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The Stress of Advancement: A Nurse Practitioner's Exploration in Providing Culturally Competent Obesity Prevention Counseling in Black Women. 进步的压力:一名执业护士在为黑人妇女提供符合其文化背景的肥胖预防咨询方面的探索。
IF 1.6 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-11-01 Epub Date: 2024-01-24 DOI: 10.1177/15248399231221767
Jasmine A Berry, Joan Cranford, Rachel Powell

Background: Black women are diagnosed, disabled, and die from obesity and associated chronic diseases at higher rates than any other sex or race. Advanced practice registered nurses (APRN) can potentially improve culturally relevant health education and counseling by using health literacy communication tools.

Objective: Explore individualized barriers and APRNs' role in providing obesity prevention education and counseling by assessing the efficacy of the Teach-Back Method (TBM) to understand health habits and attitudes.

Methods: Black women aged 18-45, previously diagnosed as overweight or obese, and identified with perceived barriers were recruited from a predominantly Black church in Atlanta. They engaged in weekly, 1-hour educational sessions via Zoom, addressing four common barriers identified in the literature. Sessions ended with a 5-10 minute Teach-Back session. Pre- and post-intervention Readiness to Change Questionnaire (RCQ) were completed. Descriptive statistics and quantitative data from surveys and pre- and post-RCQ were analyzed.

Results: Twenty women completed the intervention. Paired sample t-test revealed no statistical significance or correlation between pre- and post-RCQ scores after using TBM in educational sessions. However, Pearson's correlation showed positive associations between elevated body mass index levels as one advances their education and annual income, with a p-value of 0.05.

Discussion: Increased rates of obesity are experienced despite higher educational attainment or pay. Stress and high-coping mechanisms contributed to disordered eating, decreased physical activity engagement, and decreased motivation toward habit change. Clinicians should be held accountable for delivering culturally sensitive care using the TBM, addressing social determinants of health, performing routine stress assessments, and checking their implicit biases.

背景:黑人妇女被诊断出患有肥胖症及相关慢性疾病、致残和死亡的比例高于其他任何性别或种族。高级执业注册护士(APRN)可以通过使用健康扫盲沟通工具,改善与文化相关的健康教育和咨询:通过评估 "回授法"(TBM)在了解健康习惯和态度方面的效果,探索个性化障碍以及高级执业注册护士在提供肥胖预防教育和咨询方面的作用:方法: 从亚特兰大一个以黑人为主的教堂招募了 18-45 岁的黑人妇女,她们之前被诊断为超重或肥胖,并被认为存在障碍。她们每周通过 Zoom 参加 1 小时的教育课程,解决文献中指出的四种常见障碍。课程以 5-10 分钟的 "教学反馈 "环节结束。干预前和干预后均填写了 "改变准备情况问卷"(RCQ)。对来自调查的描述性统计和定量数据以及干预前后的 RCQ 进行了分析:结果:20 名妇女完成了干预。配对样本 t 检验显示,在教育课程中使用 TBM 后,前后 RCQ 分数之间没有统计学意义或相关性。然而,皮尔逊相关性显示,随着受教育程度的提高,身体质量指数的升高与年收入之间存在正相关,P 值为 0.05:讨论:尽管教育程度或薪酬较高,但肥胖率却在增加。压力和高度应对机制导致饮食失调、体育锻炼减少以及改变习惯的动力下降。临床医生应负责使用TBM提供文化敏感性护理,解决健康的社会决定因素,进行常规压力评估,并检查他们的隐性偏见。
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引用次数: 0
Substance Use and Mental Health Screening Within an Emergency Department-Based HIV Screening Program: Outcomes From 1 Year of Implementation. 基于急诊科的 HIV 筛查项目中的药物使用和心理健康筛查:实施一年的成果。
IF 1.6 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-11-01 Epub Date: 2023-08-31 DOI: 10.1177/15248399231193005
Jennifer L Brown, Nicole K Gause, Robert Braun, Brittany Punches, David Spatholt, T Dylanne Twitty, Joel G Sprunger, Michael S Lyons

Introduction: The emergency department (ED) may be an optimal setting to screen for substance use disorders (SUDs) and co-occurring psychiatric disorders (CODs). We report on the frequency of problematic substance use and comorbid elevated mental health symptoms detected during a 1-year implementation period of an ED-based SUD/COD screening approach within an established ED HIV screening program.

