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Formative Research to Design and Evaluate Caring Text Messages for American Indian and Alaska Native Youth, College Students, and Veterans. 为美国印第安人和阿拉斯加原住民青年、大学生和退伍军人设计和评估关爱短信的形成性研究。
IF 1.6 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-09-04 DOI: 10.1177/15248399241275610
Colbie Caughlan, Amanda Kakuska, Jane Manthei, Aurora Martinez, Lisa DiBianco, Stephanie Craig Rushing

Purpose. Caring Text Messages (CTM) is an evidence-based intervention, developed by the Northwest Portland Area Indian Health Board, modeled after the Caring Contacts (CC) intervention. CC has been shown to prevent suicide deaths, attempts, ideation, and hospitalizations in a variety of settings. Method. Three sets of CTM were developed by American Indian and Alaska Native (AI/AN) teens, college students, and veterans (tailored for each audience), which were reviewed by psychologists familiar with the intervention. To enroll in the service, participants texted a keyword to a text message short code and received two text messages per week with hopeful and encouraging messages. A robust multimedia social marketing campaign was designed to promote the service for each audience. Results. By September 2023, 387 participants enrolled in the Youth CTM intervention, 141 enrolled in the College CTM, and 31 enrolled in the Veterans CTM. Post surveys show elevated levels of user satisfaction. Conclusions. CTM can be tailored to reach populations at higher risk of suicide, including AI/AN youth, college students, and veterans, and connect them to culturally responsive peer and crisis support services. Continued monitoring and evaluation can guide next steps for marketing and outreach and will be useful to determine its impact on those who enroll.

目的。关爱短信 (CTM) 是一种循证干预措施,由西北波特兰地区印第安人健康委员会仿照关爱联系 (CC) 干预措施开发。事实证明,CC 能在各种情况下预防自杀死亡、自杀未遂、自杀意念和住院治疗。方法。美国印第安人和阿拉斯加原住民(AI/AN)青少年、大学生和退伍军人开发了三套 CTM(为每个受众量身定制),并由熟悉该干预措施的心理学家进行了审核。要注册这项服务,参与者将一个关键字发到短信短码上,每周会收到两条充满希望和鼓励的短信。我们设计了一场声势浩大的多媒体社会营销活动,针对不同受众推广这项服务。结果。到 2023 年 9 月,共有 387 人参加了青少年 CTM 干预项目,141 人参加了大学生 CTM 项目,31 人参加了退伍军人 CTM 项目。后期调查显示用户满意度较高。结论。CTM 可以针对自杀风险较高的人群(包括美国原住民/印第安人青年、大学生和退伍军人)量身定制,并将他们与文化上相适应的同伴和危机支持服务联系起来。持续的监控和评估可以指导下一步的营销和推广工作,并有助于确定其对注册者的影响。
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引用次数: 0
Empowering Youth Vaccine Ambassadors to Promote COVID-19 Vaccination in Local Communities: A 7-Step Approach. 增强青年疫苗大使在当地社区推广 COVID-19 疫苗接种的能力:七步法。
IF 1.6 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-09-01 Epub Date: 2023-06-11 DOI: 10.1177/15248399231178542
Princilla A Minkah, Amy Borg, Grace W Ryan, Melissa Goulding, Domenica Perrone, Matilde Castiel, Milagros C Rosal, Stephenie C Lemon

Despite the availability of COVID-19 vaccines for youth since 2021, vaccine hesitancy has resulted in suboptimal uptake. Public health campaigns that empower local youth ambassadors as trusted messengers who share their personal narratives related to getting vaccinated hold promise for promoting COVID-19 vaccination. We used a seven-step approach to develop, implement, and evaluate a youth-led ambassador campaign to promote COVID-19 vaccine uptake in communities experiencing COVID-19 disparities in Worcester, MA. The seven steps included (1) engaging with key partners, (2) determining a community of focus, (3) identifying trusted sources, (4) determining campaign components, (5) training the vaccine ambassadors, (6) disseminating the campaign, and (7) evaluating the campaign. We trained nine youth as vaccine ambassadors. Ambassadors were guided through self-reflection of motivations for COVID-19 vaccination and the resulting personal narratives became the campaign messaging. English/Spanish vaccine messages developed by youth ambassadors were disseminated through social media platforms (n = 3), radio (n = 2), local TV (n = 2), flyers (n = 2,086), posters (n = 386), billboards (n = 10), and local bus ads (n = 40). Qualitative youth feedback indicate participation in the campaign was a positive and empowering experience which reinforces the importance of engaging youth in public health messaging. Youth empowerment through personal narratives (and storytelling) holds promise for future public health campaigns.

