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Daraz U, Khan Y, Alsawalqa RO, Alrawashdeh MN, Alnajdawi AM. Impact of climate change on women mental health in rural hinterland of Pakistan. Front Psychiatry 2024; 15:1450943. [PMID: 39735428 PMCID: PMC11674845 DOI: 10.3389/fpsyt.2024.1450943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Accepted: 11/15/2024] [Indexed: 12/31/2024] Open
Abstract
Background Climate change significantly impacts global well-being, with rural and agricultural communities, particularly women, bearing a disproportionate burden. In Pakistan's Malakand Division, women face increased mental health challenges due to environmental stressors such as temperature rise, extreme weather, and environmental degradation. These stressors are expected to exacerbate issues like stress, anxiety, and depression. Understanding their effects on rural women's mental health is crucial for developing effective intervention strategies. Methodology This study employs quantitative methodologies to assess the impact of climate change on the mental health of rural women in Malakand Division, focusing on Dir Upper, Dir Lower, and Shangla districts. A cross-sectional design was used, with a sample size of 600 women selected through multistage cluster sampling for geographic representation. Data were collected using structured questionnaires addressing stress, anxiety, and community dynamics. Data were analyzed using multiple regression, structural equation modeling (SEM), ANOVA, and logistic regression. Results The results revealed that climate change factors-temperature increase (β = 0.42, p < 0.01), extreme weather events (β = 0.36, p < 0.01), precipitation changes (β = 0.31, p < 0.05), and environmental degradation (β = 0.28, p < 0.05)-significantly impacted rural women's mental health. High levels of stress (72%), anxiety (68%), and depression (56%) were reported. Social support (β = -0.45, p < 0.01), community cohesion (β = -0.37, p < 0.05), access to resources (β = -0.39, p < 0.01), and cultural norms (β = -0.33, p < 0.05) were key factors mitigating the effects of climate stress. Gender disparities were evident, with women showing higher mental health challenges compared to men in similar conditions. Conclusion The study concludes that climate change significantly exacerbates mental health issues for rural women. It highlights the need for gender-sensitive, community-based interventions that address both climate adaptation and mental health. Strengthening community resilience, improving access to resources, and investing in healthcare and education are vital for enhancing well-being in the face of climate change.
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Affiliation(s)
- Umar Daraz
- Department of Sociology, University of Malakand Chakddara, Chakdara, Khyber Pukhtunkhwa, Pakistan
| | - Younas Khan
- Department of Sociology, Kohat University of Science and Technology, Kohat, Pakistan
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Voss S, Bauer J, Jung-Sievers C, Moore G, Rehfuess E, Wagner LC, Coenen M. "A place where I have lost and made friends": A photovoice study on adolescents' perspectives on health in a new residential development area in Munich, Germany. Health Place 2024; 90:103384. [PMID: 39527900 DOI: 10.1016/j.healthplace.2024.103384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 10/29/2024] [Accepted: 11/06/2024] [Indexed: 11/16/2024]
Abstract
Worldwide, the number and proportion of people living in cities continue to grow. Building new districts creates opportunities for designing urban environments that promote the health of their residents from the get-go. In this study, we used the photovoice methodology to explore the perspectives of adolescents on health and well-being in a new urban development area in Munich, Germany. Eleven adolescents aged 13-19 years were recruited in the new residential development area of Freiham on the Southwestern outskirts of Munich. Participants were given ten days to take photographs in the study area, focusing on objects or sceneries they considered to be important for their health. We then conducted qualitative interviews related to these photographs. Interviews were transcribed verbatim and analyzed using thematic analysis. We identified eight recurring themes: emotional well-being, meeting peers, being physically active, growing as a person, safety, waste, development of the urban environment, aesthetics of the urban environment. Adolescents highlighted aspects of mental and social health when assessing the urban environment. Interacting with other young people was an important reason for our participants to visit public places. Public health professionals and urban planners should consider the specific needs of this age group when building new urban areas, and especially provide safe and clean public spaces that adolescents can use for recreation and social interactions.
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Affiliation(s)
- Stephan Voss
- Chair of Public Health and Health Services Research, Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), Faculty of Medicine, LMU Munich, Munich, Germany; Pettenkofer School of Public Health, Munich, Germany.
| | - Julia Bauer
- Chair of Public Health and Health Services Research, Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), Faculty of Medicine, LMU Munich, Munich, Germany; Pettenkofer School of Public Health, Munich, Germany
| | - Caroline Jung-Sievers
- Chair of Public Health and Health Services Research, Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), Faculty of Medicine, LMU Munich, Munich, Germany; Pettenkofer School of Public Health, Munich, Germany
| | - Graham Moore
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, Cardiff, UK; Wolfson Centre for Young People's Mental Health, Cardiff University, Cardiff, UK
| | - Eva Rehfuess
- Chair of Public Health and Health Services Research, Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), Faculty of Medicine, LMU Munich, Munich, Germany; Pettenkofer School of Public Health, Munich, Germany
| | - Laura Corinna Wagner
- Chair of Public Health and Health Services Research, Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), Faculty of Medicine, LMU Munich, Munich, Germany; Pettenkofer School of Public Health, Munich, Germany
| | - Michaela Coenen
- Chair of Public Health and Health Services Research, Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), Faculty of Medicine, LMU Munich, Munich, Germany; Pettenkofer School of Public Health, Munich, Germany
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Hohl SD, Abu-Rish Blakeney E, Carter-Edwards L, Ramirez M, Wright ST, Zierler BK, van Rensburg D, Jewell T, Ko LK. The intersection of community engagement and team science research: A scoping review. J Clin Transl Sci 2024; 8:e208. [PMID: 39790471 PMCID: PMC11713437 DOI: 10.1017/cts.2024.644] [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: 06/29/2024] [Revised: 09/20/2024] [Accepted: 10/07/2024] [Indexed: 01/12/2025] Open
Abstract
Introduction Integrating community expertise into scientific teams and research endeavors can holistically address complex health challenges and grand societal problems. An in-depth understanding of the integration of team science and community engagement principles is needed. The purpose of this scoping review was to identify how and where team science and community engagement approaches are being used simultaneously in research. Methods We followed Levac's enhancement of Arksey and O'Malley's Scoping Review Framework and systematically searched PubMed, CINAHL, Scopus, ERIC, and Embase for team science and community engagement terms through January 2024. Results Sixty-seven articles were reviewed. Publications describing integrated team science and community-engaged research have increased exponentially since 2004. Over half were conducted outside of the U.S., utilized qualitative methods, included community-researcher co-development of research question and study design, and described team partnership goals, roles, and management. Fewer studies evaluated partnership, built community capacity, described financial compensation to communities, or described team dynamics facilitation. Conclusion As researchers continue to integrate community engagement and team science, common criteria and strategies for integrating the approaches are needed. We provide 19 recommendations for research teams, research institutions, journals, and funding bodies in service of advancing the science and practice of this integration.
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Affiliation(s)
- Sarah D. Hohl
- Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, WA, USA
- Department of Family Medicine and Community Health, University of Madison-Wisconsin, Madison, WI, USA
| | - Erin Abu-Rish Blakeney
- Department of Biobehavioral Nursing and Health Informatics, University of Washington School of Nursing, Seattle, WA, USA
- Institute of Translational Health Sciences, University of Washington, Seattle, WA, USA
| | - Lori Carter-Edwards
- Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, USA
- Public Health Leadership Program, Gillings School of Global Public Health, and the NC Translational and Clinical Sciences Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Magaly Ramirez
- Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, WA, USA
- Institute of Translational Health Sciences, University of Washington, Seattle, WA, USA
| | - Sarah Towner Wright
- Health Sciences Library, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Brenda K. Zierler
- Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, WA, USA
- Department of Biobehavioral Nursing and Health Informatics, University of Washington School of Nursing, Seattle, WA, USA
- Institute of Translational Health Sciences, University of Washington, Seattle, WA, USA
| | - Dillon van Rensburg
- Institute of Translational Health Sciences, University of Washington, Seattle, WA, USA
| | - Teresa Jewell
- Health Sciences Library, University of Washington, Seattle, WA, USA
| | - Linda K. Ko
- Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, WA, USA
- Institute of Translational Health Sciences, University of Washington, Seattle, WA, USA
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Palumbo L, Picchio CA, Barbier F, Calderon-Cifuentes A, James J, Lunchenkov N, Nutland W, Owen G, Orkin C, Rocha M, Shanley A, Stevenson L, Vinti P, Salvi C. Co-creating a Mpox Elimination Campaign in the WHO European Region: The Central Role of Affected Communities. Open Forum Infect Dis 2024; 11:ofae523. [PMID: 39355261 PMCID: PMC11443334 DOI: 10.1093/ofid/ofae523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Accepted: 09/06/2024] [Indexed: 10/03/2024] Open
Abstract
Between May 2022 and September 2023, the World Health Organization (WHO) Regional Office for Europe engaged in a collaborative effort with affected communities to address the outbreak of mpox in the region. This concerted endeavor led to the development of a risk communication campaign specifically tailored to address the perceptions and needs of the target audience, thereby contributing to the control and the long-term goal of mpox elimination. Various community engagement interventions were implemented, including the establishment of an informal civil society organizations' working group to provide feedback on the WHO mpox campaign, webinars targeting event organizers, and roundtable discussions with country-level responders. The invaluable feedback garnered from the community was utilized to customize materials and extend outreach to groups that may have been overlooked in the initial response. This successful initiative underscored the immense potential of placing communities at the forefront of emergency response efforts, equipping them with the necessary resources, engagement, and empowerment. This offers 1 model of co-creation that can be applied to health emergencies. It is asserted that the pivotal role played by communities in this response should be recognized as a valuable lesson and incorporated into all emergency responses, ensuring sustained community involvement and empowerment throughout the entire emergency cycle.
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Affiliation(s)
- Leonardo Palumbo
- Risk Communication, Community Engagement, and Infodemic Management Unit, World Health Organization European Regional Office, Copenhagen, Denmark
| | - Camila A Picchio
- Risk Communication, Community Engagement, and Infodemic Management Unit, World Health Organization European Regional Office, Copenhagen, Denmark
| | | | | | - Jules James
- European Sex Worker Rights Alliance, Amsterdam, The Netherlands
| | - Nikolay Lunchenkov
- Health and Capacity Building Department, Eurasian Coalition on Health, Rights, Gender, and Sexual Diversity, Tallinn, Estonia
- School of Social Sciences and Technology, Technical University of Munich, Munich, Germany
| | | | - Greg Owen
- PrEP Team, Terrence Higgins Trust, London, United Kingdom
| | - Chloe Orkin
- SHARE Collaborative, Blizard Institute, Queen Mary University of London, London, United Kingdom
| | - Miguel Rocha
- Grupo de Ativistas em Tratamentos, Lisbon, Portugal
| | | | - Luca Stevenson
- European Sex Worker Rights Alliance, Amsterdam, The Netherlands
| | - Pietro Vinti
- Joint Infectious Diseases Unit, World Health Organization European Regional Office, Copenhagen, Denmark
| | - Cristiana Salvi
- Risk Communication, Community Engagement, and Infodemic Management Unit, World Health Organization European Regional Office, Copenhagen, Denmark
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Wilson DH, Sarche M, Ricker A, Krienke LK, Brockie N T. Engagement with reservation-based Head Start teachers to explore their stress and coping: A qualitative study. Arch Psychiatr Nurs 2024; 51:246-258. [PMID: 39034085 DOI: 10.1016/j.apnu.2024.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 01/24/2024] [Accepted: 06/09/2024] [Indexed: 07/23/2024]
Abstract
BACKGROUND Native Americans residing in remote reservation communities find strength in connection to place, culture, language, and sovereignty; they also face challenges as their communities struggle with historical and contemporary traumas that have resulted in poverty, high crime and suicide rates and drug misuse. The psychological well-being of Head Start teachers who teach and support the needs of Native American children, is overlooked. METHODS Qualitative interviews (n = 18) and focus groups (n = 9) were conducted with Head Start teachers, supervisors, parents, and ancillary staff to identify risk and protective factors at each level of the socioecological model (individual, relationships, community, society). Using content analysis and F4 analyse software two coders identified recurring themes. RESULTS Individually teachers are resilient, focused more on the children's well-being than their own. Family was both significant support and stressor. Community struggles with drug and alcohol misuse and homelessness were the most frequent stressors. Workplace support included their supervisors and the mentorship they provided each other. Spirituality in the form traditional cultural practices, prayer and Christen faith were important sources of support and well-being. CONCLUSIONS This paper provides insight into the stress and coping mechanisms of reservation-based Head Start teachers, identifying ways to protect and promote their health and well-being. It is important to provide support at all levels of the socioecological model to enable these teachers to strengthen their physical and psychological health and wellbeing so that they may support the children and families of Head Start to help strengthen Native American health overall.
