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Nutrition and Training Recommendations for Transgender and Gender-Diverse Athletes Involved in Strength Sports and Resistance Training: A Case Series of Nine Athletes Assigned Female at Birth. 变性和性别多元化运动员参与力量运动和阻力训练的营养与训练建议:九名出生时被指定为女性的运动员的案例系列。
IF 1.6 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-10-22 DOI: 10.1177/15248399241286027
Whitney Linsenmeyer, Bari Glassman, Nikias Tomasiello, Katherine Walcott

Transgender and gender diverse (TGGD) athletes have distinct nutrition and training considerations. Guidance for nutrition and sport professionals working with TGGD athletes is lacking, especially when addressing sex-specific data. The purpose of this case series was to depict nutrition and training assessment approaches and recommendations for TGGD athletes involved in strength sports or resistance training. Six types of data informed each case presentation, including: demographic, anthropometric, health history, and survey data (Eating Competence Scale, Exercise Benefits and Barriers Scale); a 3-day food and physical activity record; and an in-depth interview. Nine TGGD athletes assigned female at birth (AFAB) presented with a range of gender identities, experiences, sport involvement, and transition journeys. Most athletes consumed inadequate energy and fiber, adequate or marginally high levels of saturated fat and added sugars, and high levels of sodium. Most athletes scored low on the Eating Competence Scale and high on the Exercise Benefits and Barriers Scale. Nutrition and sports professionals can individualize the care they provide for TGGD athletes when addressing sex-specific data and help athletes ensure they are meeting their nutrient needs.

变性和性别多元化(TGGD)运动员在营养和训练方面有不同的考虑。目前还缺乏针对 TGGD 运动员的营养和体育专业指导,尤其是在处理特定性别数据时。本案例系列旨在描述针对参与力量运动或阻力训练的 TGGD 运动员的营养和训练评估方法及建议。每个案例都包含六种类型的数据,包括:人口统计学、人体测量、健康史和调查数据(饮食能力量表、运动益处和障碍量表);3 天的饮食和体育活动记录;以及深度访谈。九名在出生时被分配为女性的 TGGD 运动员(AFAB)具有不同的性别认同、经历、运动参与和转变历程。大多数运动员摄入的能量和纤维不足,饱和脂肪和添加糖含量充足或略高,钠含量较高。大多数运动员在饮食能力量表中得分较低,而在运动益处和障碍量表中得分较高。营养和运动专业人员在处理性别特异性数据时,可以为 TGGD 运动员提供个性化护理,并帮助运动员确保满足其营养需求。
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引用次数: 0
Health Workers' Attitudes Toward Adverse Gender Norms and Implications for Young People's Sexual and Reproductive Health in Nigeria. 尼日利亚卫生工作者对不良性别规范的态度及其对年轻人性健康和生殖健康的影响》(Health Workers' Attitudes Toward Adverse Gender Norms and Implications for Young People's Sexual and Repductive Health in Nigeria)。
IF 1.6 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-10-18 DOI: 10.1177/15248399241287211
Chinyere Mbachu, Irene Eze, Ozioma Agu, Obinna Onwujekwe

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.

背景:医疗保健系统中的不良性别规范不利于年轻人的性健康和生殖健康。本研究从亲密伴侣暴力(IPV)、性行为和生殖健康行为三个方面评估了医疗工作者对亲密伴侣关系中不良性别规范的态度:方法:对尼日利亚埃邦尼州青年友好型初级保健中心的 255 名医务工作者进行了横断面定量调查。对性别规范声明的态度采用 3 级评分法进行评估,包括同意(3 分)、部分同意(2 分)和不同意(1 分)。通过多元线性回归分析(P 值为 0.05)估算了每个陈述的平均态度分数,并确定了态度的预测因素:大多数卫生工作者对男性控制性决策、男性对性的欲望和价值更高以及女性有责任避孕等问题持有性别偏见。超过 40% 的受访者将女性携带安全套与滥交联系在一起,39.6% 的受访者认为只有男性才有购买安全套的 "社会 "权利。城市居住地预示着医务工作者对与性行为相关的不良性别规范的态度(β = -.179,p = .003):本研究的结果为在职培训计划提供了依据,这些计划旨在改变医务工作者对不良性别规范的态度,并改变他们的做法。
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引用次数: 0
Advocacy Skill Development in Public Health Education Curriculum: A Pilot Study. 公共卫生教育课程中的宣传技能培养:试点研究。
IF 16.4 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-10-18 DOI: 10.1177/15248399241287207
Alexis Blavos, Heidi Hancher-Rauch, Antonio Gardner, Vincent Lam, Salma Haidar, Jodi Brookins-Fisher, Amy Thompson

