Health Promotion Practice最新文献

As the COVID-19 pandemic recedes, SARS-CoV-2 vaccination is crucial for reducing transmission and severity, but vaccine hesitancy remains a challenge. The study explored community actions and initiatives addressing vaccine hesitancy among Somali immigrant communities in cities in the Upper Midwest, USA, and Western Norway, focusing on trust factors and comparing members of the Somali diaspora in two distinct social and cultural contexts. Qualitative collective case studies were conducted, involving 14 semi-structured interviews with key informants from the Upper Midwest and Western Norway knowledgeable about initiatives designed to address SARS-CoV-2 vaccine hesitancy. Data were coded in NVivo 12 and analyzed thematically, guided by the Bergen Model of Collaborative Functioning and the Socioecological Model to identify basic and organizational themes. The findings illustrate critical sociopolitical influences on vaccine hesitancy, like racial tensions following George Floyd's murder in Minneapolis and mistrust toward the government in Norway. Effective strategies in the Upper Midwest included maintaining long-term community relationships and culturally tailored outreach and communication to reduce hesitancy. Conversely, Western Norway's less community-centric approach, focusing on translation services without deeper engagement, faced challenges in trust-building. The study highlights the essential role of culturally affirming and community-centric approaches in addressing health challenges in immigrant communities. Trust, fostered through community involvement and understanding sociopolitical contexts, is pivotal in addressing vaccine hesitancy. This research offers insights into designing and implementing effective health promotion strategies tailored to immigrant populations' unique needs. It emphasizes the necessity of integrating socioecological perspectives and community-specific interventions in health promotion practice and policy.

As calls for improved menstrual health management have gained momentum in sociopolitical contexts, period poverty and menstrual equity have gradually been established and recognized in the discipline of public health. These conversations typically take place in the context of low- and middle-income countries (LMICs) where donor-sponsored projects are already underway. Nevertheless, research on period poverty in high-income countries (HICs) is seldom performed. In addition, current literature on the topic tends to generalize HICs and LMICs, thereby ignoring crucial cultural and socioeconomic distinctions that necessitate a more detailed comparison of individual countries facing period poverty. This case examines the current body of research on period poverty in the United States and India, and compares the causes, effects, and approaches toward ameliorating this phenomenon. Through performing a scoping review of the current literature on period poverty, this case illustrates that-as opposed to the breadth of research available on period poverty in LMICs-research on period poverty in HICs is underrepresented. In addition, the findings demonstrate a stunning parallel between the contributing factors of period poverty in India and the United States, suggesting that the current approach to isolate conversations on the topic based on regional economic incongruencies is inappropriate. Finally, this case identifies dismantling the stigmatization of periods, investing in water or hygiene infrastructure, promoting the economic mobilization of females, and reforming menstrual health curricula in schools as essential to ending period poverty.

In this practice note, we examine the implementation and impact of the Texas Cancer Screening, Training, Education, and Prevention (C-STEP) program, which aims to reduce cancer disparities in medically underserved and rural areas. The program utilizes community health workers (CHWs) or promotor(a)s to provide outreach, education, and early detection services for breast, cervical, colorectal, and lung cancers. C-STEP employs a multidisciplinary approach, partnering with the Center for Community Health Development National Community Health Worker Training Center to certify CHWs in cancer prevention and detection. The program establishes community and clinical partnerships to promote cancer screening uptake in priority populations. Key outcomes include training over 33 CHWs, establishing more than 1500 partnerships, providing cancer education to over 30,000 individuals, conducting over 8300 screening exams and 600 diagnostic procedures, and diagnosing 69 cancers. Successes encompass increased screening rates, community engagement, and partnership development. Challenges involve financial inequities, technology literacy, role complexity, and outreach difficulties. Lessons learned highlight the need for proactive planning, diverse recruitment, and consistent communication with partners. Our findings suggest that integrating CHWs into cancer screening programs effectively increases awareness and screening rates, particularly among low-income populations. Future implications suggest the importance of strategic planning, systematic training, and creative partnership approaches to recognize CHWs as vital health care team members. The findings highlight the potential of community-based interventions in addressing cancer disparities and improving health outcomes practices in rural and underserved areas.

