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Participatory Process for Implementing a Colorectal Cancer Screening Intervention: an Action Plan for Local Sustainability 实施癌症筛查干预的参与性过程:地方可持续性行动计划
Pub Date : 2019-10-25 DOI: 10.20429/JGPHA.2019.070202
Selina A Smith, B. Ansa, Joyce Q Sheats, Sandra J Hamilton, M. Whitehead
INTRODUCTION METHODS Background: Rigid protocols can hamper translation of evidence-based interventions (EBIs) from research to real-world settings. Nevertheless, employing principles of community-based participatory research holds potential for successful implementation. The primary aim of this investigation was to develop procedures for modifying the study protocol of a colorectal cancer screening educational intervention implemented in African American communities to fit local needs while maintaining fidelity to its core elements. Methods: To ensure sustainability of the Educational Program to Increase Colorectal Cancer Screening (EPICS), four-hour guided discussions between researchers and 15 community coalitions were undertaken to include: 1) assessing strengths, weaknesses, opportunities and threats; 2) establishing specific, measurable, achievable, realistic and timely goals; and 3) developing local action plans. Results: In the local action plans, adherence to core intervention elements (theoretical framework, educational content, and sessions) was maintained with adaptation to roles and responsibilities. For example, the coalition leader modified views to reflect local ownership of data and members accepted responsibilities for marketing, education, communication, and data management. Conclusions: Enhancing interactions between researchers and community partners and addressing weaknesses and threats ensure transition from efficacy to implementation and promote sustainability of interventions. Grant Support: NIH 1R01CA166785  Colorectal cancer (CRC) is the second leading cause of cancer-related deaths in the United States and the third most common cancer in men and in women. African Americans (AAs) have the highest over-all incidence, incidence of advanced stage at disease presentation, attributable mortality, and the lowest survival rates after diagnosis.  Although screening is an effective tool for reducing CRC mortality, differences in screening accounted for 42% of disparity in CRC incidence and 19% of disparity in CRC mortality between AAs and Whites.  EPICS is an EBI for increasing CRC screening rates among AAs. Core elements are listed in Table 1.  EPICS implementation is in partnership with community coalitions organized by the National Black Leadership Initiative on Cancer (NBLIC) in 15 communities across the United States.  Sustainability of the EBI is based on acceptability, capacity, and resources within the targeted communities, using an approach that is flexible enough for local relevance.  In the present study, investigators describe a method for enhancing dissemination by adjusting the EPICS study protocol to meet local contextual challenges. Guided by Glasgow’s Evidence Integration Triangle (EIT) [Fig. 1], a variety of issues faced at the 15 sites and the process by which the basic protocol was modified are described. 1. Discussions between investigators and leaders of each NBLIC community coalition to share informa