The National Commission for Health Education Credentialing (NCHEC) released updated Responsibilities and Competencies for Health Education Specialists based on the 2020 HESPA II. For the first time, advocacy is a standalone area of responsibility (Area V: Advocacy) for health education specialists. Although this is exciting for the field of health education, there is limited consensus on how to effectively teach advocacy or what content and skills to include. Furthermore, while the HESPA II was updated, the Council on Education for Public Health (CEPH) criteria for advocacy have not been. This pilot study examined how CEPH-accredited programs in the United States are addressing the profession-wide advocacy competency in their health education curricula. A cross-sectional research design with single-point data collection was used to assess how CEPH-accredited university programs (including Standalone Baccalaureate Programs, Public Health Programs, and Schools of Public Health) are preparing health education students to meet the national advocacy responsibility. The survey included items from the Advocacy Area of Responsibility and potential barriers for faculty teaching advocacy. Results indicate that most programs are teaching something about advocacy, but there is no program teaching all listed sub-competencies. Barriers to including all components of the advocacy responsibility were largely related to faculty motivation, knowledge, and time. With a full responsibility area devoted to advocacy, it is reasonable to expect that programs will adjust with the profession. However, program administrators must be catalysts for these changes in their individual programs.

美国国家健康教育认证委员会(NCHEC)根据 2020 年 HESPA II 发布了最新的健康教育专家职责和能力要求。倡导首次成为健康教育专家的一个独立责任领域(领域 V:倡导)。尽管这对健康教育领域来说令人振奋,但对于如何有效地开展宣传教学或应包括哪些内容和技能,各方的共识还很有限。此外,虽然 HESPA II 已经更新,但公共卫生教育委员会(CEPH)的宣传标准却没有更新。这项试验性研究考察了美国经 CEPH 认证的课程如何在其健康教育课程中处理整个行业的宣传能力。研究采用了单点数据收集的横断面研究设计,以评估经 CEPH 认证的大学课程(包括独立学士学位课程、公共卫生课程和公共卫生学院)是如何培养健康教育专业学生履行国家倡导责任的。调查内容包括宣传责任领域的项目以及教师在进行宣传教学时可能遇到的障碍。结果表明,大多数课程都教授了一些有关宣传的内容,但没有一个课程教授所有列出的子能力。将宣传责任的所有内容纳入教学的障碍主要与教师的积极性、知识和时间有关。有了专门的宣传责任区,我们就有理由期待课程会随着专业的发展而调整。然而,项目管理人员必须在各自的项目中推动这些变化。
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引用次数: 0
External Factors Influencing the Implementation of Policy, System, and Environmental Change Strategies Within Cooperative Extension. 影响合作推广部门实施政策、系统和环境变革战略的外部因素。
IF 1.6 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-10-17 DOI: 10.1177/15248399241285506
Lauren E Kennedy, Heather Norman-Burgdolf, Soghra Jarvandi, Lisa T Washburn

