Health Promotion Practice最新文献

This case study describes the country-level experience and response to the COVID-19 pandemic in Gabon between December 2020 and December 2022. We structured the presentation of COVID-19 response as an action cycle with five elements: (1) engagement, (2) assessment and surveillance measures used to track new cases, (3) planning, (4) action/implementation, and (5) evaluation. We describe the participatory monitoring and evaluation (M&E) process implemented in collaboration with the WHO Regional Office for Africa M&E team. The M&E system was used to organize and make sense of emerging data regarding the evolution of new cases of COVID-19 and related response activities. We share the results of this participatory evaluation, including systematic reflection by stakeholders ("sensemaking") to identify factors associated with lowering the number of new cases and with enabling and impeding Gabon's pandemic response. We conclude with lessons learned and practice implications from Gabon's experience to guide future country-level responses to rapidly evolving public health crises. This analysis seeks to guide decision-makers and practitioners in their efforts to respond to such situations.

Background. Despite accounting for 34% of the population in Austin, Texas, Latinx individuals made up 50% of those who tested positive for coronavirus, 54% of COVID-related hospitalizations, and 51% of COVID-related deaths between March and June 2020. Of hospitalized Latinx patients, 40% had never seen a primary care provider and many had undiagnosed health conditions. A community health worker (CHW) pilot program was implemented based on these disparities. Method. This mixed-method implementation study describes a hospital-based, CHW program for Latinx patients hospitalized with COVID-19 at an academic medical center in Austin, Texas. The program included a social needs assessment, care coordination, and post-discharge follow-up. Patient data include demographics from the full sample (N = 57), social determinants of health (n = 24), and qualitative interviews (n = 6). Focus group data from health care professionals (n = 26) is also presented to describe the benefits of the CHW program. Results. Latinx patients in this study, two-thirds of who primarily spoke Spanish, reported high levels of satisfaction with the CHW program with fewer reported social needs after the CHW program. Health care providers underscored CHW expertise in addressing complex social needs, providing continuity of care within the hospital, and closing the loop through community resource navigation. Conclusion. This study demonstrated the capacity of CHWs to provide holistic care in hospital settings through trust building and increased capacity to address health-related social needs. Investment in hospital-based, CHW programs for vulnerable populations such as uninsured, Spanish-speaking patients is necessary to reduce health disparities beyond COVID-19.

The physical activity (PA) behaviors of rural youth are not fully understood and community health practitioners often lack practical PA tools to evaluate their activities. The purpose of this study was to use the Youth Compendium, a publicly available PA assessment tool, to identify activities frequently reported among a sample of rural children and to provide translational implications for PA promotion in community settings. Ninety-seven children (mean age=8.9±1.1; female=58.8%) who participated in the rural NU-HOME obesity prevention randomized controlled trial completed a 7-day PA log and provided accelerometry data (mean moderate-vigorous PA=44.5±18.9 minutes/day). Using the Youth Compendium, multiple research team members independently coded the open-response PA log data to determine specific activity types completed on weekdays and weekends. We established interrater reliability using coder triangulation methods. Activity-specific energy costs and durations were estimated using youth metabolic equivalent of task (METy) and METy-minute values. On weekdays, the most commonly reported activities were free play (75.3%), biking (37.1%), and walking (37.1%); mean METy-minutes=480±693, 92±210, and 72±233, respectively. On weekends, the most commonly reported activities were free play (61.9%), walking (50.5%), and swimming (29.9%); mean METy-minutes=714±1009, 151±280, and 520±1030, respectively. Farm chores were prevalent and were reported on weekdays (9.2%) and weekends (17.5%). Among this rural sample, children reported a diverse range of activities spanning from free play to farm chores. The Youth Compendium is a useful PA assessment tool. However, to support this tool's utility in rural community settings, compendia expansion work is needed to include activities commonly reported by rural youth.