Methods: Patients (N = 1,924) were approached by dedicated HIV screening staff in an urban, Midwestern ED. Patients first completed measures assessing problematic alcohol (Alcohol Use Disorder Identification Test-Concise [AUDIT-C]) and substance use across 10 categories of substances (National Institute on Drug Abuse-Modified Alcohol, Smoking, and Substance Involvement Screening Test [NIDA-Modified ASSIST]). Patients with positive alcohol and/or substance use screens completed measures assessing symptoms of depression (Patient Health Questionnaire-9 [PHQ-9]), anxiety (Generalized Anxiety Disorder-7 [GAD-7]), and post-traumatic stress disorder (PTSD) (PTSD Checklist-Civilian [PCL-C]).

Results: Patients were predominantly male (60.3%) with a mean age of 38.1 years (SD = 13.0); most identified as White (50.8%) or Black (44.8%). A majority (58.5%) had a positive screen for problematic alcohol and/or other substance use. Of those with a positive substance use screen (n = 1,126), 47.0% had a positive screen on one or more of the mental health measures with 32.1% endorsing elevated depressive symptoms, 29.6% endorsing elevated PTSD-related symptoms, and 28.5% endorsing elevated anxiety symptoms.

Conclusions: Among those receiving ED HIV screening, a majority endorsed problematic alcohol and/or other substance use and co-occurring elevated mental health symptoms. Substance use and mental health screening programs that can be integrated within other ED preventive services may enhance the identification of individuals in need of further assessment, referral, or linkage to substance use treatment services.

导言:急诊科(ED)可能是筛查药物使用障碍(SUD)和并发精神障碍(COD)的最佳场所。我们报告了在已有的急诊科艾滋病筛查项目中,基于急诊科的 SUD/COD 筛查方法实施 1 年期间发现的问题药物使用和合并精神健康症状升高的频率:在中西部城市的一家急诊室,由专门的艾滋病筛查人员接触患者(N = 1,924 人)。患者首先要完成评估问题酒精(酒精使用障碍识别测验-简易版 [AUDIT-C])和 10 类物质使用情况(美国国家药物滥用研究所改良版酒精、吸烟和物质参与筛查测验 [NIDA-改良版 ASSIST])的测量。酒精和/或药物使用筛查呈阳性的患者完成了抑郁症(患者健康问卷-9 [PHQ-9])、焦虑症(广泛性焦虑症-7 [GAD-7])和创伤后应激障碍(PTSD)(创伤后应激障碍检查表-平民 [PCL-C])症状的评估测量:患者主要为男性(60.3%),平均年龄为 38.1 岁(SD = 13.0);大多数患者为白人(50.8%)或黑人(44.8%)。大多数人(58.5%)的酒精和/或其他药物使用筛查呈阳性。在药物使用筛查呈阳性的人群中(n = 1,126),47.0% 的人在一项或多项心理健康测量中筛查呈阳性,其中 32.1% 的人抑郁症状加重,29.6% 的人创伤后应激障碍相关症状加重,28.5% 的人焦虑症状加重:结论:在接受 ED HIV 筛查的人群中,大多数人都有酗酒和/或使用其他药物的问题,并同时伴有精神健康症状的升高。如果能将药物使用和心理健康筛查项目整合到其他急诊室预防服务中,就能更好地识别出需要进一步评估、转诊或转入药物使用治疗服务的人群。
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引用次数: 0
Mixed-Methods Evaluation of Father Participation in an Adolescent Obesity Prevention Program With Multiple Delivery Methods. 采用多种方法对父亲参与青少年肥胖预防计划的情况进行混合方法评估。
IF 1.6 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-11-01 Epub Date: 2023-06-09 DOI: 10.1177/15248399231177300
Ghaffar Ali Hurtado Choque, Matthew R Rodriguez, Darya Soltani, Aysegul Baltaci, Sayaka Nagao-Sato, Silvia Alvarez de Davila, Javiera Monardez, Alejandro Omar Peralta Reyes, Marla Reicks