Introduction. Multilevel approaches are important to promote the adoption of healthier practices at the individual and community levels. Cooperative Extension pairs policy, systems, and environmental (PSE) change approaches with direct education programs focused on individual and community health. This study sought to understand Family and Consumer Sciences (FCS) Extension agents' perceptions of PSE change supports, benefits for their communities, and resources and partnerships important for implementation. Method. The Consolidated Framework for Implementation Research was used to develop a survey to assess outer setting domains related to PSE work. In addition to close-ended questions, the survey included several open-ended, qualitative questions exploring the benefits, resources, and relationships required to implement PSE changes. The surveys were collected online from FCS agents in two states. Descriptive statistics were calculated, open responses were coded, and key themes were established. Results. FCS agents (n=116) indicated high levels of agreement about having necessary support from state-level specialists (71%) and the overall Extension organization (64%). The largest gaps in support were reported as grant or external funding sources, time, and county programming funds. Half of the sample agreed that PSE training was adequate, but only 38.5% reported previously participating in PSE-specific training. Open-ended question responses revealed diverse relationships and numerous benefits of PSE work, including more sustainable health behavior changes and greater local Extension visibility. Discussion. Our findings corroborate previous work and identify potential gaps that future interventions can address to better support Extension and public health professionals when implementing PSE work at the community level.

导言。多层次方法对于促进个人和社区采用更健康的做法非常重要。合作推广将政策、系统和环境(PSE)变革方法与注重个人和社区健康的直接教育计划相结合。本研究旨在了解家庭与消费科学(FCS)推广代理对 PSE 变革支持的看法、对其社区的益处以及对实施非常重要的资源和合作伙伴关系。方法。使用实施研究综合框架制定了一项调查,以评估与 PSE 工作相关的外部设置领域。除了封闭式问题外,调查还包括几个开放式定性问题,探讨实施 PSE 改革所需的益处、资源和关系。调查是从两个州的家庭护理服务代理处在线收集的。计算了描述性统计数字,对开放式回答进行了编码,并确定了关键主题。结果。家政服务人员(n=116)对获得州级专家(71%)和整个推广组织(64%)的必要支持表示高度认同。据报告,最大的支持缺口是赠款或外部资金来源、时间和县计划资金。半数样本认为 PSE 培训是充分的,但只有 38.5%的样本报告说以前参加过 PSE 专门培训。开放式问题的回答揭示了 PSE 工作的各种关系和众多益处,包括更可持续的健康行为改变和更高的地方推广能见度。讨论。我们的研究结果证实了之前的工作,并找出了未来干预措施可以解决的潜在差距,以便在社区层面实施 PSE 工作时更好地支持推广和公共卫生专业人员。
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引用次数: 0
Suitability of ChatGPT as a Source of Patient Information for Screening Mammography. ChatGPT 作为乳腺 X 射线筛查患者信息来源的适用性。
IF 1.6 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-10-11 DOI: 10.1177/15248399241285060
Kelly Spuur, Geoff Currie, Dana Al-Mousa, Ruth Pape

ChatGPT3.5 and ChatGPT4 were released publicly in late November 2022 and March 2023, respectively, and have emerged as convenient sources of patient health education and information, including for screening mammography. ChatGPT4 offers enhanced capabilities; however, it is only available by paid subscription. The purported benefits of ChatGPT for health education need to be objectively evaluated. To assess performance differences, ChatGPT3.5 and GPT4 were used between 13 April and 29 May 2023 to generate breast screening patient information sheets, which were evaluated using the Patient Education Materials Assessment Tool for printed materials (PEMAT-P) and the CDC Clear Communication Index (CDC Index) Score Sheet; and benchmarked against gold standard content in BreastScreen NSW's patient information sheet. Mean scores were reported for comparison. GPT3.5 provided the appropriate tone and currency of information but lacked accuracy, omitting key insights: PEMAT-P understandability 68.0% (SD = 6.56) and actionability 36.7% (SD=20.4); CDC Index 58.8% (SD = 15.3). GPT4 was deemed superior to GPT3.5 but included several key omissions: PEMAT-P understandability 75.0% (SD = 17) and actionability 53.3% (SD = 11.54); CDC Index 66.0% (SD = 4.1). Both ChatGPT versions exhibited poor understandability and actionability and were unclear in their messaging. Those with poor health literacy will not benefit from accessing current versions of ChatGPT and may be further disadvantaged if they do not have access to a paid subscription. ChatGPT is evidenced to be an unreliable and inaccurate source of information concerning breast screening that may undermine participation and risk increased morbidity and mortality from breast cancer. ChatGPT may increase the demand on health care educators to rectify misinformation.