尽管 COVID-19 疫苗自 2021 年起就可供青少年接种,但疫苗接种的犹豫不决导致了接种率不高。授权当地青年大使作为可信赖的信使,分享他们与接种疫苗相关的个人故事的公共卫生活动有望促进 COVID-19 疫苗的接种。在马萨诸塞州伍斯特市 COVID-19 存在差异的社区,我们采用了七步方法来制定、实施和评估由青年领导的大使活动,以促进 COVID-19 疫苗的接种。这七个步骤包括:(1) 与主要合作伙伴接触;(2) 确定重点社区;(3) 确定可信来源;(4) 确定活动内容;(5) 培训疫苗大使;(6) 宣传活动;(7) 评估活动。我们培训了九名青年担任疫苗大使。我们引导大使们自我反思接种 COVID-19 疫苗的动机,并将由此产生的个人叙述作为活动信息。由青年大使编写的英语/西班牙语疫苗信息通过社交媒体平台(3 个)、广播(2 个)、当地电视台(2 个)、传单(2086 份)、海报(386 份)、广告牌(10 个)和当地公交车广告(40 个)进行传播。青少年的定性反馈表明,参与该活动是一次积极的、增强能力的经历,这也加强了让青少年参与公共卫生信息传播的重要性。通过个人叙事(和讲故事)增强青少年的能力为未来的公共卫生运动带来了希望。
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引用次数: 0
A Unique Model and Workforce to Address Health-Related Social Needs and Health Equity: Regional Health Connectors in Colorado. 解决与健康相关的社会需求和健康公平问题的独特模式和劳动力:科罗拉多州的地区健康连接器。
IF 1.6 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-09-01 Epub Date: 2023-05-24 DOI: 10.1177/15248399231173703
Jennifer K Carroll, Douglas H Fernald, Tristen L Hall, Hannah M Groves, Gillian Grant, Ashley Sherrill, Kristin Crispe, Ashlie Brown, Sarah Lampe, W Perry Dickinson

Unmet health-related social needs contribute to high morbidity and poor population health. Improving social conditions are likely to reduce health disparities and improve the health of the overall U.S. population. The primary objective of this article is to describe an innovative workforce model, called Regional Health Connectors (RHCs), and how they address health-related social needs in Colorado. This is a program evaluation that analyzed field notes and interview data from 2021-2022. We applied our findings to the framework developed by the National Academies of Sciences, Engineering, and Medicine's (NASEM's) report on strengthening social care integration into health care (2019). We found that RHCs address the following health-related social needs most commonly: food insecurity (n = 18 of 21 regions or 85% of all regions), housing (n = 17 or 81% of all regions), transportation (n = 11 or 52% of all regions), employment opportunities (n = 10 or 48% of all regions), and income/financial assistance (n = 11 or 52% of all regions). RHCs interacted across many sectors to address health-related social needs and provided multiple types of support to primary care practices at the organizational level. Examples of emerging impact of RHCs are described and mapped onto the NASEM framework. Findings from this program evaluation add to the growing landscape of knowledge and importance of detecting and addressing health-related social needs. We conclude that RHCs are a unique and emerging workforce that addresses multiple domains needed to integrate social care into health care.

