Health Promotion Practice最新文献

During the COVID-19 pandemic, high-risk clients' and caregivers' access to essential personal protective equipment (PPE) was limited especially in many remote areas of Appalachia. A multidisciplinary team of community and university partners explored how to coordinate the use of community health workers (CHWs) and drone technologies to increase access to PPE in rural and remote Appalachian regions. CHWs recruited 10 Homeplace clients in an exploratory study of drone-based package delivery of PPE to assess importance and effectiveness of PPE self-efficacy related to PPE use, use of PPE, and ease and acceptability of drone delivery (following delivery only). CHWs educated each participant via in-person and Zoom meetings on the reasons for using PPE and proper use of PPE using Centers for Disease Control and Prevention guidelines. Most participants found the drone delivery of PPE easy and 80% were extremely satisfied with the drone delivery process. The frequency of mask-wearing increased from 60% at baseline to 90% at follow-up. On average, participants rated all types of PPE as effective in preventing the spread of disease. Drone officials used the findings of this pilot study to develop a waiver application to the U.S. Federal Aviation Administration to request permission to fly beyond visual line of sight in remote areas. Aerial drone technology could be a cutting-edge approach to health promotion in remote areas. The study results provide the proof of concept to assist investigators in designing future projects to promote healthy homes by collecting air and water samples and testing novel interventions deploying drone technology in remote Appalachian regions.

The Community-based Participatory Research (CBPR) model fosters equitable partnerships between communities and academic institutions to promote health equity. This model emphasizes shared control over all phases of the research process and recognizes the limited power and inequalities experienced by marginalized communities. At our institution, Community Engagement Liaison Specialists (CELS) build relationships with New Mexico communities, guided by CBPR principles. The CELS collaborate with county and Tribal Health Councils, addressing community mistrust toward health research and academic institutions and promoting projects of interest to both academic researchers and the community. To support these efforts, we developed a website called "Ways to Engage with New Mexico's County & Tribal Health Councils," through a rigorous collaborative process involving university researchers, CELS, and the New Mexico Alliance of Health Councils. This resource provides historical context, lessons learned, and guidance for researchers who plan to engage with Health Councils. We offer implications for practice summarizing the lessons learned from the CELS work including collaboration on this website.

Engaging adolescents and young people as partners in research is increasingly acknowledged as a vital strategy to ensure diverse voices are heard and to catalyze social change. This article, coauthored by adolescent and adult researchers, presents the methodological approach and outcomes of a youth-led participatory action research (YPAR) study in which three teams of youth researchers developed and implemented projects examining equity-related factors affecting adolescent sexual and reproductive health and rights (ASRHR) in Ontario, Canada. Teams of four assigned-female youth researchers aged 16-19 years were recruited from three priority regions through purposive sampling. Selected youth completed a paid 5-day virtual YPAR training. Each youth team, supported by adult research mentors, identified key ASRHR issues in their region and developed a related research question. Each team then determined their study's design, obtained institutional ethics approval, and conducted data collection, analysis, and interpretation. Based on their findings, teams proposed potential solutions and communicated results to multiple stakeholders. Methodologically, the YPAR process amplified youth voices through a social justice-framed approach to examining ASRHR. Centering the perspectives, values, and experiences of youth positively impacted the youth researchers themselves, while yielding results that were relevant, meaningful, adolescent-responsive, and culturally informed. Results from the youth-led projects identified multiple barriers to accessing sexual and reproductive health services and products. Policy and practice implications encompassed concerns related to geographical accessibility, equity, service provider competence, and content of sexuality education curricula.

