Health Promotion Practice最新文献

Efforts to effect racial health disparity (RHD) policy change are urgent, necessary, and subject to a key barrier: defensiveness among White privileged audiences. Within the literature to date, such defensiveness is under-investigated, and when examined, is typically conceived of as an individual cognitive outcome-a message effect-rather than a communication interaction. Yet policy change advocacy efforts, ranging from community organizing to change campaigns, necessitate communication interactions between advocates and privileged policy change audiences, such as neighborhood groups or policymakers themselves. This defensiveness conceptualization, focused on individual cognitions, therefore limits our understanding of interactive communication barriers in RHD policy advocacy processes. To address this limitation, our research conceives of defensiveness using the privileged identity exploration (PIE) model, developed by Watt in 2007, which posits that defensiveness strategies are used as part of an interactive communication process when people are asked to reflect on their own privilege. Defensiveness strategies, as described by Watt and colleagues in 2021 and 2023, are normal communicative reactions to protect one's self-identity from threatening information; the PIE models eight such strategies. RHD information invokes racial privilege, therefore eliciting defensiveness. Using a thematic analysis of semi-structured qualitative interviews with White young adults from the Chicago (U.S.) area (N = 27), we identify defensiveness strategies relative to COVID-19 RHDs. Using the PIE as a lens to understand the data, we find some strategies lacking, some similar but differently nuanced, and identify a novel strategy among our participants, suggesting message tailoring opportunities. We describe implications for future research and practice.

Period poverty, characterized by inadequate access to menstrual health resources and education, detrimentally affects school attendance, academic performance, and individual health. Recent studies have revealed nearly one-fifth of college-enrolled women experienced period poverty in the past year, highlighting the urgency of addressing this issue. Through our study at Purdue University, we evaluated the effectiveness of a free pad and tampon program aimed at reducing period poverty. Findings from our survey, which included responses from 766 university student participants, revealed many utilized the program due to not having products with them (43.2%). In contrast, others cited early or late periods (33.4%) and financial constraints (5.2%) as reasons for usage. In addition, 81.7% of respondents reported they were aware of the program's existence, indicating a need for more tailored promotional efforts to reach the entire student body. These insights contribute to a deeper understanding of the program's impact and provide actionable recommendations for improving accessibility and addressing the diverse needs of menstruating individuals within the university community. Leveraging these findings, university administrators can play a vital role in advancing menstrual equity initiatives and fostering supportive environments for all menstruators on campus.

In this commentary, we, a recent Master of Public Health (MPH) graduate with hearing loss and a course instructor, share what we learned about classroom accessibility while participating in a semester-long qualitative research methods course offered during the COVID-19 pandemic. We complement our reflections on working together with findings from a student field project focused on the lived classroom experiences of graduate students with hearing loss. The field project revealed that students adapted to increased communication challenges in their learning environments without requesting official accommodations due to stigma and a desire to limit their burden on others. We then conclude with implications for partnerships and collective action to address abelism and inequitable learning environments, specifically the value of student-instructor partnerships, the incorporation of universal design for learning principles, the importance of collaboration across different campus departments, and the need for higher education institutions to adopt a cultural model of disability that will create meaningful access in learning environments.

Access to facilities that could promote physical activity (PA) and healthy eating (HE) is limited in rural areas. Shared use agreements with churches may be a promising strategy for enhancing rural community access to facilities. The goals of this qualitative study were to (a) examine rural pastors' views on the role of faith-based organizations in improving PA and HE in rural communities; (b) describe the availability of church facilities that could be used for PA and HE; (c) understand pastors' opinions on shared use of church facilities for community health promotion. A purposeful sampling strategy was used to recruit pastors in rural South Carolina. Thirteen United Methodist Church (UMC) pastors (46% female; 54% predominantly African American congregations) participated in phone interviews. Interviews were transcribed and coded using grounded theory and analyzed with NVIVO. Most pastors reported that their churches had a kitchen (88%), classrooms (82%), and open field space (71%). Nine churches (53%) said they had shared use agreements in place although only two agreements (12%) were related to PA promotion and none related to HE activities. Most pastors did not have concerns about shared use, and many believed that sharing the church's space with the community was an important aspect of outreach. These results demonstrate that rural churches have facilities to support shared use agreements for PA and HE activities and that pastors are open to sharing church space. Future studies should engage rural churches in establishing shared use agreements for health promotion.

