International Quarterly of Community Health Education最新文献

African-American (AA) women are at higher risk of breast cancer mortality than women of other races. Factors influencing breast cancer risk, including exogenous environmental exposures, and debate around timing of exposure and dose-response relationship, can cause misunderstanding. Collaboration with priority populations encourages culturally relevant health messaging that imparts source reliability, influences message adoption, and improves understanding. Through six focus groups with AA individuals in rural and urban counties in the southeastern United States, this study used a community-engaged participatory approach to design an innovative visual tool for disseminating breast cancer information. Results demonstrated that participants were generally aware of environmental breast cancer risks and were willing to share new knowledge with families and community members. Recommended communication channels included pastors, healthcare providers, social media, and the Internet. Participants agreed that a collaboratively designed visual tool serves as a tangible, focused "conversation starter" to promote community prevention and education efforts.

Background: African American women continue to have higher mortality rates of breast cancer when compared to other women, and evidence suggests that early detection of breast cancer can lead to favorable outcomes, yet there remains a paucity of literature about health beliefs and the utilization of three screening practices, namely breast self-examination, clinical breast examination and mammography in California, a state that currently has one of the highest breast cancer mortality rates among African American women.

Purpose: To investigate the relationship between health beliefs and three breast cancer detection practices, e.g. breast self-examination, clinical breast examination, and mammography in a cohort of African American women.

Methods: Using a descriptive correlational design, a convenience sample of two hundred and eighty-two (n = 282) self-identified women from six regional chapters of a national Black women's political organization in California, completed a Demographic Data Questionnaire and Champion's Health Belief Model Scale which assessed the hypothesized relationships of health beliefs and breast cancer detection practices.

Results: Among this culturally diverse group of women (49.8% American, 28.8% African, 21.4% West Indian), health motivation was positively related to the practice of BSE and annual physician visitation for clinical breast examinations. Health locus of control was positively related to the practice of BSE. Having relatives and friends who were diagnosed with breast cancer was strongly associated with having a mammogram and annual physician visitation for clinical breast examinations.

Conclusion: These findings may be used to target and develop interventions that are tailored to the unique characteristics of these diverse women.

Community-based interventions are crucial to reducing health-care disparities throughout the world. CARE, an international development nongovernmental organization (NGO), is a global leader in using a community-based approach in public health. This qualitative study sought to understand the processes through which community organizing functions to effectively facilitate change and improve health among underserved populations in three programs in Sri Lanka and Bangladesh. Sixteen in-depth interviews and two focus groups were conducted with NGO staff, partner organization staff, and community change agents. Programs are assessed through Ganz's community-organizing model, which includes (a) leadership development, (b) storytelling strategies, and (c) team building. Our findings confirm existing literature showing that public health approaches can be augmented by using community organizing to develop local engagement. Results show that program success relates to developing community members' understanding of social inequality and its impact on society. Other important strategies include systems strengthening, political engagement, coalition building, and government outreach. Empowered communities were created through recruiting, activating, and investing in community members, their stories, and their collaborative potential, at least in the sites studied here. Collectively, these programs have begun to create empowered communities among some of the most marginalized people in Sri Lanka and Bangladesh.

Background: Osteoporosis is one of the diseases that can be prevented by correcting health behaviors during adolescence.

Objective: This study was conducted to evaluate the effect of education on preventive behaviors of osteoporosis including physical activity, calcium intake and practice (primary outcomes) and knowledge and attitude related to osteoporosis (secondary outcomes) in adolescents.

Method: A search was done in Cochrane Library, PubMed, Embase, Web of Sciences, Scopus, Google Scholar, SID and Magiran regardless of the time limit. To evaluate the quality of selected controlled trials, Cochrane collaboration' instrument was used for assessing the risk of bias. RevMan software was used to analysis and report the data.

Results: Of 2159 articles retrieved, 20 of them were reviewed and 18 of them entered the mete-analysis. The meta-analysis showed significant differences between the education and control groups in terms of calcium intake (SMD = 0.78, 95%CI = 0.55 to 1.02, P < 0.00001), practice (SMD = 0.54, 95%CI = 0.41 to 0.68, P < 0.0001), knowledge (SMD = 1.76, 95%CI = 1.10 to 2.42, P < 0.00001) and attitude (SMD = 0.96, 95%CI = 0.53 to 1.40, P < 0.0001) mean score in adolescents but education is not effective on average minute/week of physical activity per week (MD = 31.94, 95%CI = -6.53 to 70.40, P = 0.10), mean score of physical activity (MD = 2.66, 95%CI = -0.55 to 5.88, P = 0.10) and percent of students participated in the physical activity (OR = 1.45, 95%CI = 0.30 to 6.91, P = 0.64).

Conclusion: Education is effective in improving their knowledge and attitudes toward osteoporosis. It can also improve some health-related behaviors for bone health such as sufficient dairy calcium intake but it has not been effective in establishing a regular exercise program.

Aim: To explore the prevalence of anemia in three cohorts of women, namely, married yet to be mothers, married and are mothers, and currently pregnant, to ascertain the patterns in anemia in women.

