Health Promotion Practice最新文献

Breastfeeding is vital to a child's lifelong health and has significant positive benefits to mother's health. World Health Organization recommends beginning exclusively breastfeeding within the first hour after birth and continuing during the first 6 months of infant's life. The purpose of this review is to identify and examine breastfeeding interventions conducted across the Spanish-speaking countries. A scoping review of the literature was conducted across 14 databases for relevant publications published through April 2023 to find studies in Spanish-speaking countries that involved breastfeeding as an intervention component. A total of 46 peer-reviewed articles were included in this review, across 12 Spanish-speaking countries. Participants ranged from pregnant women, mothers, mother-infant pair, and health care professionals. Intervention at the individual level in combination with support from trained health care professionals or peer counselors seemed to have higher improvements in breastfeeding rates. The greatest improvement in exclusively breastfeeding for 6 months was seen in interventions that included prenatal and postnatal intensive lactation education, for a period of 12 months. The most effective interventions that improved rates of any breastfeeding included promotional activities, educations workshop, and training of health care staff along with changes in hospital care. Breastfeeding promotion is an economical and effective intervention to increase breastfeeding behavior and thereby improving breastfeeding adherence across Spanish-speaking countries.

A key facet to typical undergraduate or graduate global public health programs is an applied practice experience (a practicum) that culminates in shared results and public presentations (e.g., research posters, conference and working papers, needs assessments). Requirements vary by program but may be between 80 and 200 hours of experiential learning. While not required by all undergraduate programs in global public health, a practicum occurs as part of a semester of coursework or internship experience after students have declared the major/minor or have completed an expected number of courses. Some students report that the practicum experience, while essential to their career development and future opportunities, presents certain challenges in terms of access. Practicum opportunities can be rife with assumptions that social networks, privilege, and implicit bias affect and even predict the ability to secure an effective, doable, and career-advantageous project. In 2020, the COVID-19 pandemic meant that much of the applied and experiential aspects of a practicum were necessarily shifted from "realworld" experiences to virtual and "remote" contexts. This article highlights insights from students enrolled in undergraduate global public health programs who were planning "real-life", more "traditional" practicum experiences, and had to necessarily move to "remote" and online engagement. These cases suggest that participation in virtual fieldsites is seen as legitimate, fulfilling for students and stakeholders, and can increase diversity, equity, and inclusion in the public health curricula; fostering best practices in career development.

The COVID-19 pandemic continues to exacerbate socioeconomic and educational hardships rooted in systemic inequities for youth across the United States. (Virtual) youth resilience and health promotion efforts are viable mechanisms to address these hardships in the context of a double pandemic: COVID-19 and structural racism. Health professions training programs hold a unique opportunity to incorporate COVID-19 health education to train and empower youth to become community health ambassadors. Grounded on a Grow-Your-Own (GYO) approach, UI Health CHAMPIONS spearheaded the development of the COVID-19 Youth Ambassador Program (COVID-19 YAP), a virtual multistage and multipartner effort. Its mission is to equip youth with knowledge, perspective, and tools to have empathetic, informative conversations within their networks about COVID-19. Via e-learning, modules cover viruses and the immune system; vaccine development; health disparities/equity; and health advocacy. Participants are introduced to Human-Centered Design Thinking to guide the development of advocacy projects. COVID-19 YAP's uniqueness lies in the team of program coordinators consisting of (pre-)health professional student workers with a desire to engage in health equity efforts and community health ambassadorship. Freirean principles are applied across program design and delivery; Dialogical Education encourages the educator to become the student and the student to become an educator. This co-learning process empowers students and educators to become agents of social change. COVID-19 YAP can serve as a collaborative effort addressing a public health priority, contributing toward digital health equity, and creating community resilience while encouraging youth to pursue a health profession and become community health advocates.

Introduction: Place-based systems change approaches are gaining popularity to address the complex problems associated with locational disadvantage. An important stage of place-based systems change involves understanding the context that surrounds (re)produces a target problem. Community resource mapping can be used to establish the context and identify the strengths of a community that might be leveraged through systems change efforts. Approaches to community resource mapping draw on a range of philosophical assumptions and methodological frameworks. However, comprehensive, practical guidance for researchers and practitioners to conduct community resource mapping is scarce.