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Affiliation(s)
- Deborah H Wilson
- School of Nursing, Johns Hopkins University, 525 N Wolfe St., Baltimore, MD 21205, USA; Auckland University of Technology, 90 Akoranga Drive, Auckland 0627, New Zealand.
| | - Michelle Sarche
- University of Colorado Anschutz Medical Campus, Colorado School of Public Health, Centers for American Indian and Alaska Native Health, USA
| | - Adriann Ricker
- School of Nursing, Johns Hopkins University, 525 N Wolfe St., Baltimore, MD 21205, USA
| | - Lydia Koh Krienke
- School of Nursing, Johns Hopkins University, 525 N Wolfe St., Baltimore, MD 21205, USA
| | - Teresa Brockie N
- School of Nursing, Johns Hopkins University, 525 N Wolfe St., Baltimore, MD 21205, USA
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Levin J. The challenges of epidemiologic translation: communicating with physicians, policymakers, and the public. Front Public Health 2024; 12:1270586. [PMID: 38327582 PMCID: PMC10847263 DOI: 10.3389/fpubh.2024.1270586] [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: 08/01/2023] [Accepted: 01/11/2024] [Indexed: 02/09/2024] Open
Abstract
Translational epidemiology refers to the practical application of population-health research findings to efforts addressing health disparities and other public health issues. A principal focus of epidemiologic translation is on the communication of results to constituencies who can best make use of this information to effect positive health-related change. Indeed, it is contended that findings from epidemiologic research are of greatest use only if adequately communicated to health professionals, legislators and policymakers, and the public. This paper details the challenges faced by efforts to communicate findings to the these constituencies, especially three types of miscommunication that can derail efforts at translation. These include perceived misinformation, perceived disinformation, and perceived censorship. Epidemiologists are ethically obliged to avoid these types of miscommunication, and, accordingly, are advised to place greater emphasis on messaging and media outreach to physicians, government officials, medical educators, and the general public.
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Affiliation(s)
- Jeff Levin
- Institute for Studies of Religion and Medical Humanities Program, Baylor University, Waco, TX, United States
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Duke University, Durham, NC, United States
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Nelson LE, Ogunbajo A, Abu-Ba'are GR, Conserve DF, Wilton L, Ndenkeh JJ, Braitstein P, Dow D, Arrington-Sanders R, Appiah P, Tucker J, Nam S, Garofalo R. Using the Implementation Research Logic Model as a Lens to View Experiences of Implementing HIV Prevention and Care Interventions with Adolescent Sexual Minority Men-A Global Perspective. AIDS Behav 2023; 27:128-143. [PMID: 35947235 PMCID: PMC10191897 DOI: 10.1007/s10461-022-03776-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/25/2022] [Indexed: 11/01/2022]
Abstract
Adolescents and sexual minority men (SMM) are high priority groups in the United Nations' 2021 - 2016 goals for HIV prevention and viral load suppression. Interventions aimed at optimizing HIV prevention, testing and viral load suppression for adolescents must also attend to the intersectional realities influencing key sub-populations of SMM. Consequently, there is not a robust evidence-base to guide researchers and program partners on optimal approaches to implementing interventions with adolescent SMM. Using a multiple case study design, we integrated the Implementation Research Logic Model with components of the Consolidated Framework for Implementation Research and applied it as a framework for a comparative description of ten HIV related interventions implemented across five countries (Ghana, Kenya, Nigeria, Tanzania and United States). Using self-reported qualitative survey data of project principal investigators, we identified 17 of the most influential implementation determinants as well as a range of 17 strategies that were used in 90 instances to support intervention implementation. We highlight lessons learned in the implementation research process and provide recommendations for researchers considering future HIV implementation science studies with adolescent SMM.
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Affiliation(s)
- LaRon E Nelson
- School of Nursing, Yale University, New Haven, CT, USA.
- Center for Interdisciplinary Research on AIDS, School of Public Health, Yale University, New Haven, CT, USA.
- Yale Institute of Global Health, Yale University, New Haven, CT, USA.
- Department of Social & Behavioral Sciences, School of Public Health, Yale University, New Haven, CT, USA.
| | - Adedotun Ogunbajo
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Gamji Rabiu Abu-Ba'are
- Center for Interdisciplinary Research on AIDS, School of Public Health, Yale University, New Haven, CT, USA
- School of Nursing, University of Rochester, NY, Rochester, USA
| | - Donaldson F Conserve
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Leo Wilton
- Department of Human Development, State University of New York at Binghamton, Binghamton, NY, USA
| | - Jackson Junior Ndenkeh
- Center for International Health, Ludwig Maximilian University of Munich, Munich, Germany
| | - Paula Braitstein
- Epidemiology Division, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Dorothy Dow
- Department of Pediatrics, School of Medicine, Duke University, Durham, NC, USA
| | - Renata Arrington-Sanders
- Division of Adolescent/Young Adult Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Patrick Appiah
- Youth Alliance for Health & Human Rights, Ashanti, Kumasi, Ghana
| | - Joe Tucker
- Division of Infectious Diseases, University of North Carolina Chapel Hill, Chapel Hill, NC, USA
| | - Soohyun Nam
- School of Nursing, Yale University, New Haven, CT, USA
| | - Robert Garofalo
- Division of Adolescent Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
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Kamai EM, Calderon A, Van Horne YO, Bastain TM, Breton CV, Johnston JE. Perceptions and experiences of environmental health and risks among Latina mothers in urban Los Angeles, California, USA. Environ Health 2023; 22:8. [PMID: 36641468 PMCID: PMC9840262 DOI: 10.1186/s12940-023-00963-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 01/07/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Environmental exposures during pregnancy and early childhood can have acute and chronic adverse health impacts. As minoritized populations are more likely to reside in areas with greater pollution, it is important to understand their views and lived experiences to inform action. The purpose of this community-driven qualitative research study was to understand how urban Latina mothers in Los Angeles County, California perceived environmental health and risks. METHODS We conducted semi-structured individual interviews with Latina pregnant women and mothers of young children, recruited through existing collaborations with community organizations. Interviews conducted in either English or Spanish and were coded inductively according to a modified grounded theory approach. RESULTS Thirty-six Latina mothers completed interviews between August-October 2016. Participants lived primarily in low-income communities of South-Central Los Angeles and East Los Angeles. We identified three major themes based on the participants' responses during interviews: Defining the Environment, Environment & Health Risks, and Social & Political Responsibility. Women defined their environment in terms of both "nature" and "hazards." They consistently identified foul odors, dirtiness, noise, trash, bugs, smoke, and other visible blights as indicators of household and neighborhood environmental hazards. They expressed fear and uncertainty about how their environment could affect their health and that of their children, as well as specific concerns about respiratory health, asthma, allergies, cancer, and adverse pregnancy outcomes. Mothers often changed individual behaviors around diet and cleaning during pregnancy but were frustrated by power imbalances that left them unable to change their home or neighborhood environments, despite their desire to do so. DISCUSSION Our study is among the first to describe how urban Latina mothers perceive and experience environmental health risks during pregnancy and early childhood. Our research suggests additional attention is needed by public health professionals and researchers to address the environmental health risks that matter most to urban Latina mothers. They also highlight the tension that many urban Latina mothers feel between wanting to protect their families' health and well-being and feeling powerless to change their environment. Broad policy changes, rather than additional individual recommendations, are needed to address the concerns of this vulnerable population.
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Affiliation(s)
- Elizabeth M Kamai
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
| | - Andrea Calderon
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Yoshira Ornelas Van Horne
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Theresa M Bastain
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Carrie V Breton
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Jill E Johnston
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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Wilson DH, Nelson KE, Gresh A, Ricker A, Littlepage S, Krienke LK, Brockie TN. The Pre-implementation Process of Adapting a Culturally Informed Stress Reduction Intervention for Native American Head Start Teachers. GLOBAL IMPLEMENTATION RESEARCH AND APPLICATIONS 2023; 3:16-30. [PMID: 36644672 PMCID: PMC9827016 DOI: 10.1007/s43477-022-00070-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 12/23/2022] [Indexed: 01/11/2023]
Abstract
Head Start is a federally funded program for children (3-5 years) from low-income families. In the Fort Peck Native American Reservation, tribal Head Start teachers have reported high stress in supporting children experiencing adverse childhood experiences. Thus, we adapted the Little Holy One intervention (ClinicalTrials.gov: NCT04201184) for the teachers' context and culture to enhance psychological health and well-being. Within a participatory framework, the eight-step ADAPT-ITT methodology was used to guide the adaptation process: assessment; decision; adaptation; production; topical experts; integration; training; and testing. For Step 1, we purposive sampled 27 teachers, ancillary staff, and parents to understand teachers' stress, support mechanisms, and interest in an intervention via focus groups (n = 9) and individual interviews (n = 18). Qualitative data underscored teachers' experiences of stress, depression, and need for support (Step 1). Iterative feedback from a tribal advisory board and Little Holy One designers rendered selection of five lessons (Step 2, 5), which were adapted for the teachers via theater testing (Step 3, 4). Community capacity assessment revealed their ability to implement the intervention (Step 6). Testing of this adapted intervention in a feasibility trial (steps 7, 8) will be reported in a future publication. A rigorous systematic process within a participatory framework allowed intervention adaption based on community input. Leveraging "culture as treatment" may be useful for enhancing psychological health outcomes for Native Americans who historically underutilize existing psychological services. Supplementary Information The online version contains supplementary material available at 10.1007/s43477-022-00070-3.
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Affiliation(s)
- Deborah H. Wilson
- School of Nursing, Johns Hopkins University, 525 N Wolfe St., Baltimore, MD 21205 USA
| | - Katie E. Nelson
- School of Nursing, Johns Hopkins University, 525 N Wolfe St., Baltimore, MD 21205 USA
| | - Ashley Gresh
- School of Nursing, Johns Hopkins University, 525 N Wolfe St., Baltimore, MD 21205 USA
| | - Adriann Ricker
- School of Nursing, Johns Hopkins University, 525 N Wolfe St., Baltimore, MD 21205 USA
| | - Shea Littlepage
- Johns Hopkins Bloomberg School of Public Health, Center for Indigenous Health, 415 N. Washington St. 4th Floor, Baltimore, MD 21231 USA
| | - Lydia Koh Krienke
- School of Nursing, Johns Hopkins University, 525 N Wolfe St., Baltimore, MD 21205 USA
- Johns Hopkins Bloomberg School of Public Health, Center for Indigenous Health, 415 N. Washington St. 4th Floor, Baltimore, MD 21231 USA
| | - Teresa N. Brockie
- School of Nursing, Johns Hopkins University, 525 N Wolfe St., Baltimore, MD 21205 USA
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Van Horne YO, Alcala CS, Peltier RE, Quintana PJE, Seto E, Gonzales M, Johnston JE, Montoya LD, Quirós-Alcalá L, Beamer PI. An applied environmental justice framework for exposure science. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2023; 33:1-11. [PMID: 35260805 PMCID: PMC8902490 DOI: 10.1038/s41370-022-00422-z] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 02/08/2022] [Accepted: 02/10/2022] [Indexed: 05/28/2023]
Abstract
On the 30th anniversary of the Principles of Environmental Justice established at the First National People of Color Environmental Leadership Summit in 1991 (Principles of Environmental Justice), we continue to call for these principles to be more widely adopted. We propose an environmental justice framework for exposure science to be implemented by all researchers. This framework should be the standard and not an afterthought or trend dismissed by those who believe that science should not be politicized. Most notably, this framework should be centered on the community it seeks to serve. Researchers should meet with community members and stakeholders to learn more about the community, involve them in the research process, collectively determine the environmental exposure issues of highest concern for the community, and develop sustainable interventions and implementation strategies to address them. Incorporating community "funds of knowledge" will also inform the study design by incorporating the knowledge about the issue that community members have based on their lived experiences. Institutional and funding agency funds should also be directed to supporting community needs both during the "active" research phase and at the conclusion of the research, such as mechanisms for dissemination, capacity building, and engagement with policymakers. This multidirectional framework for exposure science will increase the sustainability of the research and its impact for long-term success.
