetes 2016; 40:216-25. [PMID: 27066857 DOI: 10.1016/j.jcjd.2015.10.007] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Revised: 10/15/2015] [Accepted: 10/25/2015] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To carry out a systematic review of interventions that have aimed at improving screening, treatment, prevention and management of type 2 diabetes and obesity-related chronic disease in Indigenous communities in Canada from 2008 to 2014, with the aim of identifying current best practices. METHODS A comprehensive literature review was carried out through an electronic database search using Medline, EMBASE, PubMED and Google scholar. RESULTS We identified 17 publications, comprising 13 evaluated interventions. Of them, 7 were school-based programs focused on children, 5 focused on adults, and 1 included both adults and children. Most interventions aimed at encouraging behaviour change, especially dietary change, but did little to address the underlying context of systemic marginalization and colonialism experienced in many Indigenous communities. Interventions focused on improving fitness were more effective than those aimed at dietary change. Overall, we found a range of successes among these interventions. Those that met with limited success reported that complex social issues and poverty presented challenges to effective intervention work in these communities. Participatory action research methods and community ownership of the intervention were found to be essential for project success. CONCLUSIONS Diabetes-focused intervention research in Indigenous communities appears to be a low priority for Canadian funders and policymakers. More intervention research is urgently needed in these communities. To be effective, this work must take an approach that is historically deep and sufficiently broad as to enable the ideologic, policy and institutional changes necessary in order to achieve true equity. This will involve addressing colonialism, racism and social exclusion as broader determinants of health.
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Affiliation(s)
- Kathleen Rice
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada.
| | - Braden Te Hiwi
- Centre for Studies in Family Medicine, Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | - Merrick Zwarenstein
- Centre for Studies in Family Medicine, Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | - Barry Lavallee
- Department of Medical Education, College of Medicine, Faculty of Health Sciences, University of Manitoba, Manitoba, Canada
| | - Douglas Edward Barre
- Department of Health Sciences and Emergency Management, School of Professional Studies, Cape Breton University, Sydney, Nova Scotia, Canada
| | - Stewart B Harris
- Centre for Studies in Family Medicine, Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
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Paradiso de Sayu R, Chanmugam A. Perceptions of Empowerment Within and Across Partnerships in Community-Based Participatory Research: A Dyadic Interview Analysis. QUALITATIVE HEALTH RESEARCH 2016; 26:105-116. [PMID: 25850722 DOI: 10.1177/1049732315577606] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Although the concept of empowerment is a key principle of community-based participatory research (CBPR), little is known about how academic and community partners perceive empowerment during a CBPR process. CBPR partners' perceptions of the process were explored using semi-structured interviews with both partners in 10 CBPR partnerships that had completed projects addressing social determinants of health. Dyadic interview analysis was employed to understand dynamics within and across partnerships. Five partnerships showed no differences in perceptions of empowerment. Four had minor discrepancies. Only one partnership varied considerably between partners, where the community partner perceived less empowerment regarding determining the study topic and overall control, influence, and respect throughout the process. This article discusses implications of findings for CBPR. Evaluating partners' perceived empowerment throughout a CBPR project might reveal areas to adjust, as not all projects with quantifiably successful outcomes involve processes that are successful in terms of empowerment.