ChatGPT3.5 和 ChatGPT4 分别于 2022 年 11 月底和 2023 年 3 月公开发布,已成为患者健康教育和信息的便捷来源,包括乳腺 X 光筛查。ChatGPT4 提供了更强大的功能,但只能通过付费订阅获得。需要对 ChatGPT 在健康教育方面的所谓优势进行客观评估。为了评估性能差异,我们在 2023 年 4 月 13 日至 5 月 29 日期间使用 ChatGPT3.5 和 GPT4 生成了乳腺筛查患者信息表,并使用印刷材料患者教育材料评估工具 (PEMAT-P) 和疾病预防控制中心清晰沟通指数 (CDC Index) 评分表对其进行了评估;还将其与新南威尔士州乳腺筛查患者信息表中的黄金标准内容进行了比较。报告了平均分数,以供比较。GPT3.5 提供了适当的语气和最新的信息,但缺乏准确性,遗漏了关键的见解:PEMAT-P可理解性为68.0%(标度=6.56),可操作性为36.7%(标度=20.4);CDC指数为58.8%(标度=15.3)。GPT4 被认为优于 GPT3.5,但包括几个关键的遗漏:PEMAT-P 的可理解性为 75.0%(标准差=17),可操作性为 53.3%(标准差=11.54);CDC 指数为 66.0%(标准差=4.1)。两个 ChatGPT 版本的可理解性和可操作性都很差,信息也不明确。健康素养较差的人无法从当前版本的 ChatGPT 中获益,如果他们无法付费订阅,可能会处于更加不利的地位。有证据表明,ChatGPT 是一种不可靠、不准确的乳腺癌筛查信息来源,可能会影响乳腺癌筛查的参与度,并有可能增加乳腺癌的发病率和死亡率。ChatGPT 可能会增加对保健教育工作者纠正错误信息的需求。
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引用次数: 0
Restaurants as Environments for Healthy Eating: Factors That Contribute to Restaurant-Based Healthy Eating Program Adoption. 餐厅作为健康饮食的环境:餐厅作为健康饮食的环境:促进餐厅采用健康饮食计划的因素。
IF 1.6 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-10-11 DOI: 10.1177/15248399241285573
M Knapp, T Moore, A Lederer, M Kimball, Y Quantz, M Fuster, L Myers, C Johnson

Purpose. This study identified restaurant manager/owner factors that may contribute to adoption of a restaurant-based healthy eating program, Eat Fit. Findings may be used to engage restaurants in efforts to increase access to and availability of healthy foods, promote healthy food choices, and work toward improving diet and lowering obesity and chronic disease risk in the community. Methods. Cross-sectional survey data were collected from restaurant managers/owners interested in partnering with Eat Fit. Variables included restaurant manager/owner beliefs, perceived staff knowledge/skills, support, self-efficacy, outcome expectancies, and barriers and facilitators to implementation. Results. Forty-nine managers/owners participated. Most managers/owners held positive beliefs about offering healthy food items in restaurants (83.7%). Most agreed that restaurants could influence eating behaviors (83.7%) and that restaurants have a responsibility to offer healthy options (77.6%). Most managers/owners perceived high levels of support (83.7%) and were confident in their ability (95.9%) to implement the Eat Fit program. The most cited barriers were customer preference, ingredient availability, staff knowledge, and operational challenges. The most common reasons for involvement in the program were a desire to increase access to healthy food, to entice customers looking for healthier food, a belief that restaurants should offer healthy food, and opportunities to market through Eat Fit. Conclusions. This research contributes to knowledge about beliefs and perceptions of restaurant manager/owners. Efforts to engage restaurants should focus on benefits of offering healthy food and the role restaurants can play in promoting health. Furthermore, programs may benefit from enhanced restaurant staff training, customer-targeted marketing, and educational efforts.