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Affiliation(s)
- Yoshira Ornelas Van Horne
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, Los Angeles, CA, 90032, USA.
| | - Cecilia S Alcala
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, 17 East 102 Street, New York, NY, 10029, USA
| | - Richard E Peltier
- School of Public Health & Health Sciences, University of Massachusetts Amherst, 686 North Pleasant Street, Room 175, Amherst, MA, 01003, USA
| | - Penelope J E Quintana
- School of Public Health, San Diego State University, 5500 Campanile Dr., San Diego, CA, 92182, USA
| | - Edmund Seto
- Department of Environmental & Occupational Health Sciences, School of Public Health, University of Washington, Roosevelt One Building, 4225 Roosevelt Way NE, Suite 100, Seattle, WA, 98195, USA
| | - Melissa Gonzales
- Department of Internal Medicine, University of New Mexico School of Medicine, MSC10 5550 Epidemiology, Albuquerque, NM, 87111, USA
| | - Jill E Johnston
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, Los Angeles, CA, 90032, USA
| | | | - Lesliam Quirós-Alcalá
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, 615N. Wolfe Street, Baltimore, MD, 21205, USA
| | - Paloma I Beamer
- Department of Community, Environment and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295N. Martin Ave., Tucson, AZ, 85724, USA
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11
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Frimpong SO, Paintsil E. Community engagement in Ebola outbreaks in sub-Saharan Africa and implications for COVID-19 control: A scoping review. Int J Infect Dis 2023; 126:182-192. [PMID: 36462575 DOI: 10.1016/j.ijid.2022.11.032] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 10/27/2022] [Accepted: 11/25/2022] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES There is a paucity of scoping data on the specific roles community engagement played in preventing and managing the Ebola virus disease (EVD) outbreak in sub-Saharan Africa. We assessed the role, benefits, and mechanisms of community engagement to understand its effect on EVD case detection, survival, and mortality in sub-Saharan Africa. The implications for COVID-19 prevention and control were also highlighted. METHODS We searched for articles between 2010 and 2020 in the MEDLINE and Embase databases. The study types included were randomized trials, quasiexperimental studies, observational studies, case series, and reports. RESULTS A total of 903 records were identified for screening. A total of 216 articles met the review criteria, 103 were initially selected, and 44 were included in the final review. Our findings show that effective community involvement during the EVD outbreak depended on the survival rates, testimonials of survivors, risk perception, and the inclusion of community leaders. Community-based interventions improved knowledge and attitudes, case findings, isolation efforts, and treatment uptake. CONCLUSION Although the studies included in this review were of highly variable quality, findings from this review may provide lessons for the role of community engagement in the COVID-19 pandemic's prevention and control in sub-Saharan Africa.
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Affiliation(s)
- Shadrack Osei Frimpong
- Department of Pediatrics, Yale School of Medicine, New Haven, USA; Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK; Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, USA.
| | - Elijah Paintsil
- Department of Pediatrics, Yale School of Medicine, New Haven, USA; Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, USA; Department of Pharmacology, Yale School of Medicine, New Haven, USA; School of Management, Yale University, New Haven, USA
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12
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Using Collective Impact to Advance Birth Equity: A Comparison of Two Cross-Sector Efforts in California. Matern Child Health J 2022; 26:2517-2525. [PMID: 36348213 DOI: 10.1007/s10995-022-03528-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 07/24/2022] [Accepted: 09/08/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND Preterm birth, defined as birth at gestational age before 37 weeks, is a major public health concern with marked racial disparities driven by underlying structural and social determinants of health. To achieve population-level reductions in preterm birth and to reduce racial inequities, the University of California, San Francisco's California Preterm Birth Initiative catalyzed two cross-sector coalitions in San Francisco and Fresno using the Collective Impact (CI) approach. PURPOSE The purpose of this study is to compare two preterm birth-focused CI efforts and identify common themes and lessons learned. METHODS Researchers conducted in-depth interviews (n = 19) and three focus groups (n = 20) with stakeholders to assess factors related to collaboration. Transcripts were coded and analyzed using modified grounded theory. Findings were compared by year of data collection (first and second cycle in each location) and geographic location (Fresno and San Francisco) and discussed with CI participants for input. RESULTS Although both communities adopted the core tenets of CI to address preterm birth and racial inequities, each employed distinct organizational structures, strategic frameworks, and interventions. Common themes emerged around the importance of authentic community engagement, transparency in the process of prioritization and decision-making, addressing racism as a root cause of disparities in birth outcomes, and candid communication among partners. CONCLUSION Future CI efforts, particularly those catalyzed by academic institutions, should ensure community members are active partners in program development and decision-making. CI efforts focused on combatting racial health inequities should center racism as a root cause and build capacity among coalition partners.
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Petteway RJ, González LA. Engaging Public Health Critical Race Praxis in Local Social Determinants of Health Research: The Youth Health Equity and Action Research Training Program in Portland, OR—yHEARTPDX. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19138187. [PMID: 35805851 PMCID: PMC9266579 DOI: 10.3390/ijerph19138187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 06/17/2022] [Accepted: 06/29/2022] [Indexed: 12/04/2022]
Abstract
The social determinants of health (SDH) have long been considered a core mechanism through which racial health inequities are (re)produced and incubated in the U.S. Moreover, scholars have expressly—and appropriately—named structural racism as a precursor to inequities associated with SDH. However, while research on racial health inequities—SDH-related or otherwise—continues to grow, communities of color remain grossly underrepresented as public health researchers and practitioners. Additionally, although SDH are experienced in a very local sense, much research and practice fails to more deeply and thoroughly engage and center local community knowledges. Thus, much work around SDH and racial health inequities presents, ironically, as structurally racist itself—being done/led mostly by White scholars and in ways that do not “center the margins”. Moreover, in the context of public health practice, youth perspective is seldom centered within local health department (LHD) community SDH assessment efforts. With these challenges in mind, this paper introduces and discusses the development of the youth health equity and action research training (yHEART) program as a model for public health researchers/practitioners to engage public health critical race praxis (PHCRP) to better understand and respond to local SDH in communities of color. Specifically, we highlight the significance of PHCRP principles of “voice” and “social construction of knowledge” in advancing antiracism in research and LHD practice related to local SDH. First, we articulate core conceptual and theoretical groundings that informed the yHEART program’s development and animate its ongoing training and research activities. Second, we outline the program’s core training components and overall process, and provide some brief illustrative examples of work completed during the program’s first iteration—yHEART PDX, Vol.I: Youth Participatory Research on Local Social Determinants of Health. We then close with a discussion that reflects on program strengths, challenges, and implications for SDH and racial health equity research/practice in light of growing calls for an antiracist public health.
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14
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Physical Activity Experiences of South Asian Migrant Women in Western Australia: Implications for Intervention Development. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063585. [PMID: 35329275 PMCID: PMC8955647 DOI: 10.3390/ijerph19063585] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 03/10/2022] [Accepted: 03/15/2022] [Indexed: 11/17/2022]
Abstract
The benefits of physical activity are widely recognised; however, physical activity uptake remains low in South Asian populations. South Asian migrant women face health risks as they adapt to new cultures, and these risks are often intensified through their limited participation in physical activity as one of the behaviours that promote positive health outcomes. Three focus group discussions with sixteen South Asian migrant women aged between 33 and 64 years, with a median age of 48 years and who live in Western Australia, were conducted. Thematic analysis of the transcribed qualitative data was completed to explore and uncover South Asian women’s experiences with physical activity, as well as their motivation, beliefs, attitudes, and knowledge about physical activity. Five major themes emerged after coding and analysing the data. The themes included the women’s knowledge of physical activity, their general attitudes and beliefs surrounding physical activity, the advantages and disadvantages of participation in physical activity, their experiences with physical activity, and the barriers, challenges, and facilitators surrounding physical activity. Recommendations are proposed to increase physical activity among this group to improve overall health and wellbeing and implications for intervention development are discussed.
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15
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Maurer MA, Shiyanbola OO, Mott ML, Means J. Engaging Patient Advisory Boards of African American Community Members with Type 2 Diabetes in Implementing and Refining a Peer-Led Medication Adherence Intervention. PHARMACY 2022; 10:37. [PMID: 35314618 PMCID: PMC8938802 DOI: 10.3390/pharmacy10020037] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 03/01/2022] [Accepted: 03/08/2022] [Indexed: 11/17/2022] Open
Abstract
African Americans are more likely than non-Hispanic whites to be diagnosed with and die from diabetes. A contributing factor to these health disparities is African Americans' poor diabetes medication adherence that is due in part to sociocultural barriers (e.g., medicine and illness misperceptions), which negatively affect diabetes management. In our prior work, we engaged with community stakeholders to develop and test a brief version of a culturally adapted intervention to address these barriers to medication adherence. The objective of this study was to elicit feedback to inform the refinement of the full 8-week intervention. We utilized a community-engaged study design to conduct a series of meetings with two cohorts of patient advisory boards of African Americans with type 2 diabetes who were adherent to their diabetes medicines (i.e., peer ambassadors). In total, 15 peer ambassadors were paired with 21 African American participants (i.e., peer buddies) to provide specific intervention support as peers and serve in an advisory role as a board member. Data were collected during nine board meetings with the patient stakeholders. A qualitative thematic analysis of the data was conducted to synthesize the findings. Feedback from the patient advisory board contributed to refining the intervention in the immediate-term, short-term, and long-term. The inclusion of African American community members living with type 2 diabetes on the advisory board contributed to further tailoring the intervention to the specific needs of African Americans with type 2 diabetes in the community.
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Affiliation(s)
- Martha A. Maurer
- Sonderegger Research Center for Improved Medication Outcomes, School of Pharmacy, University of Wisconsin-Madison School of Pharmacy, Madison, WI 53705, USA;
| | - Olayinka O. Shiyanbola
- Division of Social and Administrative Sciences, School of Pharmacy, University of Wisconsin-Madison, Madison, WI 53705, USA
| | - Mattigan L. Mott
- School of Nursing, University of Wisconsin-Madison, Madison, WI 53705, USA;
| | - Julia Means
- Ebenezer Ministry & Family Worship Center, Milwaukee, WI 53212, USA;
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16
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LeMasters KH, Bledsoe SE, Brooks J, Chavis S, Little E, Pevia K, Daniel L, Jordan K, Schindler A, Lightfoot AF. The MI-PHOTOS Project: Understanding the Health and Wellbeing of Rural Historically Marginalized Mothers Through Photovoice. HEALTH EDUCATION & BEHAVIOR 2021; 49:10901981211057095. [PMID: 34963367 PMCID: PMC9377392 DOI: 10.1177/10901981211057095] [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: 11/17/2022]
Abstract
Despite the persistent health inequities faced by rural women in the United States, few researchers have partnered with women in rural communities to co-create sustainable change. To fill this gap, Mothers Improving Pregnancy and Postpartum Health Outcomes Through stOry Sharing (MI-PHOTOS) employed a community-based participatory research (CBPR) approach by partnering with mothers, community leaders, and community-based organizations in Robeson County, North Carolina, a rural, racially diverse county. The project's aims were (a) to promote maternal health by listening to mothers' stories of having and raising children in their community and (b) to develop a shared understanding of these mothers' strengths and challenges. MI-PHOTOS utilized photovoice, an exploratory and qualitative CBPR methodology. Grounded theory guided data analysis. During photovoice discussions, conversation focused on maternal experiences and evoked strengths, facilitators, and barriers impacting maternal health. Themes focused on (a) MI-PHOTOS serving as a social support group for the community and family stressors that mothers faced and (b) the necessity of professional support programs. Three overarching findings emerged during this process: (a) MI-PHOTOS as an informal support group, (b) mental health stigmatization, and (c) the need to bridge home visiting programs with peer and confidential therapeutic services. Future work should incorporate mothers' and communities' strengths into program development by drawing on existing home visiting programs, identifying opportunities for peer-support, and creating referral networks for individual, confidential therapeutic services. Through continued community partnership, we can generate fuller understandings of mothers' experiences of having and raising children and ultimately promote health equity among rural mothers.
