Health Promotion Practice最新文献

The purpose of this study was to examine college student perceptions related to institutional vaccine mandates. We utilized qualitative data (n = 2,212) from five open-ended questions in a cross-sectional study of students enrolled or intending to enroll in an institute of higher education in California in fall 2021. Data were collected between June and August 2021. Thematic analysis was employed to analyze student beliefs, and four themes were developed from the data: (1) Polarizing views and language, (2) deciding who to trust, (3) conveying rights and risk, and (4) staying focused on education. The themes represented vaccinated and nonvaccinated student perspectives, capturing views about trust, rights, and risk. Many responses were polarizing and included language that was emotional and political. Despite the range of responses, most students expressed appreciation and approval of the vaccination mandate on college campuses. Findings illustrate the important contributions of qualitative research and suggest opportunities for public health practitioners to lead and engage in critical dialogue about science and public health practices as we aim to promote public perceptions of vaccination programs and health promotion practice.

The use of alcohol and other drugs is a major public health problem in adolescence. The implementation of evidence-based prevention strategies is still scarce in the global south. This study aimed to evaluate facilitators and barriers to the implementation of the Icelandic prevention model of adolescent substance use (IPM) in Chile. We conducted a qualitative study of stakeholders during the implementation process of the IPM in six municipalities of the Metropolitan Region of Santiago, Chile. We convened six focus groups with parents and professionals from schools and municipal prevention teams (38 participants). Recordings were transcribed and submitted to a six-step thematic analysis. The following facilitators emerged: Participants valued the contribution of the IPM to articulate existing programs and teams, its community focus, and the local data obtained through the survey. There were also several barriers: Those included resistance to adopting a foreign model, the tension between generating local strategies and looking for measures to ensure the fidelity of the implementation, socioeconomic differences between and within municipalities, low-risk perception and supervision of parents in Chile, and a culture that generally does not discourage adolescent substance use. Implementation of the IPM was largely accepted by the stakeholders who agreed with the community approach of the model. The main barriers to consider were related to cultural and socioeconomic factors that need to be addressed in further research and may limit the effects of the model in Chile.

The role of housing as a social driver of health is well-established, with stable housing being an important factor in reducing health inequities. During developmentally critical periods such as young adulthood, unstable housing and related social marginalization have profound effects on development and later health, social, and economic wellbeing. This exploratory study analyzed data from a population-based, longitudinal sample of young adults (average age 31 years) from Washington State (n = 755) to compare health and economic impacts of the early days of the COVID-19 pandemic, with a focus on housing status. Descriptive results suggest the pandemic exposed underlying vulnerabilities for young adults experiencing homelessness and housing instability, with an overall widening of inequities related to financial difficulties and increased risk for poor mental health and social isolation. Findings suggest that these vulnerabilities are magnified in the context of public health crises and strengthen the case for population-based studies investigating potential modifiable causes of housing instability to inform prevention and early intervention at the earliest possible point in a young person's development. Studies examining the severity of COVID-related hardships on young adult health and social outcomes are vital for establishing an evidence base for strategic policy action that seeks to prevent a rebound in young adult homelessness and housing instability post-pandemic. These studies would bolster both emergency preparedness responses that account for the unique needs of vulnerable populations and upstream population-level prevention approaches beginning long before the imminent risk for housing instability develops.

Digital storytelling is an innovative approach that evaluators can adopt to expand their dissemination efforts. The stories use brief audio and video recordings, and they can be used to provide reflections on the perceived value, experiences, or impact of public health efforts. We offer tips for evaluators to add this tool to their portfolio using several traditional evaluation data collection techniques. We also discuss a series of planning considerations and lessons learned based on the experiences of an evaluation of a research capacity-building initiative.

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.

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

Black men in the United States have a lower life expectancy than Hispanic and White populations due to elevated morbidity and mortality from various health conditions. This is partially attributable to the experience of systemic racism and earned mistrust toward health professionals, the majority of whom are not Black. Despite recognition of this issue, limited progress has been made to improve Black men's health trajectories. Thus, there is an urgent need for health care organizations to reach more Black men and address existing health inequities through innovative means. Larry Wallace Sr., an experienced health care executive, recognized this issue in his community and created the Black Men's Health Clinic (BMHC) with his son, Larry Wallace Jr., to improve health care delivery to Black men in and around Austin, Texas. BMHC has successfully reached Black men in its catchment area through its strategic community engagement efforts and a unique financial model to increase health care accessibility for a population that has historically experienced poor health outcomes. Furthermore, they offer a comprehensive range of services that acknowledge the impact of social and structural determinants of health and address social needs to provide Black men with access to vetted, high-quality health care. Consequently, BMHC's health care model offers a useful framework for other health care organizations that are aiming to achieve health equity. The BMHC model is presented herein, highlighting strategies for other health care organizations to reach Black men and deliver trusted care. Implementing suggestions discussed in this work may lead to improved health outcomes for Black men in the United States.