与健康相关的社会需求得不到满足导致发病率高和人口健康状况差。改善社会条件有可能减少健康差异,提高美国整体人口的健康水平。本文的主要目的是介绍科罗拉多州的一种创新劳动力模式,即区域健康联系人(RHC),以及他们如何满足与健康相关的社会需求。这是一项计划评估,分析了 2021-2022 年的现场记录和访谈数据。我们将研究结果应用于美国国家科学、工程和医学研究院(NASEM)关于加强医疗保健中社会护理整合的报告(2019 年)所制定的框架。我们发现,区域健康中心最常解决以下与健康相关的社会需求:粮食不安全(21 个地区中的 18 个,占所有地区的 85%)、住房(17 个,占所有地区的 81%)、交通(11 个,占所有地区的 52%)、就业机会(10 个,占所有地区的 48%)以及收入/财务援助(11 个,占所有地区的 52%)。区域健康中心与许多部门互动,以满足与健康相关的社会需求,并在组织层面为初级保健实践提供多种类型的支持。对区域健康中心新出现的影响实例进行了描述,并将其映射到 NASEM 框架中。这项计划的评估结果进一步丰富了人们对检测和解决与健康相关的社会需求的认识和重要性。我们的结论是,区域健康中心是一支独特的新兴力量,能够解决将社会关怀融入医疗保健所需的多个领域的问题。
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引用次数: 0
Parents' and Caregivers' Support for in-School COVID-19 Mitigation Strategies: A Socioecological Perspective. 家长和照顾者对校内 COVID-19 缓解策略的支持:社会生态学视角。
IF 1.6 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-09-01 Epub Date: 2024-01-04 DOI: 10.1177/15248399231221160
Laura Prichett, Andrea A Berry, Gabriela Calderon, June Wang, Erin R Hager, Lauren M Klein, Lorece V Edwards, Yisi Liu, Sara B Johnson

Informed by the social ecological model, which asserts that health behaviors and beliefs are the result of multiple levels of influence, we examined factors related to parents' support for in-school COVID-19 mitigation strategies. Using data from a survey of 567 parents/caregivers of public elementary and middle school students in eight Maryland counties, we employed regression models to examine relationships between parent-, child-, family-, school-, and community-level factors and acceptability of mitigation strategies. Acceptance of COVID-19 mitigation strategies was positively correlated with child- and family-level factors, including child racial identity (parents of Black children were more accepting than those of White children, odds ratio [OR]: 2.5, 95% confidence interval [CI] = [1.5, 4.1]), parent receipt of the COVID-19 vaccine (OR: 2.4, 95% CI = [1.5, 3.7]), and parent Democrat or Independent political affiliation (compared with Republican affiliation, OR: 4.2, 95% CI = [2.6, 6.7]; OR: 2.2, 95%CI = [1.3, 3.8], respectively). Acceptance was also positively associated with parents' perceptions of their school's mitigation approach, including higher school mitigation score, indicating more intensive mitigation policies (OR: 1.1, 95% CI = [1.0, 1.1]), better school communication about COVID-19 (OR: 1.7, 95% CI = [1.4, 1.9]) and better school capacity to address COVID-19 (OR: 1.9, 95% CI = [1.5, 2.4]). Community-level factors were not associated with acceptance. Child- and parent-level factors identified suggest potential groups for messaging regarding mitigation strategies. School-level factors may play an important role in parents' acceptance of in-school mitigation strategies. Schools' capacity to address public health threats may offer an underappreciated and modifiable setting for disseminating and reinforcing public health guidance.

社会生态模型认为,健康行为和信念是多层次影响的结果,在此基础上,我们研究了与家长支持校内 COVID-19 缓解策略相关的因素。通过对马里兰州 8 个县 567 名公立中小学学生家长/监护人的调查数据,我们采用回归模型研究了家长、儿童、家庭、学校和社区层面的因素与缓解策略可接受性之间的关系。COVID-19缓解策略的接受度与儿童和家庭层面的因素呈正相关,包括儿童的种族身份(黑人儿童的父母比白人儿童的父母更容易接受,几率比 [OR]: 2.5, 95% 置信区间 [CI] = [1.5, 4.1])、父母是否接种过COVID-19疫苗(OR: 2.4, 95% CI = [1.5, 3.7])、父母的民主党或独立党政治倾向(与共和党政治倾向相比,OR:4.2,95% CI = [2.6,6.7];OR:2.2,95%CI = [1.3,3.8])。接受度还与家长对学校减灾方法的看法呈正相关,包括学校减灾得分越高,表明减灾政策越密集(OR:1.1,95% CI = [1.0,1.1])、学校对 COVID-19 的沟通越好(OR:1.7,95% CI = [1.4,1.9])以及学校应对 COVID-19 的能力越强(OR:1.9,95% CI = [1.5,2.4])。社区层面的因素与接受度无关。所发现的儿童和家长层面的因素表明,缓解策略的潜在信息传递群体。学校层面的因素可能对家长接受校内减灾策略起到重要作用。学校应对公共卫生威胁的能力可能为传播和加强公共卫生指导提供了一个未被充分重视且可调整的环境。
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引用次数: 0
Impact of a Culturally Grounded Running Program on Four Components of Wellness Among Indigenous Participants: A Pilot Study of the Running Medicine Program. 基于文化背景的跑步计划对土著参与者健康四个组成部分的影响:跑步医学计划试点研究。
IF 1.6 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-09-01 Epub Date: 2022-12-08 DOI: 10.1177/15248399221137804
Anthony Fleg, Nicolette Abeyta, Jonathan Houck, Kristen Baca, Cindy Nguyen, Ashleigh Claw, Jaida Shaffer

