Global Health Promotion最新文献

Background: The global effects of gender-based violence necessitate coordinated, evidence-based efforts across scientific and programmatic communities of practice. Transparent accounting of protocol implementation serves as a critical mechanism for knowledge scaffolding and fostering iterative learning, methodological refinement, and accountability. Our study purpose was to establish baseline prevalence and descriptive characteristics of physical and sexual gender-based violence experienced by adolescent and emerging adult women living in rural, resource-variable settings in Eastern Bolivia. We present a transparent account of our study protocol to strengthen and accelerate intervention efforts addressing gender-based violence.

Method: The partnership-centered and trauma-informed protocol was implemented within an innovative embedded 'care as usual' model. Data collection occurred within a clinic-based sexual and reproductive health initiative that our programmatic partner facilitates within the communities it serves. A cohort of trained community health promoters were participant-facing, field-based study team members. An on-site study team psychologist held immediate sessions with participants who disclosed experiences of physical and sexual violence and led post-event study team debrief sessions to mitigate secondary trauma.

Conclusions: The study protocol description outlines a rigorous and contextually grounded approach to gender-based violence research in rural Bolivia. We disseminate actionable steps in study implementation that prioritize equity and the safety and wellbeing of participants and study team members. Findings contribute to a deeper understanding of the dynamics of interpersonal violence in rural settings and inform culturally responsive interventions and health policy advocacy.

In most high-income countries, human immunodeficiency virus (HIV) has concentrated among minoritized, discriminated against, or otherwise marginalized communities, such as queer people, people who migrated, people who exchange sex and/or use drugs, poor people and people of color. Suboptimal prevention and treatment uptake has led to the implementation of community-based and/or participatory research integrating 'empowerment' approaches in an effort to reach marginalized groups in high-income countries. Here we present results of a cross-national examination of how national contexts influence implementation of empowerment-based HIV prevention research projects in the United States (US) and France. ETOILE was a qualitative, self-reflective study collaboration conducted between 2019 and 2022. Three study teams (two from the US and one from France) engaged in self-reflective focus groups and intervisitations where both HIV prevention scientists and community-based organization partners discussed the following topics: HIV and community-based research landscapes, the notion of empowerment in traditional research contexts, within-project tensions around hierarchies/power, positionality and racial representation, and economic resources. We applied a grounded analytic approach to identify key emergent themes. The ability to communicate around structural racism differed across study teams; the French team had greater difficulty managing within-project tensions, reflecting the national context and history of community-based research. Whether and how epidemiological data is broken down (or not) by 'race,' ethnicity, and social class shape both research and popular understandings of HIV epidemics. The roles of community-based organization members and Black researchers in accessing communities and vouching for research is particularly challenging. Representation of Black researchers on study teams can critically influence research project implementation. We found that national contexts matter. We identified recommendations for conducting community-based research based on empowerment and participatory approaches in disempowering contexts.

Background: The prevailing climate emergency continues to exacerbate health, economic and power inequities across the Global South and Global North. In particular, Two-Spirit people navigating their intersecting marginal identities confront health inequities stemming from colonially-induced climate disruptions, resource extractivism and land theft; yet, their perspectives are seldom considered in climate policy and practice. This is the case in the Deshkan Ziibi (the Thames River ecosystem in southwestern Ontario, Canada), where there is minimal climate-related literature that prioritizes Two-Spirit and Indigiqueer perspectives in the region.

Objective: To assess the impacts of the climate crisis on Two-Spirit health in the Deshkan Ziibi and highlight how Two-Spirit kincentric worldviews foster planetary health.

Methods: A critical multi-method approach was employed. A scoping review synthesized existing literature on Two-Spirit health and climate change, while traditional stories were analyzed through queer-decolonial frameworks to uncover alternative epistemologies and practices of multispecies relationality.

Results: Findings reveal that Two-Spirit people in the Deshkan Ziibi experience heightened vulnerability to the climate crisis due to intersecting systems of oppression. However, the research also identifies sites of agency that expose the colonial legacies embedded in dominant climate justice paradigms.

Conclusion: This work calls for a re-evaluation of planetary health promotion, governance and interventions by incorporating Two-Spirit worldviews of interconnectedness.

