Health Promotion Practice最新文献

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.

Thirty-five years after the Institute of Medicine report, The Future of Public Health (1988), multiple authors have considered what needs to be achieved to build a robust public health system that improves health for all. A central theme is the renewed emphasis on the role of evidence-based policy. This study provides clear evidence using a ranking methodology of how important policy is to achieving better health outcomes across the United States. The purpose of this study is to assess the association of state health rankings with well-established state health outcomes. Specifically, we calculate the strength of relationship of the rankings used in a previous study to six widely referenced health outcomes. Utilizing 88 predominantly health policy-oriented data elements found online for each of the United States, a state ranking was calculated across all actual, or behavioral, causes of death using the percent weightings attributable to each actual cause. These state rankings were correlated to state health outcomes. Findings indicated that state rankings correlated highly with five of the six health outcomes, excluding disability. States having supportive health policies ranked better in terms of the actual causes of death and population health outcomes. This finding is important to the field because it quantifies the degree that robust health policies matter to population health status and how these policies may be predictive of positive health outcomes. For practitioners, this finding supports greater emphasis on policy advocacy skills and encourages increased advocacy training in schools and programs of public health.

Background. Stringent regulations restricting tobacco access to those under 21 are in place, yet young people continue accessing tobacco products. This study aimed to assess the knowledge, opinions, resource utilization, and training needs of tobacco retailers in terms of preventing underage tobacco sales. Methodology. This cross-sectional study analyzed anonymized responses from 467 licensed tobacco retailers in 16 southern counties of Illinois. The survey included 29 questions adapted from validated items, utilized a hybrid methodology (online and in-person), and targeted both retail store owners and managers. Results. Among 118 respondents, 98.3% were aware of the Tobacco-21 law, but 56.8% doubted its impact on reducing underage sales. Gaps in knowledge persisted, especially regarding policies and enforcement laws for Electronic Nicotine Delivery Systems (ENDS). Overall, there was a disparity in preventive measures and program utilization with a low engagement in rural areas and smaller stores. Approximately 48.3% encountered older youths attempting to purchase tobacco. Most respondents (72.9%) supported training for newly hired clerks, focusing on underage sales refusal (54.2%) and ID verification (62.7%). Nearly half (44.9%) felt the need for training in handling aggressive young buyers. The main barrier to training was time constraints for in-person sessions (28.0%), although 41.5% reported no barriers. While "We Card" was widely used (82.2%), only 38.5% displayed the FDA's "This is Our Watch." Conclusion. A discrepancy exists between awareness and effective practice among retailers, especially in rural areas and smaller establishments. Findings highlighted the need for targeted retailer training and resource utilization to combat underage tobacco access.

Young people experience high rates of mental health challenges, which have been exacerbated by the pandemic, particularly for those from underserved communities and communities of color. The Mindful Mentors program demonstrated that delivery of a mindfulness-based curriculum provided by university students to school-aged children is feasible and mutually beneficial. Benefits for university student mentors included team building, increased self-awareness, and developing effective skills for dealing with stress. The pilot program highlighted specific challenges and areas for improvement related to the delivery of mindfulness curriculum to younger children. Recommendations for future implementation include the need for curriculum tailored for specific grade levels and ensuring buy-in and engagement from teachers.

While most adolescents experience mild-COVID-19 infection, those with underlying medical conditions have an increased risk of severe health outcomes. Furthermore, compared with other pediatric populations, adolescents have experienced higher rates of COVID-19-associated hospitalization. COVID-19 vaccine decision-making in adolescents during COVID-19 surges is not well understood. Our objective was to explore factors influencing parental and adolescents' COVID-19 vaccine decision-making during the Omicron winter 2021/2022 surge. Participants were recruited from an academic pediatric primary care clinic. Eligible adolescents (aged 12-17 years) who received their first dose of the COVID-19 vaccine between December 2021 and February 2022 were recruited to participate in a semistructured interview with their parent. Perspectives were illuminated through thematic analysis of the data that included coding and pattern identification. Ten parent-adolescent dyads' interview data were analyzed and classified into three principal themes influencing vaccine acceptance during the Omicron surge: perceived risk of COVID-19 infection, family member influence, and clear, two-way communication with a clinician. Despite widespread COVID-19 vaccine availability for adolescents, vaccination rates remain suboptimal even during times of increased disease prevalence. Using health promotion practices to emphasize perceived risk of infection while navigating family dynamics through two-way communication during COVID-19 surges may support vaccine uptake.

Kentucky faces the highest age-adjusted overall cancer incidence rates and the second highest overall cancer mortality rates in the United States, with the eastern Appalachian Region of the state contributing significantly to this burden. As one of 57 National Cancer Institute (NCI)-designated comprehensive cancer centers in the country, the University of Kentucky Markey Cancer Center is Kentucky's only NCI-designated comprehensive cancer center. This designation is important for receiving the support necessary to fund programs that can further the cancer research, education, and community outreach opportunities for Kentuckians. The Markey Cancer Center's Appalachian Career Training in Oncology program, created in 2016, offers cancer research, clinical, outreach, and educational experiences to Appalachian Kentucky high school students and undergraduate students enrolled at the University of Kentucky. The program creates multiple levels of mentorship designed to enrich students' interest in pursuing a cancer-related career. Mentorship partners include cancer researchers, clinicians, workshop presenters, community members, program staff, and program peers. The program has demonstrated significant success, including a high matriculation rate, numerous student-authored publications, and influential community engagement initiatives. Implications for practice include the potential to implement similar programs for other populations around the country, thus furthering knowledge and fostering passion in underrepresented groups.

