Community health equity research & policy最新文献

Background: Low-income women (LIW) are underrepresented in physician-provided cervical cancer screening. Providing women with an option for Human Papillomavirus (HPV) self-sampling would increase cervical cancer screening. However, little is known about LIW's attitude towards self-sampling for cervical cancer. We determined the associations between the Theory of Planned Behavior (TPB) constructs and LIW intention for participation in the HPV self-sampling.

Methods: A 44-item survey was administered among women receiving food from a food pantry in central Texas. Independent variables included TPB constructs (i.e., attitudes, subjective norms, and perceived control). The outcome variables were intentions and preference for self-sampling. Both variables were measured on a 5-point scale. Hierarchical linear regression models were used to analyze the data.

Results: A sample of 241 participants (age 50.13 ± 9.60 years) comprising non-Hispanic White (40%), Black/African American (27%), and Hispanic (30%) participated in the study. The participants were current with a pap test (54.8%) and preferred self-sampling (42%). The participant's attitudes and subjective norms were significantly associated with their intention for self-sampling, accounting for 38.7% of the variance (p < .001). Women who were overdue for pap testing versus current with pap testing had increased odds of preferring self-sampling (OR = 1.72, 95% CI: 1.27, 6.04).

Conclusions: The key predictors for LIW's intention for self-sampling included attitudes and subjective norms. Future research should use the TPB as a framework to examine whether intention predicts self-sampling behavior among LIW.

Background: In global health, international nongovernmental organizations (NGOs) frequently hire, train, and partner with host-country clinicians who manage public outreach and patient care. Purpose and Research Design: We conducted a general interpretivist study of Basotho clinicians hired by NGOs and academic affiliates in Lesotho to identify cultural barriers and facilitators to community and patient education. Data Collection and Analysis: We conducted 13 interviews involving 16 participants (one physician, one nutritionist, 14 nurses). Using an inductive and iterative approach, we analyzed interview transcripts through the lens of social cognitive theory and identified 15 themes. Results: Major findings highlighted: 1) patient and community learners may view Basotho clinicians as authority figures; 2) family and community power dynamics affect healthcare access for vulnerable patient groups; and 3) village leaders may refuse community education when excluded from problem-solving and early planning. Conclusions: Although local clinicians and community members may identify with the same cultural group, clinicians can encounter cultural barriers to patient and community education.

The novel Coronavirus (COVID-19) is a highly contagious viral illness that has caused the most significant global health crisis in recent human history. Individuals experiencing homelessness represent one of the more vulnerable populations for COVID-19 infection and morbidity. Amongst individuals experiencing homelessness in Phoenix, a student-led interprofessional organization called Street Medicine Phoenix (SMP) sought to both reduce the risk of COVID-19 transmission and morbidity/mortality related to infection. Through collaborations with the Maricopa County Department of Public Health and various community organizations, SMP developed a format for street-based vaccination clinics. SMP deployed these clinics on numerous occasions to the streets directly surrounding the community homeless shelter, allowing SMP to vaccinate individuals directly in their encampments. Through SMP's efforts starting in February 2021, 400 individuals experiencing homelessness have received at least one COVID-19 vaccine. Challenges encountered included low health literacy, lack of established rapport and trust, low vaccine confidence, difficulty verifying patients' vaccination status, difficulty obtaining sufficient information from patients to create a record in the Arizona State Immunization Information System (ASIIS), monitoring patients post-vaccination, transporting vaccine supplies from encampment to encampment, and lack of patient awareness of the mobile vaccine clinic services. Despite challenges, SMP's outreach efforts have demonstrated the feasibility and importance of mobile public health services to reach homeless encampments, particularly mobile vaccination clinics in response to disease outbreaks, and the necessity of strategic partnerships with community agencies to effectively meet the needs of underserved populations.

This commentary makes the case for greater collaboration between public health professionals and integrative, complementary and traditional health practitioners (ICTHP). Previous partnerships have been successful, and more such collaborative work is needed to help overcome division, enhance the health workforce, and move all involved toward shared goals. ICTHP providers may be uniquely able to work across ideological differences and engage individuals and communities who are less trusting of public health, including those who are vaccine hesitant. Diverse partnerships can be difficult to maintain, but the application of equitable processes may aid their success. In the face of highly complex public health challenges, partnerships with ICTHP are critical.

Social determinants of health, the effects of colonialism, and systemic injustices result in some groups being at disproportionately higher risk for developing type 2 diabetes (T2D). Many T2D prevention programs have not been designed to provide equitable and inclusive care to everyone. This paper presents an example of the steps taken in an evidence-based community T2D prevention program, Small Steps for Big Changes (SSBC), to improve equitable access and inclusivity based on input from a stakeholder advisory group and the ConNECT Framework. To improve reach to those most at risk for T2D, SSBC has changed both eligibility criteria and program delivery. To ensure that all testing is done in an inclusive manner, changes have been made to measurements, and to training for those delivering the program. This paper also provides actionable recommendations for other researchers to incorporate into their own health programs to promote inclusivity and ensure that they reach those most at risk of T2D.

