Community health equity research & policy最新文献

Objective: The goal of this study was to partner with community organizations to understand the research experiences of communities who speak languages other than English (LOE).

Methods: We conducted semi-structured qualitative interviews in Spanish, Nepali, Mandarin, French, or Kizigua with LOE community members and community leaders who completed recruitment and data collection. Audio-recordings of the interviews were transcribed and translated. We conducted qualitative coding using a mixed deductive-inductive analysis approach and thematic analyses using three rounds of affinity clustering. This study occurred in partnership with an established community-academic collaboration.

Results: Thirty community members and six community leaders were interviewed. 83% of LOE participants were born outside of the US and most participants (63%) had never participated in a prior research study. Six themes emerged from this work. Many participants did not understand the concept of research, but those that did thought that inclusion of LOE communities is critical for equity. Even when research was understood as a concept, it was often inaccessible to LOE individuals, particularly because of the lack of language services. When LOE participants engaged in research, they did not always understand their participation. Participants thought that improving research trust was essential and recommended partnering with community organizations and disseminating research results to the community.

Conclusion: This study's results can serve as an important foundation for researchers seeking to include LOE communities in future research to be more inclusive and scientifically rigorous.

Background: Ample evidence demonstrates Latina adolescents' elevated risk for sexual health disparities, but knowledge of how they manage their sexual health during this critical period of sexual development is limited. Countering the overfocus on Latina adolescents as "at-risk" girls in extant research, this study uses a strengths-based perspective to explore this topic.

Methods: This study used a narrative research design to gather and analyze the stories of 18 Latina young people who attended school in New York. We employed holistic-content and categorical-content approaches to identify themes and interpret findings through a strengths-based view of sexual health.

Results: We identified three major themes across participants' narratives: (1) agency in gaining sexual health information; (2) self-protection; and (3) obtaining sexual healthcare despite barriers.

Conclusions: Findings underscore the need for more inclusive, culturally relevant sexual health education initiatives, youth-centered services, and interventions that capitalize on the strengths of Latina adolescents.

Given the finite space available for parks in most urban areas, understanding the impact of design and park amenities on park visitation and physical activity should be considered when remodeling or creating new parks. This study analyzed park use and engagement in moderate-to-vigorous physical activity (MVPA) in specific park amenities across 198 parks in 27 US cities from the 2016 National Study of Neighborhood Parks based on each feature's square footage. The study also specifically measured use of park space by age group and gender. After mapping the parks, measuring the square feet of the most common amenities and controlling for factors like population density, neighborhood poverty levels, and park size, we found varied and inequitable use of amenities by age and gender, with men and boys having considerably greater use than women and girls. The findings suggest that park management and design should support more efficient, equitable, and beneficial use of public spaces.

Background: Women with upstream social determinants of health, particularly those with recent experiences of incarceration, homelessness, and/or substance use, encounter a series of barriers in accessing health care services and consequently face poor sexual and reproductive health outcomes. Driven by a community concern for increasing rates of syphilis and congenital syphilis among women who are structurally disadvantaged, this study focuses on their experiences with reproductive healthcare access across healthcare settings.Research Design and Study Sample: This community-based pláticas (conversational) research project gathered 12 in-depth interviews and testimonios (testimonies) with women who reported a criminalized upstream barrier (incarceration, homelessness, and/or substance use) in a small city in the southwestern U.S. - most of whom identified as Latina/Hispanic.Analysis and Results: Using a grounded analysis and drawing upon Chicana feminist methodologies, this study identifies four major themes: (1) homelessness and economic vulnerabilities, (2) incarceration and health care, (3) drug use, provider stigma, and motherhood, and (4) desired changes to the healthcare experience.Conclusion: Results highlight the need for economic and transportation supports, community-based preventive services as alternatives to incarcerated healthcare, along with more compassionate and structurally competent provider-patient dialogue.

Background: Collecting demographic data is critical for identifying inequities in healthcare services and delivery. Inaccurate collection of demographic data can make developing equitable health interventions and improving reach of existing interventions difficult. This study aimed to (a) examine experiences in completing a community-based type 2 diabetes prevention program Small Steps for Big Changes (SSBC) demographic questionnaire (SSBC-DQ) among adults from equity-owed groups, and (b) assess recommendations for improvement to the questionnaire.

Methods: Adults with no prior involvement in SSBC were recruited. Participants completed the SSBC-DQ online and then engaged in one-on-one structured interviews. Interview data was analyzed using interpretive description and coded using the APEASE criteria.

Results: Twelve participant interviews were included in analysis. Five principle themes were developed to capture the experiences of completing the SSBC-DQ: representation, comprehension, demographics are an emotional experience, the role that privilege plays, and beliefs about demographic data. Sixty suggested changes were coded using the APEASE criteria; six suggestions met the criteria for implementation, 20 did not meet the criteria, and 34 required further discussion with the research team.

Conclusions: Results from this study illustrate that people's lived experiences can drive their reactions and interpretations to demographic questionnaires. Based on end-user suggestions, SSBC made changes to its demographic questionnaire to be more inclusive. Having a demographic questionnaire that is more inclusive can help SSBC better understand what populations it is and is not reaching in an acceptable and inclusive manner. This will help inform future directions regarding evaluating program reach and equity.