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Affiliation(s)
| | - Sarah E Bledsoe
- The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- The University of Maryland, Baltimore, Baltimore, MD, USA
| | - Jada Brooks
- The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - Erica Little
- The University of North Carolina at Pembroke, Pembroke, NC, USA
| | - Kim Pevia
- KAP Inner Prizes, Red Springs, NC, USA
| | - Leah Daniel
- The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Kiva Jordan
- The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Ann Schindler
- The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Messer LC, Richardson DM. Police violence and preterm birth-Moving towards antiracism in our research on racism. Paediatr Perinat Epidemiol 2021; 35:479-481. [PMID: 33689175 DOI: 10.1111/ppe.12764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 02/16/2021] [Indexed: 11/26/2022]
Affiliation(s)
- Lynne C Messer
- Community Health and Epidemiology, Graduate Academic Affairs, OHSU-PSU School of Public Health, Portland, OR, USA
| | - Dawn M Richardson
- Community Health, Social Justice, OHSU-PSU School of Public Health, Portland, OR, USA
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Botchwey N, OConnell LK, Bryan K, Ricks T. Youth Advocacy Programs: Lessons From YEAH! Adult Leaders Evaluation Study. JOURNAL OF HEALTHY EATING AND ACTIVE LIVING 2021; 1:51-62. [PMID: 37789907 PMCID: PMC10544923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
Disparities in youth obesity continue despite an increasing number of programs designed to address this challenge. Policy, systems, and environmental (PSE) changes hold promise. Youth Engagement & Action for Health! (YEAH!) is a youth advocacy curriculum for PSE change that promotes healthy behaviors. From 2017-2019, 18 youth-serving organizations hosted YEAH! clubs serving 237 middle school youth from low-income communities. Study data include YEAH! adult leader surveys and interviews. Data were coded on themes of youth advocacy action, youth retention, and opportunities and threats to program success. After coding, the data were organized into four categories for validation by representative adult leaders. This study found that positive outcomes were facilitated by adult leaders who had previous engagement with the youth, who showed enthusiasm for youth advocacy, and who had access to resources to motivate group cohesion, participation, and commitment. Best practices highlighted from this study offer tested strategies for adult leaders of youth advocacy groups.
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Affiliation(s)
| | | | - Kim Bryan
- Glades Middle School, Miramar, Florida
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19
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Using community engagement to implement evidence-based practices for opioid use disorder: A data-driven paradigm & systems science approach. Drug Alcohol Depend 2021; 222:108675. [PMID: 33757707 PMCID: PMC8058324 DOI: 10.1016/j.drugalcdep.2021.108675] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 01/11/2021] [Accepted: 01/31/2021] [Indexed: 12/18/2022]
Abstract
Community-driven responses are essential to ensure the adoption, reach and sustainability of evidence-based practices (EBPs) to prevent new cases of opioid use disorder (OUD) and reduce fatal and non-fatal overdoses. Most organizational approaches for selecting and implementing EBPs remain top-down and individually oriented without community engagement (CE). Moreover, few CE approaches have leveraged systems science to integrate community resources, values and priorities. This paper provides a novel CE paradigm that utilizes a data-driven and systems science approach; describes the composition, functions, and roles of researchers in CE; discusses unique ethical considerations that are particularly salient to CE research; and provides a description of how systems science and data-driven approaches to CE may be employed to select a range of EBPs that collectively address community needs. Finally, we conclude with scientific recommendations for the use of CE in research. Greater investment in CE research is needed to ensure contextual, equitable, and sustainable access to EBPs, such as medications for OUD (MOUD) in communities heavily impacted by the opioid epidemic. A data-driven approach to CE research guided by systems science has the potential to ensure adequate saturation and sustainability of EBPs that could significantly reduce opioid overdose and health inequities across the US.
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20
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Carolan K, Charlot M, Gawuga C, Freeman E, Kim JH, Sprague Martinez L. Assessing cancer center researcher and provider perspectives on patient engagement. Transl Behav Med 2020; 10:1573-1580. [PMID: 31560395 DOI: 10.1093/tbm/ibz132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Participatory research approaches can help ensure research is culturally relevant and aligned with stakeholder priorities, but barriers exist between researchers and community stakeholders, particularly in communities of color. We developed a measurement tool for assessing oncology researcher and provider readiness to undertake patient-engaged research, and piloted this measurement tool among oncology researchers and providers at the hospital's cancer care center. A survey was developed by drawing from existing PCORI assessments as well as creating original questions, in an effort to develop an evidence-based survey tailored to this project. A total of 23 researchers and providers responded to the survey. The majority of respondents indicated that they were moderately or very familiar with the concept of patient-centered outcomes research. Most respondents had little to no experience engaging in participatory research and endorsed several barriers to engaging patients in the research process, including lack of experience and time. A mechanism for preparing and supporting researchers and providers is needed if cancer centers are to implement patient-powered research agendas as recommended by PCORI.
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Affiliation(s)
| | - Marjory Charlot
- Division of Hematology and Oncology, UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC
| | - Cyrena Gawuga
- Macro Department, Boston University School of Social Work, Boston, MA
| | - Elmer Freeman
- Center for Community Health Education Research and Service, Inc, Boston, MA
| | - Ji Hyang Kim
- Macro Department, Boston University School of Social Work, Boston, MA
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21
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Sprague Martinez L, Rapkin BD, Young A, Freisthler B, Glasgow L, Hunt T, Salsberry PJ, Oga EA, Bennet-Fallin A, Plouck TJ, Drainoni ML, Freeman PR, Surratt H, Gulley J, Hamilton GA, Bowman P, Roeber CA, El-Bassel N, Battaglia T. Community engagement to implement evidence-based practices in the HEALing communities study. Drug Alcohol Depend 2020; 217:108326. [PMID: 33059200 PMCID: PMC7537729 DOI: 10.1016/j.drugalcdep.2020.108326] [Citation(s) in RCA: 65] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Revised: 09/13/2020] [Accepted: 09/15/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND The implementation of evidence-based practices to reduce opioid overdose deaths within communities remains suboptimal. Community engagement can improve the uptake and sustainability of evidence-based practices. The HEALing Communities Study (HCS) aims to reduce opioid overdose deaths through the Communities That HEAL (CTH) intervention, a community-engaged, data-driven planning process that will be implemented in 67 communities across four states. METHODS An iterative process was used in the development of the community engagement component of the CTH. The resulting community engagement process uses phased planning steeped in the principles of community based participatory research. Phases include: 0) Preparation, 1) Getting Started, 2) Getting Organized, 3) Community Profiles and Data Dashboards, 4) Community Action Planning, 5) Implementation and Monitoring, and 6) Sustainability Planning. DISCUSSION The CTH protocol provides a common structure across the four states for the community-engaged intervention and allows for tailored approaches that meet the unique needs or sociocultural context of each community. Challenges inherent to community engagement work emerged early in the process are discussed. CONCLUSION HCS will show how community engagement can support the implementation of evidence-based practices for addressing the opioid crisis in highly impacted communities. Findings from this study have the potential to provide communities across the country with an evidence-based approach to address their local opioid crisis; advance community engaged research; and contribute to the implementation, sustainability, and adoption of evidence-based practices. TRIAL REGISTRATION ClinicalTrials.gov (NCT04111939).
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Affiliation(s)
- Linda Sprague Martinez
- Macro Department, School of Social Work, Boston University, 264 Baystate Road, Boston, MA 02215, United States.
| | - Bruce D. Rapkin
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, 1225 Morris Park Avenue, Van Etten, Room 3A2E, Bronx, NY 10461, United States
| | - April Young
- Department of Epidemiology, University of Kentucky College of Public Health, 111 Washington Avenue Office 211C, Lexington, KY 40536, United States
| | - Bridget Freisthler
- Ohio State University College of Social Work, 1947 College Rd N, Columbus, OH 43210, United States
| | - LaShawn Glasgow
- RTI International, 3040 East Cornwallis Road, Research Triangle Park, NC 27709-2194, United States
| | - Tim Hunt
- Columbia University, School of Social Work, Center for Healing of Opioid and Other Substance Use Disorders (CHOSEN), 1255 Amsterdam, Avenue, Rm 806, New York, NY 10027, United States
| | - Pamela J. Salsberry
- Ohio State University College of Public Health, 250 Cunz Hall, 1841 Neil Ave., Columbus, OH 43210, United States
| | - Emmanuel A. Oga
- RTI International, 3040 East Cornwallis Road, Research Triangle Park, NC 27709-2194, United States
| | - Amanda Bennet-Fallin
- University of Kentucky College of Nursing, 751 Rose Street, Lexington, KY 40536-0232, United States
| | - Tracy J. Plouck
- College of Health Sciences and Professions, Ohio University, 1 Ohio University Drive, Athens, OH 45701, United States
| | - Mari-Lynn Drainoni
- Section of Infectious Diseases, School of Medicine, & Department of Health Law Policy, School of Public Health, Boston University, 801 Massachusetts Avenue 2ndFloor, Boston, MA 02118, United States
| | - Patricia R. Freeman
- Department of Pharmacy Practice and Science, University of Kentucky College of Pharmacy, 789 S Limestone St, Lexington, KY 40536, United States
| | - Hilary Surratt
- Department of Behavioral Science, College of Medicine, University of Kentucky, 125 Medical Behavioral Science Building, Lexington, KY 40536-0298, United States
| | - Jennifer Gulley
- Clark County Health Department, 400 Professional Ave, Winchester, KY 40391, United States
| | - Greer A. Hamilton
- School Work, Boston University, 264 Baystate Road, Boston, MA 02215, United States
| | - Paul Bowman
- South End Community Health Center, 1601 Washington St, Boston, MA 02118, United States
| | - Carter A. Roeber
- National Mental Health and Substance Use Policy Laboratory, Substance Abuse and Mental Health Services Administration, 5600 Fishers Lane, Rockville, MD 20857, United States
| | - Nabila El-Bassel
- Columbia University School of Social Work, 1255 Amsterdam Avenue, New York, NY 10027-5927, United States
| | - Tracy Battaglia
- Women's Health Unit Boston Medical Center, Schools of Medicine & Public Health, Boston University, 801 Massachusetts Avenue 2ndFloor, Boston, MA 02118, United States
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22
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Dutta T, Meyerson BE, Agley J, Barnes PA, Sherwood-Laughlin C, Nicholson-Crotty J. A qualitative analysis of vaccine decision makers' conceptualization and fostering of 'community engagement' in India. Int J Equity Health 2020; 19:185. [PMID: 33081792 PMCID: PMC7574459 DOI: 10.1186/s12939-020-01290-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 09/24/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Globally, and in India, research has highlighted the importance of community engagement in achieving national vaccination goals and in promoting health equity. However, community engagement is not well-defined and remains an underutilized approach. There is also paucity of literature on community engagement's effectiveness in achieving vaccination outcomes. To address that gap, this study interviewed Indian vaccination decision makers to derive a shared understanding of the evolving conceptualization of community engagement, and how it has been fostered during India's Decade of Vaccines (2010-2020). METHODS Semi-structured interviews were conducted with 25 purposefully sampled national-level vaccine decision makers in India, including policymakers, immunization program heads, and vaccine technical committee leads. Participants were identified by their 'elite' status among decisionmakers in the Indian vaccination space. Schutz' Social Phenomenological Theory guided development of an a priori framework derived from the Social Ecological Model. The framework helped organize participants' conceptualizations of communities, community engagement, and related themes. Inter-rater reliability was computed for a subsample of coded interviews, and findings were validated in a one-day member check-in meeting with study participants and teams. RESULTS The interviews successfully elucidated participants' understanding of key terminology ("community") and approaches to community engagement propagated by the vaccine decision makers. Participants conceptualized 'communities' as vaccine-eligible children, their parents, frontline healthcare workers, and vaccination influencers. Engagement with those communities was understood to mean vaccine outreach, capacity-building of healthcare workers, and information dissemination. However, participants indicated that there were neither explicit policy guidelines defining community engagement nor pertinent evaluation metrics, despite awareness that community engagement is complex and under-researched. Examples of different approaches to community engagement ranged from vaccine imposition to empowered community vaccination decision-making. Finally, participants proposed an operational definition of community engagement and discussed concerns related to implementing it. CONCLUSIONS Although decision makers had different perceptions about what constitutes a community, and how community engagement should optimally function, the combined group articulated its importance to ensure vaccination equity and reiterated the need for concerted political will to build trust with communities. At the same time, work remains to be done both in terms of research on community engagement as well as development of appropriate implementation and outcome metrics.