In 2021, the Centers for Disease Control and Prevention's (CDC) National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP) funded community health workers (CHWs) for COVID Response and Resilient Communities (CCR). CCR is a 3-year, $350 million initiative to implement CHW strategies aimed at reducing COVID-19 impacts, building resilience, and improving health equity by addressing health-related social needs. This paper describes the CCR initiative and experiences to date, underscoring CHWs' critical role in CDC's pandemic response. CCR funds 67 recipients to reach communities who are disproportionately affected by long-standing health disparities (hereafter, priority populations). CCR aims to decrease the impact of COVID-19 and increase community resilience to respond to COVID-19 and future public health emergencies. Recipients implement three strategies: train CHWs to support the COVID-19 response, increase the workforce of CHWs to manage the spread of the disease, and improve utilization of community and clinical resources to engage CHWs to help strengthen communities' resilience to mitigate the impact of COVID-19. We funded three additional organizations to provide technical assistance to CCR recipients and collaborate with us on a national evaluation of the program. CCR recipients hired about 950 CHWs and integrated these CHWs into over 1,000 organizations and care teams. At the end of the second program year, CHWs made over 250,000 referrals to social services and over 150,000 referrals to address specific health conditions. CCR demonstrates that CHWs can be quickly mobilized to participate in a public health emergency and reach those most affected by COVID-19.

Tens of thousands of trucks cross the U.S.-Mexico border every day. Cross-border truckers' high mobility puts them at risk of acquiring and transmitting infectious diseases and creates challenges reaching them with emergency public health messaging due to their everchanging locations and limited English proficiency. Despite this community-level transmission risk and documented health disparities related to various infectious and noninfectious diseases experienced by truckers themselves, little has been published to provide practical recommendations on better reaching this audience through innovative outreach methods. This article describes a COVID-19 health promotion campaign that aimed to (1) identify, pilot test, and evaluate effective messages, channels, sources, and settings for reaching truckers on both sides of the U.S.-Mexico border and (2) build capacity and sustainability for messaging around future health emergencies. The pilot program ran for 6 weeks, June to August 2023, in three key commercial border crossings and delivered approximately 50,000,000 impressions, nearly 45% more impressions than expected. Considerations for practitioners include the areas of design, implementation, and evaluation. The results provide insight into how to design health promotion messages that resonate with cross-border truckers and how to place these messages where they will be seen, heard, and understood. This includes working effectively with community health workers (CHW), known locally as promotores; identifying local partners that allow CHW to set up onsite; and, working with partner organizations including employers. Practical insights for building evaluation metrics into traditional and grassroots outreach strategies to facilitate real-time optimization as well as continued learning across efforts are also described.

Despite initiatives aimed at improving study participation and inclusion among ethnic and racially minoritized and marginalized populations, participation remains low. While necessary to ensure ethical practice in human participant research, certain Institutional Review Board (IRB) guidelines may introduce additional barriers in research involving these populations. This work outlines guidelines pertaining to consent translation for non-English speaking populations and offers discussion on a greater emphasis for more inclusive methods for marginalized communities. The University of Wisconsin's IRB approved alternative oral consent processes after the community partner determined that standard translation processes would be inefficient. Researchers used translated consent materials for four different ethnic groups (Hmong, Karen, Karenni, and Burmese). We provided recorded consents in each respective language to participants before study participation and obtained verbal consent prior to study participation at the study location. We experienced time and resource constraints in both access to translators and the consent-translation process itself. Furthermore, many participants were unable to read in their native language making standard written consent processes both difficult and impractical. Oral discussion and verbal consent processes were efficient. Adjustments to consent-related guidelines may prevent and eliminate time and resource-related barriers in consent processes. In eliminating such barriers, subsequent improved efficiency in both study design and study promotion areas can work to better promote diversity in research among populations that emphasize oral language and in instances where literacy rates in written non-English language may be lower.