Padres Preparados, Jóvenes Saludables was a Latino family-based obesity prevention intervention implemented from 2017 to 2020 across eight programs in-person only, in a blended format (online/in-person), and online only. The intervention aimed to enhance father parenting skills to improve adolescent diet and activity behaviors. Mothers were encouraged to attend. Factors associated with participation were explored using a mixed-methods, qualitative (focus group/individual interviews by Zoom) and quantitative (process evaluation) design. Eleven focus group and 24 individual interviews were completed after participation with 24 fathers, 27 mothers, and 40 adolescents with responses not sorted by delivery method before analysis. Binomial logistic regression models examined associations between fathers' program completion and predictor variables of delivery characteristics, father demographic characteristics, and family attendance patterns. Parents were married (96% fathers, 76% mothers), had low income, a high school education or less (68% fathers, 81% mothers), and had lived in the United States a mean of 19 years. Parents were motivated to participate to improve health, and to be involved with and improve communication with their child. Common barriers to participation were work and life priorities and programmatic factors including scheduling conflicts and technological issues. Participation was greater for fathers attending sessions in-person compared with online only (OR = 11.6). Fathers were more likely to participate if they attended sessions with family members vs. not attending with family members (OR = 7.2). To maximize participation, findings suggest involving multiple parents/caregivers and adolescents, addressing contextual and programmatic barriers, and promoting benefits of better health and relations with family members.

Padres Preparados, Jóvenes Saludables 是一项以拉丁裔家庭为基础的肥胖预防干预措施,于 2017 年至 2020 年期间在八个项目中实施,包括仅面对面干预、混合形式(在线/面对面)干预和仅在线干预。该干预旨在提高父亲的育儿技能,以改善青少年的饮食和活动行为。鼓励母亲参加。采用混合方法、定性(焦点小组/个人访谈 Zoom)和定量(过程评估)设计探讨了与参与相关的因素。参加活动后,对 24 名父亲、27 名母亲和 40 名青少年进行了 11 次焦点小组访谈和 24 次个别访谈,分析前未按授课方式对回答进行分类。二项式逻辑回归模型检验了父亲完成计划情况与授课特征、父亲人口特征和家庭出席模式等预测变量之间的关联。父母均已婚(96% 的父亲,76% 的母亲),收入较低,高中或以下学历(68% 的父亲,81% 的母亲),在美国平均居住时间为 19 年。家长参与的动机是为了改善健康状况,参与并改善与孩子的沟通。参加活动的常见障碍是工作和生活的优先次序以及计划因素,包括时间安排冲突和技术问题。与只通过网络参加活动相比,父亲亲自参加活动的比例更高(OR = 11.6)。与不与家人一起参加活动的父亲相比,与家人一起参加活动的父亲更有可能参与活动(OR = 7.2)。为了最大限度地提高参与度,研究结果建议让多名父母/照顾者和青少年参与进来,解决环境和计划方面的障碍,并宣传改善健康和与家庭成员关系的益处。
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引用次数: 0
Policy for Equity: Associations Between Community Mental Health Agency Policies and Clinicians' Cultural Competence. 公平政策:社区精神卫生机构政策与临床医生文化能力之间的关系。
IF 1.6 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-11-01 Epub Date: 2023-11-10 DOI: 10.1177/15248399231208422
Noah S Triplett, Jasmin L Blanks Jones, Yasmin Garfias, Natasha D Williams, Shannon Dorsey