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Affiliation(s)
- Tapati Dutta
- Room No. 469, Berndt Hall, Public Health Department, Health Sciences Division, Fort Lewis College, Durango, CO, 81301, USA.
| | - Beth E Meyerson
- Southwest Institute for Research on Women, College of Social & Behavioral Sciences, Family & Community Medicine, College of Medicine, University of Arizona, Tucson, USA
| | - Jon Agley
- Department of Applied Health Science, Prevention Insights, Indiana University School of Public Health-Bloomington, 809 E 9th Street, Room 101, Bloomington, IN, 47405, USA
| | - Priscilla A Barnes
- Department of Applied Health Science, Indiana University School of Public Health-Bloomington, 809 E 9th Street, Room 203, Bloomington, IN, 47405, USA
| | - Catherine Sherwood-Laughlin
- Department of Applied Health Science, Indiana University School of Public Health-Bloomington, 801 E 7th Street, Room 102, Bloomington, IN, 47405, USA
| | - Jill Nicholson-Crotty
- School of Public and Environmental Affairs, Indiana University, Room 351, 1315 E 10th Street, Bloomington, IN, 47405, USA
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Sprague Martinez LS, Tang Yan C, Augsberger A, Ndulue UJ, Libsch EA, Pierre JS, Freeman E, Gergen Barnett K. Changing The Face Of Health Care Delivery: The Importance Of Youth Participation. Health Aff (Millwood) 2020; 39:1776-1782. [PMID: 33017230 DOI: 10.1377/hlthaff.2020.00728] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Young people are often the intended audience for health and social programs, yet they rarely participate in the decision-making processes that determine how these programs are designed, implemented, or evaluated. Failing to meaningfully engage young people, well-intended adults may miss opportunities to create relevant and effective programs and policies for youth. This article describes a youth-led health assessment conducted with researchers from an academic medical center accountable care organization and stakeholders from a local community center. We explain the process of recruiting and engaging youth in this project, along with health concerns they identified in their communities via a survey, including mental and sexual health, food access, and community safety, as well as recommendations the youth researchers developed for improving health and tackling inequities. Our findings show that youth participation fosters a deeper sense of empowerment and leadership potential. Policy makers and other health leaders should consider engaging young people as they make decisions about health care delivery.
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Affiliation(s)
- Linda S Sprague Martinez
- Linda S. Sprague Martinez is an associate professor and department chair of macro practice at the Boston University School of Social Work, in Boston, Massachusetts
| | - Catalina Tang Yan
- Catalina Tang Yan is a doctoral research assistant in the Department of Macro Practice at the Boston University School of Social Work
| | - Astraea Augsberger
- Astraea Augsberger is an assistant professor of clinical practice at the Boston University School of Social Work
| | - Uchenna J Ndulue
- Uchenna J. Ndulue is an associate bureau director in the Child, Adolescent, and Family Health Bureau at the Boston Public Health Commission
| | - Emanuel Ayinde Libsch
- Emanuel Ayinde Libsch is a youth facilitator at the Center for Community Health Education Research and Service, Inc., in Boston
| | - Ja'Karri S Pierre
- Ja'Karri S. Pierre is a student in the Boston Latin School, Boston Public Schools
| | - Elmer Freeman
- Elmer Freeman is the executive director of the Center for Community Health Education Research and Service, Inc
| | - Katherine Gergen Barnett
- Katherine Gergen Barnett is the vice chair of Primary Care Innovation and Transformation and the program director of family medicine at the Boston Medical Center and Boston University Medical School
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Jemal A, Gunn A, Inyang C. Transforming responses: Exploring the treatment of substance-using African American women. J Ethn Subst Abuse 2020; 19:659-687. [PMID: 30940008 PMCID: PMC6776726 DOI: 10.1080/15332640.2019.1579141] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
This article explores how intrapersonal and structural oppression may impact treatment and the recovery process of 23 self-identified African American women with histories of incarceration and substance use. Using a critical consciousness (CC) framework and content-based thematic analysis, researchers systematically coded and extracted themes and patterns from focus group data to evaluate how marginalizing processes-such as race-based discrimination-impact treatment, the therapeutic relationship, and service provision. Results indicate that participants' health and treatment were negatively impacted by oppressive factors, specifically the oppressive process of silencing. The authors discuss research and practice implications.
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Affiliation(s)
- Alexis Jemal
- Silberman School of Social Work at Hunter College, 2180 3 Ave, New York, NY 10035
| | - Alana Gunn
- Department of Criminology, Law, and Justice, University of Illinois at Chicago, 1007 W. Harrison ST, Chicago, IL 60607
| | - Christina Inyang
- Clarity Treatment Center, LLC, 262 State St., Perth Amboy, NJ 08861
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Oichi M, Kamishima T, Hirano M. Processes that enable public health professionals to organize preventive care support groups. Public Health Nurs 2020; 37:880-888. [PMID: 32914476 DOI: 10.1111/phn.12806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 08/24/2020] [Accepted: 08/25/2020] [Indexed: 12/01/2022]
Abstract
OBJECTIVES This study examines the structure of the process that public health professionals (PHPs) use to organize preventive care groups for older adults and the elements that strengthen this process. DESIGN AND SAMPLE The study was conducted using a quantitative descriptive design. Anonymous self-administered questionnaires were distributed by mail to 919 PHPs, including nurses and social workers employed by local governments in a Japanese prefecture, who facilitated recreational groups for older adults for the purposes of preventive care. Measures Items related to the process and the awareness of support were based on previous research. The process structure was examined using exploratory factor analysis, while multiple logistic regression analysis was used to study strengthening elements. RESULTS The process yielded six factors (encouraging clarity with respect to the group's activity policy; creating connections with other resources; fostering independence; encouraging activity evaluation; creating relationships with group members; understanding the strengths and weaknesses of communities and individuals) with a total of 23 items. Two of three indicators of awareness of support were significantly related to the process. CONCLUSIONS Understanding the importance of strengthening elements might improve support groups for older adults.
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Affiliation(s)
- Miki Oichi
- Graduate School of Health Sciences, Hokkaido University, Hokkaido, Japan
| | | | - Michiyo Hirano
- Faculty of Health Sciences, Hokkaido University, Hokkaido, Japan
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Thommesen T, Kismul H, Kaplan I, Safi K, Van den Bergh G. "The midwife helped me ... otherwise I could have died": women's experience of professional midwifery services in rural Afghanistan - a qualitative study in the provinces Kunar and Laghman. BMC Pregnancy Childbirth 2020; 20:140. [PMID: 32138695 PMCID: PMC7059669 DOI: 10.1186/s12884-020-2818-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 02/18/2020] [Indexed: 11/11/2022] Open
Abstract
Background Afghanistan has one of the world’s highest maternal mortality ratios, with more than 60% of women having no access to a skilled birth attendant in some areas. The main challenges for childbearing Afghan women are access to skilled birth attendance, emergency obstetric care and reliable contraception. The NGO-based project Advancing Maternal and Newborn Health in Afghanistan has supported education of midwives since 2002, in accordance with the national plan for midwifery education. The aim of this study is to explore women’s experiences of professional midwifery care in four villages in Afghanistan covered by the project, so as to reveal challenges and improve services in rural and conflict-affected areas of the country. Methods An exploratory case-study approach was adopted. Fourteen in-depth interviews and four focus-group discussions were conducted. A total of 39 women participated – 25 who had given birth during the last six months, 11 mothers-in-law and three community midwives in the provinces of Kunar and Laghman. Data generated by the interviews and observations was analysed using thematic content analysis. Findings Many of the women greatly valued the trained midwives’ life-saving experience, skills and care, and the latter were important reasons for choosing to give birth in a clinic. Women further appreciated midwives’ promotion of immediate skin-to-skin contact and breastfeeding. However, some women experienced rudeness, discrimination and negligence on the part of the midwives. Moreover, relatives’ disapproval, shame and problems with transport and security were important obstacles to women giving birth in the clinics. Conclusions Local recruitment and professional education of midwives as promoted by Afghan authorities and applied in the project seem successful in promoting utilisation and satisfaction with maternal and neonatal health services in rural Afghanistan. Nevertheless, the quality of the services is still lacking, with some women complaining of disrespectful care. There seems to be a need to focus more on communication issues during the education of midwives. An increased focus on in-service training and factors promoting quality care and respectful communication is necessary and should be prioritised.
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Affiliation(s)
- Trude Thommesen
- Centre for International Health, Department for Global Public Health and Primary Health Care, University of Bergen, Bergen, Norway.
| | - Hallgeir Kismul
- Centre for International Health, Department for Global Public Health and Primary Health Care, University of Bergen, Bergen, Norway
| | - Ian Kaplan
- Norwegian Afghanistan Committee, Kabul, Afghanistan
| | - Khadija Safi
- Norwegian Afghanistan Committee, Kabul, Afghanistan
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Sumbul T, Spellen S, McLemore MR. A Transdisciplinary Conceptual Framework of Contextualized Resilience for Reducing Adverse Birth Outcomes. QUALITATIVE HEALTH RESEARCH 2020; 30:105-118. [PMID: 31752598 DOI: 10.1177/1049732319885369] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Research in preterm birth has focused on the disparate outcomes for Black, Hispanic, and Latina women as compared with White women. However, research studies have not focused on centering these women in frameworks that discuss how resilience is embodied. This article is a presentation of our transdisciplinary contextual framework of resilience, building on work that centers Black, Hispanic, and Latina women, as well as historical oppression and trauma resilience frameworks developed by transcultural psychiatry, psychology, public health, anthropology, medicine, nursing, sociology, and social work. To develop the model, we reviewed 115 articles and books (1977-2019), which were then evaluated and synthesized to develop a transdisciplinary framework of contextualized resilience to enable a better understanding of the complex interplay of medical and social conditions influencing preterm birth. The framework includes multiple ecological layers that cross the individual, familial and intimate, community, structural, policy and law, and hegemonic domains.
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Affiliation(s)
- Tijen Sumbul
- University of California, San Francisco, San Francisco, California, USA
| | - Solaire Spellen
- University of California, Berkeley, Berkeley, California, USA
| | - Monica R McLemore
- University of California, San Francisco, San Francisco, California, USA
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Petteway R, Mujahid M, Allen A, Morello-Frosch R. Towards a People's Social Epidemiology: Envisioning a More Inclusive and Equitable Future for Social Epi Research and Practice in the 21st Century. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E3983. [PMID: 31635327 PMCID: PMC6843593 DOI: 10.3390/ijerph16203983] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 10/13/2019] [Accepted: 10/16/2019] [Indexed: 12/17/2022]
Abstract
Social epidemiology has made critical contributions to understanding population health. However, translation of social epidemiology science into action remains a challenge, raising concerns about the impacts of the field beyond academia. With so much focus on issues related to social position, discrimination, racism, power, and privilege, there has been surprisingly little deliberation about the extent and value of social inclusion and equity within the field itself. Indeed, the challenge of translation/action might be more readily met through re-envisioning the role of the people within the research/practice enterprise-reimagining what "social" could, or even should, mean for the future of the field. A potential path forward rests at the nexus of social epidemiology, community-based participatory research (CBPR), and information and communication technology (ICT). Here, we draw from social epidemiology, CBPR, and ICT literatures to introduce A People's Social Epi-a multi-tiered framework for guiding social epidemiology in becoming more inclusive, equitable, and actionable for 21st century practice. In presenting this framework, we suggest the value of taking participatory, collaborative approaches anchored in CBPR and ICT principles and technological affordances-especially within the context of place-based and environmental research. We believe that such approaches present opportunities to create a social epidemiology that is of, with, and by the people-not simply about them. In this spirit, we suggest 10 ICT tools to "socialize" social epidemiology and outline 10 ways to move towards A People's Social Epi in practice.
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Affiliation(s)
- Ryan Petteway
- OHSU-PSU School of Public Health, Portland State University, Portland, OR 97201, USA.
| | - Mahasin Mujahid
- School of Public Health, University of California, Berkeley, CA 94720, USA.
| | - Amani Allen
- School of Public Health, University of California, Berkeley, CA 94720, USA.
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Chen E, Leos C, Kowitt SD, Moracco KE. Enhancing Community-Based Participatory Research Through Human-Centered Design Strategies. Health Promot Pract 2019; 21:37-48. [PMID: 31131633 DOI: 10.1177/1524839919850557] [Citation(s) in RCA: 106] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction. The purpose of this review is to compare and contrast the values, purpose, processes, and outcomes of human-centered design (HCD) and community-based participatory research (CBPR) approaches to address public health issues and to provide recommendations for how HCD can be incorporated into CBPR partnerships and projects. Review Process. By consulting published literature, source materials, and experts on both approaches, a team of researchers completed a three-phased process of synthesizing key similarities and differences between HCD and CBPR and generating recommendations for ways to integrate HCD strategies in CBPR projects. Results. There are five HCD strategies that can be readily incorporated into CBPR projects to improve outcomes: (1) form transdisciplinary teams, (2) center empathy, (3) recruit and work with "extreme users," (4) rapidly prototype, and (5) create tangible products or services. Conclusions. Integrating HCD in CBPR projects may lead to solutions that potentially have greater reach, are more readily adopted, are more effective, and add innovation to public health services, products, and policies.