Many patients experiencing incarceration (PEI) in the United States (U.S.) have significant and complex medical conditions that require offsite consultation and hospitalization. Physicians in our academic medical system report that their education in caring for PEI is limited. We developed an online learning resource for physicians who care for PEI within our institution. Development included project planning, content development, iterative graphical design, feedback incorporation from key constituents, including individuals previously incarcerated, and module launch. The e-module was designed with a graphic user interface including video and case simulations. The curriculum includes background information on the U.S. carceral system, the basics of carceral health care, ethical considerations for community-based health care workers (introducing concepts of "dual loyalty" and examining patient privacy and autonomy for PEI), and policy and procedural considerations specific to our health care system. Future directions include disseminating the module to practicing physicians, advanced practice providers, and other allied health professionals (such as nursing, social work, and skilled therapists) and collecting feedback on user engagement. Institutions and groups wishing to improve care for this vulnerable patient population can implement training to address limitations in knowledge and confidence among staff and providers.

To address complex problems like health disparities, public health interventions have become increasingly ''complex''-engaging multisector partners and communities at multiple ecological levels. Complex interventions are intentionally flexible, making them challenging to evaluate with predetermined measures. While innovative evaluation methods tailored to complex interventions have been developed, there is a need for practical guidance to enhance capacity within public health. This article describes the qualitative FIND (Frame, Identify, Narrow, Do) evaluation process for a complex, community-engaged health equity intervention. Illustrative examples and take-away tools are provided. The FIND process is sensitive to complexity, involving ongoing data collection that helps guide implementation. The evaluator is embedded within the project team, facilitating frequent, direct interaction between the evaluator and those whose roles position them to hear or see happenings with the on-the-ground implementation in real time. The FIND process includes (a) developing a flexible framework for determining relevant processes and outcomes, (b) identifying important project events, (c) narrowing in on the most impactful events, and (d) making decisions informed by data. Using the FIND process, the project team learned about significant project events that would have been missed without a complexity-sensitive approach. Having the evaluator embedded within the project team, rather than as an independent entity, was crucial for understanding and utilizing on-the-ground developments in an evolving intervention. There is a need for more practical guidance to build capacity for evaluating complex public health interventions, including strategies for communicating with stakeholders about approaches that diverge from traditional scientific norms.

Purpose. Lung cancer is the leading cause of cancer death, with most cases attributable to cigarette smoking. Many communities within the lesbian, gay, bisexual, transgender and queer/questioning (LGBTQ+) umbrella have high rates of smoking, but focused lung cancer prevention is limited. Our objective was to utilize a community-based participatory research (CBPR) approach to guide the development of a program focused on lung cancer prevention in LGBTQ+ elders. Methods. Through community partnerships, we recruited participants who self-identified as LGBTQ+ and were eligible for lung cancer screening (LCS) to participate in semi-structured qualitative discussions with complementary surveys. Qualitative guides were developed to collect data on determinants of smoking cessation and LCS and to elicit feedback on interventions to support lung cancer prevention through a tailored approach to patient navigation. Qualitative data were analyzed using rapid templated analysis to elucidate themes. Results. The 21 enrolled participants had diverse sexual and gender identities and 57% were of minoritized race/ethnicity. Most (81%) had experience with smoking cessation but few (10%) had undergone LCS. Overall themes suggest interest in personalized (to individuals), tailored (to the LGBTQ+ community) and integrated longitudinal programs to support lung cancer prevention. Themes suggest strong endorsement of focused messaging to LGBTQ+ persons and reducing stigma related to LGBTQ+ identity and smoking. Conclusions. Themes highlight the need for integrated tobacco and LCS programming which can provide longitudinal support, and ideally, center community settings and peer support. This formative work will be utilized to adapt a patient navigation program to assist screen-eligible LGBTQ+ elders.

Introduction: We examined youth and young adult access to flavored vaping products following New York's (NY's) flavored vaping product sales restriction in 2020.

Method: In 2021, we conducted an online survey (N = 493) and focus groups (N = 33) with NY youth and young adults who vaped in the past year (ages 15-24). We summarize findings and use logistic regression to assess associations with access to flavored vaping products.