地方EPICS实施行动计划要素方法适应选择理论框架创新扩散理论CRC教育内容指南(DRE*;FOBT*,乙状结肠镜检查;结肠镜检查);CRC风险因素(可修改;不可修改)适合听众会话组设置的饮食和体育活动信息;三(3)次一小时会议团体设置规模3)辅导员公共卫生专业人员、癌症幸存者和倡导者、社区成员、教会和民间领袖其他对降低CRC发病率和死亡率感兴趣的个人辅导员培训(11⁄2天会期)和TA*TA基于随机化设置教堂、诊所和社区场所其他设置表1。EPICS核心要素结果
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引用次数: 0
88th Annual Georgia Public Health Association Meeting & Conference Report 第88届格鲁吉亚公共卫生协会年度会议报告
Pub Date : 2019-10-25 DOI: 10.20429/JGPHA.2019.070207
Selina A. Smith, R. Abbott, C. Sims
The 86(th) annual meeting of the Georgia Public Health Association (GPHA) and joint conference with the Southern Health Association was held in Atlanta, Georgia, on April 13-14, 2015, with pre-conference (April 12(th)) and post-conference (April 14(th)) Executive Board meetings. As Georgia's leading forum for public health researchers, practitioners, and students, the annual meeting of the GPHA brings together participants from across the state to explore recent developments in the field and to exchange techniques, tools, and experiences. Historically, the GPHA conference has been held in Savannah (n=24); Jekyll Island (n=20); Atlanta (n=16); Augusta (n=4); and Gainesville (n=1). There was no annual meeting during the early years (1929-1936); during World War II (1941-1943 and 1945); and for four years during the 1980s. Between 2006 and 2010, GPHA held one-day annual meetings and business sessions with educational workshops. Several new initiatives were highlighted as part of this year's conference. These included a "move and groove" physical activity lounge, registration scholarships for students with a dedicated meet-and-greet reception, an expanded exhibit hall, presentation and approval of three resolutions (related to healthy foods at official activities and events; weapons at official activities and events; and memorials), and approval of the 2015 legislative policy positions and amended association bylaws. The theme for the conference was Advocacy in Action for Public Health. Specifically, the program addressed ensuring access to care; protecting funding for core programs, services, and infrastructure; eliminating health disparities; and addressing key public health issues important to the state of Georgia. One hundred and nine (109) abstracts were submitted for peer review; 36 were accepted for poster and 40 for workshop presentations. Four plenary sessions with keynote speakers covered the intersection between advocacy and policy, Georgia's response to the Ebola crisis, palliative care, and essentials of advocacy in action for public health. Concurrent workshops focused on Board of Health training, public health accreditation, capacity building, collaboration, patient-centered outcomes, synthetic cannabinoid use, the HIV care continuum, use of data for informed decision making, environmental threats, organizational development, epidemiology, policy, and regulation. Thirty-two (32) awards were presented, including Lawmaker of the Year Award to Governor Nathan and First Lady Sandra Deal for their active and engaged role in promoting public health in Georgia; and the Sellers-McCroan Award to Commissioner Brenda Fitzgerald, Georgia Department of Public Health (DPH) State Health Officer, for her leadership of the Georgia Ebola Response Team and leadership of the newly formed department. The conference attracted 569 registrants primarily through pre-registration (n=561) with limited onsite registration (n=8). For this year's conference, there