Systemic reform is needed to address racism as a root cause of mental health inequities, such as understanding how community mental health (CMH) agencies' practices and policies may impact care provided to racially minoritized populations. This study described and examined associations between CMH clinicians' multicultural knowledge and awareness and agency practices and policies to improve care for Clients of Color. CMH clinicians (N = 119) across Washington State reported on their multicultural competence and agencies' practices and policies in an online survey. Multicultural competence was assessed with the Multicultural Counseling Knowledge and Awareness Scale (MCKAS), which assesses respondents' knowledge of multicultural counseling frameworks and awareness of multicultural counseling issues. Agency policies were examined with an adapted version of the Multiculturally Competent Service System (MCSS) Assessment Guide, which asked respondents to endorse the degree to which their agencies had taken specific steps to better serve racially and ethnically minoritized populations across 11 domains, including policies, linguistic diversity in services, and quality monitoring and improvement. Multicultural knowledge and awareness were generally high across the sample. Clinicians commonly endorsed that their agencies had mission statements that were committed to cultural competence. Endorsement of concrete steps to improve services for non-English speaking clients was associated with greater multicultural knowledge and awareness, and practices to monitor and improve care provided to Clients of Color were associated with lower scores. Addressing mental health inequities requires multifaceted solutions. Results highlight the potential of examining agency practices and policies as one solution to improve care for Clients of Color.

需要进行系统改革,以解决种族主义作为心理健康不平等的根本原因的问题,例如了解社区心理健康机构的做法和政策如何影响为种族少数群体提供的护理。这项研究描述并检查了CMH临床医生的多元文化知识和意识与改善有色人种客户护理的机构实践和政策之间的关系。华盛顿州的CMH临床医生(N=119)在一项在线调查中报告了他们的多元文化能力以及机构的做法和政策。多元文化能力采用多元文化咨询知识和意识量表(MCKAS)进行评估,该量表评估受访者对多元文化咨询框架的知识和对多元文化辅导问题的认识。机构政策采用了《多元文化胜任服务体系评估指南》的修订版进行了审查,该指南要求受访者认可其机构在多大程度上采取了具体措施,更好地为11个领域的种族和族裔少数群体服务,包括政策、服务中的语言多样性以及质量监测和改进。样本中的多元文化知识和意识普遍较高。临床医生普遍认为,他们的机构有致力于文化能力的使命声明。认可改善非英语客户服务的具体步骤与提高多元文化知识和意识有关,而监督和改善向有色人种客户提供的护理的做法与得分较低有关。解决心理健康不平等问题需要多方面的解决方案。研究结果突出了审查机构实践和政策的潜力,将其作为改善有色人种客户护理的一个解决方案。
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引用次数: 0
Examining the Perceptions of mHealth on Racial and Ethnic Disparities in Postpartum Health for Black Women: A Scoping Review. 研究移动医疗对黑人妇女产后健康中种族和民族差异的看法:范围审查。
IF 1.6 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-11-01 Epub Date: 2024-03-31 DOI: 10.1177/15248399241234636
Natalie Hernandez-Green, Morgan V Davis, Merna S Beshara, Kaitlyn Hernandez-Spalding, Sherilyn Francis, Andrea Parker, Oluyemi Farinu, Rasheeta Chandler

Background. Several disparities exist for Black mothers during the postpartum period, including but not limited to increased maternal mortality and morbidity rates, decreased access to care, and limited access to resources. Given the racial discrepancies in attention to postpartum care, coupled with the critical importance of the postpartum period for preventing adverse maternal health outcomes, research is warranted to explore how mobile health (mHealth) applications may help to alleviate maternal health disparities by optimizing postpartum care and addressing barriers to care for postpartum Black women. Thus, this review examines the perceptions of mHealth applications and their utility in health outcomes among postpartum Black women. Methods. We undertook a comprehensive literature search using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. We included peer-reviewed articles published between 2010 and 2022 that were written in English, utilized mHealth as a primary intervention, and focused on postpartum health and access to resources, primarily among Black women in the United States. Results. A total of eight articles were included in our synthesis, encompassing mobile phone-based interventions for Black women. Cultural tailoring was included in five studies. Interventions that incorporated tailored content and fostered interactions reported high rates of follow-up. Conclusions. Tailored mHealth interventions can effectively promote behavior change and improve health care outcomes for Black women. However, there is a critical need for more research to assess user engagement and retention and whether these improvements indicate long-term sustainability.