研究目的本研究确定了餐厅经理/业主可能有助于采用以餐厅为基础的健康饮食计划 "吃得健康 "的因素。研究结果可用于让餐馆参与到增加健康食品的获取和供应、促进健康食品选择的工作中来,并致力于改善社区饮食、降低肥胖和慢性疾病风险。调查方法向有意与 "健食 "合作的餐厅经理/业主收集横向调查数据。调查变量包括餐厅经理/业主的信念、员工的知识/技能、支持、自我效能、结果预期以及实施的障碍和促进因素。结果。49 位经理/业主参加了此次活动。大多数经理/业主对餐厅提供健康食品持积极态度(83.7%)。大多数人认为餐厅可以影响饮食行为(83.7%),餐厅有责任提供健康食品(77.6%)。大多数经理/业主都认为他们得到了很大的支持(83.7%),并对自己实施 "健 食计划 "的能力充满信心(95.9%)。提及最多的障碍是顾客偏好、食材供应、员工知识和运营挑战。参与计划的最常见原因是希望增加获得健康食品的机会,吸引顾客寻找更健康的食品,认为餐馆应该提供健康食品,以及通过 "健食计划 "进行营销的机会。结论。这项研究有助于了解餐厅经理/业主的信念和看法。让餐馆参与进来的努力应侧重于提供健康食品的益处以及餐馆在促进健康方面所能发挥的作用。此外,加强对餐厅员工的培训、针对顾客的营销和教育工作也会使项目受益。
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引用次数: 0
Exploring Empathic Communication Among Community Health Workers: Applying the ENACT Tool in Two South African Sites. 探索社区卫生工作者之间的移情沟通:在南非两地应用 ENACT 工具。
IF 1.6 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-10-05 DOI: 10.1177/15248399241285888
Christina A Laurenzi, Stephan Rabie, Sihle Mamutse, Sarah Skeen, Nicola Jansen van Vuuren, Rosanne Neethling, Sally Field, Simone Honikman

Introduction. Effective empathic communication between health care providers and patients is an essential part of health care. In resource-poor contexts, evidence is needed to understand the quality and content of health care communication within real-life clinical engagements. We used the existing Enhancing Assessment of Common Therapeutic Factors (ENACT) tool to measure empathic communication skills among a group of community health workers (CHWs) receiving a novel quality improvement intervention called Nyamekela4Care in South Africa. Methods. In two resource-limited sites in the Western Cape, South Africa, we audio-recorded CHWs, with consent, in routine client consultations at baseline and postintervention. All sessions were in Afrikaans. We used the adapted ENACT tool to rate recordings at both timepoints, assessing 11 items including communication skills, emotional engagement, process and interaction. We used ANOVA to assess preimplementation and postimplementation differences in empathic communication, and analyzed coders' feedback on the coding process itself. Results. We analyzed n = 66 recordings from 11 CHWs, observing positive directionality overall, with most skills improving over time. Despite near-significant improvements in communication delivery (p = .083), self-confidence/groundedness (p = .029) significantly changed but in the opposite direction. Large effect sizes were observed in verbal communication, responsiveness to client, and identifying external resources, with no significant difference between timepoints. ENACT was feasible to apply to audio recordings; inter-coder reliability was suboptimal despite coder training and ongoing monitoring and support. Discussion. Quality improvement interventions may improve empathic skills in diverse contexts, and our results demonstrate how empathic skills could be more routinely assessed in low-resource health care settings.