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Affiliation(s)
| | - Amy Chanmugam
- The University of Texas at San Antonio, San Antonio, Texas, USA
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Finderup J, Bjerre T, Soendergaard A, Nielsen ME, Zoffmann V. DEVELOPING LIFE SKILLS IN HAEMODIALYSIS USING THE GUIDED SELF-DETERMINATION METHOD: A QUALITATIVE STUDY. J Ren Care 2015; 42:83-92. [DOI: 10.1111/jorc.12146] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Jeanette Finderup
- Department of Renal Medicine; Aarhus University Hospital; Aarhus N Denmark
| | - Tina Bjerre
- Department of Medicine; Roskilde Hospital; Roskilde Denmark
| | | | | | - Vibeke Zoffmann
- Research Unit Women's and Children's Health; Copenhagen University Hospital; Rigshospitalet Copenhagen Denmark
- Institute of Clinical Medicine; Copenhagen University; Copenhagen Denmark
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Amed S, Naylor PJ, Pinkney S, Shea S, Mâsse LC, Berg S, Collet JP, Wharf Higgins J. Creating a collective impact on childhood obesity: Lessons from the SCOPE initiative. Canadian Journal of Public Health 2015; 106:e426-33. [PMID: 26680435 DOI: 10.17269/cjph.106.5114] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Revised: 09/15/2015] [Accepted: 07/14/2015] [Indexed: 11/17/2022]
Abstract
OBJECTIVES We describe the processes used in SCOPE, a community-based participatory research (CBPR) initiative, to achieve multisectoral engagement and collective action to prevent childhood obesity. PARTICIPANTS SCOPE engages representatives from various sectors (local government, health, schools, recreation, local media, early childhood, community services) who influence the environments in which children live, learn and play. SETTING SCOPE has been implemented in three communities in British Columbia (BC). INTERVENTION SCOPE (www.live5210.ca) is a multi-setting, multi-component initiative designed to enhance a community's capacity to create and deliver localized solutions to promote healthy weights among children. SCOPE, in partnership with a local organization, engages multiple stakeholders who plan and implement actions framed by a common evidence-based health message ('Live 5-2-1-0'). SCOPE's central team in Vancouver, BC facilitates alignment with provincial initiatives, knowledge translation and exchange (KTE) within and across communities, and the collection, analysis and reporting of shared data. OUTCOMES Best practice processes that have emerged from SCOPE's experience align with the principles of CBPR and the five conditions of Collective Impact - a common agenda, mutually reinforcing action, continuous communication, a backbone organization and shared measurement. SCOPE has achieved sustainable practice change framed by a common agenda ('Live 5-2-1-0') leading to mutually reinforcing cross-sectoral action. CONCLUSION A multi-pronged community-led childhood obesity prevention initiative can be achieved using CBPR principles and attending to the conditions for achieving collective impact.
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Affiliation(s)
- Shazhan Amed
- University of British Columbia - Department of Paediatrics.
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Moore TG, McDonald M, Carlon L, O'Rourke K. Early childhood development and the social determinants of health inequities. Health Promot Int 2015; 30 Suppl 2:ii102-15. [DOI: 10.1093/heapro/dav031] [Citation(s) in RCA: 117] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Arbour L, Asuri S, Whittome B, Polanco F, Hegele RA. The Genetics of Cardiovascular Disease in Canadian and International Aboriginal Populations. Can J Cardiol 2015; 31:1094-115. [DOI: 10.1016/j.cjca.2015.07.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Revised: 07/08/2015] [Accepted: 07/09/2015] [Indexed: 12/16/2022] Open
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Mansuri S, Badawi A, Kayaniyil S, Cole DE, Harris SB, Mamakeesick M, Maguire J, Zinman B, Connelly PW, Hanley AJ. Associations of circulating 25(OH)D with cardiometabolic disorders underlying type 2 diabetes mellitus in an Aboriginal Canadian community. Diabetes Res Clin Pract 2015; 109:440-9. [PMID: 25944538 DOI: 10.1016/j.diabres.2015.04.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Revised: 02/23/2015] [Accepted: 04/12/2015] [Indexed: 10/23/2022]
Abstract
AIMS To investigate the associations of 25-hydroxyvitamin D (25(OH)D) with insulin resistance (IR), beta-cell function and metabolic syndrome (MetS) in a First Nations population. METHODS We conducted a cross-sectional analysis using data from the Sandy Lake Health and Diabetes Project (2003-2005). A total of 390 participants (>12 y) were assessed for 25(OH)D, fasting glucose, insulin, lipids, blood pressure, inflammatory markers, anthropometric and lifestyle variables and a 75-g oral glucose tolerance test was administered. IR was calculated using the Matsuda insulin sensitivity index (ISOGTT) and the computational homeostasis model assessment of IR (HOMA2-IR). Beta-cell function was calculated using the insulinogenic index (IGI) divided by HOMA-IR (IGI/IR) and the insulin secretion sensitivity index-2 (ISSI-2). The 2009 harmonized criteria were used to define MetS. RESULTS Higher 25(OH)D was associated with a decreased prevalence of dysglycemia (OR = 0.71 95% CI, 0.51-0.97 per SD increase). In addition, there were significant associations of 25(OH)D with measures of insulin action (ISOGTT; beta=0.31; 95% CI, 0.12, 0.49; HOMA2-IR; beta = -29; 95% CI -0.46, -0.11 and beta-cell function (ISSI-2; beta = 0.15; 95% CI, 0.02, 0.28). The prevalence of MetS was 41%. There was a decreased risk (OR=0.73, 95% CI 0.56, 0.94) of MetS per SD increase in baseline 25(OH)D. Finally, there was a significant positive association of 25(OH)D with adiponectin (beta = 0.16; 95% CI = 0.01, 0.31). CONCLUSIONS These results support a potential role for vitamin D metabolism in the natural history of T2DM among Aboriginal Canadians, although carefully designed randomized trials will be required to establish causality.
