The Journal of Primary Prevention最新文献

CenteringPregnancy, an alternative to traditional prenatal care, offers additional time between clinicians and patients with the goal of increasing knowledge, understanding, and autonomy in pregnant participants. We investigated whether these women would be more likely to receive recommended Tdap and influenza vaccinations relative to others who received one-on-one traditional prenatal care. Our study employed a retrospective chart review of all women who participated in CenteringPregnancy group care compared to a group of matched women who received only traditional prenatal care at a large, quaternary care referral academic center. We extracted demographic and clinical characteristics from charts that included maternal age during pregnancy care and parity. Outcome variables of interest were influenza and Tdap vaccination status. Compared with traditional obstetrical care patients, women who participated in CenteringPregnancy were 1.7-2.7 times more likely to obtain the Tdap and influenza vaccines. These findings may be attributable to the increased opportunity for patient education and social support offered by the CenteringPregnancy model.

This paper describes our approach to forming and engaging a community advisory board (CAB) to assist in the development of a proposed exercise intervention pilot study. The intervention aimed to examine the effects of exercise on exercise adherence, the provision of partner support and receptivity to partner health influence, and cardiometabolic risk in older African-American romantic couples. CAB invitations were extended to local community members and leaders who had a stake in the health of the target population. Seven individuals accepted the invitation and attended at least one of two CAB meetings during which we proposed ideas for the exercise intervention pilot study, then solicited CAB input in four key areas related to the study including: (1) priority health concerns of the target population, (2) the intervention protocol and methodologies, (3) cultural relevance, and (4) sustainability. Two investigators jointly led both CAB meetings, which lasted approximately 3 h each. Recorded community feedback was summarized and coded using a thematic analysis approach. Themes were identified and agreed upon within the four areas identified above. Overall, the proposed study was well-received by the CAB and considered beneficial for and relevant to the target population. Although not all suggestions put forth by the CAB were feasible given the inherent limitations of pilot work, we made multiple study modifications as a result of CAB recommendations. Further, all CAB feedback helped inform plans to launch the intervention on a larger scale and were vital in ensuring that the pilot study was valued in the local community. Although community-based participatory research that originates within a community may be preferable, we demonstrate the utility of a community-partnered approach to intervention design in a vulnerable population. This model could assist researchers who wish to engage the local community to help develop a preliminary idea for a health-related intervention.

Since African Americans are disproportionately affected by HIV/AIDS, interventions that increase correct and consistent condom use are urgently needed. We report baseline acceptability data from a randomized controlled trial (RCT) testing the Tailored Information Program for Safer Sex, a computer-tailored intervention designed to increase correct and consistent condom use among low income, heterosexually active African Americans attending an urban sexually transmitted infection (STI) clinic. We enrolled 274 participants at baseline in an RCT-147 in the intervention group. The intervention had high acceptability, with a mean acceptability of 4.35 on a 5-point scale. We conducted a multiple regression analysis examining demographic, structural, and sexual risk characteristics that revealed only sex to be significantly (p < .01) associated with intervention acceptability. While women were more likely than men to find the intervention acceptable, overall the results indicated broad acceptability of this intervention to the target audience. eHealth interventions are a viable option for HIV prevention among African Americans visiting a publicly-funded STI clinic. We discuss implications of these results for the future application of such programs.

Health-related behaviours in children can be influenced by parental support programmes. The aim of this study was to explore barriers to and facilitators for the implementation of a parental support programme to promote physical activity and healthy dietary habits in a school context. We explored the views and experiences of 17 coordinating school nurses, non-coordinating school nurses, and school principals. We based the interview guide on the Consolidated Framework for Implementation Research. We held four focus group discussions with coordinating and non-coordinating school nurses, and conducted three individual interviews with school principals. We analysed data inductively using qualitative content analysis. We identified "Creating commitment in an overburdened work situation" as an overarching theme, emphasising the high workload in schools and the importance of creating commitment, by giving support to and including staff in the implementation process. We also identified barriers to and facilitators of implementation within four categories: (1) community and organisational factors, (2) a matter of priority, (3) implementation support, and (4) implementation process. When implementing a parental support programme to promote physical activity and healthy dietary habits for 5- to 7-year-old children in the school context, it is important to create commitment among school staff and school nurses. The implementation can be facilitated by political support and additional funding, external guidance, use of pre-existing resources, integration of the programme into school routines, a clearly structured manual, and appointment of a multidisciplinary team. The results of this study should provide useful guidance for the implementation of similar health promotion interventions in the school context.

U.S. Latinos face multiple inter-related barriers to access health and social services. Researchers and practitioners have called upon community-based participatory research (CBPR) to address such challenges and health disparities, with the community health worker-or promotoras-model evidencing positive outcomes. What is less clear, however, are the promising strategies to support the development of a multisystem, community-based promotoras program. In response, the current study applied a CBPR conceptual model as an organizing framework to develop a promotora program. Lazos Hispanos (Hispanic Links) was developed to enhance the health and well-being of Latinx residing in low-income communities in the Southeastern United States. This study highlights 16 lessons learned, anchored in the first two dimensions of the CBPR conceptual model: community context and partnership development. First, the community assessment and activities leading to Lazos Hispanos took nearly 2 years but were crucial to develop a strong basis for the program. Second, the development of a multicultural and interdisciplinary research team enriched every aspect of the program and enhanced culturally responsive community engagement. Selection, training, and ongoing support of the promotoras were fundamental to program success. Particularly important were the following: receiving mentorship from a successful promotora organization; delineating mutually agreed upon roles and responsibilities; following national training standards for community health workers; and, holding monthly meetings for training, support, and data collection. The engagement of community service providers as partners was facilitated by building upon existing community relationships, signing a memorandum of understanding that specified roles and responsibilities, conducting tours of provider facilities with the promotoras, and keeping providers abreast of the program via bi-annual community gatherings. The development process showed fidelity to the conceptual model. Lazos Hispanos has proven an asset to participants, the promotoras, and service providers as the program continues to develop a community-based, health supportive infrastructure.