Health Promotion Practice最新文献

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.

Mental illness, affecting one in eight people worldwide, is often exacerbated by stigma-which can result in self-stigmatization, isolation, and loneliness and negatively impact access to health care, education, and social connection. Previous research has found that stigma is best reduced through a combination of education about the stigmatized population and intentional contact with individuals from that population. Studies also note the benefits of community-based, culturally-relevant interventions and cultural experiences such as live music. Thus, this study posited that community-centered sources of contact and education, such as live music concerts, could offer effective, sustainable opportunities to reduce stigma and increase empathy about mental illness. To explore this approach, researchers evaluated Sound Mind Live's "Road to Recovery" (RtR) program, which addresses mental health stigma by training musicians to discuss the topic from stage, and by providing concert attendees with resources to improve education, awareness, and access to mental health supports. This pilot study evaluated RtR's impacts on stigma, empathy, knowledge, and actions related to mental illness. Using a pre-/post-survey design at two concerts in New York City, researchers measured changes in participants' attitudes, behaviors, and understanding of mental health issues. Findings indicate that concert attendance reduced stigma and negative behavioral assumptions related to mental illness, increased affective empathy, improved knowledge about mental illness, and increased attendees' likelihood of seeking support. This study informs further use of community-based arts experiences to address stigma, cultivate empathy and social connection, and improve care access.

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 COVID-19 pandemic placed significant burden on public health professionals, with many experiencing burnout and leaving the profession. The New York State Public Health Association (NYSPHA) recognized the impact of the pandemic on the state's public health workforce and sought professional development opportunities to support current and future generations of public health professionals. To achieve this goal, NYSPHA solicited input from its members and potential members via survey and focus groups as part of its New Directions Initiative. Seventy individuals participated in listening sessions, and 850 responded to the survey. While more than half felt that NYSPHA is invested in the health and wellness of New Yorkers, fewer considered NYSPHA a leader in public health or a go-to source for public health information. Only about one-third felt connected to NYSPHA as a public health professional. Participants identified multiple professional development opportunities that would encourage them to join or renew their membership including sections or special interest groups (57.4%), opportunities to gain leadership experience (56.7%), volunteering (58.1%), a new committee that addresses public health in the community (55.9%), and mentorship (48.4%). NYSPHA used the results of the survey and focus groups to provide several professional development opportunities including a mentorship program, a new Public Health in Action Committee, and special interest groups in mental health and climate change that have already made a difference in local New York State communities. Similar organizations may use NYSPHA's experience as an example for supporting their workforce to maximize impact on the communities they serve.

A bystander to racial violence is conventionally thought of as someone who witnesses an overt act of racial oppression at the interpersonal level, such as police brutality. However, racial violence in health research, pedagogy, and practice often shows up more covertly, like through epistemic injustice, deficits-based framing, and racial essentialism. We aim to expand how we think about bystanders and perpetrators of racial violence within health institutions, and how antiracism bystander behavioral approaches can be deployed to intervene against such violence. Existing public health antiracism frameworks, such as the Public Health Critical Race Praxis and the PEN-3 Cultural Model, offer valuable constructs and processes through which health practitioners, researchers, and academics can disrupt racial violence. Such antiracism frameworks are well suited to provide individuals within public health and health care with the knowledge, skills, and efficacy to intervene as engaged bystanders against racism within their contexts. To illustrate how constructs within antiracism frameworks can be applied by bystanders in various health settings, we outline case examples of antiracism bystander interventions across three scenarios. The more bystanders there are within health institutions that are equipped with antiracism tools, the more likely normative behaviors uplifting White supremacy within these institutions can be disrupted and health equity can be actualized.

Community-clinical partnerships are an effective approach to connecting primary care with public health to increase disease prevention and screenings and reduce health inequities. We explore how the National Breast and Cervical Cancer Early Detection Program (NBCCEDP) award recipients and clinic teams are using community-clinical linkages to deliver services to populations who are without access to health care and identify barriers, facilitators, and lessons that can be used to improve program implementation. We used purposive sampling to select nine state recipients of the NBCCEDP and a clinic partner for each recipient. The data collection was implemented through a multimodal approach using questionnaires, semistructured interviews, and focus groups. Partnerships between award recipients and clinic teams enhanced planning as clinics were able to optimize the use of electronic medical records to identify women who were not up to date with screening. Partnerships with community organizations, hospital systems, and academic institutions were important to increase community outreach and access to services. These partnerships offered a source of client referrals, a forum to deliver in-person education, a platform for joint dissemination activities to reach a wider audience, collaborations to provide transportation, and coverage for clinical services not available at NBCCEDP participating clinics. In conclusion, partnerships between various organizations are important to enhance planning, increase outreach, and improve access to cancer screening. Internal organizational and external support is important to identify appropriate partners, and technical assistance and training may be beneficial to maintain and optimize community partnerships to address health disparities.

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.

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.

The college athletics landscape has evolved dramatically in the past decade. While the legal question of whether college athletes are employees remains open, court proceedings have regularly revealed that schools treat their athletes similarly to employees, namely by exerting a high degree of control over their schedules, academic freedoms, and personal conduct. The advent of schools paying their athletes only furthers the employee argument. Therefore, principles of worksite wellness would benefit the athletes and their institutions, regardless of their legal status as employees or non-employee students. Worksite wellness programs, also referred to as employee wellness programs, aim to provide employees with access to healthy supports in the work environment. Program components combined with other healthy supports at the worksite (e.g., built environment changes, access to healthy options, etc.) are referred to as organizational supports. We conducted a content analysis to determine what is known about wellness efforts for college athletes in the Atlantic Coast Conference (ACC), Big 10 Conference, Big 12 Conference, and Southeastern Conference (SEC), also known as the NCAA "Power 4" institutions. Overall, the results of this content analysis show a lack of clear communication regarding wellness efforts for college athletes in the included conferences. The challenge lies in making the case for wellness programs geared to college athletes that are both supported and effectively communicated by University and Athletics leadership.