Journal of Prevention & Intervention in the Community最新文献

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.

Recovery homes can provide critical support for individuals taking Medications for Opiate Use Disorders (MOUD). However, some abstinence-based self-help groups and organizations have expressed skepticism toward this harm-reduction strategy. One abstinence-based organization that has welcomed those on MOUD is Oxford House. With over 3,000 self-run recovery homes in the US, many individuals on MOUD currently live in these settings. This study examined how Oxford House residents interact and support those on MOUD. We examined these community-based recovery settings with a resident on MOUD over four months. Findings indicated that within Oxford Houses with a resident on MOUD versus those without a resident on MOUD, more positive changes occurred for friendship, advice-seeking, and loaning social network variables. It appears that residents in Oxford Houses where a resident is on MOUD experience positive transformations in their social networks, illustrating how recovery communities can welcome and support those using this harm reduction strategy.

In Nigeria, drug abuse presents mounting public health challenges, understanding community readiness for harm reduction strategies is crucial yet understudied. This qualitative study examined community readiness to adopt harm reduction approaches and support the reintegration of individuals with drug use disorders. Through in-depth interviews with 18 participants, including parents of children with and without drug use disorders and healthcare providers from the Neuro-Psychiatric Hospital in Akure; the study revealed a complex interplay of factors affecting drug use and recovery. Despite identifying over seventy eligible households for this research, widespread stigma significantly limited participation, highlighting the deep-rooted social barriers facing intervention efforts. The findings uncovered that drug use is driven by an intricate web of factors: knowledge gaps about health risks, peer influence, economic hardship, and spiritual beliefs. Critical barriers to implementing harm reduction strategies emerged, including resource constraints and leadership buy-in. The study illuminates how strong family support systems, transformed social perceptions, and enhanced government policies could create pathways for effective harm reduction implementation. These insights suggest that successful intervention requires a nuanced, culturally attuned approach that combines stigma reduction, family empowerment, religious institution engagement, and policy advocacy offering a blueprint for community psychologists and healthcare providers working to build resilient, recovery-supportive communities in similar cultural contexts.

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.

Hyperlipidemia, a major risk factor for cardiovascular disease, disproportionately affects racial and ethnic minority populations. This cross-sectional study examined the prevalence and risk factors for hyperlipidemia among middle-aged adults in the United States using data from the fifth wave of the Adolescent to Adult Health Study (Add Health). The study analyzed merged sociodemographic and biomarker data (N = 4,196) using descriptive statistics and binary logistic regression. The mean age was 37.14 years (SD = ±1.99), with a slightly higher proportion of males (50.38%). The overall prevalence of hyperlipidemia was 16.26%, with higher rates observed in males (20.1%) compared to females. Notably, Asian individuals had significantly higher odds of hyperlipidemia (OR = 2.70, 95% CI: 1.28-5.65), whereas Black/African Americans had a significantly lower risk (OR = 0.57, 95% CI: 0.34-0.94) compared to Whites. Chronic health conditions, including hypertension (OR = 2.46, 95% CI: 1.72-3.52) and diabetes (OR = 4.95, 95% CI: 3.08-7.97), were strong predictors of hyperlipidemia. Additionally, individuals with higher income levels had increased odds of hyperlipidemia (OR = 1.10, 95% CI: 1.01-1.19). Contrary to prior research, obesity was not significantly associated with hyperlipidemia risk. Physical activity was marginally protective, though the effect lost significance in the adjusted model. These findings highlight the importance of targeted cardiovascular health interventions, particularly for Asian populations and those with chronic conditions, to reduce disparities in hyperlipidemia and improve public health outcomes.

Housing First for Youth (HF4Y) is a youth-focused adaptation of the well-established Housing First (HF) approach to housing and service provision for individuals experiencing homelessness. Given that youth homelessness is associated with an increased likelihood of substance use issues, a central tenet of the HF4Y framework is the use of a harm reduction approach to substance use. However, research on HF4Y has yet to examine how harm reduction is specifically being implemented in these settings. This study addresses this gap by examining how the principles and philosophies of harm reduction were operationalized and implemented in an HF4Y program for youth experiencing homelessness and concurrent disorders. This study was part of a larger evaluation of a 5-year HF4Y research demonstration project - the Restart Project in Kelowna, British Columbia, and Toronto, Ontario, Canada. Eight program leaders and service providers at the Kelowna site were interviewed to gather their perspectives on harm reduction delivery within the HF4Y program. Additionally, program documents and case management materials were analyzed to examine how harm reduction was operationalized and implemented through the guiding tools and resources available to staff for program delivery. Findings highlighted several ways in which harm reduction was being delivered within the HF4Y program, including working with youth to ensure safe substance use; connecting youth to services in the community; providing youth with individualized support; reducing stigma around substance use; and empowering youth who use substances. Barriers to harm reduction delivery were also identified, including a lack of low-barrier housing for youth who actively use substances and the expectations of some landlords. These findings emphasize the need for increased advocacy for housing options for youth experiencing homelessness and substance use issues and further research to address other contextual factors promoting and limiting harm reduction delivery in HF programming.