Background: A recent programmatic shift in the provision of family planning in the Global South led to a renewed focus on post-partum family planning (PPFP). PPFP embodies a shift in the primary narrative of global family planning programs, from fertility reduction to promoting maternal and child well-being.Purpose: We examine key factors that shape women's knowledge, attitudes and practice of PPFP in Banyumas, Indonesia.Methodology: We employed a qualitative approach utilizing focus group discussions with pregnant women and women with children aged less than 1 year old (n = 44), and in-depth interviews with health service providers (n = 10). Guided by the research questions, we conducted a thematic analysis of the transcripts.Results: Our findings demonstrate how women's agency within marriage, their social and familial networks, their interactions with healthcare providers, and policy changes related to reproductive health and health insurance schemes, all influence the extent to which women's rights to information and choice regarding post-partum family planning can be realized. Conclusions: Key implications for practice include the necessity for health providers to offer unbiased information about contraceptive options, to engage local leadership effectively, and to ensure that government targets for the PPFP program align with women's needs and the health and social conditions of the community.

This study explores how participatory music programs can help build social connection for people experiencing loneliness in contexts of social marginalisation. Loneliness is a growing, global public health issue with social and structural drivers. There is an urgent need to investigate innovative approaches to programming that go beyond opportunities for social contact to address the multiple domains of loneliness. Designed collaboratively with two social sector organisations in an urban context in Australia, this study presents outcomes from two community programs that involved groups of people experiencing or at risk of loneliness engaging in music together. Using a qualitative methodology that included semi-structured and brief interviews, focus groups and ethnographic observation, researchers identified positive shifts in relation to social loneliness (related to social contact), emotional loneliness (related to social bonds and meaningful connections), and existential loneliness (related to community connection and acceptance) for participants of the music programs. This study contributes to an urgent gap in understanding effective programming to support people experiencing loneliness and bolsters emerging evidence about the role arts can play in strengthening health, community and social sector efforts to address inequity.

Background: Historical injustices, structural racism, and negative healthcare experiences contribute to Black and Brown communities' distrust of science. Bridging Research, Accurate Information, and Dialogue (BRAID) is a community engagement model that leverages trusted messengers to share accurate, co-created health and science messages to their community through their social networks. In our prior research, trusted messengers reported encountering resistance or "discord" when conveying information about controversial topics such as COVID-19 vaccines and the importance of diversity in clinical trials. Motivational Interviewing (MI) is an evidence-based communication style widely practiced by healthcare providers to guide ambivalent patients toward behavior change. However, MI's application by community members, particularly trusted messengers, as a strategy for enhancing health message dissemination remains unexplored.

Purpose: This study used mixed methods to explore the feasibility of training trusted messengers in MI to support the dissemination of public health messages through social networks. Specifically, we sought to understand perspectives on learning MI and use of MI in conversations about clinical trial diversity and research subject protection.

Research design: 13 trusted messengers completed a MI introductory training.

Results: Eighty-five percent found the training highly valuable, 54% reported high self-efficacy, and 69% expressed a desire for additional training. Qualitative analysis revealed trusted messenger endorsement of MI, recognition of MI's applicability to various contexts, and a sense of empowerment to share accurate information to their communities.

Conclusions: Our findings suggest that empowering trusted messengers with communication skills can be a practical, feasible, and cost-effective public health strategy for effective dissemination of accurate public health messages.

US Black women are disproportionally represented in new HIV diagnoses. PrEP is effective in HIV prevention, but Black women's uptake is low. The UPDOs salon-based intervention is effective in overcoming barriers to care but scaling implementation is needed. This mixed-method pilot study sought to understand how salon organizational factors may have influenced UPDOs implementation with a focus on organizational culture, team culture, relational connection, and communication within a Consolidated Framework for Implementation Research (CFIR) inner setting lens. Organizational culture and team culture were measured using the Organizational Culture Survey (OCS) and Team Psychological Safety Scale (TPS). Relational connection and communication were explored qualitatively using participant observations and semi-structured interviews. Findings were positive towards teamwork, morale, information flow, involvement, and supervision as well as reflected positive organizational environment that were supportive of developing knowledge and skills. Relational connection and communication created a trusting environment that facilitated implementation. Future research can benefit from examining organizational environment when scaling interventions to overcome HIV and PrEP inequities.

Background: This study examines the outcomes of the 24-months Charleston FoodRx food prescription program implemented in rural Mississippi to address dietary-related health disparities.Purpose: Examine changes in participant produce consumption, food seccurity, and anthropometrics over a 24-month period.Research Design: A one-group, repeated measures design, was utilized to assess changes in produce consumption, food security, and anthropometric data from baseline.Study Sample: A total of 55 households completed the study.Data analyses: longitudinal and regression analyses were conducted to identify significant change over time.Results: Results indicated an increase in weekly produce consumption, and a decrease in the prevalence of food insecurity over the follow-up periods. Among adults, statistically significant reductions in weight, body mass index (BMI), waist circumference, and triglyceride levels were observed at the 24-month endpoint.Conclusions: These outcomes support the efficacy of food prescription programs in promoting healthier dietary behaviors and improving health-related outcomes. The study provides valuable insights into the impact of such interventions on dietary-related health disparities in underserved communities. However, more robust research is needed to maximize the potential of these interventions.