Movement as medicine is the premise behind Running Medicine (RM), a community-based wellness program that began in 2016 in New Mexico. RM is centered in the Indigenous traditions of running and is oriented to improving the four dimensions of wellness-mind, body, spirit, and social. Using retroactive surveys of RM's Spring 2019 participants, we investigated the program's effectiveness in the realms of physical, mental, spiritual, and social wellness. Based on data from participant surveys, RM appears to be effective at improving the four realms of wellness. Indigenous participants improved to a greater degree in mental and social wellness than non-Indigenous participants, while the opposite was true for physical and spiritual wellness. For both groups, the largest effect size among the four domains was seen in social wellness. Among our participants, this culturally grounded approach to wellness appears to be effective at improving the four realms of physical, mental, spiritual, and social wellness.

运动即医疗是 "跑步医疗"(Running Medicine,RM)背后的前提,这是一项基于社区的健康计划,于 2016 年在新墨西哥州启动。RM以原住民的跑步传统为中心,旨在改善健康的四个维度--思想、身体、精神和社会。通过对 RM 2019 年春季参与者的追溯调查,我们研究了该计划在身体、心理、精神和社交健康领域的有效性。根据参与者的调查数据,RM 在改善四个领域的健康方面似乎都很有效。与非原住民参与者相比,原住民参与者在心理和社交健康方面的改善程度更高,而在身体和精神健康方面的改善程度则恰恰相反。对这两个群体而言,四个领域中效果最大的是社交健康。在我们的参与者中,这种以文化为基础的健康方法似乎能有效改善身体、心理、精神和社交四个领域的健康。
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引用次数: 0
A Disparity. 差距。
IF 1.6 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-09-01 DOI: 10.1177/15248399241261328
Paris B Adkins-Jackson

As a living being that was passed down the role of storytelling, I describe the conditions under which individuals find themselves. Science, and specifically public health research, affords me the opportunity to deploy my storytelling skills toward advocacy and intervention for communities that disproportionately bear the burden of poor health. Although neither role makes space for the emotional toll of this work. Neither allows me to rest long enough to move through the emotional mist of what it means to be perceived as a queer, Black, cisgender woman, and storytelling scientist in a stratified and hateful world where I am so much more. This poem pools from various worlds within me for each stanza. The poem seeks to reconcile for my whole self, and others who experience marginality, why our colleagues, countrypersons, and community members see it fit to perpetuate notions of human difference along racialized, socioeconomic, sexualized, gendered, able-bodied, and other stratified lines-to the detriment of our lives. How can my colleagues, countrypersons, and community members be willing to receive the privileges of a democratic society but discard the lives from which that society was built? How can my colleagues, countrypersons, and community members be willing to receive our science but discard our health? This poem brings together multidisciplinary discourse from the humanities and the social and biological sciences to state plainly what many others have academically. May this poem be paired with existing literature on the falsity of biologized race, reparations, and methodologies of reflexivity in science.To view the original version of this poem, see the Supplemental Material section of this article online.

