Health Promotion Practice最新文献

Engaging peers and other substance use service providers in research increases the relevance and impact of findings, including ways to further integrate peers into the recovery workforce. Academics also have much to learn about peer recovery by engaging professionals with lived experience in collaborative research. Despite these benefits, there have been few intersectoral, peer-focused initiatives dedicated to building research skills through hands-on scientific inquiry. Grounded in community-based participatory research, the IRIS Recovery Research Fellowship aimed to develop connectedness, commitment to peer workforce integration, trust in research, research skills, and practice-driven studies. Learning sessions and research coaching were provided to a cohort of 17 peers, other agency staff, and academics. Evaluation was conducted using mixed methods. Pre- and post-test surveys measured change over time using paired-sample t-tests. Thematic analysis was used for open-ended responses and Rivers of Life drawings. All fellows completed studies while contributing to a position paper on peer workforce integration. Results indicated statistically significant gains in trust in qualitative research, connectedness, and an array of research skills. The fellowship "drove home the value and necessity of peers," leading to increased advocacy for peers and enhanced studies on peer services. Additional fellowship and related professional development opportunities are needed to build research capacity for peers and other providers, for researchers to ground inquiry in peer recovery, and for interdisciplinary groups to engage in recovery research. These activities will help to ground practice in the evidence base, support employers to effectively integrate peers into the workforce, and strengthen scientific inquiry.

The burden of obesity and other chronic diseases negatively affects the nation's health, businesses, economy, and military readiness. From 2018 to 2023, the Centers for Disease Control and Prevention's Division of Nutrition, Physical Activity, and Obesity (DNPAO) awarded funding to 71 recipients to advance evidence-based strategies to increase opportunities for healthy eating, physical activity, breastfeeding, and tobacco-free living. Recipients consisted of states, universities, and communities funded through the following three cooperative agreements: State Physical Activity and Nutrition (SPAN), Racial and Ethnic Approaches to Community Health (REACH), and the High Obesity Program (HOP). Recipients tailored efforts to their state or local contexts by using community engagement methods, needs assessments, and coalitions to accomplish their work. DNPAO transparently developed an evaluation approach that was feasible for recipients. DNPAO annually collected and validated recipient self-reported data using a two-way cloud-based platform to increase the visibility around data sharing and to ensure real-time communication. SPAN, REACH, and HOP recipients made considerable impact in funded states and communities. For example, more than 28 million people have increased access to places to be physically active, and more than 9 million people have increased access to places with healthy nutrition standards. Recipients also leveraged additional resources from a source other than the granting organization totaling almost US$400 million during the five-year cooperative agreement period. This article documents the combined five-year impact of three public health programs funded by one CDC Division and illustrates the rigorous methods used to evaluate impact.

Introduction. While physical inactivity remains a pervasive public health problem, issues surrounding measuring physical activity plague researchers. Accelerometers are the gold-standard tool to assess physical activity and consumer-grade devices are increasingly used in research. However, accelerometer wear compliance varies by population and is influenced by factors, such as social acceptability, among others. Non-compliance threatens data validity and limits the usefulness regarding health promotion. Therefore, the purpose of this study is to compare the effects of three consumer-grade accelerometer protocols on wear compliance among adolescents. Methods. Study participants were provided a Garmin VivoFit4 accelerometer watch; participant wear compliance, steps, and physical activity were measured during the study period. Three methods of data collection were used to assess physical activity: (1) continuous wear, self-sync (n = 59); (2) continuous wear, researcher-sync (n = 160); and (3) intermittent wear, researcher-sync (n = 62). A one-way analysis of variance was conducted to assess between-group differences. Results. Mean valid days were significantly higher at baseline (F = 27.52, p < .001) and endpoint (F = 9.98, p < .001) for the intermittent wear, researcher-synced condition than for both the continuous wear conditions, and significantly higher at midpoint (F = 4.05, p < .05) for the continuous wear, research-synced condition. Conclusion. Study findings suggest that an intermittent wear, researcher-synced protocol significantly improves wear compliance and meets recommendations needed for reliable estimates of physical activity compared with continuous wear protocols as measured by mean valid days. Implementing protocols to increase wear compliance will improve data for interventional studies and health promotion capabilities of consumer-grade accelerometers.

AIM (Assess, Identify, Make it happen) is a community-engaged, data-driven, strategic planning process for school districts to develop and implement comprehensive health and wellness plans (CHWPs) aligned with the Whole School, Whole Community, Whole Child (WSCC) model. AIM was facilitated in 21 rural school districts and an 81-item survey was administered to participants completing this process (n = 236). Those surveyed indicated that the benefits of AIM were more pronounced than challenges. Top benefits included developing a shared commitment and long-term mindset to promote health and wellness in schools. Top challenges included fitting AIM into already busy schedules and getting buy-in from all task force members. The most common health problems prioritized in district CHWPs were poor mental health and alcohol tobacco and other drugs. These results support the effectiveness of AIM as a method for developing community-engaged, data-driven CHWPs with rural school districts. Future efforts to create school plans to promote health should account for the benefits and challenges noted in this work. Furthermore, approaches designed for rural and historically under-resourced schools are necessary to promote the equitable implementation of the WSCC model.

