Journal of Prevention & Intervention in the Community最新文献

Background: Cardiovascular disease (CVD) is common in American Indian/Alaska Native (AI/AN) adults and represents the leading cause of mortality. Risk factors for CVD in AI/AN adults are well-described, and a growing body of evidence reports the inequitable prevalence of factors associated with the development of CVD in AI/AN children, including obesity, physical inactivity, and diabetes mellitus (DM).

Objective: This article organizes and summarizes the evidence describing CVD risk factors in AI/AN children, discusses the social drivers of health impacting these risks, and highlights several programs that have demonstrated effectiveness in improving AI/AN child health.

Results: Fortunately, multiple community- and Tribal-based programs have aimed to mitigate the impact of obesity, diabetes, and physical activity in AI/AN youth, given that nascent CVD begins in the pediatric years. These efforts include screening, lifestyle choices, including diet and exercise, and, importantly, culturally relevant programming to promote cardiovascular health in AI/AN children.

Discussion: Though at a disproportionate risk for CVD based on biological and social drivers of health, AI/AN children are being prioritized by their communities, and there are many ongoing efforts to support their cardiovascular health. However, further investigation and investment is warranted to protect this population and address ongoing disparities in AI/AN CVD.

The article uses theory and qualitative evidence to show how youth participatory action research (YPAR) can advance educational equity. YPAR engages young people and adult allies in research and action on issues in their schools and communities. Interviews with over two dozen YPAR researchers-students and partner teachers-elaborate the mechanisms through which school-based YPAR can affect equity, including through direct changes to policy and practice as a result of YPAR actions, a school culture that values student experiences, transformative teacher-student relationships, and improved individual outcomes for participants. To help theorize a theory of change, we draw on Doreen Massey's space theory to explain how YPAR done in schools can transform culture, relationships, practice, and policy. Further, we suggest how YPAR can be infused in schools.

Democratic innovations offer a promising set of interventions to empower citizens, reduce polarization, and reimagine participatory governance. This article examines the Petaluma Fairgrounds Advisory Panel (PFAP), a citizens assembly convened to deliberate the future of a locally significant property. This qualitative study consisted of 15 panelist interviews exploring panelist experiences of nine equity strategies incorporated into the PFAP design as well as broader themes around how equity was conceptualized. Certain equity strategies emerged as particularly salient in shaping panelists' experiences, underscoring the significance of specific design components in fostering equity. In most cases appraisals were positive, though several critiques and negative assessments were mentioned. Panelist conceptualizations of equity centered around notions of fairness and belonging. The current study offers a window into how strategies to promote equity are experienced, and can inform participatory and deliberative practices that seek to effectively incorporate values of equity.

Rural hospitals are closing rapidly across the US, causing a decline in access to health care for rural populations. Tennessee has the highest rate of rural hospital closures per capita; however, some rural hospitals have managed to survive. To better understand protective strategies against rural hospital closures in Tennessee, fourteen interviews were conducted with hospital stakeholders in five racially and geographically diverse rural communities. Interviewees shared perspectives on strategies that have supported their hospital's continued operations. Interviews were recorded and transcribed. Transcripts were analyzed using rapid qualitative analysis. Analysis of participants' interviews resulted in the emergence of six major themes to reduce hospitals' risk for closure: government policy; commercial factors; business-internal strategies; community-engagement strategies; ongoing challenges, and behavioral health and substance abuse. Within these major themes, subthemes were elucidated. Amplifying the concerns and successful strategies of rural hospital stakeholders may provide solutions to address the health crisis affecting rural communities throughout the US and advance rural health equity.

The Earned Income Tax Credit (EITC) is an important economic safety net for many working families across America. Enacted in 1975, the credit provides credit to low- and moderate-income households with labor income. Receipt of the EITC has been demonstrated to provide substantial benefits to direct recipients, benefits that cascade intergenerationally, and benefits for communities in which recipients reside. The full potential of the EITC has not been realized because of a relatively low participation rate. In this paper, we describe a framework designed to increase participation in the EITC and the results of pilot testing that utilized this framework in Utah. Overall, our work suggests that schools might work best as locations for EITC take-up interventions when family engagement centers are present. Our recommendation is to use these structures as effective outreach.