背景。黑人母亲在产后期间存在一些差异,包括但不限于孕产妇死亡率和发病率增加、获得护理的机会减少以及获得资源的机会有限。鉴于对产后护理的关注存在种族差异,加上产后期间对预防不良孕产妇健康后果至关重要,因此有必要开展研究,探讨移动医疗(mHealth)应用如何通过优化产后护理和解决黑人产后妇女的护理障碍来帮助缓解孕产妇健康差异。因此,本综述研究了黑人产后妇女对移动医疗应用的看法及其对健康结果的作用。方法。我们采用 PRISMA(系统综述和元分析首选报告项目)指南进行了全面的文献检索。我们收录了 2010 年至 2022 年间发表的同行评议文章,这些文章均以英语撰写,使用移动医疗作为主要干预手段,主要关注美国黑人妇女的产后健康和资源获取情况。结果。共有八篇文章被纳入我们的综述,其中包括针对黑人妇女的基于手机的干预措施。其中五项研究包含了文化定制内容。纳入定制内容并促进互动的干预措施报告了较高的随访率。结论量身定制的移动医疗干预可有效促进行为改变并改善黑人妇女的医疗保健结果。然而,目前亟需开展更多研究,以评估用户参与度和保留率,以及这些改善是否表明具有长期可持续性。
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引用次数: 0
The Black Church and Co-Occuring Pandemics. 黑人教会和共同发生的流行病。
IF 1.6 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-11-01 Epub Date: 2023-10-20 DOI: 10.1177/15248399231204589
LaNita S Wright, John A Reed

Black people represent less than 13% of the population in the United States, but over 15% of COVID-19 deaths, with a mortality rate two times higher than White people. The Black Church system has historically been in a unique position to serve Black communities, particularly during times of crisis. The deep-rooted connection of the Black Church system within Black communities was largely shaped by slavery and segregation. However, there have been questions about the relevance of the Black Church system today. The objective of this commentary is to describe the intersectionality of ministry and health that has been illuminated in a profound way during this pandemic. Those in leadership had to evaluate and disseminate COVID-19 information to congregants, recognizing mistrust of the medical and public health systems still permeates throughout Black communities. Moreover, the death of George Floyd sparked international outcry, which launched church leaders to respond to a second pandemic: systemic racism. Understanding ways the Black Church responded to COVID-19, and systemic racism, is significantly important to public health and medical communities as it addresses the relevance of this system and ways to appropriately support during another public health crisis.

黑人占美国人口的比例不到13%,但占新冠肺炎死亡人数的15%以上,死亡率是白人的两倍。黑人教会系统在历史上一直处于为黑人社区服务的独特地位,尤其是在危机时期。黑人教会系统在黑人社区中根深蒂固的联系在很大程度上是由奴隶制和种族隔离形成的。然而,今天黑人教会制度的相关性一直存在疑问。本评论的目的是描述卫生部和卫生部的交叉性,这在这场疫情期间得到了深刻的阐述。领导层必须评估新冠肺炎信息,并向集会者传播这些信息,认识到对医疗和公共卫生系统的不信任仍然渗透到整个黑人社区。此外,乔治·弗洛伊德之死引发了国际社会的强烈抗议,促使教会领导人应对第二次疫情:系统性种族主义。了解黑人教会应对新冠肺炎和系统性种族主义的方式,对公共卫生和医学界至关重要,因为它解决了这一系统的相关性以及在另一场公共卫生危机期间提供适当支持的方式。
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引用次数: 0
The Culturally Infused Curricular Framework (CICF) for Suicide Prevention Trainings. 预防自杀培训的文化渗透课程框架 (CICF)。
IF 16.4 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-11-01 Epub Date: 2024-03-05 DOI: 10.1177/15248399241234064
Lorna Chiu, Gabriel H Corpus, Mego Lien, Joyce P Chu