Method: Drawing on the learnings from a literature review, scoping workshops, and reflective practice sessions, we developed a flexible, methodologically robust process called the Contextualize, Collect, Analyze, and Present (C-CAP) process: a four-phase approach to preparing for, conducting, and reporting on community resource mapping. The C-CAP process was co-developed by researchers and practitioners and was tested and refined in two different communities.

Results: The C-CAP process provides robust guidance for conducting and reporting on a community resource mapping project. The C-CAP process can be applied by public health practitioners and researchers and adapted for use across different communities, problems, and target groups. We encourage others guided by differing theoretical perspectives to apply C-CAP and share the learnings.

Conclusion: Application of the C-CAP process has the potential to improve the comparability and comprehensiveness of findings from community resource mapping projects and avoids duplication of effort by reducing the need to design new processes for each new community resource mapping activity.

Background.: Intervention effectiveness in a randomized controlled trial is attributed to intervention fidelity. Measuring fidelity has increasing significance to intervention research and validity. The purpose of this article is to describe a systematic assessment of intervention fidelity for VITAL Start (Video intervention to Inspire Treatment Adherence for Life)-a 27-minute video-based intervention designed to improve antiretroviral therapy adherence among pregnant and breastfeeding women.

Method.: Research Assistants (RAs) delivered VITAL Start to participants after enrolment. The VITAL Start intervention had three components: a pre-video orientation, video viewing, and post-video counseling. Fidelity assessments using checklists comprised self (RA assessment) and observer (Research Officers, also known as ROs) assessment. Four fidelity domains (adherence, dose, quality of delivery, and participant responsiveness) were evaluated. Score scale ranges were 0 to 29 adherence, 0 to 3 dose, 0 to 48 quality of delivery and 0 to 8 participant responsiveness. Fidelity scores were calculated. Descriptive statistics summarizing the scores were performed.

Results.: In total, eight RAs delivered 379 VITAL Start sessions to 379 participants. Four ROs observed and assessed 43 (11%) intervention sessions. The mean scores were 28 (SD = 1.3) for adherence, 3 (SD = 0) for dose, 40 (SD = 8.6) for quality of delivery, and 10.4 (SD = 1.3) for participant responsiveness.

Conclusion.: Overall, the RAs successfully delivered the VITAL Start intervention with high fidelity. Intervention fidelity monitoring should be an important element of randomized control trial design of specific interventions to ensure having reliable study results.

Health-related social needs (HRSNs), such as food insecurity and housing instability, drive health and well-being. The socioeconomic impacts of the COVID-19 pandemic increased the prevalence of HRSNs and highlighted the critical need for strategies to address those needs, particularly in communities experiencing health disparities. Implementing HRSN screening requires adopting effective strategies to overcome common challenges. This report synthesizes promising implementation approaches and lessons learned from the Accountable Health Communities Model, a national effort funded by the Centers for Medicare & Medicaid Services Innovation Center to systematically screen for and address HRSNs in clinical settings. Key strategies include increasing patient engagement and building trust through culturally tailored language and outreach; using and sharing data for monitoring and improvement; using technology to expand access to screening and referrals; dedicating staff to screening roles; integrating screening into existing workflows; and building buy-in among staff by communicating the impact of screening and encouraging peer connections.

Smoke-free policies in multi-unit housing are associated with reduced exposure to secondhand smoke (SHS); however, attitudes toward comprehensive smoke-free policies among residents in subsidized multi-unit housing are unknown. In this mixed-methods study, we explored the socio-ecological context for tobacco and cannabis use and attitudes toward policies restricting indoor use of these products through interviews with residents (N = 134) and staff (N = 22) in 15 federally subsidized multi-unit housing in San Francisco, California. We conducted a geo-spatial and ethnographic environmental assessment by mapping alcohol, cannabis, and tobacco retail density using ArcGIS, and conducted systematic social observations of the neighborhood around each site for environmental cues to tobacco use. We used the Capability, Opportunity, and Motivation behavior (COM-B) model to identify factors that might influence implementation of smoke-free policies in multi-unit housing. Knowledge and attitudes toward tobacco and cannabis use, social norms around smoking, neighborhood violence, and cannabis legalization were some of the social-ecological factors that influenced tobacco use. There was spatial variation in the availability of alcohol, cannabis, and tobacco stores around sites, which may have influenced residents' ability to maintain smoke-free homes. Lack of skill on how to moderate indoor smoking (psychological capability), lack of safe neighborhoods (physical opportunity), and the stigma of smoking outdoors in multi-unit housing (motivation) were some of the barriers to adopting a smoke-free home. Interventions to increase adoption of smoke-free policies in multi-unit housing need to address the co-use of tobacco and cannabis and commercial and environmental determinants of tobacco use to facilitate smoke-free living.

