Pub Date : 2024-10-22DOI: 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.
{"title":"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.","authors":"Whitney Linsenmeyer, Bari Glassman, Nikias Tomasiello, Katherine Walcott","doi":"10.1177/15248399241286027","DOIUrl":"https://doi.org/10.1177/15248399241286027","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":47956,"journal":{"name":"Health Promotion Practice","volume":" ","pages":"15248399241286027"},"PeriodicalIF":1.6,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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.
{"title":"Health Workers' Attitudes Toward Adverse Gender Norms and Implications for Young People's Sexual and Reproductive Health in Nigeria.","authors":"Chinyere Mbachu, Irene Eze, Ozioma Agu, Obinna Onwujekwe","doi":"10.1177/15248399241287211","DOIUrl":"https://doi.org/10.1177/15248399241287211","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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 <i>p</i>-value set at .05.</p><p><strong>Results: </strong>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, <i>p</i> = .003).</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":47956,"journal":{"name":"Health Promotion Practice","volume":" ","pages":"15248399241287211"},"PeriodicalIF":1.6,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-18DOI: 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。
{"title":"Advocacy Skill Development in Public Health Education Curriculum: A Pilot Study.","authors":"Alexis Blavos, Heidi Hancher-Rauch, Antonio Gardner, Vincent Lam, Salma Haidar, Jodi Brookins-Fisher, Amy Thompson","doi":"10.1177/15248399241287207","DOIUrl":"10.1177/15248399241287207","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":47956,"journal":{"name":"Health Promotion Practice","volume":" ","pages":"15248399241287207"},"PeriodicalIF":16.4,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-17DOI: 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。
{"title":"External Factors Influencing the Implementation of Policy, System, and Environmental Change Strategies Within Cooperative Extension.","authors":"Lauren E Kennedy, Heather Norman-Burgdolf, Soghra Jarvandi, Lisa T Washburn","doi":"10.1177/15248399241285506","DOIUrl":"https://doi.org/10.1177/15248399241285506","url":null,"abstract":"<p><p><i>Introduction</i>. 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. <i>Method</i>. 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. <i>Results</i>. 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. <i>Discussion</i>. 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.</p>","PeriodicalId":47956,"journal":{"name":"Health Promotion Practice","volume":" ","pages":"15248399241285506"},"PeriodicalIF":1.6,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-11DOI: 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.
{"title":"Suitability of ChatGPT as a Source of Patient Information for Screening Mammography.","authors":"Kelly Spuur, Geoff Currie, Dana Al-Mousa, Ruth Pape","doi":"10.1177/15248399241285060","DOIUrl":"https://doi.org/10.1177/15248399241285060","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":47956,"journal":{"name":"Health Promotion Practice","volume":" ","pages":"15248399241285060"},"PeriodicalIF":1.6,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142407017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-11DOI: 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.
{"title":"Restaurants as Environments for Healthy Eating: Factors That Contribute to Restaurant-Based Healthy Eating Program Adoption.","authors":"M Knapp, T Moore, A Lederer, M Kimball, Y Quantz, M Fuster, L Myers, C Johnson","doi":"10.1177/15248399241285573","DOIUrl":"https://doi.org/10.1177/15248399241285573","url":null,"abstract":"<p><p><i>Purpose.</i> 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. <i>Methods</i>. 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. <i>Results</i>. 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. <i>Conclusions</i>. 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.</p>","PeriodicalId":47956,"journal":{"name":"Health Promotion Practice","volume":" ","pages":"15248399241285573"},"PeriodicalIF":1.6,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142406948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-05DOI: 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.
{"title":"Exploring Empathic Communication Among Community Health Workers: Applying the ENACT Tool in Two South African Sites.","authors":"Christina A Laurenzi, Stephan Rabie, Sihle Mamutse, Sarah Skeen, Nicola Jansen van Vuuren, Rosanne Neethling, Sally Field, Simone Honikman","doi":"10.1177/15248399241285888","DOIUrl":"https://doi.org/10.1177/15248399241285888","url":null,"abstract":"<p><p><i>Introduction</i>. 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. <i>Methods</i>. 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. <i>Results</i>. We analyzed <i>n</i> = 66 recordings from 11 CHWs, observing positive directionality overall, with most skills improving over time. Despite near-significant improvements in communication delivery (<i>p</i> = .083), self-confidence/groundedness (<i>p</i> = .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. <i>Discussion</i>. 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.</p>","PeriodicalId":47956,"journal":{"name":"Health Promotion Practice","volume":" ","pages":"15248399241285888"},"PeriodicalIF":1.6,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142378436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-05DOI: 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.
{"title":"Network Analysis to Visualize Qualitative Results: Example From a Qualitative Content Analysis of The National Child Abuse Hotline.","authors":"Laura M Schwab-Reese, Nicholas C Lenfestey, Amelia W Hartley, Lynette M Renner, Tyler Prochnow","doi":"10.1177/15248399241283144","DOIUrl":"https://doi.org/10.1177/15248399241283144","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":47956,"journal":{"name":"Health Promotion Practice","volume":" ","pages":"15248399241283144"},"PeriodicalIF":1.6,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142378437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-30DOI: 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.
{"title":"Supporting Research Staff Working With People Experiencing Homelessness: Integrating Trauma-Informed and Resilience-Building Approaches Into Community-Engaged Research Studies.","authors":"Jessica Alway, Jesus Omar Gomez, Phoebe Lee, Jordan Cuby, Deepalika Chakravarty, Maya Vijayaraghavan","doi":"10.1177/15248399241275619","DOIUrl":"10.1177/15248399241275619","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":47956,"journal":{"name":"Health Promotion Practice","volume":" ","pages":"15248399241275619"},"PeriodicalIF":1.6,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142336983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-30DOI: 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。
{"title":"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.","authors":"Lauren S Tailor, Jonathan Angell, Syeda Hasan, Sharon Low, Nicola Willis, Abigail Mutsinze, Vivian Chitiyo, Peggy Kuchocha, Carmen H Logie","doi":"10.1177/15248399241278974","DOIUrl":"https://doi.org/10.1177/15248399241278974","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":47956,"journal":{"name":"Health Promotion Practice","volume":" ","pages":"15248399241278974"},"PeriodicalIF":1.6,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142337071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}