This article emphasized the urgency of promoting LGBTQ+ mental health in the Philippines, a nation known for its friendly attitude toward LGBTQ+ individuals. Despite this, a significant portion of the population maintains negative attitudes, fostering persistent stigmatization and discrimination against gay men and lesbians. These adverse social conditions, coupled with the absence of comprehensive LGBTQ+ rights protection, exacerbate mental health disparities among LGBTQ+ individuals. Recognizing the pivotal role of educational institutions, this article explores the integration of an elective course, "LGBT+ Mental Health," within an applied behavioral science program. The curriculum was based on international reports and local studies, employing frameworks like Minority Stress and Intersectionality to scrutinize factors influencing LGBTQ+ mental health disparities. The course's blended approach encourages student engagement through discussions, group work, and assessments. Insights from the course reveal students' capacity to develop organizational programs and policies that promote mental health and inclusivity. Recommendations include expanding LGBTQ+ mental health integration beyond health-related degrees, providing support and resources, fostering a cultural shift toward acceptance within educational institutions, and tailoring the course to better respond to local LGBTQ+ needs. Moreover, the paper emphasizes the critical role of educational institutions in addressing LGBTQ+ mental health disparities, serving as a model for future progress and inclusivity. Overall, this integration of LGBTQ+ mental health promotion in a non-health academic degree program can serve as a model for institutions to advance the well-being of LGBTQ+ individuals and dismantle systemic barriers.

Background. Improving children's diets from 6 to 24 months can support children's survival, growth, and development, but progress toward this goal has stalled globally. Human-centered design offers a new approach to resolving program challenges, especially when integrated with social and behavior change (SBC) theory and rigorous evaluation. Method. Two human-centered design processes were conducted. In Ebonyi state, Federal Capital Territory, and Sokoto state a combined high-fidelity prototype, drawn from three low-fidelity prototypes, focusing on improving dietary diversity was developed and tested. In Kebbi state eight low-fidelity prototypes focused on developing tools to improve community health worker (CHW) nutrition counseling were developed and tested. High-fidelity prototype testing combined design and behavior change indicators and qualitative and quantitative methods. Prototype Testing Results. Seven of the eight prototypes in Kebbi state tested well. Prototypes that integrated SBC theory and encouraged two-way conversations between CHWs and caregivers were most successful. The high-fidelity prototype tested in Sokoto demonstrated improved knowledge and efficacy regarding dietary diversity and increased self-reported dietary diversity. Three low-fidelity prototypes in Kebbi will be combined into a counseling package for CHWs. The implementation of the high-fidelity nutrition prototype will be expanded. Discussion. Human-centered design is a promising approach to address complex global health challenges and can be strengthened through the integration of SBC theory and traditional monitoring and evaluation approaches, but this is challenging. Implications for Practice. It is essential to establish a foundation of human-centered design and SBC knowledge among all implementers, incorporate both knowledge bases throughout the process, and center in-country expertise.

Online exercise videos can reach adolescents who lack access to in-person physical activity (PA). Yet, health professionals are wary of recommending online exercise resources because most free videos fail to represent diverse teens and perpetuate harmful norms. Our study had two purposes. First, we examined adolescents' perceptions of standard online exercise videos. Second, we sought their responses to Move + Thrive, a novel, free, online exercise video library designed to meet developmental needs of adolescents, be inclusive, and promote exercise behavior. We created Move + Thrive videos guided by self-determination and self-efficacy theories. In this qualitative study, we held focus groups with 28 adolescents (mean age = 16.4 ± 2.1 years) after they used two Move + Thrive videos. We asked participants what they enjoyed and what they would change about fitness videos in general and Move + Thrive videos. We had focus groups professionally transcribed, then used general content analysis to consolidate qualitative data into five themes: (a) online exercise videos should foster connection and motivation, (b) teen-specific considerations, (c) diversity, equity, and inclusion, (d) polarized views on yoga, and (e) desire for professional video elements. Adolescents appreciated Move + Thrive's emphases on supporting competence, autonomy, relatedness, and building self-efficacy and our focus on featuring instructors diverse in race and ethnicity, gender, and body shape and size. Based on adolescents' feedback, Move + Thrive is meeting adolescents' needs and addressing shortcomings of online exercise videos. Online exercise content and related research should incorporate adolescents' insights, perspectives, and developmental stages.