Results: Most youth and young adults who vaped in the past year (64%) had obtained flavored vaping products. Among them, 49% purchased in a store, 47% got them from social sources, and 11% bought online. Focus group participants reported restricted products were available on store shelves or behind the counter. Those under age 21 were less likely to buy flavored vaping products in store than those aged 21-24, but age was unrelated to online purchases. Focus group participants reported websites did not require age verification, or they found ways to circumvent it. Most believed buying flavored vaping products was easy (77%) and had gotten easier or stayed the same in the past year (70%).

Discussion: Most NY youth and young adults who vaped in the past year obtained flavored vaping products and found it easy to buy them after the statewide sales restriction, suggesting that implementation has not occurred as intended. Findings also raise questions about retailer compliance and highlight enforcement challenges with online purchases. Continued retailer education and enforcement efforts, including for online sales, may help flavored vaping product sales restrictions achieve intended outcomes.

The COVID-19 pandemic and its related economic challenges exacerbated food insecurity across New York State (NYS). Approximately one third of New York City residents reported use of emergency food services in the pandemic's first year and, in 2021, approximately 1 in 10 NYS residents was food insecure, with rates among Hispanic and Black New Yorkers more than double that of White residents. Although these numbers have decreased following the acute phase of the pandemic, disparities by race and ethnicity persist and use of emergency food services remain elevated for New Yorkers born outside of the United States. Despite this, few policies and interventions that aim to improve the charitable and emergency food systems focus on the cultural relevance and appropriateness of foods provided. In 2022, researchers conducted 12 interviews with key stakeholders from organizations and institutions providing food distribution services to culturally diverse New Yorkers to understand barriers and facilitators related to providing culturally appropriate foods and elicit lessons learned and recommendations to inform future programs and policies. Findings from this study indicate that organizations serving diverse communities recognize the importance of providing culturally appropriate food services and make efforts to tailor these services accordingly. However, they face challenges that limit their capacity to offer foods consistent with the dietary needs and preferences of their clients. Additional funding, policies, and support are needed to improve the availability of culturally inclusive food distribution services within the emergency and charitable food systems.

Our collaboration to strengthen applied practice in public health training between two public universities in New Mexico has offered us insight into the types of institutional, administrative, and programmatic support beneficial for navigating work with limited resources and varying geographic considerations. We share some lessons from this burgeoning partnership between University of New Mexico's (UNM) College of Population Health and New Mexico State University's (NMSU) Department of Public Health Sciences which began in 2022. The main areas of learning focus on exchanging resources to extend relationships with fieldwork sites and site supervisors, engage and support students in their planning and implementation of their fieldwork, and identify institutional resources to maintain and grow programmatic quality. Implications from this work include efforts to reinforce the public health workforce pipeline, especially to ensure the participation and success of students from underrepresented backgrounds.

Water justice-equitable, reliable access to clean, sufficient water, and the knowledge and mechanisms related to its management-is a key global social justice and environmental issue. Cape Town, South Africa, is an important context to explore water justice due to its 2018 water crisis. Water scarcity intersects with other issues, including health disparities, food insecurity, and gender inequity, in turn requiring citizen engagement in water-related issues and knowledge sharing to produce sustainable, contextually relevant solutions. The arts are powerful tools for citizen engagement and knowledge sharing and translation in research, as well as social and environmental action. In this Resources, Frameworks, and Perspectives article, we outline the methods and lessons learned from developing Confluency, an arts-based exhibit and resource that aimed to generate and share knowledge on water justice issues between academics, practitioners, artists, and activists in Canada and South Africa. We detail the methods used to develop the Confluency exhibit and resource, including preparing the art exhibit framework, facilitating art workshops, designing interactive stations, and implementing the interactive art exhibit. Lessons learned are shared from implementing Confluency in diverse South African and Canadian settings. These case studies signal that the methodological approaches used in designing and implementing this exhibit and resource hold promise for providing opportunities to reflect on, and learn about, global and local water justice issues. This resource could be expanded to engage communities in research, policy, and practices regarding water justice in other diverse global settings to advance health, equity, and rights.