导言医疗服务提供者与患者之间有效的移情沟通是医疗保健的重要组成部分。在资源匮乏的情况下,我们需要证据来了解实际临床工作中医护沟通的质量和内容。我们使用现有的 "常见治疗因素强化评估"(ENACT)工具来测量南非一组接受名为 "Nyamekela4Care "的新型质量改进干预措施的社区医疗工作者(CHWs)的移情沟通技能。方法在南非西开普省的两个资源有限的地点,我们在征得同意的情况下,对社区保健员在基线和干预后的常规客户咨询过程进行了录音。所有咨询均以南非荷兰语进行。我们使用经过改编的 ENACT 工具对两个时间点的录音进行评分,评估包括沟通技巧、情感投入、过程和互动在内的 11 个项目。我们使用方差分析来评估移情沟通实施前和实施后的差异,并分析了编码员对编码过程本身的反馈。结果。我们分析了来自 11 名社区保健工作者的 n = 66 份录音,观察到总体上存在积极的方向性,大多数技能随着时间的推移得到了提高。尽管在沟通表达方面有了近乎显著的提高(p = .083),但自信心/踏实度(p = .029)却发生了显著变化,但方向相反。在口头交流、对客户的响应能力和识别外部资源方面,观察到了较大的效应大小,不同时间点之间没有明显差异。ENACT 适用于录音是可行的;尽管对编码员进行了培训并提供了持续的监控和支持,但编码员之间的可靠性并不理想。讨论。质量改进干预措施可在不同情况下提高移情技能,我们的研究结果表明了如何在资源匮乏的医疗环境中对移情技能进行更常规的评估。
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引用次数: 0
Network Analysis to Visualize Qualitative Results: Example From a Qualitative Content Analysis of The National Child Abuse Hotline. 可视化定性结果的网络分析:国家虐待儿童热线》定性内容分析实例。
IF 1.6 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-10-05 DOI: 10.1177/15248399241283144
Laura M Schwab-Reese, Nicholas C Lenfestey, Amelia W Hartley, Lynette M Renner, Tyler Prochnow

Data visualization, such as figures created through network analysis, may be one way to present more complete information from qualitative analysis. Segments of qualitatively coded data can be treated as objects in network analysis, thus creating visual representations of the code frequency (i.e., nodes) and the co-occurrence (i.e., edges). By sharing an example of network analysis applied to qualitative data, and then comparing our process with other applications, our goal is to help other researchers reflect on how this approach may support their interpretation and visualization of qualitative data. A total of 265 de-identified transcripts between help-seekers and National Child Abuse Hotline crisis counselors were included in the network analysis. Post-conversation surveys, including help-seekers' perceptions of the conversations, were also included in the analysis. Qualitative content analysis was conducted, which was quantified as the presence or absence of each code within a transcript. Then, we divided the dataset based on help-seekers' perceptions. Individuals who responded that they "Yes/Maybe" felt more hopeful after the conversation were in the "hopeful" dataset, while those who answered "No" were in the "unhopeful" dataset. This information was imported to UCINET to create co-occurrence matrices. Gephi was used to visualize the network. Overall, code co-occurrence networks in hopeful conversations were denser. Furthermore, the average degree was higher in these hopeful conversations, suggesting more codes were consistently present. Codes in hopeful conversations included information, counselor support, and problem-solving. Conversely, non-hopeful conversations focused on information. Overall, network analysis revealed patterns that were not evident through traditional qualitative analysis.