There is an urgent need to ensure the opioid overdose reversal agent naloxone is available to protect youth given the increasing rates of overdose among this population. Through a public-academic partnership, overdose education and naloxone distribution training were provided to nonmedical public school staff in New York City. School staff were invited to a 90-minute in-person training. Consented participants took a pre- and post-survey to assess their overdose knowledge, confidence, and substance use stigma. A majority of respondents had never received training on how to identify an opioid overdose (70.7%) or how to administer naloxone (73.5%). Participants' overdose knowledge, including recognition of the signs of an overdose, response actions, and confidence to respond, significantly increased pre- to post-training. Participants' stigmatization of drug use significantly decreased following the training. Naloxone access and opioid overdose response training for nonmedical school staff is an acceptable and effective solution to expand overdose response. The significant reduction in participants' stigmatization of drug use suggests overdose education and naloxone training that address stigma may help prevent unnecessary mortality among youth.

Community health workers provide important services to support public health outcomes, particularly in low-income and low-resource settings. This practice note describes the training and supervision of community health workers for a program that aims to provide community-based support to families of children with disabilities in Lusaka, Zambia. Faculty from the United States partnered with a local organization to develop a multiday experiential training for supervisors, who then provided this training to volunteers in the community. An evaluation of supervisors and community health workers revealed that supervisors and community health workers gained significant knowledge and skills to work with children with disabilities. However, the attitude scales about children with disabilities did not show such robust change for the community health workers. A key challenge for this project was timing, as the training was completed just before COVID-19, leading to program implementation delays. Successes included increasing supervisor and community health workers' knowledge and skills in working with children with disabilities. This training highlighted the importance of local partners who could provide additional context for the community's needs and ongoing supervision for the community health workers to maintain program fidelity. This practice note adds to the limited knowledge base on developing additional support and services for children with disabilities and their families.

Parks and green spaces have been shown to improve human health. Yet, in cities such as Philadelphia, people with lower incomes and racially minoritized populations have less access to these health-promoting spaces. Furthermore, there are more than 42,000 lots and properties which sit vacant in Philadelphia neighborhoods. Park in a Truck (PiaT) is a green space development initiative in Philadelphia that helps communities transform available lots into neighborhood parks. PiaT works with communities to acquire neighborhood land, design and build parks, and train local youth to program and maintain the parks. In this article, we present lessons learned and best practices generated from years of working with communities to design, build, and maintain parks through the PiaT initiative. We have found that transforming lots into community parks needs to be driven by communities, and particularly, champions on the ground who work to gain access to lots and motivate resident engagement. We have also found success in training neighborhood teens to maintain the parks-to keep them clean and organize park events. Finally, PiaT works to transmit the message that open lots can be transformed into community assets that bring people together. Overall, PiaT empowers residents to design, build, and maintain parks within their neighborhoods. This process can reduce park inequities, and if scaled, improve the health of populations.

Efforts to effect racial health disparity (RHD) policy change are urgent, necessary, and subject to a key barrier: defensiveness among White privileged audiences. Within the literature to date, such defensiveness is under-investigated, and when examined, is typically conceived of as an individual cognitive outcome-a message effect-rather than a communication interaction. Yet policy change advocacy efforts, ranging from community organizing to change campaigns, necessitate communication interactions between advocates and privileged policy change audiences, such as neighborhood groups or policymakers themselves. This defensiveness conceptualization, focused on individual cognitions, therefore limits our understanding of interactive communication barriers in RHD policy advocacy processes. To address this limitation, our research conceives of defensiveness using the privileged identity exploration (PIE) model, developed by Watt in 2007, which posits that defensiveness strategies are used as part of an interactive communication process when people are asked to reflect on their own privilege. Defensiveness strategies, as described by Watt and colleagues in 2021 and 2023, are normal communicative reactions to protect one's self-identity from threatening information; the PIE models eight such strategies. RHD information invokes racial privilege, therefore eliciting defensiveness. Using a thematic analysis of semi-structured qualitative interviews with White young adults from the Chicago (U.S.) area (N = 27), we identify defensiveness strategies relative to COVID-19 RHDs. Using the PIE as a lens to understand the data, we find some strategies lacking, some similar but differently nuanced, and identify a novel strategy among our participants, suggesting message tailoring opportunities. We describe implications for future research and practice.

Period poverty, characterized by inadequate access to menstrual health resources and education, detrimentally affects school attendance, academic performance, and individual health. Recent studies have revealed nearly one-fifth of college-enrolled women experienced period poverty in the past year, highlighting the urgency of addressing this issue. Through our study at Purdue University, we evaluated the effectiveness of a free pad and tampon program aimed at reducing period poverty. Findings from our survey, which included responses from 766 university student participants, revealed many utilized the program due to not having products with them (43.2%). In contrast, others cited early or late periods (33.4%) and financial constraints (5.2%) as reasons for usage. In addition, 81.7% of respondents reported they were aware of the program's existence, indicating a need for more tailored promotional efforts to reach the entire student body. These insights contribute to a deeper understanding of the program's impact and provide actionable recommendations for improving accessibility and addressing the diverse needs of menstruating individuals within the university community. Leveraging these findings, university administrators can play a vital role in advancing menstrual equity initiatives and fostering supportive environments for all menstruators on campus.

In this commentary, we, a recent Master of Public Health (MPH) graduate with hearing loss and a course instructor, share what we learned about classroom accessibility while participating in a semester-long qualitative research methods course offered during the COVID-19 pandemic. We complement our reflections on working together with findings from a student field project focused on the lived classroom experiences of graduate students with hearing loss. The field project revealed that students adapted to increased communication challenges in their learning environments without requesting official accommodations due to stigma and a desire to limit their burden on others. We then conclude with implications for partnerships and collective action to address abelism and inequitable learning environments, specifically the value of student-instructor partnerships, the incorporation of universal design for learning principles, the importance of collaboration across different campus departments, and the need for higher education institutions to adopt a cultural model of disability that will create meaningful access in learning environments.