Leaders undertaking the effort to dismantle structural inqualities at the organizational level often find traditional professional development on diversity, equity, and inclusion to be limited in scope, rarely leading to meaningful organizational change. The Racial Equity, Diversity, and Inclusion (REDI) Movement was developed in 2020 by associates within a Midwest university research center to increase efforts toward the pursuit of a holistic, systems-level approach to equity, social justice, and inclusion. REDI now includes several interventions that prepare associates and their teams to advance racial justice and equity across four levels of the REDI Framework: Intrapersonal, Interpersonal, Institutional, and Societal. This case study investigates a team-based, voluntary pilot intervention within REDI known as the Equity Inventory Planning Process (EIPP), specifically targeting policy development to address structural racism at the institutional level. We piloted the EIPP with seven early care and education organizations following a year of strategic planning and consultation with the leading statewide Head Start association.

To foster meaningful participation within a community, people must have access to suitable and safe housing. Unfortunately, many people with disabilities currently reside in homes that fail to meet their functional, social, and psychological needs. Limited research has explored the interaction between housing and home usability on community participation for people with disabilities. This analysis seeks to delve deeper into the intricacies of the relationship between home usability and community participation. Employing a qualitative approach and analysis, we examine the experiences of participants who completed the Home Usability Program at Centers for Independent Living across the United States. Results indicate that home usability affects community participation dynamically through five, interconnected mechanisms: Health and Function, Autonomy and Choice, Social Interaction, Organization, and Safety.

Cardiovascular diseases (CVDs) are a major cause of death globally, and minority communities are at higher risk of chronic health outcomes. A combination of lifestyle, including physical activity (PA), good nutrition, and reduced stress, can improve life expectancy. This study aimed to analyze the association between CVDs and PA among the adult population (N = 3,956) based on the World Health Organization (WHO) STEPwise Approach to Surveillance (STEPS) survey in Afghanistan. Descriptive statistics, logistic regression, and spatial analytical techniques were used to analyze the data. Based on the WHO STEPS data, the computed prevalence of CVDs, obesity, hypertension, diabetes, and high cholesterol were 7.41%, 45.57%, 34.06%, 9.51%, and 12.16%, respectively. Multivariate logistic analysis indicated that moderate work-related PA was associated with higher odds of CVDs and high cholesterol while inversely associated with obesity. Moderate leisure-related PA was positively associated with obesity. Vigorous leisure-related PA was associated with lower risks of CVDs, obesity, and high cholesterol but had a positive association with hypertension. Spatial analysis revealed a CVD hotspot in the southern region and the risk factors clustered in the northern region. These findings offer valuable insights for community and public health practitioners to design targeted interventions for reducing the burden of CVDs and risk factors in communities in developing countries.

Purpose: To present information on the feasibility and acceptability of a Stroke Champion "train-the-trainer" program, including lessons learned, for dissemination of stroke prevention knowledge and resources among African Americans (AA) residing within the Minneapolis-St. Paul, MN metropolitan area.

Design: One arm pre-post-test design.

Methods: Twelve AA "Stroke Champions" were recruited to assess the feasibility and acceptability of an online stroke prevention education curriculum and peer-to-peer education.

Results: We successfully designed, developed, and implemented a stroke prevention education website for community use. All Stroke Champions completed initial training and evaluation, and reported the usefulness and usability of the website., However, they also reported that they needed more facilitation support from our research team to deliver education in the community.

Conclusion: Engaging Stroke Champions is potentially beneficial in increasing stroke prevention knowledge. However, Stroke Champions need more support to effectively engage, educate, and disseminate knowledge among peers.

During the most recent wave of anti-racism movements in the U.S., Critical Race Theory has gained attention as a key mechanism to identify, deconstruct, and challenge dominant white American ideologies and their associated institutional practices. Given that Critical Race Theory threatens to unmask and destabilize centralized white racialized power in the United States, dominant white cultural and institutional backlash to attack, suppress, and invalidate anti-racist ideologies and practices has reached new levels. This article proposes that the American conservative right-wing uses a core rhetorical strategy known as Institutional DARVO to undermine anti-racism movements and Critical Race Theory. Institutional DARVO is a systems-level extension of DARVO (Deny, Attack, Reverse Victim and Offender) which identifies three specific patterns of abuse seen in intimate partner violence. This article will provide an analysis of the document issued by former President Donald J. Trump on September 22, 2020, "Executive Order on Combating Race and Sex Stereotyping," to illustrate the governmental-political use of Institutional DARVO in the backlash against Critical Race Theory. This Executive Order has influenced conservative political ideas and rhetoric that has fueled the growing surge of book bans, anti-DEI governmental practices and policies, anti-education legislation, and the recent supreme court decision to declare affirmative action unlawful. Identifying these core patterns and strategies used by primarily white conservative groups and institutions to challenge anti-racist movements is critically important in addressing both the realities and false narratives around race and inequity in the United States, as these narratives are impacting our current social, political, legal, and educational culture, practices, and policies.