数据可视化(如通过网络分析创建的图表)可能是呈现来自定性分析的更完整信息的一种方法。定性编码数据的片段可被视为网络分析中的对象,从而创建代码频率(即节点)和共现(即边)的可视化表示。通过分享一个将网络分析应用于定性数据的例子,然后将我们的分析过程与其他应用进行比较,我们的目标是帮助其他研究人员思考这种方法可以如何支持他们对定性数据的解释和可视化。网络分析共包括 265 份求助者与国家虐待儿童热线危机顾问之间的去标识化文字记录。对话后调查,包括求助者对对话的看法,也包括在分析中。我们进行了定性内容分析,并将其量化为记录中每个代码的存在与否。然后,我们根据求助者的看法对数据集进行了划分。回答 "是/可能 "的求助者在谈话后感觉更有希望,他们被归入 "有希望 "数据集,而回答 "否 "的求助者被归入 "无希望 "数据集。这些信息被导入 UCINET 以创建共现矩阵。Gephi 用于将网络可视化。总体而言,"有希望 "对话中的代码共现网络更为密集。此外,这些有希望的对话中的平均程度较高,这表明有更多的代码持续存在。有希望对话中的代码包括信息、顾问支持和问题解决。相反,非希望型对话则侧重于信息。总体而言,网络分析揭示了传统定性分析中不明显的模式。
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引用次数: 0
Supporting Research Staff Working With People Experiencing Homelessness: Integrating Trauma-Informed and Resilience-Building Approaches Into Community-Engaged Research Studies. 支持与无家可归者合作的研究人员:在社区参与式研究中融入创伤认知和复原力建设方法。
IF 1.6 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-09-30 DOI: 10.1177/15248399241275619
Jessica Alway, Jesus Omar Gomez, Phoebe Lee, Jordan Cuby, Deepalika Chakravarty, Maya Vijayaraghavan

Traumatic experiences are highly prevalent among people experiencing homelessness who face structural inequities, which may impact engagement in research. Research staff ("staff") working with people experiencing homelessness are under-equipped to cope with structural inequities and the trauma present in participants' lives, even if they are well-trained in the regulatory aspects of the research process. Six staff involved in tobacco cessation intervention research with people experiencing homelessness described their experiences and highlighted areas of training to integrate trauma-informed and resilience-building approaches to support field staff and people experiencing homelessness. We identified three themes: (a) impact of trauma on the research process; (b) the importance of engagement with community partners and participants; and (b) the need for a field worker's guide. Staff described being the bearers of participants' traumas, while also coping with their own vicarious traumatization. Staff believed they would benefit from a fieldworker's guide that includes best practices for engagement with community partners as well as trauma-informed approaches like training in trauma-informed care and tools to address vicarious traumatization. Resilience-building approaches include real-time debriefing to celebrate successes and troubleshoot problems in the field. Training in resilience-building can be integrated as part of the general training required of all research staff prior to conducting intervention research studies with people experiencing homelessness. These approaches may need institutional support to be integrated into standard research workflows. In doing so, they may not only safeguard research staff and participants but also promote research as a means to dismantle inequities by being inclusive, safe, and empowering.

在面临结构性不平等的无家可归者中,创伤经历非常普遍,这可能会影响他们参与研究。与无家可归者合作的研究人员("工作人员")在应对结构性不平等和参与者生活中的创伤方面能力不足,即使他们在研究过程的监管方面接受过良好的培训。参与无家可归者戒烟干预研究的六名工作人员讲述了他们的经历,并强调了培训的领域,以整合创伤知情和复原力建设方法,为现场工作人员和无家可归者提供支持。我们确定了三个主题:(a) 创伤对研究过程的影响;(b) 与社区合作伙伴和参与者接触的重要性;(b) 需要一份现场工作人员指南。据工作人员描述,他们是参与者创伤的承受者,同时也要应对自己的替代性创伤。工作人员认为,实地工作者指南将使他们受益匪浅,该指南包括与社区合作伙伴合作的最佳实践以及创伤知情方法,如创伤知情护理培训和解决替代性创伤的工具。复原力建设方法包括实时汇报,以庆祝成功并解决现场问题。在对无家可归者进行干预研究之前,可以将复原力建设培训作为所有研究人员必须接受的一般培训的一部分。这些方法可能需要机构的支持才能纳入标准研究工作流程。这样做不仅可以保障研究人员和参与者的安全,还可以通过包容、安全和赋权的方式促进研究,使其成为消除不平等的一种手段。
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引用次数: 0
Bolstering Access to HIV-Related Health care in Zimbabwe Among Young Mothers Living With HIV: Lessons Learned on HIV Health Promotion From Zvandiri's Young Mentor Mother Program. 促进津巴布韦感染艾滋病毒的年轻母亲获得与艾滋病毒相关的医疗服务:从 Zvandiri 的年轻母亲指导计划中汲取的 HIV 健康促进经验。
IF 1.6 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-09-30 DOI: 10.1177/15248399241278974
Lauren S Tailor, Jonathan Angell, Syeda Hasan, Sharon Low, Nicola Willis, Abigail Mutsinze, Vivian Chitiyo, Peggy Kuchocha, Carmen H Logie