Although suicide prevention trainings (SPT) have been a standard approach for suicide prevention for years, researchers have noted a need for more clarity in the definition of core competencies for SPTs, particularly in the areas of diversity and culture. Recent research has identified key theoretically- and empirically-based cultural considerations for suicide prevention, but translation is needed to infuse these standards for culture-related competencies into SPTs. This study performed a systematic literature review with a thematic synthesis analytic approach to establish a set of curricular guidelines for infusion of cultural considerations into SPTs. The study also examined the extent to which existing community trainings already incorporate cultural components. Based on the thematic synthesis of 39 SPT studies from 2010 to 2020 and seminal reviews of the cultural and suicide literature, results identified three overarching categories of cultural curricular competencies (suicide knowledge and awareness, suicide intervention skills, and curriculum delivery) and 14 core cultural curricular subthemes for community trainings (e.g., culturally informed risk factors and warning signs, systemic inequities, etc.). These three categories with 14 core cultural curricular competencies comprise the Culturally Infused Curricular Framework (CICF) for Suicide Prevention Trainings. The majority of trainings (62%) included five or less out of 14 total possible core cultural competencies in their training curricula, pointing to insufficient integration of cultural components in existing community trainings. This study's research-based guideline establishes a culture-inclusive framework to strengthen content and approach of community trainings and suicide prevention across cultural groups.

虽然自杀预防培训(SPT)多年来一直是预防自杀的标准方法,但研究人员注意到,SPT 核心能力的定义需要更加清晰,尤其是在多样性和文化领域。最近的研究已经确定了预防自杀的关键理论和实证文化因素,但还需要将这些与文化相关的能力标准转化为 SPT。本研究采用专题综合分析方法进行了系统的文献综述,为将文化因素纳入 SPT 制定了一套课程指南。本研究还考察了现有社区培训在多大程度上已经融入了文化元素。根据对 2010 年至 2020 年期间 39 项 SPT 研究的专题综合以及对文化和自杀文献的开创性综述,研究结果确定了文化课程能力的三个总体类别(自杀知识和意识、自杀干预技能和课程实施)以及社区培训的 14 个核心文化课程次主题(例如,具有文化信息的风险因素和警示信号、系统性不平等等)。这三个类别和 14 个核心文化课程能力构成了预防自杀培训的文化渗透课程框架 (CICF)。大多数培训(62%)在其培训课程中包含了 14 种可能的核心文化能力中的 5 种或更少,这表明在现有的社区培训中,文化元素的整合还不够充分。本研究以研究为基础的指南建立了一个文化包容性框架,以加强社区培训和跨文化群体自杀预防的内容和方法。
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引用次数: 0
Describing the Lived Experience and Resource Needs of Individuals With Long COVID. 描述长期 COVID 患者的生活经历和资源需求。
IF 1.6 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-11-01 Epub Date: 2024-02-15 DOI: 10.1177/15248399241228823
David Von Nordheim, Mikayla Johnson, Charlene Caburnay, Sarah Alleman, Matthew Kreuter, Amy McQueen