作为一个传承了讲故事这一角色的活生生的人,我描述了个人所处的环境。科学,特别是公共卫生研究,让我有机会运用讲故事的技巧,为那些承受着过重健康负担的社区进行宣传和干预。尽管这两种角色都没有为这项工作的情感付出留出空间。这两种角色都无法让我休息足够长的时间,以穿越情感的迷雾,了解在一个分层和充满仇恨的世界中,作为一名同性恋、黑人、顺性别女性和故事科学家,我究竟意味着什么。这首诗的每一节都来自我内心的不同世界。这首诗试图让我和其他经历过边缘化的人明白,为什么我们的同事、同胞和社区成员认为有必要按照种族、社会经济、性别、性别、健全人和其他分层的界限来延续人类差异的概念,从而损害我们的生活。我的同事、同胞和社区成员怎么能甘愿接受民主社会的特权,却丢弃建立这个社会的生命?我的同事、同胞和社区成员怎么能甘愿接受我们的科学,却丢弃我们的健康?这首诗汇集了人文科学、社会科学和生物科学等多学科的论述,直截了当地阐述了许多其他学术界人士的观点。愿这首诗能与现有的关于生物化种族的虚假性、赔偿和科学中的反思性方法论的文献配对。如需查看这首诗的原始版本,请参阅本文的在线补充材料部分。
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引用次数: 0
Lights, Facts, and Goals: A Novel Framework to Enhance Community Health Messaging Campaign Design, Implementation, and Assessment. 光、事实和目标:一个新的框架来加强社区健康信息宣传活动的设计、实施和评估。
IF 1.6 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-09-01 Epub Date: 2023-11-06 DOI: 10.1177/15248399231209028
James S Brooks, Luz Claudio, Faven Araya, Muhammed Y Idris, Kristelle Pierre, Maya Korin

The spread of health misinformation has made the task of health communicators more difficult. However, the success of health messaging hinges not only on meaningful message content but also on the credibility of who is delivering the message. "Trusted messengers," like local leaders and community-based organizations, have a greater ability to influence improvements in community health, due to their shared cultural experience with their communities. Health communication agencies should empower trusted messengers with the tools they need to succeed in health communication. One tool critical for their success is a succinct health messaging framework to plan and implement health messaging. Marketing has "See, Think, Do"-a simple, practical framework used to influence consumer purchases. As a more trustworthy corollary, we propose the "Lights, Facts, and Goals" framework, a concise, authentic, and transparent method for planning, implementing, and assessing health messaging campaigns that influence health improvements. "Lights" refers to different methods of reaching communities like trusted messengers, advertisements, and text messages. "Facts" refers to key sourced scientific information relevant to a specific aspect of community health. "Goals" refers to actions community members can take to improve their health in connection with the communicated health facts. This article describes how the "Lights, Facts, and Goals" framework both simplifies the creation and communication of scientifically sound health messaging and strengthens the partnership between health agencies and trusted messengers in the community. Through "Lights, Facts, and Goals," community-based organizations, community leaders, and their partners will be more effective at improving community health through messaging.

健康错误信息的传播使健康传播者的任务更加困难。然而,健康信息的成功不仅取决于有意义的信息内容,还取决于谁在传递信息的可信度。“值得信赖的信使”,如地方领导人和社区组织,由于与社区共享文化经验,有更大的能力影响社区健康的改善。卫生沟通机构应为值得信赖的信使提供在卫生沟通中取得成功所需的工具。他们成功的一个关键工具是一个简洁的健康信息框架,用于规划和实施健康信息。市场营销有“看、想、做”——一个简单实用的框架,用来影响消费者的购买。作为一个更值得信赖的推论,我们提出了“光、事实和目标”框架,这是一种简洁、真实和透明的方法,用于规划、实施和评估影响健康改善的健康信息宣传活动。“Lights”指的是接触社区的不同方法,如可信信使、广告和短信。“事实”是指与社区卫生特定方面相关的关键科学信息。“目标”是指社区成员可以根据交流的健康事实采取行动来改善他们的健康状况。这篇文章描述了“光、事实和目标”框架如何简化科学合理的健康信息的创建和传播,并加强卫生机构和社区中值得信赖的信使之间的伙伴关系。通过“光、事实和目标”,社区组织、社区领导人及其合作伙伴将更有效地通过信息改善社区健康。
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引用次数: 0
A Systematic Review of the Impacts of Media Mental Health Awareness Campaigns on Young People. 媒体心理健康宣传活动对年轻人影响的系统性回顾。
IF 1.6 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-09-01 Epub Date: 2024-03-12 DOI: 10.1177/15248399241232646
Mallorie T Tam, Julia M Wu, Cindy C Zhang, Colleen Pawliuk, Julie M Robillard