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Affiliation(s)
- Sudaba Mansuri
- Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada
| | - Alaa Badawi
- Office of Biotechnology, Genomics and Population Health, Public Health Agency of Canada, Toronto, ON, Canada
| | - Sheena Kayaniyil
- Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada
| | - David E Cole
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Stewart B Harris
- Center for Studies in Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | | | - Jonathon Maguire
- Keenan Research Centre of the Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, ON, Canada
| | - Bernard Zinman
- Division of Endocrinology, University of Toronto, Toronto, ON, Canada; Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, Toronto, ON, Canada; Samuel Lunenfeld Research Institute, Mount Sinai Hospital, Toronto, ON, Canada
| | - Philip W Connelly
- Keenan Research Centre of the Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, ON, Canada
| | - Anthony J Hanley
- Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada; Division of Endocrinology, University of Toronto, Toronto, ON, Canada; Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, Toronto, ON, Canada.
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Anderson LM, Adeney KL, Shinn C, Safranek S, Buckner‐Brown J, Krause LK. Community coalition-driven interventions to reduce health disparities among racial and ethnic minority populations. Cochrane Database Syst Rev 2015; 2015:CD009905. [PMID: 26075988 PMCID: PMC10656573 DOI: 10.1002/14651858.cd009905.pub2] [Citation(s) in RCA: 79] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Racial and ethnic disparities in health status are pervasive at all stages of the life cycle. One approach to reducing health disparities involves mobilizing community coalitions that include representatives of target populations to plan and implement interventions for community level change. A systematic examination of coalition-led interventions is needed to inform decision making about the use of community coalition models. OBJECTIVES To assess effects of community coalition-driven interventions in improving health status or reducing health disparities among racial and ethnic minority populations. SEARCH METHODS We searched MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Central Register of Controlled Trials (CENTRAL), PsycINFO, Social Science Citation Index, Dissertation Abstracts, System for Information on Grey Literature in Europe (SIGLE) (from January 1990 through September 30, 2013), and Global Health Library (from January 1990 through March 31, 2014). SELECTION CRITERIA Cluster-randomized controlled trials, randomized controlled trials, quasi-experimental designs, controlled before-after studies, interrupted time series studies, and prospective controlled cohort studies. Only studies of community coalitions with at least one racial or ethnic minority group representing the target population and at least two community public or private organizations are included. Major outcomes of interest are direct measures of health status, as well as lifestyle factors when evidence indicates that these have an effect on the direct measures performed. DATA COLLECTION AND ANALYSIS Two review authors independently extracted data and assessed risk of bias for each study. MAIN RESULTS Fifty-eight community coalition-driven intervention studies were included. No study was considered to be at low risk of bias. Behavioral change outcomes and health status change outcomes were analyzed separately. Outcomes are grouped by intervention type. Pooled effects across intervention types are not presented because the diverse community coalition-led intervention studies did not examine the same constructs or relationships, and they used dissimilar methodological designs. Broad-scale community system level change strategies led to little or no difference in measures of health behavior or health status (very low-certainty evidence). Broad health and social care system level strategies leds to small beneficial changes in measures of health behavior or health status in large samples of community residents (very low-certainty evidence). Lay community health outreach worker interventions led to beneficial changes in health behavior measures of moderate magnitude in large samples of community residents (very low-certainty evidence). Lay community health outreach worker interventions may lead to beneficial changes in health status measures in large samples of community residents; however, results were not consistent across studies (low-certainty evidence). Group-based health education led by professional staff resulted in moderate improvement in measures of health behavior (very low-certainty evidence) or health status (low-certainty evidence). Adverse outcomes of community coalition-led interventions were not reported. AUTHORS' CONCLUSIONS Coalition-led