Uganda has a rapidly urbanizing population and the world's second youngest population. Further, gender inequities contribute to young women in urban Uganda experiencing multiple unmet health and wellbeing needs. However, their perspectives are rarely included in health research or decision making and their lives rarely examined to capture community strengths. We conducted a qualitative study using Photovoice with 15 women aged 18-24 years across three urban sites within Kampala, Uganda. To capture perceptions of strengths, we prompted participants to take photos reflecting 'TOPOWA', meaning 'don't give up' in Luganda. Researchers conducted inductive thematic analysis of photos and discussion transcripts and participants contributed to theme validation. Multiple themes emerged from the narrative and visual data across all three sites. This article focuses on the theme of wellbeing and mental health, which encompasses community strengths, protective factors and resilience. Findings provide evidence for health promotion for young women in urban Kampala and similar sub-Saharan African settings through unique, contextual visual and narrative evidence. Notably, existing community strengths are highlighted as potential areas to build upon for health promotion interventions for wellbeing and mental health. Furthermore, findings shaped an ongoing cohort study of mental health trajectories for young women in Uganda.

Health impact assessment (HIA) can magnify the positive impacts of health promotion in practice, but practitioners face many challenges in implementing it, from the difficulties of intersectoral work to a lack of resources. These challenges require flexibility and sometimes involve adapting best practices in health promotion and the typical HIA process. This article presents an agile approach to conducting HIA when the window of opportunity is short, resources are scarce, and the expected value of appraisal is uncertain. Accordingly, this approach prioritizes the recommendations step over the appraisal step, while proposing an iterative and co-constructive process involving a limited number of stakeholders. The approach is exemplified through a case study of an HIA conducted in Québec on a guide promoting green, active and safe transportation networks. We argue that the adapted method can, in certain circumstances, lead to better results than a typical HIA. The article also suggests contextual criteria that allow HIA practitioners to assess whether this approach is suitable for their needs.

Competency frameworks play an important role in strengthening workforce capacity for promoting population health and wellbeing. However, competencies need to be periodically reviewed and revised to maintain their relevance to changing practice and contexts. This paper reports on the process of reviewing and updating the International Union for Health Promotion and Education (IUHPE) Core Competencies for Health Promotion. A multistage process was employed, which involved conducting a scoping review of the literature on health promotion competencies (2012-2022), based on which suggested revisions to the IUHPE Core Competency statements were made. An online consultation was then undertaken with the health promotion community, as represented by practitioners and members registered with the IUHPE Accreditation System, to consider the updated Revised Draft Framework with proposed changes. There was a high level of consensus concerning the proposed changes among respondents, based on which a revised version of the Competency Framework was produced. This was then forwarded to the IUHPE Global Accreditation System Management Committee and Executive Board for approval. The findings from this updating process are discussed and the implications for future developments are considered.

Dado el aumento constante en la tasa de incidencia del VIH en Chile, se han impulsado estrategias de prevención conjunta, con la promoción del testeo de VIH como uno de sus pilares fundamentales. El presente estudio se propuso identificar los determinantes sociales del testeo de VIH en la población chilena a partir de datos secundarios provenientes de la Encuesta Nacional de Salud, Sexualidad y Género 2022-2023. Se contó con un diseño transversal y una muestra representativa de 20392 adultos chilenos residentes en sectores urbanos. La variable dependiente fue la realización del test de VIH en los últimos 12 meses, mientras que las variables independientes fueron los determinantes estructurales (edad, género, macrozona de residencia, pertenencia a pueblos originarios y nivel educacional) e intermediarios (previsión de salud, religión, orientación sexual, situación de pareja, educación sexual, calidad de vida, salud percibida). Se llevaron a cabo modelos de regresión logística binomial múltiple, con estimaciones de datos basadas en encuestas para diseños de estudios complejos. De acuerdo con el modelo estimado, las personas de 40 años o más, de género masculino, con nivel educacional primario, orientación heterosexual, que no tenían pareja y con una mayor percepción de salud, tenían una menor probabilidad de haberse realizado un test de VIH en el último año. Es crucial identificar los determinantes sociales del testeo de VIH, con el fin de desarrollar políticas públicas e intervenciones de promoción efectivas. Los resultados presentados permiten identificar grupos de población que tienen un menor acceso a servicios de testeo, hacia los cuales orientar los esfuerzos para la promoción de la detección oportuna.