Individuals with long COVID report diverse symptoms lasting weeks or months after initial infection, causing significant psychosocial distress. Navigating health care interactions are often difficult for these individuals due to the diffuse nature of their symptoms, a lack of effective treatment options, and skepticism from some providers. To better understand these challenges, this study sought to further describe the lived experience of individuals with long COVID. A survey was conducted with individuals evaluated for long COVID at a specialty clinic (n = 200), which included questions about prior conditions, symptoms, use of medical and support services, and information and resource needs. Participants reported a mean of 10.75 persistent symptoms, the most common being fatigue and difficulty concentrating, with broad effects on daily functioning. Participants saw a mean of 5.92 providers for treatment of their symptoms, and 88.5% identified health care providers as a trusted source of information. Interest in research findings (60.5%) and opportunities for participation (47.5%) were moderate and varied by COVID vaccination status. Unvaccinated individuals (n = 27) also reported less trust in government sources of information, less college education, lower household income, and greater likelihood of having public insurance. Our findings suggest that individuals with long COVID experience many ongoing and complex symptoms with diverse effects on daily living; that health care providers are an important source for public health messaging about long COVID; and that unvaccinated individuals are likely to have differing needs and receptiveness to information than vaccinated individuals with long COVID.

长期感染 COVID 的患者在初次感染后会出现持续数周或数月的各种症状,给社会心理造成严重困扰。由于这些患者的症状具有分散性,缺乏有效的治疗方案,而且一些医疗服务提供者对其持怀疑态度,因此他们在与医疗服务提供者进行互动时往往会遇到困难。为了更好地了解这些挑战,本研究试图进一步描述长期 COVID 患者的生活经历。我们在一家专科门诊对接受长程COVID评估的患者(n = 200)进行了一项调查,调查内容包括先前的病情、症状、医疗和支持服务的使用情况以及信息和资源需求等问题。参与者平均报告了 10.75 种持续性症状,其中最常见的是疲劳和注意力难以集中,对日常功能产生了广泛影响。参与者平均向 5.92 名医疗服务提供者寻求症状治疗,88.5% 的参与者认为医疗服务提供者是他们可信赖的信息来源。参与者对研究结果(60.5%)和参与机会(47.5%)的兴趣适中,并因 COVID 疫苗接种状况而异。未接种者(n = 27)也表示对政府信息来源的信任度较低、大学教育程度较低、家庭收入较低以及拥有公共保险的可能性较大。我们的研究结果表明,长期慢性阻塞性肺气肿患者会出现许多持续且复杂的症状,对日常生活造成不同程度的影响;医疗保健提供者是长期慢性阻塞性肺气肿公共卫生信息的重要来源;未接种疫苗的患者与接种疫苗的长期慢性阻塞性肺气肿患者相比,其需求和对信息的接受能力可能有所不同。
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引用次数: 0
Development, Implementation, and Formative Evaluation of a Social Needs Screening Tool. 社会需求筛查工具的开发、实施和形成性评估。
IF 1.6 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-10-25 DOI: 10.1177/15248399241291865
Lillian W Acton, Natasha M Lerner, Katharine O White, Sarah L Johns, Deborah Dill, Elizabeth Janiak

We aim to develop and formatively evaluate a brief social needs screening tool that adheres to Massachusetts Department of Public Health (MDPH) clinical service standards for sexual and reproductive health (SRH) agencies and is acceptable and feasible for use by staff during a clinical encounter. Through a multi-stage literature and expert review process, we developed an evidence-informed, two-page social needs screening tool, scoring form, and implementation guide. We piloted this tool at three SRH agencies in Massachusetts and recruited staff to provide quantitative and qualitative feedback through post-pilot test self-reported surveys and semi-structured interviews. Participants (n = 13) felt the social needs screening tool was easy to integrate into their clinical workflow and were comfortable using it with patients. All participants reported feeling comfortable administering the tool, scoring it, and referring patients to appropriate resources, if applicable. Most reported they would like to continue using the tool after the pilot implementation period, either with or without modifications. Our multi-stage tool development and formative evaluation process involving literature review, expert review, and pilot-testing in clinical settings enabled our team to create a brief, evidence-informed social needs screening tool that is acceptable to staff and feasible for use during a short clinic visit at SRH agencies in Massachusetts. Staff felt that there is value in using this tool, are comfortable using it, and are able to integrate it into their existing clinical workflows.