Background. Lack of physical activity (PA) causes over 5.3 million deaths every year and causes more deaths than smoking worldwide. Prolonged periods of sitting contributes to chronic diseases, which are among the leading causes of deaths, illnesses, and health care costs worldwide. Over 133 million Americans are currently affected by chronic diseases and associated health care costs the United States an estimated $3.5 trillion annually. Working adults spend an average of 7.6 hours per day at work and office-based employees spend 75% of their time sitting. Prolonged periods of sitting also causes stress, and stress is the leading cause of 75%-90% of all doctor visits. Purpose. The purpose of this study was to determine facilitators and barriers of workplace PA to relieve stress at a Florida Department of Health (FDOH) site. Methods. Mixed-methods data were collected in an anonymous Qualtrics survey. Sample included employees ≥ 18 years old with sedentary or active occupations who completed or not completed recommended PA at FDOH site. Results. A total of 336 responses were recorded and produced an 84% response rate. Lack of time was the most commonly reported barrier. Discussion. Too much sitting has become a global epidemic. Completing 30 minutes of daily PA can reverse 10 hours of sitting, relieve stress, improve health outcomes, and ultimately save lives. Workplace PA facilitators/barriers and stress relief behaviors were identified and provided practical methods to improve overall workforce health outcomes. Implementing fun, inclusive and healthy interventions in policy and practice, can encourage happier and healthier workforces and communities worldwide.

This summary report describes partners' experiences and reflections on responding to the COVID-19 pandemic in selected countries in the African Region. Using a common protocol for participatory evaluation and sensemaking, it communicates country partners' experiences with the COVID-19 response in Gabon, Kenya, and Senegal as well as a regional perspective from partners in the World Health Organization Regional Office for Africa (WHO AFRO). This report describes factors identified as associated with decreases (bending the curve) of new cases of COVID-19 over time, as well those associated with increases (worsening) of new cases, seen during the study period (2020-2021). We also report on partners' identification of factors that enabled (made easier or possible) implementation of the COVID-19 response; and those that impeded (made more difficult) the response in participating countries, and in the broader WHO African Region. This report concludes with lessons learned and recommendations for practice in responding to public health emergencies based on experiences in the African Region.

Background. Improving children's diets from 6 to 24 months can support children's survival, growth, and development, but progress toward this goal has stalled globally. Human-centered design offers a new approach to resolving program challenges, especially when integrated with social and behavior change (SBC) theory and rigorous evaluation. Method. Two human-centered design processes were conducted. In Ebonyi state, Federal Capital Territory, and Sokoto state a combined high-fidelity prototype, drawn from three low-fidelity prototypes, focusing on improving dietary diversity was developed and tested. In Kebbi state eight low-fidelity prototypes focused on developing tools to improve community health worker (CHW) nutrition counseling were developed and tested. High-fidelity prototype testing combined design and behavior change indicators and qualitative and quantitative methods. Prototype Testing Results. Seven of the eight prototypes in Kebbi state tested well. Prototypes that integrated SBC theory and encouraged two-way conversations between CHWs and caregivers were most successful. The high-fidelity prototype tested in Sokoto demonstrated improved knowledge and efficacy regarding dietary diversity and increased self-reported dietary diversity. Three low-fidelity prototypes in Kebbi will be combined into a counseling package for CHWs. The implementation of the high-fidelity nutrition prototype will be expanded. Discussion. Human-centered design is a promising approach to address complex global health challenges and can be strengthened through the integration of SBC theory and traditional monitoring and evaluation approaches, but this is challenging. Implications for Practice. It is essential to establish a foundation of human-centered design and SBC knowledge among all implementers, incorporate both knowledge bases throughout the process, and center in-country expertise.

Background: While cultural competency has been recognized as an important feature in health care delivery, evaluating intervention effectiveness is often overlooked.