As calls for improved menstrual health management have gained momentum in sociopolitical contexts, period poverty and menstrual equity have gradually been established and recognized in the discipline of public health. These conversations typically take place in the context of low- and middle-income countries (LMICs) where donor-sponsored projects are already underway. Nevertheless, research on period poverty in high-income countries (HICs) is seldom performed. In addition, current literature on the topic tends to generalize HICs and LMICs, thereby ignoring crucial cultural and socioeconomic distinctions that necessitate a more detailed comparison of individual countries facing period poverty. This case examines the current body of research on period poverty in the United States and India, and compares the causes, effects, and approaches toward ameliorating this phenomenon. Through performing a scoping review of the current literature on period poverty, this case illustrates that-as opposed to the breadth of research available on period poverty in LMICs-research on period poverty in HICs is underrepresented. In addition, the findings demonstrate a stunning parallel between the contributing factors of period poverty in India and the United States, suggesting that the current approach to isolate conversations on the topic based on regional economic incongruencies is inappropriate. Finally, this case identifies dismantling the stigmatization of periods, investing in water or hygiene infrastructure, promoting the economic mobilization of females, and reforming menstrual health curricula in schools as essential to ending period poverty.

Background: While cultural competency has been recognized as an important feature in health care delivery, evaluating intervention effectiveness is often overlooked.

Methods: This project used an explanatory sequential mixed methods study design within a community-based participatory research structure. A 29-item Organization cultural competency Checklist was created and distributed to a purposive sample of staff at 55 New York State (NYS) Department of Health AIDS Institute-funded health and human service providers. Organizations recruited clients to complete a 27-item Client Checklist. Basic univariate analyses were conducted on quantitative items (Stata v.18). For questions asked to both groups, we conducted chi-square tests to determine statistically significant differences (p-value < 0.10). Qualitative stories about the impact of culturally competent care provision were analyzed using the Most Significant Change process by a Community Advisory Board (CAB) of LGBTQ+ NYS residents.

Results: The Organization Checklist had 92 responses from 37 organizations. The Client Checklist yielded 32 responses from five organizations. While high agreement between client and staff was reached on the majority of items, opportunities for improvement included updated intake forms and strengthening relationships with other local LGBTQ+ organizations. Using 62 raw stories, the CAB identified two main themes of affirming and un-affirming care, further organized into personal, perception, provider, and systemic categories.

Discussion: Clients reported higher engagement in health-seeking behavior with culturally competent providers and care-avoidance with culturally incompetent care. Clients decided the safety of expending emotional labor to educate providers. Improving organizational cultural competency is an ongoing process requiring consistent and prompt attention.

This pilot, exploratory project examined the relationship among the health, work, and social support of university housekeepers. The first objective was to examine the influence of social support on work-related outcomes among university housekeepers. The secondary objective was to examine the influence of social support on physical and psychological health among housekeepers. Using a mixed-methods approach, the study assessed work-related outcomes and the influence of social support using least square regression models and multinomial logistic regression models. Qualitative data was obtained via one-on-one interviews. Participants (N = 46, 72% female; 87.2% Black) averaged 4.43 ± 0.72 for job satisfaction with stress levels occasionally high for most of the sample (75%). Support was moderate across all three types of support with the highest perceived support in tangible support (2.85 ± 0.52). Four major themes emerged from the interviews, including lack of support and trust from supervisors and administrators; lack of respect from other members of the university community; need for positive recognition; and impact of the job on health. Findings revealed that when housekeepers feel they belong and are appreciated at work, they feel more positive about their jobs and likely do better work. Housekeepers and their work are critical to students, faculty, and staff in the university system. Future research should examine existing health issues and assess for factors contributing to physical or mental health treatment, especially post-COVID. Universities should invest in wellness programming and policies supporting mental health leave to improve overall well-being and stress in this under-resourced population.

Recruiting women participants with criminal legal system involvement (CLSI) has always presented challenges, whether gaining access to them in prisons and jails or locating them after release. This research brief describes how the COVID-19 pandemic required us to change our recruitment strategies from previously successful approaches to a hybrid strategy using techniques from respondent-driven sampling (RDS) to recruit CLSI women. The RDS techniques, with internet social media, enabled us to capitalize on the community-based social networks of CLSI women to recruit 255 into our clinical trial of a health education intervention. This new avenue for recruitment can be useful beyond pandemic conditions.