我们的目标是开发并正式评估一种简短的社会需求筛查工具,该工具应符合马萨诸塞州公共卫生部(MDPH)为性与生殖健康(SRH)机构制定的临床服务标准,并能被工作人员在临床接触中接受和使用。通过多阶段的文献和专家审查过程,我们开发出了一个有实证依据的、两页纸的社会需求筛查工具、评分表和实施指南。我们在马萨诸塞州的三家性健康和生殖健康机构试用了这一工具,并招募员工通过试点测试后的自我报告调查和半结构化访谈提供定量和定性反馈。参与者(n = 13)认为社会需求筛查工具很容易整合到他们的临床工作流程中,并能自如地对患者使用。所有参与者都表示在使用该工具、为其评分以及将患者转介至适当的资源(如适用)方面感觉得心应手。大多数人表示,试点实施期结束后,他们希望继续使用该工具,无论是否进行修改。我们的多阶段工具开发和形成性评估过程包括文献综述、专家评审和临床环境中的试点测试,这使我们的团队能够创建一个简短的、有实证依据的社会需求筛查工具,该工具可为员工所接受,并可在马萨诸塞州性健康和生殖健康机构的短期门诊中使用。工作人员认为该工具有使用价值,使用起来得心应手,并能将其纳入现有的临床工作流程。
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引用次数: 0
Knowledge About Food Insecurity Among Dental Practitioners: Preliminary Findings From the National Dental Practice-Based Research Network. 牙科医生对粮食不安全的认识:全国牙医实践研究网络的初步发现。
IF 1.6 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-10-23 DOI: 10.1177/15248399241287206
Rahma Mungia, Alexander Testa, Daphne C Hernandez, Joana Cunha-Cruz, Kayla M Garcia, Gregg H Gilbert

Food insecurity is a household-level economic and social condition characterized by limited access to nutritious food. This study explored dental practitioners' views on food insecurity screening and its impact on oral health. A five-question survey ("Quick Poll") was conducted through the National Dental Practice-Based Research Network (PBRN) in the United States. A total of 332 dental practitioners responded. Preferences for food insecurity screening in dental practice settings showed substantial variability: 30% in favor, 39% neutral, and 29% against. When identifying the primary oral health issue influenced by food insecurity, 68% pinpointed dental caries. Over half (53%) expressed comfort in directing patients experiencing food insecurity to relevant resources. Notably, 61% of respondents expressed interest in being involved in future food insecurity clinical studies. This preliminary study underscores the relevance of food insecurity in the professional dental setting and suggests that the clinical setting may be well suited for educational programs designed to improve the oral health of patients experiencing food insecurity. Future research may achieve this goal, including a PBRN clinical study of interventions to improve oral health among patients experiencing food insecurity.

粮食不安全是一种家庭层面的经济和社会状况,其特点是获得营养食品的机会有限。本研究探讨了牙科医生对食物不安全筛查及其对口腔健康影响的看法。通过美国国家牙科实践研究网络 (PBRN) 进行了一项包含五个问题的调查("快速民意调查")。共有 332 名牙科医生做出了回复。调查结果显示,牙科医生对在牙科诊疗环境中进行食物不安全筛查的偏好存在很大差异:30%赞成,39%中立,29%反对。在确定受食物不安全影响的主要口腔健康问题时,68% 的人指出是龋齿。超过半数(53%)的受访者表示,他们乐于将面临食物不安全问题的患者引向相关资源。值得注意的是,61% 的受访者表示有兴趣参与未来的食物不安全临床研究。这项初步研究强调了食物不安全与专业牙科环境的相关性,并表明临床环境非常适合开展旨在改善食物不安全患者口腔健康的教育项目。未来的研究可能会实现这一目标,包括对改善食物不安全患者口腔健康的干预措施进行 PBRN 临床研究。
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Health Promotion Practice
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