Mental health issues are prevalent among young people. An estimated 10% of children and adolescents worldwide experience a mental disorder, yet most do not seek or receive care. Media mental health awareness campaigns, defined as marketing efforts to raise awareness of mental health issues through mass media, are an effort to address this concern. While previous research has evaluated the outcomes of specific media mental health awareness campaigns, there is limited data synthesizing their overall effects. This study addresses the knowledge gap by reviewing the existing literature on the impact of media mental health awareness campaigns on young people. A search was conducted on MEDLINE, EMBASE, PsychINFO, Web of Science, and Google Scholar for studies published between 2004 and 2022 with results specific to people aged 10 to 24. Out of 20,902 total studies identified and screened, 18 studies were included in the review. The following data were extracted from each study: characteristics and descriptions of the campaign, evaluation design and sampling, and summary of impact. The review identified evaluations of 15 campaigns from eight different countries. Outcome evaluation methods commonly comprised of surveys and quantitative data. The campaigns were generally associated with positive changes in the attitudes, beliefs, and intentions of young people (e.g., reduced stigma) and positive changes in behaviors (e.g., increased help-seeking behaviors). The inclusion of few studies in the review indicates a need for ongoing evaluations of media mental health awareness campaigns for young people to inform good practices in their development and distribution.

青少年普遍存在心理健康问题。据估计,全世界有 10% 的儿童和青少年患有精神障碍,但大多数人并没有寻求或接受治疗。媒体心理健康宣传活动,即通过大众媒体提高人们对心理健康问题认识的营销活动,就是为解决这一问题所做的努力。虽然以往的研究对特定媒体心理健康意识活动的结果进行了评估,但综合其整体效果的数据却很有限。本研究通过回顾媒体心理健康宣传活动对青少年影响的现有文献,填补了这一知识空白。研究人员在 MEDLINE、EMBASE、PsychINFO、Web of Science 和 Google Scholar 上检索了 2004 年至 2022 年间发表的、针对 10-24 岁人群的研究。在已确定和筛选的总共 20902 项研究中,有 18 项研究被纳入综述。从每项研究中提取了以下数据:活动的特点和描述、评估设计和抽样,以及影响概要。审查确定了对 8 个不同国家的 15 项活动的评估。成果评估方法通常包括调查和定量数据。这些活动通常与年轻人态度、信念和意向的积极变化(如减少耻辱感)以及行为的积极变化(如增加寻求帮助的行为)有关。综述中纳入的研究很少,这表明有必要对针对年轻人的媒体心理健康宣传活动进行持续评估,以便为其发展和传播提供良好的实践依据。
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引用次数: 0
Group-Based Medical Mistrust in Adolescents With Poorly Controlled Asthma Living in Rural Areas. 生活在农村地区、哮喘控制不佳的青少年对集体医疗的不信任。
IF 1.6 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-09-01 Epub Date: 2023-01-19 DOI: 10.1177/15248399221150913
Sarah I Leonard, Connor T Pizii, Yihong Zhao, Amarilis Céspedes, Sharon Kingston, Jean-Marie Bruzzese

Black youth and rural adolescents are two groups who experience asthma disparities. Racism and discrimination in health care likely lead to group-based (systems-level) medical mistrust for some adolescents. Group-based medical mistrust, one pathway by which racism drives health inequities, is associated with poorer outcomes for patients with chronic conditions. Despite its potential importance in adolescent asthma, previous research has not considered group-based medical mistrust in this population. To fill this gap, we characterize group-based medical mistrust among rural adolescents with poorly controlled asthma, examining demographic differences. We analyzed baseline data from a school-based clinical trial in which 164 adolescents (mean age = 16.3; 76.2% Black) completed the Group-Based Medical Mistrust Scale (GBMMS). Using linear regression, we tested associations with race, gender, and age, controlling for recent medical visits and insurance status. The total GBMMS mean score was 2.3 (SD = 1.22); subscale scores ranged from 2.3 to 2.4. Black adolescents reported significantly higher total GBMMS scores (β = .45, p = .003) and significantly higher scores on two GBMMS subscales: suspicion of health care providers (β = .56, p = .007) and lack of support from health care providers (β = .36, p = .007). Gender and age were not associated with GBMMS scores. Health care providers need to consider medical mistrust and its role in their clinical care. Together with their institutions, health care providers and researchers should work toward changing systems that perpetuate racism to build trust as a means of reducing asthma disparities among adolescents.