This research investigates the implementation and challenges of harm reduction strategies, emphasizing gender-informed approaches and geographical disparities across Atlantic Canada. Despite compassionate principles aimed at minimizing the adverse effects of substance use, harm reduction strategies face significant opposition from policymakers and the public. This study uniquely contributes to the field by examining the intersection of gender-informed approaches, regional disparities, and policy challenges in harm reduction services within Atlantic Canada, an area that has received limited attention in previous research. Gender-informed harm reduction services address unique risks faced by different genders in substance use, including the differential impacts of gender roles and expectations. Tailored programs addressing mental health and experiences of violence and trauma benefit women and gender-diverse individuals. However, such services are often limited and concentrated in urban centers, leaving gaps in smaller provinces/territories and rural settings in Canada. Health and social spending reductions have exacerbated the inaccessibility of holistic harm reduction services. Time-limited programs pose a significant barrier, often failing to meet the evolving needs of pregnant and parenting women and gender-expansive AFAB individuals. Strong collaborations and place-based approaches are essential for equitable access to services and well-being during pregnancy and postnatally. Flexible, long-term support systems for both parents and children are necessary, and reduce common fears and experiences of judgment, stigma, and child welfare involvement that deter people from seeking care. An environmental scan study of community-based harm reduction projects in Atlantic Canada was conducted. Environmental scans involve a systematic process of collecting, analyzing, and interpreting information about organizations' internal and external environments and are used to inform policy and programming. Data analysis using open and focused coding revealed critical gaps in service provision as well as notable improvements in the availability and quality of harm reduction services in the region. Findings indicate a need for gender-specific services, a comprehensive continuum of care, and equitable geographic distribution of services. Addressing these gaps through tailored, informed, and inclusive strategies can enhance the effectiveness of harm reduction, improving long-term health outcomes for individuals, families, and communities across Atlantic Canada.

Harm reduction strategies in the community includes the work of practitioners, activists, and researchers conducting community-based work in domestic and international settings to alleviate pain and suffering for people who use drugs (PWUD) by providing services to meet their needs. This themed issue features a wide variety of community examples of harm reduction efforts that have been developed to reduce stigma associated with substance use. The articles focused on creating culturally appropriate messaging for opioid users while at the same time decriminalizing substance use and emphasizing the importance of implementing a social determinants of health framework in the community, including gender-specific care and ensuring safe substance use and connecting youth with services.

The purpose of this study was to examine the association of rurality and veteran status on cardiovascular disease (CVD) risk in US adult females. A retrospective, cross-sectional cohort analysis was conducted utilizing data from the 2021-2023 National Survey on Drug Use and Health. The sample included female veterans and non-veterans (n = 25,543). A multivariable logistic regression model was applied to the data to understand the association between the aforementioned variables, including an interaction term for rurality and veteran status. The interaction term showed that rural veteran females had a higher predicted rate of CVD risk than the other cohorts studied (aOR = 1.85, 95% CI = 1.14-3.00), even after adjusting for covariates. These findings highlight the relationship between veteran status and geographic location on CVD risk among females in the US.

In the city of Chicago, opioid overdose is one of the top five drivers of the life expectancy gap between Black and non-Black Chicagoans, which reached 11.4 years in 2022. The city has responded by supporting social and behavioral health community-based organizations (i.e., delegate agencies) in implementing place-based and community-centered evidence-informed harm reduction strategies for local populations most impacted by opioid overdoses. This study highlights key findings from qualitative interviews with agency staff related to how agencies are implementing a variety of harm reduction strategies emergent practice-based innovations. Findings demonstrated how agencies creatively contended with systems-level challenges through emergent harm reduction innovations that emphasized community-based education, outreach, and choice; a person-centered approach; and a hyperlocal, place-based coordination of overdose response. Findings from this study contribute to the growing harm reduction evidence base while offering practical recommendations and examples of uptake to address challenges that impact the effectiveness of harm reduction strategies.