HIV disproportionately affects adolescent girls and young women living in Southern Africa. Rates of perinatal HIV transmission are high in this population, emphasizing the need for targeted health promotion and public health programming to improve the health of young mothers living with HIV. Zvandiri, a non-profit organization in Zimbabwe, created the Young Mentor Mother (YMM) program in response to this issue. This health promotion program uses peer-led service delivery conducted by trained young mothers living with HIV, called YMMs. We conducted semi-structured virtual interviews (N = 29) among Zvandiri staff and YMMs to identify benefits and challenges, and to inform future program scaling. We applied thematic analyses to the transcriptions. Participant narratives revealed several themes, including three key benefits from the YMM program: (1) peer support, (2) holistic care, and (3) women's empowerment. Participants also shared barriers to the success of the program, reflecting two overarching dimensions: (1) barriers related to scaling up the YMM program and (2) challenges related to addressing socio-structural factors. Barriers to scale-up included limited funds and resources, and food insecurity. Socio-structural challenges included HIV-related stigma, cultural and geographic differences, and intimate partner violence (IPV). These challenges align with the social-ecological model, whereby structural factors (lack of funding, food insecurity), community factors (HIV-related stigma, socio-cultural differences in accepting HIV care), and interpersonal factors (IPV) affect the implementation and scale-up of the program. We recommend future adopters of the YMM program to tailor the model for their community, prioritize peer supporter's well-being, foster women's empowerment, and adopt a holistic care approach.

艾滋病毒对生活在南部非洲的少女和年轻妇女的影响尤为严重。在这一人群中,围产期艾滋病毒传播率很高,这就强调了有必要制定有针对性的健康促进和公共卫生计划,以改善感染艾滋病毒的年轻母亲的健康状况。津巴布韦的一家非营利组织 Zvandiri 针对这一问题创建了年轻导师母亲 (YMM) 计划。这项健康促进计划由经过培训的感染艾滋病病毒的年轻母亲(称为 YMMs)提供同伴指导服务。我们对 Zvandiri 员工和 YMM 进行了半结构化虚拟访谈(N = 29),以确定项目的益处和挑战,并为未来的项目推广提供参考。我们对访谈记录进行了主题分析。参与者的叙述揭示了几个主题,包括 YMM 计划的三个主要益处:(1) 同伴支持,(2) 整体护理,(3) 妇女赋权。参与者还分享了该计划取得成功的障碍,反映了两个主要方面:(1)与扩大 YMM 计划规模有关的障碍;(2)与解决社会结构因素有关的挑战。扩大规模的障碍包括资金和资源有限以及粮食不安全。社会结构方面的挑战包括与 HIV 相关的污名化、文化和地域差异以及亲密伴侣暴力 (IPV)。这些挑战符合社会生态模式,即结构性因素(缺乏资金、粮食不安全)、社区因素(与 HIV 相关的污名化、接受 HIV 护理的社会文化差异)和人际因素(IPV)会影响计划的实施和推广。我们建议未来采用 YMM 计划的机构为其社区量身定制模式,优先考虑同伴支持者的福利,促进妇女赋权,并采用整体护理方法。
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引用次数: 0
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Health Promotion Practice
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