Since the start of the COVID-19 pandemic, wastewater surveillance has emerged as a public health tool that supplements traditional surveillance methods used to detect the prevalence of the SARS-CoV-2 virus in communities. In May 2020, the Houston Health Department (HHD) partnered with a coalition of municipal and academic partners to develop a wastewater monitoring and reporting system for the city of Houston, Texas. The HHD subsequently launched a program to conduct targeted wastewater sampling at 52 school sites located in a large, urban school district in Houston. Data generated by this program are shared with school district officials and nurses from participating schools. Although initial feedback from these stakeholders indicated that they considered the wastewater data valuable, the emergency nature of the pandemic prevented a systematic evaluation of the program. To address this gap in knowledge, the HHD and Rice University conducted a study to determine how wastewater data are used to make decisions about COVID-19 prevention and mitigation practices in schools. Our findings indicate that maximizing the utility of wastewater data in the school context will require the development of communication strategies and education efforts tailored to the needs of specific audiences and improving collaboration between local health departments, school districts, and school nurses.

In the United States, approximately one in five persons experience period poverty, defined as the inability to obtain resources needed for healthy, safe, and dignified menstrual management. Limited access to an inadequate number of menstrual supplies may lead to longer-than-recommended use, which can increase skin chafing, disruption of vaginal flora, and intravaginal toxin overgrowth. However, period poverty goes beyond simply having enough menstrual products and can encompass the embarrassment, stigma, shame, and barriers in conversation surrounding menstruation. Discussion and critical examination of the multilayered attributes surrounding period poverty have been intermittent in academic literature, particularly from a domestic lens. Thus, this narrative review and theoretical analysis aimed to describe the epidemiology of period poverty and analyze its biological, socio-emotional, and societal implications. We applied a descriptive epidemiology approach of person, place, and time, and employed a social-ecological lens to examine risk factors. Our findings describe the incidence, distribution, and possible ways to alleviate period poverty. Practitioners, medical providers, and public health professionals may have limited knowledge of period poverty, what it entails, and who it impacts, but they have great potential to address it and associated menstrual inequities in their work. With its widespread implications for psychosocial and community-level health, this phenomenon needs urgent attention to promote menstrual equity as an issue of human rights and social justice. We conclude with research and policy recommendations for alleviating period poverty.

Context. The public health workforce is increasingly being asked to provide leadership in addressing complex community health needs. Effective leadership requires adaptiveness and cross-sector collaboration in developing solutions to address community needs. Program. An annual yearlong public health leadership development program, which engages cross-sector teams and uses an iterative design to build competencies for adaptive and collaborative leadership across sectors (e.g., public health, business, education, nonprofits). Implementation. The program engages cross-sector teams through a national retreat, coaching, site visits, interactive webinars, readings, and a community-based action learning project. As of 2020, the program was offered to nine cohorts, serving more than 100 communities across the United States. Results. Results from a mixed-methods evaluation found that high proportions of participants reported increased leadership skills, cross-sector collaboration, continued use of tools and concepts, and positive impact on their communities after participating in the program. Across all cohorts, participants rated themselves on five leadership domains and 17 leadership competencies focused on by the program. All domains and all competencies had statistically significant improvements from the beginning to the end of their program year. Discussion. The improvements in leadership skills were seen across all cohorts, geographies, roles, and sectors. The success of the program suggests the need for leadership programs that emphasize adaptive and collaborative leadership to advance community health and equity.