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Affiliation(s)
- Elizabeth Chen
- The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Cristina Leos
- The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Sarah D Kowitt
- The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Kathryn E Moracco
- The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Inzeo PT, Christens BD, Hilgendorf A, Sambo A. Advancing Coalition Health Equity Capacity Using a Three-Dimensional Framework. Health Equity 2019; 3:169-176. [PMID: 31289776 PMCID: PMC6608683 DOI: 10.1089/heq.2018.0063] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose: We examined coalition health equity capacity using a three-dimensional conceptual framework in a 3-year study (2011–2014) of 28 local coalitions engaged in health promotion. Methods: Coalition health equity capacity was defined according to (1) conceptual foundations, (2) collective action and impact, and (3) civic orientation. This framework was used to qualitatively assess progress in capacity building efforts at two time points. Coalition materials and archival documents were analyzed qualitatively for indications of each dimension of coalition health equity capacity. Results: The overall cohort of coalitions was initially determined to be near mid-range in conceptual foundations, above mid-range on collective impact, and below mid-range on civic orientation. As part of ongoing training and technical assistance, coalitions were offered examples of high coalition health equity capacity in each dimension. At time point two, growth in health equity capacity was observed in a majority of coalitions. Conclusions: These findings indicate that a multidimensional approach to coalition health equity capacity can be useful for both analysis and practical purposes of community capacity building, which may, in turn, produce long-term gains in health equity.
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Affiliation(s)
- Paula Tran Inzeo
- Population Health Institute, University of Wisconsin-Madison, Madison, Wisconsin
| | - Brian D Christens
- Department of Human and Organizational Development, Vanderbilt University, Nashville, Tennessee
| | - Amy Hilgendorf
- Department of Civil Society and Community Studies, University of Wisconsin-Madison, Madison, Wisconsin
| | - Allison Sambo
- Department of Civil Society and Community Studies, University of Wisconsin-Madison, Madison, Wisconsin
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Bawah AA, Phillips JF, Asuming PO, Jackson EF, Walega P, Kanmiki EW, Sheff MC, Oduro A. Does the provision of community health services offset the effects of poverty and low maternal educational attainment on childhood mortality? An analysis of the equity effect of the Navrongo experiment in Northern Ghana. SSM Popul Health 2019; 7:100335. [PMID: 30623010 PMCID: PMC6304464 DOI: 10.1016/j.ssmph.2018.100335] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 12/03/2018] [Accepted: 12/05/2018] [Indexed: 10/27/2022] Open
Abstract
The Government of Ghana has instituted a National Poverty Reduction Program with an initiative known as the Community-based Health Planning and Services (CHPS) as its core health development strategy. CHPS was derived from a plausibility trial of the Navrongo Health Research Centre testing four contrasting primary health care strategies: i) Training unpaid volunteers to promote health in communities, ii) placing nurses in communities with training and supplies for treating childhood illnesses, iii) combining the nurse and volunteer approaches, and iv) sustaining a comparison condition whereby clinic services were provided without community resident workers. This paper presents an age-conditional proportional hazard analysis of the long term impact of community health worker exposure among 94,599 children who were ever under age five over the January 1, 1995 to December 2010 period, adjusting for age conditional effects of shifts in exposure type as CHPS was scaled up in Navrongo project area over the 1995-2000 period. Results show that children whose parents are uneducated and relatively poor experience significantly higher mortality risks than children of the educated and less poor. Conditional hazard regression models assess the impact of CHPS on health equity by estimating the interaction of equity indicators with household exposure to CHPS service operations, adjusting for age conditional exposure to original Community Health and Family Planning Project (CHFP) service strategies as scale-up progressed. The association of mortality risk among children with uneducated and relatively impoverished mothers is offset by exposure to community health nursing services. If exposure is limited to volunteer-provided services alone, survival benefits arise only among children of relatively advantaged households. Findings lend support to policies that promote the CHPS nurse approach to community-based services as a core health component of poverty reduction programs.
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Affiliation(s)
- Ayaga A. Bawah
- Regional Institute for Population Studies, University of Ghana, P. O. Box LG 96, Legon, Accra, Ghana
| | - James F. Phillips
- Heilbrunn Department of Population and Family Health, Columbia University, 60 Haven Ave, B-2, New York, NY 10032, USA
| | | | - Elizabeth F. Jackson
- Heilbrunn Department of Population and Family Health, Columbia University, 60 Haven Ave, B-2, New York, NY 10032, USA
| | - Paul Walega
- Navrongo Health Research Centre, Ghana Health Service, P. O. Box 114, Navrongo, Ghana
| | - Edmund W. Kanmiki
- Regional Institute for Population Studies, University of Ghana, P. O. Box LG 96, Legon, Accra, Ghana
| | - Mallory C. Sheff
- Heilbrunn Department of Population and Family Health, Columbia University, 60 Haven Ave, B-2, New York, NY 10032, USA
| | - Abraham Oduro
- Navrongo Health Research Centre, Ghana Health Service, P. O. Box 114, Navrongo, Ghana
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Merino Y, Barrington C, Villa-Torres L, Carcano J, Hightow-Weidman L. Negotiating Control of HIV: A Qualitative Analysis of HIV-Positive Latino MSM in North Carolina. AIDS Behav 2018; 22:4048-4056. [PMID: 29995205 DOI: 10.1007/s10461-018-2228-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The majority of HIV disease management happens outside of clinical encounters. As such, understanding how HIV fits into the lives of patients is key to improving HIV outcomes. The concept of control is a vital part of the social context within which health is managed. This qualitative study explores how a sample of Latino men who have sex with men living with HIV in North Carolina (n = 16) conceptualize and negotiate control in the context of living with HIV. We found that participants use a range of strategies to exert control over their lives including: understanding their infection, engaging with health care, and developing relationships with health professionals. By considering how individuals make sense of their HIV diagnosis and integrate it into their lives, HIV providers can direct efforts at strategic points of control decision-making and advanced clinicians can prioritize issues to address during clinical encounters.
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Affiliation(s)
- Yesenia Merino
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 302 Rosenau Hall, CB #7440, Chapel Hill, NC, 27599-7440, USA.
| | - Clare Barrington
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 302 Rosenau Hall, CB #7440, Chapel Hill, NC, 27599-7440, USA
| | - Laura Villa-Torres
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 302 Rosenau Hall, CB #7440, Chapel Hill, NC, 27599-7440, USA
| | - Joaquin Carcano
- Department of Infectious Diseases, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Lisa Hightow-Weidman
- Department of Infectious Diseases, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Kowitt SD, Donahue KE, Fisher EB, Mitchell M, Young LA. How is neighborhood social disorganization associated with diabetes outcomes? A multilevel investigation of glycemic control and self-reported use of acute or emergency health care services. Clin Diabetes Endocrinol 2018; 4:19. [PMID: 30377539 PMCID: PMC6194713 DOI: 10.1186/s40842-018-0069-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Accepted: 10/08/2018] [Indexed: 01/02/2023] Open
Abstract
Background Diabetes management is influenced by a number of factors beyond the individual-level. This study examined how neighborhood social disorganization (i.e., neighborhoods characterized by high economic disadvantage, residential instability, and ethnic heterogeneity), is associated with diabetes-related outcomes. Methods We used a multilevel modeling approach to investigate the associations between census-tract neighborhood social disorganization, A1c, and self-reported use of acute or emergency health care services for a sample of 424 adults with type 2 diabetes. Results Individuals living in neighborhoods with high social disorganization had higher A1c values than individuals living in neighborhoods with medium social disorganization (B = 0.39, p = 0.01). Individuals living in neighborhoods with high economic disadvantage had higher self-reported use of acute or emergency health care services than individuals living in neighborhoods with medium economic disadvantage (B = 0.60, p = 0.02). Conclusions High neighborhood social disorganization was associated with higher A1c values and high neighborhood economic disadvantage was associated with greater self-reported use of acute or emergency health care services. Controlling for individual level variables diminished this effect for A1c, but not acute or emergency health care use. Comprehensive approaches to diabetes management should include attention to neighborhood context. Failure to do so may help explain the continuing disproportionate diabetes burden in many neighborhoods despite decades of attention to individual-level clinical care and education. Trial registration For this study, we used baseline data from a larger study investigating the impacts on patient-centered outcomes of three different approaches to self-monitoring of blood glucose among 450 adults with non-insulin dependent type 2 diabetes living in North Carolina. This study was registered as a clinical trial on 1/7/2014 (https://clinicaltrials.gov/ct2/show/NCT02033499).
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Affiliation(s)
- Sarah D Kowitt
- 1Peers for Progress and Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Rosenau Hall, CB #7440, Chapel Hill, NC 27599-7440 USA.,2Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599 USA
| | - Katrina E Donahue
- 2Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599 USA.,3Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599 USA
| | - Edwin B Fisher
- 1Peers for Progress and Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Rosenau Hall, CB #7440, Chapel Hill, NC 27599-7440 USA
| | - Madeline Mitchell
- 3Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599 USA
| | - Laura A Young
- 4Division of Endocrinology & Metabolism, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599 USA
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Ward M, Schulz AJ, Israel BA, Rice K, Martenies SE, Markarian E. A conceptual framework for evaluating health equity promotion within community-based participatory research partnerships. EVALUATION AND PROGRAM PLANNING 2018; 70:25-34. [PMID: 29894902 PMCID: PMC6077092 DOI: 10.1016/j.evalprogplan.2018.04.014] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 03/07/2018] [Accepted: 04/29/2018] [Indexed: 05/12/2023]
Abstract
Community-based participatory research (CBPR) approaches present strong opportunities to promote health equity by improving health within low-income communities and communities of color. CBPR principles and evaluation frameworks highlight an emphasis on equitable group dynamics (e.g., shared leadership and power, participatory decision-making, two-way open communication) that promote both equitable processes within partnerships and health equity in the communities with whom they engage. The development of an evaluation framework that describes the manner in which equitable group dynamics promote intermediate and long-term equity outcomes can aid partners in assessing their ability to work together effectively and improve health equity in the broader community. CBPR principles align with health equity evaluation guidelines recently developed for Health Impact Assessments (HIAs), which emphasize meaningful engagement of communities in decision-making processes that influence their health. In this paper, we propose a synergistic framework integrating contributions from CBPR and HIA evaluation frameworks in order to guide efforts to evaluate partnership effectiveness in addressing health inequities. We suggest specific indicators that might be used to assess partnership effectiveness in addressing health equity and discuss implications for evaluation of partnership approaches to address health equity.
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Affiliation(s)
- Melanie Ward
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, USA 48109-2029,
| | - Amy J. Schulz
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, USA 48109-2029,
| | - Barbara A. Israel
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, USA 48109-2029,
| | - Kristina Rice
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, USA 48109-2029,
| | - Sheena E. Martenies
- 28221 SPH I, Department of Health Behavior and Health Education, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, USA 48109-2029,
| | - Evan Markarian
- 2794 SPH I, Department of Health Behavior and Health Education, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, USA 48109-2029,
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Vaughn LM, Jacquez F, Zhen-Duan J. Perspectives of Community Co-Researchers About Group Dynamics and Equitable Partnership Within a Community-Academic Research Team. HEALTH EDUCATION & BEHAVIOR 2018; 45:682-689. [PMID: 29618239 DOI: 10.1177/1090198118769374] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Equitable partnership processes and group dynamics, including individual, relational, and structural factors, have been identified as key ingredients to successful community-based participatory research partnerships. The purpose of this qualitative study was to investigate the key aspects of group dynamics and partnership from the perspectives of community members serving as co-researchers. Semistructured, in-depth interviews were conducted with 15 Latino immigrant co-researchers from an intervention project with Latinos Unidos por la Salud (LU-Salud), a community research team composed of Latino immigrant community members and academic investigators working in a health research partnership. A deductive framework approach guided the interview process and qualitative data analysis. The LU-Salud co-researchers described relationships, personal growth, beliefs/identity motivation (individual dynamics), coexistence (relational dynamics), diversity, and power/resource sharing (structural dynamics) as key foundational aspects of the community-academic partnership. Building on existing CBPR and team science frameworks, these findings demonstrate that group dynamics and partnership processes are fundamental drivers of individual-level motivation and meaning making, which ultimately sustain efforts of community partners to engage with the research team and also contribute to the achievement of intended research outcomes.