Methods: This project used an explanatory sequential mixed methods study design within a community-based participatory research structure. A 29-item Organization cultural competency Checklist was created and distributed to a purposive sample of staff at 55 New York State (NYS) Department of Health AIDS Institute-funded health and human service providers. Organizations recruited clients to complete a 27-item Client Checklist. Basic univariate analyses were conducted on quantitative items (Stata v.18). For questions asked to both groups, we conducted chi-square tests to determine statistically significant differences (p-value < 0.10). Qualitative stories about the impact of culturally competent care provision were analyzed using the Most Significant Change process by a Community Advisory Board (CAB) of LGBTQ+ NYS residents.

Results: The Organization Checklist had 92 responses from 37 organizations. The Client Checklist yielded 32 responses from five organizations. While high agreement between client and staff was reached on the majority of items, opportunities for improvement included updated intake forms and strengthening relationships with other local LGBTQ+ organizations. Using 62 raw stories, the CAB identified two main themes of affirming and un-affirming care, further organized into personal, perception, provider, and systemic categories.

Discussion: Clients reported higher engagement in health-seeking behavior with culturally competent providers and care-avoidance with culturally incompetent care. Clients decided the safety of expending emotional labor to educate providers. Improving organizational cultural competency is an ongoing process requiring consistent and prompt attention.

Health promotion commonly focuses on supporting youth wellness, as health behaviors acquired in childhood and adolescence tend to have a significant impact on an individual's future. Adolescent health education is associated with positive health and educational outcomes, yet young people experience barriers to fully engaging in learning about health issues that are often unique to their social location. Barriers for successful engagement in health education for African diaspora youth in North American and European contexts may include school initiatives built around engagement models that do not center Black youth; for Black youth in majority-Black societies, barriers may include access to resources or exclusionary practices based on other social characteristics. Global health promotion has used a variety of multimodal educational tools from radio to more recently online engagement, especially in African contexts, to reach young people. This essay shares experiences using AI and in-person facilitation to engage in community health education with youth in Liberia and the United States. In our practice, we found that there are far more underlying systemic and structural similarities to the inequities experienced between African and Black American youth and that utilizing AI tools alongside of in-person discussion may contribute to better outcomes for youth health education.

Background: Adverse gender norms within the health care system are detrimental to the sexual and reproductive health of young people. This study assessed the attitudes of health workers toward adverse gender norms related to intimate partner relationships across three domains: intimate partner violence (IPV); sexuality; and reproductive health behavior.

Methods: A cross-sectional quantitative survey was conducted among 255 health workers in youth-friendly primary health centers in Ebonyi State, Nigeria. Attitudes to gender norm statements were assessed on a 3-point scale of agree (3 points), partially agree (2 points), and disagree (1 point). Mean attitude scores were estimated for each statement and the predictors of attitudes were determined through multiple linear regression analysis with p-value set at .05.

Results: Majority of the health workers held gender biases regarding male control over sexual decision-making, men's higher desire and value for sex, and the woman's responsibility to prevent pregnancy. Over 40% of the respondents associated women carrying condoms with promiscuity, and 39.6% believed that only men have the "social" rights to purchase condoms. Urban residence predicted health workers' attitudes to adverse gender norms related to sexuality (β = -.179, p = .003).

Conclusions: Findings from this study provide a basis for in-service training programs that are designed to change the attitudes of health workers to adverse gender norms and transform their practices.

Gender-affirming care is a highly politicized topic in the United States. Trans+ individuals do not control the narratives about their access to care, quality of life, and decision-making. Trans+ people are othered, marginalized, and abused by medical systems. The author of this poem accessed life-changing, gender-affirming care partly due to educational, racial, and geographic privilege. In 2023, 220 (and counting) state legislative bills targeting trans and non-binary people were filed. Many of these bills target transgender youth, but some states have even considered limiting adult care. Gender-expansive people face misinformation, microaggressions, and ridicule due to oppressive political narratives. From the family of origin to Twitter, trans people have to make themselves palatable. Even in the best situations, trans+ people face well-intentioned healthcare providers' intrusions, ignorance, or infantilization. Allies who have not unpacked their transphobia may cause harm, even in seemingly innocuous interactions. Public health can benefit from the irreverence of gender euphoria. This poem is me living a vibrant, queer life in academia and at my family's kitchen table, resisting moral panic one stanza at a time. To view the original version of this poem, see the supplemental material section of this article online.