interventions are characterized by connection of multi-sectoral networks of health and human service providers with ethnic and racial minority communities. These interventions benefit a diverse range of individual health outcomes and behaviors, as well as health and social care delivery systems. Evidence in this review shows that interventions led by community coalitions may connect health and human service providers with ethnic and racial minority communities in ways that benefit individual health outcomes and behaviors, as well as care delivery systems. However, because information on characteristics of the coalitions themselves is insufficient, evidence does not provide an explanation for the underlying mechanisms of beneficial effects. Thus, a definitive answer as to whether a coalition-led intervention adds extra value to the types of community engagement intervention strategies described in this review remains unattainable.
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Affiliation(s)
- Laurie M Anderson
- University of WashingtonDepartment of Epidemiology, School of Public HealthP.O. Box 357236SeattleWAUSA98195‐7236
| | - Kathryn L Adeney
- Washington State Institute for Public PolicyEpidemiology and Public Health110 Fifth Avenue SE, Suite 214SeattleWAUSA98504
| | - Carolynne Shinn
- New Hampshire Department of Health and Human ServicesNew Hampshire Division of Public Health ServicesConcordNew HampshireUSA03301‐3852
| | - Sarah Safranek
- University of WashingtonHealth Sciences Library1959 NE Pacific StreetSeattleWAUSA98195‐7155
| | - Joyce Buckner‐Brown
- Centers for Disease Control and PreventionNational Center for Chronic Disease Prevention and Health Promotion, Division of Community Health, Research Surveillance & Evaluation Branch4770 Buford Hwy NE, Mailstop K81AtlantaGeorgiaUSA30341
| | - L Kendall Krause
- Bill & Melinda Gates FoundationEpidemiology and Surveillance DivisionSeattleWAUSA
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Magnusson M, Hallmyr Lewis M, Smaga-Blom M, Lissner L, Pickering C. Health Equilibrium Initiative: a public health intervention to narrow the health gap and promote a healthy weight in Swedish children. BMC Public Health 2014; 14:763. [PMID: 25074482 PMCID: PMC4131039 DOI: 10.1186/1471-2458-14-763] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Accepted: 07/04/2014] [Indexed: 11/17/2022] Open
Abstract
Background Inequity in health is a global concern. Even in Sweden there are considerable health gaps between different social groups, not least concerning life-style related conditions. Interventions drawing on Community-based participatory research (CBPR) have potential to build prerequisites for complex, supportive structures that constitute basis for implementation of sustainable health promoting programs. CBPR rests on principles of empowerment. The researchers are responsible for the scientific quality and that ethical standards are met. Health Equilibrium Initiative (HEI) aims at narrowing the health gap and promoting healthy weight in children; “healthy weight” including both anthropometric criteria and aspects having to do with self-esteem and self-efficacy. Evaluation objectives are to compare outcome between children in intervention and control areas, conduct health economic assessments (HEA) and evaluate the processes of the project. Methods/design HEI is a repeated cross-sectional and longitudinal study. The Program Logic Model is based on Social Cognitive Theory and Intervention Mapping. Primary contact groups are children in disadvantaged communities. Core efforts are to confirm and convey knowledge, elucidate and facilitate on-going health work and support implementation of continuous health work. Socioeconomic status is assessed on area level by the parameters yearly average income, degree of employment, tertiary education and percent of inhabitants born in countries where violent conflicts recently have taken place or were ongoing. Anthropometry, food patterns, physical activity and belief in ability to affect health; together with learning, memory and attention assessment will be assessed in 350 children (born 2006). Examinations will be repeated after two years, forming the basis of a health economic analysis. The process evaluation procedure will use document analysis (such as structured reports from meetings and dialogues, school/workplaces policies and curriculum, food service menus); key informant interviews and focus groups with parents, children and professionals. Discussion Inviting, awaiting and including local perspectives create mutual confidence and collaboration. Enhanced self-efficacy and access to relevant knowledge has potential to enable individuals and communities to choose alternatives that are relevant for their health and well-being in a long perspective. The economic of this study may contribute in decision- making processes regarding appropriate public health interventions.