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Affiliation(s)
- Lisa M Vaughn
- 1 Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
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Sprague Martinez L, Richards-Schuster K, Teixeira S, Augsberger A. The Power of Prevention and Youth Voice: A Strategy for Social Work to Ensure Youths' Healthy Development. SOCIAL WORK 2018; 63:135-143. [PMID: 29373731 DOI: 10.1093/sw/swx059] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Accepted: 09/20/2017] [Indexed: 06/07/2023]
Abstract
The opening plenary session at the 2017 Annual Conference of the Society for Social Work and Research, which focused on ensuring healthy youth development, highlighted the need to include young people as partners in research and evaluation. In doing so, the conference participants joined the voices of a growing group of social work scholars committed to youth participation and engagement, who have also highlighted the importance of youth voice in the development of prevention strategies and programming that are aligned with the lived experience of young people. Presenting four unique social work efforts designed to harness the power of youth voice, this article shines a spotlight on the role of social work research and practice in harnessing the power of youth participation in efforts of promote healthy youth development. This article concludes by illustrating the benefits of youth engagement for young people, communities, and researchers.
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Affiliation(s)
- Linda Sprague Martinez
- Linda Sprague Martinez, PhD, is a Center for Promise research fellow and assistant professor, Macro Department, School of Social Work, Boston University, 264 Bay State Road, Boston, MA 02215; e-mail: . Katie Richards-Schuster, PhD, is assistant professor, School of Social Work, University of Michigan, Ann Arbor. Samantha Teixeira, PhD, is assistant professor, School of Social Work, Boston College, Chestnut Hill, MA. Astraea Augsberger, PhD, is assistant professor, Department of Clinical Practice, School of Social Work, Boston University. The research described in the case studies was supported by Target, Boston College, the Boston University Initiative on Cities, and the Community Foundation for Southeast Michigan
| | - Katie Richards-Schuster
- Linda Sprague Martinez, PhD, is a Center for Promise research fellow and assistant professor, Macro Department, School of Social Work, Boston University, 264 Bay State Road, Boston, MA 02215; e-mail: . Katie Richards-Schuster, PhD, is assistant professor, School of Social Work, University of Michigan, Ann Arbor. Samantha Teixeira, PhD, is assistant professor, School of Social Work, Boston College, Chestnut Hill, MA. Astraea Augsberger, PhD, is assistant professor, Department of Clinical Practice, School of Social Work, Boston University. The research described in the case studies was supported by Target, Boston College, the Boston University Initiative on Cities, and the Community Foundation for Southeast Michigan
| | - Samantha Teixeira
- Linda Sprague Martinez, PhD, is a Center for Promise research fellow and assistant professor, Macro Department, School of Social Work, Boston University, 264 Bay State Road, Boston, MA 02215; e-mail: . Katie Richards-Schuster, PhD, is assistant professor, School of Social Work, University of Michigan, Ann Arbor. Samantha Teixeira, PhD, is assistant professor, School of Social Work, Boston College, Chestnut Hill, MA. Astraea Augsberger, PhD, is assistant professor, Department of Clinical Practice, School of Social Work, Boston University. The research described in the case studies was supported by Target, Boston College, the Boston University Initiative on Cities, and the Community Foundation for Southeast Michigan
| | - Astraea Augsberger
- Linda Sprague Martinez, PhD, is a Center for Promise research fellow and assistant professor, Macro Department, School of Social Work, Boston University, 264 Bay State Road, Boston, MA 02215; e-mail: . Katie Richards-Schuster, PhD, is assistant professor, School of Social Work, University of Michigan, Ann Arbor. Samantha Teixeira, PhD, is assistant professor, School of Social Work, Boston College, Chestnut Hill, MA. Astraea Augsberger, PhD, is assistant professor, Department of Clinical Practice, School of Social Work, Boston University. The research described in the case studies was supported by Target, Boston College, the Boston University Initiative on Cities, and the Community Foundation for Southeast Michigan
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Lucero J, Wallerstein N, Duran B, Alegria M, Greene-Moton E, Israel B, Kastelic S, Magarati M, Oetzel J, Pearson C, Schulz A, Villegas M, White Hat ER. Development of a Mixed Methods Investigation of Process and Outcomes of Community-Based Participatory Research. JOURNAL OF MIXED METHODS RESEARCH 2018; 12:55-74. [PMID: 29230152 PMCID: PMC5722275 DOI: 10.1177/1558689816633309] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
This article describes a mixed methods study of community-based participatory research (CBPR) partnership practices and the links between these practices and changes in health status and disparities outcomes. Directed by a CBPR conceptual model and grounded in indigenous-transformative theory, our nation-wide, cross-site study showcases the value of a mixed methods approach for better understanding the complexity of CBPR partnerships across diverse community and research contexts. The article then provides examples of how an iterative, integrated approach to our mixed methods analysis yielded enriched understandings of two key constructs of the model: trust and governance. Implications and lessons learned while using mixed methods to study CBPR are provided.
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Affiliation(s)
| | | | | | | | | | | | - Sarah Kastelic
- National Indian Child Welfare Association, Portland, OR, USA
| | | | - John Oetzel
- University of Waikato, Hamilton, New Zealand
| | | | - Amy Schulz
- University of Michigan, Ann Arbor, MI, USA
| | - Malia Villegas
- National Congress of American Indians Policy Research Center, Washington, DC, USA
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Cuevas HE, Brown SA. Self-Management Decision Making of Cuban Americans With Type 2 Diabetes. J Transcult Nurs 2017; 29:222-228. [PMID: 28826301 DOI: 10.1177/1043659617696977] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
PURPOSE Although researchers have studied how individuals manage type 2 diabetes, none have examined how Cuban Americans do so. This article explores how Cuban Americans make self-management choices and examines whether an empowerment framework is viable for informing interventions. DESIGN A qualitative descriptive study was conducted ( n = 20) with Cuban Americans with type 2 diabetes. Individual interviews were analyzed with content analysis. RESULTS Motivation and temporal factors, such as knowledge of symptoms and the ability to plan ahead, positively affect self-management. Cultural factors, such as access to cultural foods, negatively affect self-management. Empowerment formed a comprehensive lens through which self-management decisions were acted on. CONCLUSION Given the cultural context, empowerment and unique barriers and facilitators can affect diabetes self-management in this population. Strategies to promote healthy decisions must take into account the strengths of this community as well as its challenges.
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Devia C, Baker EA, Sanchez-Youngman S, Barnidge E, Golub M, Motton F, Muhammad M, Ruddock C, Vicuña B, Wallerstein N. Advancing system and policy changes for social and racial justice: comparing a Rural and Urban Community-Based Participatory Research Partnership in the U.S. Int J Equity Health 2017; 16:17. [PMID: 28219386 PMCID: PMC5319156 DOI: 10.1186/s12939-016-0509-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Accepted: 12/28/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The paper examines the role of community-based participatory research (CBPR) within the context of social justice literature and practice. METHODS Two CBPR case studies addressing health inequities related to Type 2 Diabetes and Cardiovascular disease were selected from a national cross-site study assessing effective academic-community research partnerships. One CBPR partnership works with African Americans in rural Pemiscot County, Missouri and the other CBPR partnership works with African American and Latinos in urban South Bronx, New York City. Data collection included semi-structured key informant interviews and focus groups. Analysis focused on partnerships' context/history and their use of multiple justice-oriented strategies to achieve systemic and policy changes in order to address social determinants of health in their communities. RESULTS Community context and history shaped each partnership's strategies to address social determinants. Four social justice approaches (identity/recognition, procedural, distributive, and structural justice) used by both partnerships were identified. These social justice approaches were employed to address underlying causes of inequitable distribution of resources and power structures, while remaining within a scientific research framework. CONCLUSION CBPR can bridge the role of science with civic engagement and political participation, empowering community members to become political agents who integrate evidence into their social justice organizing strategies.
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Affiliation(s)
- Carlos Devia
- Bronx Health REACH, Institute for Family Health, New York, USA
- School of Public Health and Health Policy, City University of New York, New York, USA
| | - Elizabeth A. Baker
- College for Public Health and Social Justice, Saint Louis University, St. Louis, USA
| | | | - Ellen Barnidge
- College for Public Health and Social Justice, Saint Louis University, St. Louis, USA
| | - Maxine Golub
- Bronx Health REACH, Institute for Family Health, New York, USA
| | - Freda Motton
- Men on the Move, Saint Louis University, College for Public Health and Social Justice, St. Louis, USA
| | | | | | - Belinda Vicuña
- Department of Political Science, University of New Mexico, Albuquerque, USA
| | - Nina Wallerstein
- Center for Participatory Research, University of New Mexico, Albuquerque, USA
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Bach M, Jordan S, Hartung S, Santos-Hövener C, Wright MT. Participatory epidemiology: the contribution of participatory research to epidemiology. Emerg Themes Epidemiol 2017; 14:2. [PMID: 28203262 PMCID: PMC5301332 DOI: 10.1186/s12982-017-0056-4] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Accepted: 01/21/2017] [Indexed: 11/26/2022] Open
Abstract
Background Epidemiology has contributed in many ways to identifying various risk factors for disease and to promoting population health. However, there is a continuing debate about the ability of epidemiology not only to describe, but also to provide results which can be better translated into public health practice. It has been proposed that participatory research approaches be applied to epidemiology as a way to bridge this gap between description and action. A systematic account of what constitutes participatory epidemiology practice has, however, been lacking. Methods A scoping review was carried out focused on the question of what constitutes participatory approaches to epidemiology for the purpose of demonstrating their potential for advancing epidemiologic research. Relevant databases were searched, including both the published and non-published (grey) literature. The 102 identified sources were analyzed in terms of comparing common epidemiologic approaches to participatory counterparts regarding central aspects of the research process. Exemplary studies applying participatory approaches were examined more closely. Results A highly diverse, interdisciplinary body of literature was synthesized, resulting in a framework comprised of seven aspects of the research process: research goal, research question, population, context, data synthesis, research management, and dissemination of findings. The framework specifies how participatory approaches not only differ from, but also how they can enhance common approaches in epidemiology. Finally, recommendations for the further development of participatory approaches are given. These include: enhancing data collection, data analysis, and data validation; advancing capacity building for research at the local level; and developing data synthesis. Conclusion The proposed framework provides a basis for systematically developing the emergent science of participatory epidemiology.
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Affiliation(s)
| | | | - Susanne Hartung
- Catholic University of Applied Sciences Berlin, Berlin, Germany
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Perceived community environmental influences on eating behaviors: A Photovoice analysis. Soc Sci Med 2016; 171:18-29. [PMID: 27863286 PMCID: PMC5241160 DOI: 10.1016/j.socscimed.2016.11.004] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Revised: 08/30/2016] [Accepted: 11/02/2016] [Indexed: 11/24/2022]
Abstract
People's perceptions of local food environments influence their abilities to eat healthily. PhotoVoice participants from four communities in Alberta, Canada took pictures of barriers and opportunities for healthy eating and shared their stories in one-on-one semi-structured interviews. Using a socioecological framework, emergent themes were organized by type and size of environment. Findings show that, while availability and access to food outlets influence healthy eating practices, these factors may be eclipsed by other non-physical environmental considerations, such as food regulations and socio-cultural preferences. This study identifies a set of meta-themes that summarize and illustrate the interrelationships between environmental attributes, people's perceptions, and eating behaviors: a) availability and accessibility are interrelated and only part of the healthy eating equation; b) local food is synonymous with healthy eating; c) local food places for healthy eating help define community identity; d) communal dining (commensality) does not necessarily mean healthy eating; e) rewarding an achievement or celebrating special occasions with highly processed foods is socially accepted; f) food costs seemed to be driving forces in food decisions; g) macro-environmental influences are latent in food decisions. Recognizing the interrelationship among multiple environmental factors may help efforts to design effective community-based interventions and address knowledge gaps on how sociocultural, economic, and political environments intersect with physical worlds.