佐治亚州公共卫生协会(GPHA)第86届年会和与南方卫生协会的联合会议于2015年4月13日至14日在佐治亚州亚特兰大举行,会前(4月12日)和会后(4月14日)分别举行了执行委员会会议。作为乔治亚州公共卫生研究人员、从业人员和学生的主要论坛,GPHA的年度会议汇集了来自全州各地的参与者,探讨该领域的最新发展,并交流技术、工具和经验。历史上,GPHA会议一直在萨凡纳举行(n=24);Jekyll Island (n=20);亚特兰大(n = 16);奥古斯塔(n = 4);Gainesville (n=1)。最初几年(1929-1936)没有年会;第二次世界大战期间(1941-1943和1945);在20世纪80年代的四年里。2006年至2010年期间,GPHA举办了为期一天的年会和商业会议,并举办了教育研讨会。今年的会议强调了几项新的倡议。其中包括一个“动起来”的体育活动休息室,为学生提供的注册奖学金,一个专门的见面会,一个扩大的展厅,在官方活动和活动中介绍和批准三项决议(与健康食品有关);官方活动和活动中的武器;以及2015年立法政策立场和修订的协会章程的批准。会议的主题是“为公共卫生采取行动”。具体而言,该方案解决了确保获得护理的问题;保护核心项目、服务和基础设施的资金;消除健康差距;解决对乔治亚州至关重要的关键公共卫生问题。109篇摘要提交同行评议;36人被接受作海报,40人被接受作讲习班发言。四次全体会议的主题发言者讨论了宣传与政策之间的交集、格鲁吉亚对埃博拉危机的反应、姑息治疗以及在公共卫生行动中宣传的要点。同时举办的讲习班侧重于卫生委员会培训、公共卫生认证、能力建设、协作、以患者为中心的成果、合成大麻素使用、艾滋病毒护理连续体、使用数据进行知情决策、环境威胁、组织发展、流行病学、政策和法规。颁发了32个奖项,包括向内森州长和第一夫人桑德拉·迪尔颁发的年度议员奖,以表彰他们在促进格鲁吉亚公共卫生方面发挥的积极和积极作用;佐治亚州公共卫生部(DPH)州卫生官员布伦达·菲茨杰拉德(Brenda Fitzgerald)专员因领导佐治亚州埃博拉应对小组和新成立的部门而获得塞勒斯-麦克罗恩奖。会议吸引了569名注册者,主要是通过预先注册(n=561),有限的现场注册(n=8)。与2014年相比,今年的展会出席人数(36%)和参展商(33%)均有显著增长。在报告GPHA部分参与的注册人中,代表性包括:学术(5%);政府(10%);卫生委员会(13%);职业发展(15%);应急准备(2%);流行病学(5%);健康教育和促进(2%);信息技术(2%);妇幼保健(3%);医疗/牙科(3%);护理(10%);营养(< 1%);其他/无记录(15%)。该州18个公共卫生区100%参加了会议。由具有代表性的注册人样本完成的会议评估指出了可能改进的领域:按时开始会议,使用电子和社交媒体作为会议议程/教学大纲,以及将研讨会时间减少到45分钟。大多数人对这次会议的评价是“好”或“优秀”。
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引用次数: 0
The Impact of Maternal Literacy Skills on Child Weight in Mozambique 莫桑比克母亲识字技能对儿童体重的影响
Pub Date : 2019-10-25 DOI: 10.20429/JGPHA.2019.070216
Ashley E. N. Watson, S. Self-Brown, Iris Feinberg, Whitney L. Rostad
Background: Infant mortality is a serious public health problem. One factor that is strongly associated with infant mortality is low weight in children. The percentage of underweight children under the age of five in Mozambique was 16% in 2012. In order to reduce the number of underweight children in this country, contributing caregiver characteristics of this problem should be investigated. One potentially relevant characteristic is maternal literacy, which has been under investigated. Objective: This study aims to determine whether maternal literacy affected the weight and body-mass-index (BMI) of children ages 0 to 3 years old in Mozambique. Methodology: A cross-sectional study of 6,762 children between the ages of 0 and 47 months was conducted using the 2011 Demographic and Health Survey for Mozambique. Analysis of covariance (ANCOVA) procedures with Scheffe post hoc tests were performed in order to identify differences in mean child weight and BMI Z-score in reference to maternal literacy level, controlling for several covariates (e.g., mother’s weight, education). The data were analyzed using Statistical Analysis Software Version 9.4. Results: In the study sample, 396 (6.05%) children were found to be underweight and 4467 (58.69%) of mothers were found to be illiterate. There was a statistically significant association between maternal literacy level and the weight and BMI of children between the ages of 0 and 3 years of age, after controlling for other known predictors. A trend of stronger association was observed for each one-year increase in child age. Conclusions: Maternal literacy is significantly associated with child weight and BMI. Prioritizing secondary education for women is one important approach for ameliorating the risk of underweight children. Increased literacy rates in women could lead to better understanding of child nutritional needs, and ultimately, an overall reduction in the number of underweight children
