Journal of Prevention & Intervention in the Community最新文献

Mobile healthcare clinics have emerged as a promising method to address physical obstacles and sociocultural limitations to rural healthcare while improving health outcomes for communities. These clinics address rural healthcare needs by providing accessible, culturally sensitive, patient-centered care. This study examined the experiences of volunteers at a mobile healthcare provider in Appalachian Tennessee. Semi-structured interviews with volunteers were conducted to explore how volunteering shapes perceptions of rural healthcare, impacts personal and professional lives, and informs volunteers' understanding of healthcare disparities. Participants reported growth and professional development as major personal impacts of their volunteering experience. A common theme was a distinction between volunteer groups and their personal impacts. All volunteers, irrespective of their role, felt they gained valuable insight into the broader context of rural healthcare as well as gained perspective into the unique communities they serve. The results of this study highlight the impact of volunteering in shaping community understanding.

This retrospective cohort study examined 693 elderly patients (≥65 years) with severe pneumonia admitted to Renmin Hospital of Wuhan University, assessing risk factors across two periods: pre-pandemic, during China's zero-Covid policy. Using logistic regression and Cox models, we found notable shifts in risk factor associations. Before the pandemic, chronic kidney disease significantly increased the odds of severe pneumonia (OR: 1.69, 95% CI: 1.45-1.81). During the pandemic, hazard ratios rose for endotracheal intubation (72%), ischemic heart disease (80%), and hospital stays (30%), while hypertension showed a decreased association with severe pneumonia from HR: 0.8 (95% CI: 0.49, 1.32) to HR: 0.61(95% CI: 0.45, 0.85). These findings suggest that pneumonia severity intensified during the pandemic, possibly reflecting healthcare disruptions or delayed care. Elderly patients, especially those with chronic conditions, would benefit from strengthened community-based health interventions to improve outcomes and resilience against future respiratory infections.

Discussing equity issues at structural levels, particularly within policy frameworks, has always been a dangerous endeavor, frequently met with resistance and censure from established power structures. However, recent global developments, most notably in America, have escalated the risks associated with such critical dialogues, making practitioners, advocates, and scholars increasingly vulnerable to severe repercussions. This special issue includes eight articles that focus on equity policy reform within the domains of housing, healthcare, economic policy, education, racial justice, and democratic governance in order to lay the foundation for enduring transformation and meaningful structural change.

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.

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.

A small community-based justice organization focused on worker and food justice in central Maine has been involved in a years-long process to integrate a racial justice lens following 2020's nation-wide reckoning with white supremacy culture underpinning the deaths of Breonna Taylor, George Floyd and others, as well as the hugely disproportionate health and economic impacts of COVID-19 on communities of color. This empowerment evaluation proposes a process to support small nonprofit organizations in identifying how to explicitly integrate racial justice into established programming by examining organizational identity, goals and values regarding racial justice, and identifying appropriate measures specific to the organization. Once the elements have been identified, staff will have the tools to self-evaluate their activities to hold themselves accountable to the commitment of structural change. The evaluation of this organization's experience illustrates the complexities and practicalities of meaningfully integrating racial justice and equity to organizational policy and culture.

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.

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.

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.

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.