Relatively little is known about readiness of urban health systems to address health needs of the poor. This study explored stakeholders' perception of health needs and strategies for improving health of the urban poor using qualitative analysis. Focus group discussions (n = 5) were held with 26 stakeholders drawn from two Nigerian states during a workshop. Urban areas are characterised by double burden of diseases. Poor housing, lack of basic amenities, poverty, and poor access to information are determinants of health of the urban poor. Shortage of health workers, stock-out of medicines, high cost of care, lack of clinical practice guidelines, and dual practice constrain access to primary health services. An overarching strategy, that prioritises community-driven urban planning, health-in-all policies, structured linkages between informal and formal providers, financial protection schemes, and strengthening of primary health care system, is required to address health needs of the urban poor.

The present study aimed to investigate the relationship between women's cultural capital and self-care. A survey was employed with a sample size of 737 women living in the marginal, middle, and upper areas of Yazd in terms of socioeconomic characteristics. Data were analyzed using structural equation modelling by SPSS and Amos version 24. The results revealed that the effect of cultural capital on self-care was positive and significant (β = 0.46, p < 0.001). The effectiveness rates of cultural capital on women's self-care in the marginal, middle, and upper areas were 0.44, 0.32 and 0.45, respectively (p < 0.001). Besides, there was no significant difference between the intensity of the relationship between cultural capital and self-care in the three areas (CR < 1.96). The fit indices also indicated that the model had a good fit (CMIN/DF = 2.560, NFI = 0.916, RMSEA = 0.033, CFI = 0.946, TLI = 0.922, GFI = 0.963, IFI = 0.947).

The current coronavirus disease 2019 (COVID-19) pandemic has led Cameroon's government to implement public health measures aimed at preventing its spread. This paper investigates how community health education on the virus was being carried out, what gaps exist and what further action could be taken. A survey instrument was used to gather data among a total of 179 Cameroonians recruited via opportunistic and snowball sampling methods. According to our findings, gaps exist. These include the need for adequate community health education on COVID-19, maximising multilingualism and indigenous cultural assets and disbanding misconceptions on the pandemic, as well as stigmatisation. The paper culminates by underlining the significance of an integrated approach to confront the pandemic. This approach captures the need to frame but also firm up community health education architecture on COVID-19 that captures inputs from different stakeholders, including indigenous knowledge holders, for collective wellbeing.

This journal article was primarily carried out to pinpoint whether emotional intelligence and pro-social behavior predicts academic achievement of University students. To achieve this, data was gathered from 111 (m = 50, F = 53) students by using stratified simple random sampling technique. As the results of Pearson correlation coefficient showed that, there was statistically significant positive association between emotional intelligence and pro-social behavior. However, it was found that there was no relationship between emotional intelligence and academic achievement. On the other hand, there was a statistically significant negative correlation between pro-social behavior and academic achievement of students. Findings from multiple regression indicated that, emotional intelligence predicted pro-social behavior of students, whereas, emotional intelligence didn't predict academic achievement of students. On the other hand, pro-social behavior negatively and significantly predicted academic achievement of students. Besides, there was no significant gender difference in emotional intelligence and pro-social behavior. However, there was statistically significant disparity amidst male and female students in academic achievement and male students exceed female counterparts in general level of academic performance. As one sample t-test result depicted, Majority of students have high level of emotional intelligence, pro-social behavior and academic performance. The researcher forwarded the following recommendations for instructors, the university management and Medias. Socio-emotional training's should be provided to students, intensive studies should be conducted on this topic, teachers of the university should advocate the importance of emotional intelligence and pro-social behavior in the class room, the university and broadcasting Medias should give attention for the topic.

Arsenic induced cancer is a major public health issue in Indo-Gangetic plains of Bihar, India where 22 out of 38 districts report arsenic contamination of groundwater. Its psychological aspect is under studied in contrast to the physiological and social. This baseline correlational survey research explores the relationship and role of proactive coping on depression, anxiety and stress among this population. Depression, anxiety and stress were assessed in 77 consenting arsenic induced cancer patients with depression, anxiety and stress scales. Proactive Coping was assessed with proactive coping inventory. Results demonstrated negative association and influence of proactive coping on stress, anxiety and depression. Avoidance coping associated positively with depression and reflective coping predicted for depression and anxiety. The findings advocate for more research attention on psychological aspects of arsenic induced cancer. Timely psychological interventions to build proactive coping are warranted to alleviate depression, anxiety and stress among this population.