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Affiliation(s)
- Maria Magnusson
- Department of Public Health and Community Medicine, Unit of Public Health Epidemiology, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Box 454, SE-405 30 Gothenburg, Sweden.
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Big-Canoe K, Richmond CA. Anishinabe youth perceptions about community health: Toward environmental repossession. Health Place 2014; 26:127-35. [DOI: 10.1016/j.healthplace.2013.12.013] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Revised: 12/16/2013] [Accepted: 12/17/2013] [Indexed: 11/16/2022]
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Mohammadpour-Ahranjani B, Pallan MJ, Rashidi A, Adab P. Contributors to childhood obesity in Iran: the views of parents and school staff. Public Health 2013; 128:83-90. [PMID: 24332408 DOI: 10.1016/j.puhe.2013.10.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2013] [Revised: 10/07/2013] [Accepted: 10/12/2013] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To explore the contextual influences on childhood obesity in Tehran, Iran to inform future development of an obesity prevention intervention for Iranian primary school children. STUDY DESIGN Qualitative study. METHODS Focus groups and interviews with parents and school staff were convened to explore their perceptions of the causes of childhood obesity. Eleven focus groups and three interviews were held with parents and school staff (88 participants in total) from three different socio-economic areas in Iran's capital city, Tehran. All the discussions were transcribed verbatim in Persian. An iterative thematic approach was used for data analysis. RESULTS Overall, the causes of childhood obesity were perceived to relate to macro-level policy influences, the school environment, sociocultural factors, and family and individual behavioural factors, acting in combination. A key emergent theme was the pervasive influence of Government policies on children's food intake and physical activity. Another key theme was the political and sociocultural context that does not support girls and women in Iran in having active lifestyles. CONCLUSION The findings suggest that parents and school staff have sophisticated views on the possible causes of childhood overweight and obesity which encompassed behavioural, structural and social causes. A prominent emerging theme was the need for state level intervention and support for a healthy environment. Any local initiatives in Iran are unlikely to be successful without such support. WHAT IS KNOWN ON THIS SUBJECT Childhood obesity is growing in Iran and it is seen as one of the features of the nutrition transition in developing countries. Findings from cross-sectional studies suggest a range of lifestyle factors contribute to obesity in the Iranian population. WHAT THIS STUDY ADDS This qualitative study explores the socioenvironmental changes contributing to childhood obesity in primary school-aged children in Iran. Findings have provided important contextual data on the perceived contributors to childhood obesity in Iran, such as macro-level policy influences on accessibility to healthy food and physical activity, competing priorities at school level, sociocultural influences on diet and physical activity and limited knowledge and skills of parents. This has laid the foundation for the development of appropriate childhood obesity prevention interventions.
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Affiliation(s)
- B Mohammadpour-Ahranjani
- National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Iran
| | - M J Pallan
- School of Health and Population Sciences, College of Medical and Dental Sciences, University of Birmingham, United Kingdom.