We share insights from a community engagement studio aimed at addressing anxiety in Quay County, a remote rural area in New Mexico. The studio involved eight local experts representing various sectors, including health care, education, and faith-based organizations. These experts identified key insights surrounding anxiety, including its causes, community perceptions of mental health services, and strategies for addressing anxiety within the community. Contributions included a rubber band metaphor to describe lingering anxiety, the role of societal pressures (particularly for men), and the impact of physical activity and infrastructure on mental well-being. The studio also highlighted the importance of integrating faith-based support and promoting community pride as a mental health intervention. Our insights underscore the value of community engagement in understanding and addressing mental health challenges in rural settings.

The meat processing industry was significantly impacted by the COVID-19 pandemic. Deemed essential, the meat processing workforce faced the risk of exposure to the SARS-CoV-2 virus. Along with other essential workforces, meat processing workers were prioritized in the national approach to receive COVID-19 vaccines by the Centers for Disease Control and Prevention Advisory Committee on Immunization Practices. This mixed methods study aimed to identify the facilitators and barriers to COVID-19 vaccine uptake by meat processing workers in Nebraska through interviews (n = 29), a survey (n = 857), and application of the COM-B model. We found that facilitators for vaccine uptake included having information about the vaccine available; providing vaccines at the workplace, in pharmacies, and throughout the community to increase accessibility; feeling that there was a social responsibility to get vaccinated; believing that the vaccine was protective; and the use of various incentives. Barriers for vaccine uptake included workers' personal health issues; not having the right information to make an informed decision; logistical and contextual issues that made it challenging to get vaccinated; the disconnect between faith and science; individual choice being highly valued; and uncertainty and misinformation causing fear of the vaccine. Understanding facilitators and barriers to vaccine uptake by meat processing workers is critical to informing public health interventions, evidence-informed guidelines and policies, and tailored messaging to increase vaccination coverage among an essential workforce that inherently assumes occupational risk during infectious disease events, such as the COVID-19 pandemic. Implications for public health practitioners are provided.

This pilot, exploratory project examined the relationship among the health, work, and social support of university housekeepers. The first objective was to examine the influence of social support on work-related outcomes among university housekeepers. The secondary objective was to examine the influence of social support on physical and psychological health among housekeepers. Using a mixed-methods approach, the study assessed work-related outcomes and the influence of social support using least square regression models and multinomial logistic regression models. Qualitative data was obtained via one-on-one interviews. Participants (N = 46, 72% female; 87.2% Black) averaged 4.43 ± 0.72 for job satisfaction with stress levels occasionally high for most of the sample (75%). Support was moderate across all three types of support with the highest perceived support in tangible support (2.85 ± 0.52). Four major themes emerged from the interviews, including lack of support and trust from supervisors and administrators; lack of respect from other members of the university community; need for positive recognition; and impact of the job on health. Findings revealed that when housekeepers feel they belong and are appreciated at work, they feel more positive about their jobs and likely do better work. Housekeepers and their work are critical to students, faculty, and staff in the university system. Future research should examine existing health issues and assess for factors contributing to physical or mental health treatment, especially post-COVID. Universities should invest in wellness programming and policies supporting mental health leave to improve overall well-being and stress in this under-resourced population.

Workplace sexual harassment (WSH) and other forms of sexual violence are pervasive in the agricultural sector, yet remain overlooked as critical occupational health and safety concerns. In this scoping review, the social-ecological model was used as a framework to examine contributing and protective factors in the literature that inform WSH interventions, policy, and research. Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocols, the authors searched eight databases using Boolean terms related to "sexual harassment" and "agriculture." Articles that were peer-reviewed, empirical, and nonempirical, published in English, available as full-text, and pertaining to agriculture were included in the sample. A total of 93 articles were found, and 20 met inclusion criteria. Results showed most studies were qualitative and exploratory. A number of contributing factors were discussed in the literature, including: harmful gender beliefs and myths, gender inequity and inequality, hierarchical workplace structures, poverty, precarious immigration status, language barriers, permissive workplace climate, fear of retaliation, a need for culturally responsive workplace training, and lack of clear anti-harassment workplace policies. There is also a lack of legal protections for agricultural workers at the state and federal levels, highlighting the need for advocacy and policy reform. The socio-ecological model (SEM) offers a comprehensive approach to understanding and addressing WSH across the spectrum of prevention. More empirical and longitudinal studies are needed to strengthen the evidence base for developing comprehensive solutions to WSH that address the many barriers and risks that agricultural workers face.