Methods: We analyzed a sample of 130,965 married women from four Demographic Health Surveys: 2000, 2005, 2009 and 2015. The primary focus for the analysis was married women aged 15 to 49 years. In the absence of a longitudinal data that followed the same women over the periods, a synthetic cohort of the women of that age-group was constructed to get women aged 15 to 64 years over the four surveys. Women who were aged 15 to 19 years in 2000 were the same as those 30 to 34 years in 2015, while those aged 45 to 49 years in 2000 were the same as 60 to 64 years in 2015.

Results: Logistic regression revealed that young mothers were significantly more infected (p < .001). Pregnancy affected anemia in the women (p < .001). Being younger and richer were associated with odds ratios of 0.599 (95% confidence interval, CI: [0.560, 0.640]) and 0.765 (95% CI: [0.726, 0.807]) for anemia, respectively. Being pregnant had odds ratio of 1.642 (95% CI: [1.439, 1.872]) for anemia.

Conclusion: Public health strategies should target social deprivation at the household level while addressing maternal health issues. An analysis of data on unmarried women and their children is recommended.

Fisherfolks participate in unsafe sexual behaviors which can predispose them to HIV infection. This research was designed to assess the effects of training on HIV/AIDS-related knowledge and sexual behavior among fisherfolks in two fishing communities in Nigeria. Respondents were allocated into Experimental Group (EG, n = 103) and Control Group (CG, n = 105). Data were collected at baseline using a questionnaire which included questions on socio-demographic characteristics, sexual behavior among others. A 3-day HIV/AIDS training was conducted for EG. Fisherfolks in EG and CG with good knowledge were 16.5% and 54.3%, respectively at baseline. The number increased to 100.0% in EG than CG (60%) at follow-up. At baseline, fisherfolks in EG and CG with high riskperception scores were 26.2% and 59.0%, respectively; corresponding figures at post intervention for EG and CG were 100.0% and 70.0% respectively. Training increased HIV/AIDS knowledge, improved risk perception and reduced risky sexual practices among fisherfolks.

Excluding communities in planning and implementing research maximizes internal risks that are otherwise visible and avoidable when there is adequate community consultation. Communities might not meaningfully use research results if majority of the researched people have minimal or no participation in information generation and dissemination. However, effective participation of researched communities in research is key to transferring knowledge to action. Using a qualitative approach, the study identified barriers to, and relevant strategies for improving health research uptake, particularly for schistosomiasis (commonly known as bilharzia) in the Ingwavuma area, uMkhanyakude District of KwaZulu-Natal. Data was collected through modified ethnography using participant observation, focus group discussions, unstructured in-depth interviews, and ethnographic conversational interviews. Results reveal that research uptake is inhibited by reduced opportunities for habitual interaction between residents, a paucity of innovative and inclusive health education activities and unsafe recreational facilities. The community's strategies on strengthening social capital for disease control include using existing social systems and power hierarchies to mobilise and organise and using the performing arts to facilitate habitual interaction and knowledge sharing. The study recommends a community consultation flow which facilitates openness about the benefits and the community's role in research, a pre-condition for community wide efforts in local disease prevention and control.

Introduction: During the care of incapacitated patients, physicians, and medical residents discuss treatment options and gain consent to treat through healthcare surrogates. The purpose of this study is to ascertain medical residents' knowledge of healthcare consent laws, application during clinical practice, and appraise the education residents received regarding surrogate decision making laws.

Methods: Beginning in February of 2018, 35 of 113 medical residents working with patients within Indiana completed a survey. The survey explored medical residents' knowledge of health care surrogate consent laws utilized in Indiana hospitals and Veterans Affairs (VA) hospitals via clinical vignettes.

Results: Only 22.9% of medical residents knew the default state law in Indiana did not have a hierarchy for settling disputes among surrogates. Medical residents correctly identified which family members could participate in medical decisions 86% of the time. Under the Veterans Affairs surrogate law, medical residents correctly identified appropriate family members or friends 50% of the time and incorrectly acknowledged the chief decision makers during a dispute 30% of the time. All medical residents report only having little or some knowledge of surrogate decision making laws with only 43% having remembered receiving surrogate decision making training during their residency.

Conclusions: These findings demonstrate that medical residents lack understanding of surrogate decision making laws. In order to ensure medical decisions are made by the appropriate surrogates and patient autonomy is upheld, an educational intervention is required to train medical residents about surrogate decision making laws and how they are used in clinical practice.

As part of a campaign to encourage healthier beverage consumption in a rural New Mexico high school, we wanted to understand students' perceptions of their habits, and the associated health risks and benefits surrounding water and sugar-sweetened beverage consumption to influence future messaging to change behavior. We conducted a posthoc qualitative analysis of 27 student interviews from the program evaluation with both students who participated in the campaign and those who did not. Pre-campaign, students appeared largely unaware of the health risks posed by their beverage consumption habits, lacking any knowledge of nutritional recommendations, water recommendations, or of the sugar levels in products. When informed of the risks, students expressed concern for themselves, their family members, and friends, indicated a desire to make significant changes, and reported making changes for themselves, and educating others regarding the risks. Given the large amounts of money spent and concentrated efforts focused on marketing SSBs to teens, it is critically important to be educating teens and engaging them in behavior change strategies. These data can inform future strategies to improve teen health behaviors and encourage teens to become family health messengers for obesity and diabetes prevention.