| | - A Rashidi
- National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Iran
| | - P Adab
- School of Health and Population Sciences, College of Medical and Dental Sciences, University of Birmingham, United Kingdom
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The Role of Transacademic Interface Managers in Transformational Sustainability Research and Education. SUSTAINABILITY 2013. [DOI: 10.3390/su5114614] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Schoenberg NE, Howell BM, Swanson M, Grosh C, Bardach S. Perspectives on healthy eating among Appalachian residents. J Rural Health 2013; 29 Suppl 1:s25-34. [PMID: 23944277 PMCID: PMC3752844 DOI: 10.1111/jrh.12009] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE Extensive attention has been focused on improving the dietary intake of Americans. Such focus is warranted due to increasing rates of overweight, obesity, and other dietary-related disease. To address suboptimal dietary intake requires an improved, contextualized understanding of the multiple and intersecting influences on healthy eating, particularly among those populations at greatest risk of and from poor diet, including rural residents. METHODS During 8 focus groups (N = 99) and 6 group key informant interviews (N = 20), diverse Appalachian rural residents were queried about their perceptions of healthy eating, determinants of healthy food intake, and recommendations for improving the dietary intake of people in their communities. Participants included church members and other laypeople, public health officials, social service providers, health care professionals, and others. FINDINGS Participants offered insights on healthy eating consistent with the categories of individual, interpersonal, community, physical, environmental, and society-level influences described in the socioecological model. Although many participants identified gaps in dietary knowledge as a persistent problem, informants also identified extraindividual factors, including the influence of family, fellow church members, and schools, policy, advertising and media, and general societal trends, as challenges to healthy dietary intake. We highlight Appalachian residents' recommendations for promoting healthier diets, including support groups, educational workshops, cooking classes, and community gardening. CONCLUSIONS We discuss the implications of these findings for programmatic development in the Appalachian context.
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Affiliation(s)
- Nancy E Schoenberg
- Department of Behavioral Sciences, University of Kentucky, Lexington, KY 40536, USA.
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Shippee ND, Domecq Garces JP, Prutsky Lopez GJ, Wang Z, Elraiyah TA, Nabhan M, Brito JP, Boehmer K, Hasan R, Firwana B, Erwin PJ, Montori VM, Murad MH. Patient and service user engagement in research: a systematic review and synthesized framework. Health Expect 2013; 18:1151-66. [PMID: 23731468 DOI: 10.1111/hex.12090] [Citation(s) in RCA: 390] [Impact Index Per Article: 35.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/08/2013] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND There is growing attention towards increasing patient and service user engagement (PSUE) in biomedical and health services research. Existing variations in language and design inhibit reporting and indexing, which are crucial to comparative effectiveness in determining best practices. OBJECTIVE This paper utilizes a systematic review and environmental scan to derive an evidence-based framework for PSUE. DESIGN A metanarrative systematic review and environmental scan/manual search using scientific databases and other search engines, along with feedback from a patient advisory group (PAG). ELIGIBLE SOURCES English-language studies, commentaries, grey literature and other sources (including systematic and non-systematic reviews) pertaining to patient and public involvement in biomedical and health services research. DATA EXTRACTED Study description (e.g. participant demographics, research setting) and design, if applicable; frameworks, conceptualizations or planning schemes for PSUE-related endeavours; and methods for PSUE initiation and gathering patients'/service users' input or contributions. RESULTS Overall, 202 sources were included and met eligibility criteria; 41 of these presented some framework or conceptualization of PSUE. Sources were synthesized into a two-part framework for PSUE: (i) integral PSUE components include patient and service user initiation, reciprocal relationships, colearning and re-assessment and feedback, (ii) sources describe PSUE at several research stages, within three larger phases: preparatory, execution and translational. DISCUSSION AND CONCLUSIONS Efforts at developing a solid evidence base on PSUE are limited by the non-standard and non-empirical nature of much of the literature. Our proposed two-part framework provides a standard structure and language for reporting and indexing to support comparative effectiveness and optimize PSUE.