黑人青少年和农村青少年是哮喘发病率较高的两个群体。医疗保健中的种族主义和歧视可能会导致一些青少年对基于群体(系统层面)的医疗不信任。基于群体的医疗不信任是种族主义导致医疗不公平的一个途径,它与慢性病患者较差的治疗效果有关。尽管它对青少年哮喘有潜在的重要影响,但以往的研究并未考虑过这一人群中基于群体的医疗不信任。为了填补这一空白,我们研究了哮喘控制不佳的农村青少年中基于群体的医疗不信任,并考察了人口统计学差异。我们分析了一项学校临床试验的基线数据,其中有 164 名青少年(平均年龄 = 16.3 岁;76.2% 为黑人)完成了团体医疗不信任量表(GBMMS)。我们使用线性回归法测试了与种族、性别和年龄的关系,并控制了最近的就诊情况和保险状况。GBMMS 总分平均值为 2.3(SD = 1.22);分量表得分介于 2.3 到 2.4 之间。黑人青少年的 GBMMS 总分明显更高(β = .45,p = .003),GBMMS 两个分量表的得分也明显更高:怀疑医疗服务提供者(β = .56,p = .007)和缺乏医疗服务提供者的支持(β = .36,p = .007)。性别和年龄与 GBMMS 分数无关。医疗服务提供者需要考虑医疗不信任及其在临床护理中的作用。医疗服务提供者和研究人员应与他们的机构一起,努力改变使种族主义长期存在的制度,以建立信任,从而减少青少年哮喘的差异。
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引用次数: 0
COVID-19 Implications on Worksite Wellness Programming. COVID-19 对工作场所健康计划的影响。
IF 1.6 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2024-09-01 Epub Date: 2024-05-14 DOI: 10.1177/15248399241251831
Renee A Underwood, Angela R Wood, Ralph J Wood, Rylie B Broussard, Stephanie T Broyles

Seven of the top ten leading causes of death in the United States are due to chronic diseases and treating these accounts for 86 percent of our nation's health care costs. The workplace offers an environment to implement chronic disease prevention strategies, such as worksite wellness programs, due to the large amount of time spent at the worksite daily by employees. As a result of COVID-19, many organizations began to change their workdays (i.e., working from home). This research sought to understand what, if any, implications the COVID-19 epidemic had on worksite wellness programming. Semistructured interviews were employed and recorded via Zoom conferencing to gather qualitative data. Four themes were identified: (a) relationship building among remote employees, (b) creativity in how to carry out program components, (c) increased physical activity and work-life balance, and (d) increased knowledge of health issues and mental health resources. Both challenges and successes were reported within themes. The main finding from this research indicates a mostly positive experience for worksite wellness programs during the COVID-19 epidemic. Many organizations have continued nontraditional work environments and the lessons learned from this study can both encourage and provide ideas for how to create and continue a worksite wellness program outside of the normal face-to-face working environment.

预计到 2060 年,多种族和多民族人口将占美国总人口的 11.6%,因此公共卫生研究和实践必须找到有效捕捉和覆盖这些不同群体的方法。单一的种族识别一直是公共卫生实践中的规范;然而,这种方法在捕捉多种族和多族裔个人的健康状况方面存在局限性。根据作者的个人经历和多学科学术研究,本研究评论探讨了单一种族识别的局限性,以及这种识别方法如何影响种族化进程。作者为公共卫生研究提供了重要的启示,提出了更复杂、更有效的方法来捕捉个人的种族认同和种族观念,并探讨了如何通过公共卫生干预措施来覆盖多种族和多民族群体,因为在这些群体中,个人可能认同多种文化身份。
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