Online exercise videos can reach adolescents who lack access to in-person physical activity (PA). Yet, health professionals are wary of recommending online exercise resources because most free videos fail to represent diverse teens and perpetuate harmful norms. Our study had two purposes. First, we examined adolescents' perceptions of standard online exercise videos. Second, we sought their responses to Move + Thrive, a novel, free, online exercise video library designed to meet developmental needs of adolescents, be inclusive, and promote exercise behavior. We created Move + Thrive videos guided by self-determination and self-efficacy theories. In this qualitative study, we held focus groups with 28 adolescents (mean age = 16.4 ± 2.1 years) after they used two Move + Thrive videos. We asked participants what they enjoyed and what they would change about fitness videos in general and Move + Thrive videos. We had focus groups professionally transcribed, then used general content analysis to consolidate qualitative data into five themes: (a) online exercise videos should foster connection and motivation, (b) teen-specific considerations, (c) diversity, equity, and inclusion, (d) polarized views on yoga, and (e) desire for professional video elements. Adolescents appreciated Move + Thrive's emphases on supporting competence, autonomy, relatedness, and building self-efficacy and our focus on featuring instructors diverse in race and ethnicity, gender, and body shape and size. Based on adolescents' feedback, Move + Thrive is meeting adolescents' needs and addressing shortcomings of online exercise videos. Online exercise content and related research should incorporate adolescents' insights, perspectives, and developmental stages.

User experience (UX) is a key element in the design of effective public health websites. The Centers for Disease Control and Prevention (CDC) Yellow Book, a key travel health resource published by the U.S. CDC, adapted its print publication into a free companion website in the late 1990s to increase the resource's online reach and allow for more frequent updates of content. This process did not adopt a digital-first approach, leading to UX gaps such as barriers to finding relevant content, poor visual appeal, and inaccessibility on mobile devices. On May 10, 2023, the CDC Travelers' Health Branch implemented a UX update for the CDC Yellow Book 2024 website to improve the website's overall structure, content, and functionalities. This meant that the previous CDC Yellow Book 2020 website was replaced with the updated CDC Yellow Book 2024 website. Website metrics from Adobe Analytics were collected to show the outcomes of these updates. The CDC Yellow Book 2024 website received 5,726,545 page views for the year following the UX update, which was a 46% increase in web traffic compared to the CDC Yellow Book 2020 website the year prior to the update. In addition, there were 2,375,995 users who returned to the CDC Yellow Book 2024 website seven or more days after their first visit. This case study provides an overview of how the UX framework was used for the CDC Yellow Book 2024 website, which includes describing the lessons learned to inform future digitization efforts for health promotion tools.

Mental illness, affecting one in eight people worldwide, is often exacerbated by stigma-which can result in self-stigmatization, isolation, and loneliness and negatively impact access to health care, education, and social connection. Previous research has found that stigma is best reduced through a combination of education about the stigmatized population and intentional contact with individuals from that population. Studies also note the benefits of community-based, culturally-relevant interventions and cultural experiences such as live music. Thus, this study posited that community-centered sources of contact and education, such as live music concerts, could offer effective, sustainable opportunities to reduce stigma and increase empathy about mental illness. To explore this approach, researchers evaluated Sound Mind Live's "Road to Recovery" (RtR) program, which addresses mental health stigma by training musicians to discuss the topic from stage, and by providing concert attendees with resources to improve education, awareness, and access to mental health supports. This pilot study evaluated RtR's impacts on stigma, empathy, knowledge, and actions related to mental illness. Using a pre-/post-survey design at two concerts in New York City, researchers measured changes in participants' attitudes, behaviors, and understanding of mental health issues. Findings indicate that concert attendance reduced stigma and negative behavioral assumptions related to mental illness, increased affective empathy, improved knowledge about mental illness, and increased attendees' likelihood of seeking support. This study informs further use of community-based arts experiences to address stigma, cultivate empathy and social connection, and improve care access.