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Affiliation(s)
- Nathan D Shippee
- Division of Health Policy and Management, University of Minnesota, Minneapolis, MN, USA
| | - Juan Pablo Domecq Garces
- Knowledge Synthesis Program, Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA.,Henry Ford Hospital, Detroit, MI, USA
| | - Gabriela J Prutsky Lopez
- Knowledge Synthesis Program, Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA.,Department of Pediatrics, Children's Hospital of Michigan, Wayne State University School of Medicine/Detroit Medical Center, Detroit, MI, USA
| | - Zhen Wang
- Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA
| | - Tarig A Elraiyah
- Knowledge Synthesis Program, Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA
| | - Mohammed Nabhan
- Knowledge Synthesis Program, Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA.,Saint Joseph Mercy Hospital, Ann Arbor, MI, USA
| | - Juan P Brito
- Endocrinology Division, Mayo Clinic, Rochester, MN, USA
| | - Kasey Boehmer
- Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA
| | - Rim Hasan
- Knowledge Synthesis Program, Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA
| | - Belal Firwana
- Knowledge Synthesis Program, Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA
| | | | - Victor M Montori
- Mayo Clinic, Rochester, MN, USA.,Center for the Science of Healthcare Delivery, Mayo Clinic, Rochester, MN, USA
| | - M Hassan Murad
- Mayo Clinic, Rochester, MN, USA.,Knowledge Synthesis Program, Mayo Clinic, Rochester, MN, USA
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Lessons in Translation. J Ambul Care Manage 2013; 36:156-65. [DOI: 10.1097/jac.0b013e31827fb325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Mead EL, Gittelsohn J, Roache C, Corriveau A, Sharma S. A Community-Based, Environmental Chronic Disease Prevention Intervention to Improve Healthy Eating Psychosocial Factors and Behaviors in Indigenous Populations in the Canadian Arctic. HEALTH EDUCATION & BEHAVIOR 2012; 40:592-602. [DOI: 10.1177/1090198112467793] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Diet-related chronic diseases are highly prevalent among indigenous populations in the Canadian Arctic. A community-based, multi-institutional nutritional and lifestyle intervention—Healthy Foods North—was implemented to improve food-related psychosocial factors and behaviors among Inuit and Inuvialuit in four intervention communities (with two comparison communities) in Nunavut and the Northwest Territories, Canada, in 2008. The 12-month program was developed from theory (social cognitive theory and social ecological models), formative research, and a community participatory process. It included an environmental component to increase healthy food availability in local stores and activities consisting of community-wide and point-of-purchase interactive educational taste tests and cooking demonstrations, media (e.g., radio ads, posters, shelf labels), and events held in multiple venues, including recreation centers and schools. The intervention was evaluated using pre- and postassessments with 246 adults from intervention and 133 from comparison communities (311 women, 68 men; mean age 42.4 years; 78.3% retention rate). Outcomes included psychosocial constructs (healthy eating knowledge, self-efficacy, and behavioral intentions), frequency of healthy and unhealthy food acquisition, healthiness of commonly used food preparation methods, and body mass index (kg/m2). After adjustment for demographic, socioeconomic status, and body mass index variables, respondents living in intervention communities showed significant improvements in food-related self-efficacy (β = 0.15, p = .003) and intentions (β = 0.16, p = .001) compared with comparison communities. More improvements from the intervention were seen in overweight, obese, and high socioeconomic status respondents. A community-based, multilevel intervention is an effective strategy to improve psychosocial factors for healthy nutritional behavior change to reduce chronic disease in indigenous Arctic populations.
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Affiliation(s)
| | | | - Cindy Roache
- University of Alberta, Edmonton, Alberta, Canada
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Mendenhall TJ, Seal KL, Greencrow BA, Littlewalker KN, Brownowl SA. The Family Education Diabetes Series: improving health in an urban-dwelling American Indian community. QUALITATIVE HEALTH RESEARCH 2012; 22:1524-1534. [PMID: 22910585 DOI: 10.1177/1049732312457469] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Community-based participatory research has shown great promise as a mutually engaging and respectful way to partner contemporary biomedical knowledge with the lived experience, wisdom, and customs of American Indian people. Designed and implemented through this approach, our Family Education Diabetes Series (FEDS) has evidenced pilot and longitudinal physiological data supporting its effectiveness. However, the multifaceted nature of the program makes it difficult to know which factors are responsible for its success. This difficulty hinders efforts to improve the FEDS and/or inform others' work to advance similar projects. In this study, we conducted a qualitative investigation using talking circles to explore participants' views about what elements of the FEDS are most salient. Our findings suggest that social support and group-oriented sequences hold the most value. We conclude that an emphasis on these processes (instead of program content per se) is most indicated in effecting behavior change and facilitating ongoing disease management.
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