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Reisner SL, Poteat T, Keatley J, Cabral M, Mothopeng T, Dunham E, Holland CE, Max R, Baral SD. Global health burden and needs of transgender populations: a review. Lancet 2016; 388:412-436. [PMID: 27323919 PMCID: PMC7035595 DOI: 10.1016/s0140-6736(16)00684-x] [Citation(s) in RCA: 839] [Impact Index Per Article: 93.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Transgender people are a diverse population affected by a range of negative health indicators across high-income, middle-income, and low-income settings. Studies consistently document a high prevalence of adverse health outcomes in this population, including HIV and other sexually transmitted infections, mental health distress, and substance use and abuse. However, many other health areas remain understudied, population-based representative samples and longitudinal studies are few, and routine surveillance efforts for transgender population health are scarce. The absence of survey items with which to identify transgender respondents in general surveys often restricts the availability of data with which to estimate the magnitude of health inequities and characterise the population-level health of transgender people globally. Despite the limitations, there are sufficient data highlighting the unique biological, behavioural, social, and structural contextual factors surrounding health risks and resiliencies for transgender people. To mitigate these risks and foster resilience, a comprehensive approach is needed that includes gender affirmation as a public health framework, improved health systems and access to health care informed by high quality data, and effective partnerships with local transgender communities to ensure responsiveness of and cultural specificity in programming. Consideration of transgender health underscores the need to explicitly consider sex and gender pathways in epidemiological research and public health surveillance more broadly.
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Affiliation(s)
- Sari L Reisner
- Division of General Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA; Department of Epidemiology, Harvard T H Chan School of Public Health, Boston, MA, USA; Fenway Institute, Fenway Health, Boston, MA, USA.
| | - Tonia Poteat
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - JoAnne Keatley
- Center of Excellence for Transgender Health, University of California San Francisco, San Francisco, CA, USA
| | - Mauro Cabral
- Global Action for Trans* Equality, Buenos Aires, Argentina and New York, NY, USA
| | | | - Emilia Dunham
- Fenway Institute, Fenway Health, Boston, MA, USA; Heller School for Social Policy and Management, Brandeis University, Waltham, MA, USA
| | - Claire E Holland
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Ryan Max
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Stefan D Baral
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Strike C, Guta A, de Prinse K, Switzer S, Carusone SC. Opportunities, challenges and ethical issues associated with conducting community-based participatory research in a hospital setting. RESEARCH ETHICS REVIEW 2016. [DOI: 10.1177/1747016115626496] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Community-based participatory research (CBPR) is growing in popularity as a research strategy to engage communities affected by health issues. Although much has been written about the benefits of using CBPR with diverse groups, this research has usually taken place in community-based organizations which offer social services and programs. The purpose of this article is to explore the opportunities and challenges encountered during a CBPR project conducted in a small hospital serving people living with HIV and addictions issues. The structure of hospital-based care delivery required the team to account for participants’ health-related limitations, including adopting recruitment strategies built on clinical care, and modifying the original research design to better protect participant confidentiality in a small space. Although CBPR offers an important strategy for researching with members of hospitalized communities, it requires research teams to develop context-relevant approaches to ethically engaging community members that recognize the ways clinical space mediates the research process.
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Affiliation(s)
- C Strike
- University of Toronto, Dalla Lana School of Public Health, Toronto, Canada
- Centre for Addiction and Mental Health, Toronto, Canada
| | - A Guta
- Carleton University, Department of Health Sciences, Ottawa, Canada
| | | | - S Switzer
- York University, Faculty of Environmental Studies, Toronto, Canada
| | - S Chan Carusone
- McMaster University, Department of Clinical Epidemiology and Biostatistics, Hamilton, Canada
- Casey House Hospital, Toronto, Canada
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Vaughn LM, Jacquez F, Marschner D, McLinden D. See what we say: using concept mapping to visualize Latino immigrant’s strategies for health interventions. Int J Public Health 2016; 61:837-45. [DOI: 10.1007/s00038-016-0838-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Revised: 05/05/2016] [Accepted: 05/11/2016] [Indexed: 11/29/2022] Open
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Muhammad M, Wallerstein N, Sussman AL, Avila M, Belone L, Duran B. Reflections on Researcher Identity and Power: The Impact of Positionality on Community Based Participatory Research (CBPR) Processes and Outcomes. CRITICAL SOCIOLOGY 2015; 41:1045-1063. [PMID: 27429512 PMCID: PMC4943756 DOI: 10.1177/0896920513516025] [Citation(s) in RCA: 154] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
The practice of community based participatory research (CBPR) has evolved over the past 20 years with the recognition that health equity is best achieved when academic researchers form collaborative partnerships with communities. This article theorizes the possibility that core principles of CBPR cannot be realistically applied unless unequal power relations are identified and addressed. It provides theoretical and empirical perspectives for understanding power, privilege, researcher identity and academic research team composition, and their effects on partnering processes and health disparity outcomes. The team's processes of conducting seven case studies of diverse partnerships in a national cross-site CBPR study are analyzed; the multi-disciplinary research team's self-reflections on identity and positionality are analyzed, privileging its combined racial, ethnic, and gendered life experiences, and integrating feminist and post-colonial theory into these reflections. Findings from the inquiry are shared, and incorporating academic researcher team identity is recommended as a core component of equalizing power distribution within CBPR.
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Ballard PJ, Syme SL. Engaging youth in communities: a framework for promoting adolescent and community health. J Epidemiol Community Health 2015; 70:202-6. [PMID: 26443541 DOI: 10.1136/jech-2015-206110] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Accepted: 09/20/2015] [Indexed: 11/04/2022]
Abstract
Health researchers and practitioners increasingly recognise the important role communities play in shaping individual health. Health researchers recognise the role of community factors as causes or determinants of health problems; use community-based methods for understanding complex health issues; and design community-level health solutions. In this commentary, we propose a fourth way to think about the role of communities in individual health by arguing that the community engagement process itself has implications for individual health and strong communities. This topic is especially important during adolescence, a developmental window of opportunity during which individuals need meaningful opportunities to contribute to the world around them.
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Affiliation(s)
- Parissa J Ballard
- University of California, Berkeley and University of California, San Francisco, California, USA
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Smith VC, Jemal A. Addressing the Health of Formerly Imprisoned Persons in a Distressed Neighborhood Through a Community Collaborative Board. Health Promot Pract 2015; 16:733-44. [PMID: 26055460 PMCID: PMC4824636 DOI: 10.1177/1524839915588293] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This article provides a case study evaluating the structure and dynamic process of a Community Collaborative Board that had the goal of creating an evidence-based substance abuse/health intervention for previously incarcerated individuals. Meeting agendas, attendance, minutes, video recording of meetings, and in-depth interviews with 13 Community Collaborative Board members were used to conduct an independent process evaluation. Open coding identified quotes exemplifying specific themes and/or patterns across answers related to the desired domain. Several themes were identified regarding membership engagement, retention, and power distribution. Results showed member retention was due to strong personal commitment to the targeted problem. Analysis also revealed an unequal power distribution based on participants' background. Nevertheless, the development of an innovative, community-based health intervention manual was accomplished. Aspects of the process, such as incentives, subcommittees, and trainings, enhanced the Board's ability to integrate the community and scientific knowledge to accomplish its research agenda. Community-based participatory research was a useful framework in enhancing quality and efficiency in the development of an innovative, substance abuse/health intervention manual for distressed communities. Overall, this article sheds light on a process that illustrates the integration of community-based and scientific knowledge to address the health, economic, and societal marginalization of low-income, minority communities.
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Salemi JL, Salinas-Miranda AA, Wilson RE, Salihu HM. Transformative Use of an Improved All-Payer Hospital Discharge Data Infrastructure for Community-Based Participatory Research: A Sustainability Pathway. Health Serv Res 2015; 50 Suppl 1:1322-38. [PMID: 25879276 PMCID: PMC4545334 DOI: 10.1111/1475-6773.12309] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To describe the use of a clinically enhanced maternal and child health (MCH) database to strengthen community-engaged research activities, and to support the sustainability of data infrastructure initiatives. DATA SOURCES/STUDY SETTING Population-based, longitudinal database covering over 2.3 million mother-infant dyads during a 12-year period (1998-2009) in Florida. SETTING A community-based participatory research (CBPR) project in a socioeconomically disadvantaged community in central Tampa, Florida. STUDY DESIGN Case study of the use of an enhanced state database for supporting CBPR activities. PRINCIPAL FINDINGS A federal data infrastructure award resulted in the creation of an MCH database in which over 92 percent of all birth certificate records for infants born between 1998 and 2009 were linked to maternal and infant hospital encounter-level data. The population-based, longitudinal database was used to supplement data collected from focus groups and community surveys with epidemiological and health care cost data on important MCH disparity issues in the target community. Data were used to facilitate a community-driven, decision-making process in which the most important priorities for intervention were identified. CONCLUSIONS Integrating statewide all-payer, hospital-based databases into CBPR can empower underserved communities with a reliable source of health data, and it can promote the sustainability of newly developed data systems.
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Affiliation(s)
- Jason L Salemi
- Address correspondence to Jason L. Salemi, Ph.D., Department of Family and Community Medicine, Baylor College of Medicine, 3701 Kirby Drive, Suite 600 (MS: BCM700), Houston, TX; e-mail:
| | - Abraham A Salinas-Miranda
- Abraham A. Salinas-Miranda, M.D., Ph.D., Roneé E. Wilson, Ph.D., and Hamisu M. Salihu, M.D., Ph.D., are with The Maternal and Child Health Comparative Effectiveness Research Group, Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, FL
- Hamisu M. Salihu, M.D., Ph.D., is also with the, Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX
| | - Roneé E Wilson
- Abraham A. Salinas-Miranda, M.D., Ph.D., Roneé E. Wilson, Ph.D., and Hamisu M. Salihu, M.D., Ph.D., are with The Maternal and Child Health Comparative Effectiveness Research Group, Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, FL
- Hamisu M. Salihu, M.D., Ph.D., is also with the, Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX
| | - Hamisu M Salihu
- Abraham A. Salinas-Miranda, M.D., Ph.D., Roneé E. Wilson, Ph.D., and Hamisu M. Salihu, M.D., Ph.D., are with The Maternal and Child Health Comparative Effectiveness Research Group, Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, FL
- Hamisu M. Salihu, M.D., Ph.D., is also with the, Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX
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Guidry VT, Lowman A, Hall D, Baron D, Wing S. Challenges and benefits of conducting environmental justice research in a school setting. New Solut 2015; 24:153-70. [PMID: 25085828 DOI: 10.2190/ns.24.2.c] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Environmental justice (EJ) research requires attention to consequences for research participants beyond those typically considered by institutional review boards. The imbalance of power between impacted communities and those who create and regulate pollution creates challenges for participation, yet research can also benefit those involved. Our community-academic partnership designed the Rural Air Pollutants and Children's Health (RAPCH) study to provide positive impacts while measuring health effects at three low-resource public middle schools near concentrated animal feeding operations (CAFOs) in North Carolina. We evaluated perceived benefits and challenges of study involvement by interviewing school staff and community liaisons who facilitated data collection. Reported benefits included enhancement of students' academic environment and increased community environmental awareness; challenges were associated mainly with some participants' immaturity. Leadership from a strong community-based organization was crucial to recruitment, yet our approach entailed minimal focus on EJ, which may have limited opportunities for community education or organizing for environmental health.
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Affiliation(s)
- Virginia T Guidry
- Department of Epidemiology, University of North Carolina at Chapel Hill
| | - Amy Lowman
- Department of Epidemiology, University of North Carolina at Chapel Hill
| | - Devon Hall
- Rural Empowerment Association for Community Help (REACH), Warsaw, NC
| | - Dothula Baron
- Epidemiology Department at UNC-Chapel Hill, Rural Empowerment Association for Community Help (REACH)
| | - Steve Wing
- University of North Carolina at Chapel Hill
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Ashing KT, Miller AM, Mitchell E, Martin V, McDowell K, Santifer R, Smith J, Brown S, Ragin C, Carrington A. Nurturing Advocacy Inclusion to Bring Health Equity in Breast Cancer among African American Women. BREAST CANCER MANAGEMENT 2014; 3:487-495. [PMID: 26913082 DOI: 10.2217/bmt.14.41] [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] [Indexed: 11/21/2022] Open
Abstract
This paper will present the multiple roles and the impact of cancer advocates. The emerging literature provides evidence for the consideration and integration of African American BC survivors as advocates in practice, policy and research relevant to cancer prevention and control. We present a practical outline for organizational assessment for the inclusion of advocates in these arenas. This assessment can be conducted by all levels of partners, including community advocacy and scientific organizations.
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Affiliation(s)
- Kimlin Tam Ashing
- Center of Community Alliance for Research and Education (CCARE), Department of Population Sciences, City of Hope National Medical Center, Duarte, CA, United States
| | - Aria M Miller
- Center of Community Alliance for Research and Education (CCARE), Department of Population Sciences, City of Hope National Medical Center, Duarte, CA, United States
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