The U.S. trans/gender diverse (TGD) community experiences considerable mental health disparities and barriers to health care. To address these challenges, Trans Wellness, Trans Brilliance (TWTB) was developed to advance the resilience, self-compassion, and community connectedness of TGD people in Michigan. Designed by TGD people for TGD people, this community-based research project was a joint partnership between a local trans community care organization and a large Midwestern research institution, supported by state foundation funding. The construction of TWTB was sequential and iterative. The project concept originally emerged from previous research, which identified a need for a program to enhance resilience, capacity, and emotional well-being in the broader Michigan TGD community. This led to the innovative idea of designing an intervention that was both virtually accessible and capable of being implemented by any community advocate, regardless of professional training. Interviews were conducted with community stakeholders statewide to identify the needs, desired skills, and objectives for such a skill-based program. Findings from these interviews were used to design the online intervention. Community members further shaped the intervention through a focus group, which assessed the desirability and anticipated effectiveness of the curriculum. The final product was TWTB: an 8-week, peer-support, virtual wellness intervention.

Cervical cancer is the leading cause of cancer-related death among Latin American women, including Guatemalans. This is troubling, given we have a vaccine, screening tool, and treatment for this preventable disease. Human papillomavirus (HPV) causes most cervical cancer. HPV self-testing is a viable option for women in low-resource areas, such as Guatemala. More information is needed about barriers to HPV self-testing. We conducted four focus groups (N = 43) in three locations in San Raymundo with female community leaders to assess the lived experience of their attitudes, practices, and knowledge about cervical cancer. Participants shared barriers they face receiving Pap tests, the HPV vaccine, and self-testing for HPV. We concluded culturally targeted information is needed about cervical cancer prevention, screening, and treatment. Policies should include outreach to marginalized populations in remote areas with low-literacy indigenous Mayans. Practices should include partnerships with lay midwives and health promoters to help Guatemalan women self-test for HPV.

Background. Despite accounting for 34% of the population in Austin, Texas, Latinx individuals made up 50% of those who tested positive for coronavirus, 54% of COVID-related hospitalizations, and 51% of COVID-related deaths between March and June 2020. Of hospitalized Latinx patients, 40% had never seen a primary care provider and many had undiagnosed health conditions. A community health worker (CHW) pilot program was implemented based on these disparities. Method. This mixed-method implementation study describes a hospital-based, CHW program for Latinx patients hospitalized with COVID-19 at an academic medical center in Austin, Texas. The program included a social needs assessment, care coordination, and post-discharge follow-up. Patient data include demographics from the full sample (N = 57), social determinants of health (n = 24), and qualitative interviews (n = 6). Focus group data from health care professionals (n = 26) is also presented to describe the benefits of the CHW program. Results. Latinx patients in this study, two-thirds of who primarily spoke Spanish, reported high levels of satisfaction with the CHW program with fewer reported social needs after the CHW program. Health care providers underscored CHW expertise in addressing complex social needs, providing continuity of care within the hospital, and closing the loop through community resource navigation. Conclusion. This study demonstrated the capacity of CHWs to provide holistic care in hospital settings through trust building and increased capacity to address health-related social needs. Investment in hospital-based, CHW programs for vulnerable populations such as uninsured, Spanish-speaking patients is necessary to reduce health disparities beyond COVID-19.