背景:婴儿死亡率是一个严重的公共卫生问题。与婴儿死亡率密切相关的一个因素是儿童体重过轻。2012年,莫桑比克五岁以下儿童体重不足的比例为16%。为了减少这个国家体重不足儿童的数量,应该调查造成这一问题的照顾者的特征。一个可能相关的特征是孕产妇识字,这一点正在调查中。目的:本研究旨在确定母亲识字是否影响莫桑比克0 - 3岁儿童的体重和身体质量指数(BMI)。方法:利用2011年莫桑比克人口与健康调查,对6 762名0至47个月的儿童进行了横断面研究。采用Scheffe事后检验进行协方差分析(ANCOVA)程序,以确定参考母亲识字水平的儿童平均体重和BMI z分数的差异,控制几个协变量(例如,母亲的体重,教育)。采用统计分析软件9.4版对数据进行分析。结果:在研究样本中,396名(6.05%)儿童体重过轻,4467名(58.69%)母亲不识字。在控制了其他已知的预测因素后,母亲的识字水平与0至3岁儿童的体重和BMI之间存在统计学上显著的关联。观察到,儿童年龄每增加一岁,这种联系就有增强的趋势。结论:母亲识字率与儿童体重和BMI显著相关。优先让妇女接受中等教育是减轻儿童体重不足风险的一个重要办法。提高妇女的识字率可以使人们更好地了解儿童的营养需求,并最终全面减少体重不足儿童的数量
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引用次数: 0
Implementing Mindfulness Practices With Parents of Young Children in a Low-socioeconomic Status Neighborhood 在社会经济地位较低的社区与幼儿父母一起实施正念练习
Pub Date : 2019-10-25 DOI: 10.20429/jgpha.2019.070206
Andrew T. Roach, Josephine Mhende, Brian Barger, Douglas A. Roberts
Background: The purpose of this study was to investigate whether instruction in mindfulness practices would results in improved self-reported mindfulness and reduced depression, anxiety, and family stress in parents of young children living in a low socioeconomic status (SES) neighborhood. Methods: The study utilized a pretest-posttest group design to evaluate the effectiveness of the Mindfulness Ambassador Council-Interactive curriculum with attendees in a parent support program. Participants (n=15) were recruited from families with young children who received support from a community-based organization in one low-SES neighborhood in Atlanta. Mental health assessments, measures of family stress and parenting competency, and a demographic questionnaire with non-identifying questions were administered to all participants during the first and last session of the 8-week mindfulness program. Results: Participants reported increased mindfulness and decreased levels of anxiety and depression. Parent reports of family stressors were relatively stable across the two time points, while self-reported parenting competence decreased. Discussion: Based on the parents’ reports of program acceptability and the impact on their well-being, mindfulness training appears to be a promising strategy for addressing the stressors experienced by parents of young children.
背景:本研究的目的是调查生活在低社会经济地位(SES)社区的幼儿父母的正念实践指导是否会改善自我报告的正念,并减少抑郁、焦虑和家庭压力。方法:本研究采用前测后测小组设计,与家长支持计划的参与者一起评估正念大使理事会互动课程的有效性。参与者(n=15)来自亚特兰大一个低社会经济地位社区的有幼儿的家庭,这些家庭得到了社区组织的支持。在为期8周的正念课程的第一次和最后一次课程中,对所有参与者进行了心理健康评估、家庭压力和育儿能力的测量,以及一份包含非识别性问题的人口统计问卷。结果:参与者报告正念增加,焦虑和抑郁水平降低。父母对家庭压力源的报告在这两个时间点上相对稳定,而自我报告的育儿能力下降。讨论:根据父母对项目可接受性和对他们幸福感的影响的报告,正念训练似乎是一种很有前途的策略,可以解决幼儿父母所经历的压力。
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引用次数: 0
Health Care Access by Weight Status in the State of Georgia 格鲁吉亚州按体重状况划分的医疗保健服务
Pub Date : 2019-10-25 DOI: 10.20429/jgpha.2019.070205
Elizabeth Pullekines, Janani Rajbhandari-Thapa
Background: Obesity continues to grow in prevalence in the United States and within the state of Georgia. Obesity is a risk factor for many chronic and preventable diseases. As such, obese individuals have higher demand for health care services than non-obese individuals. In addition, the health care system can play a role in preventing obesity and other conditions caused by obesity. Methods: This research follows the established positive relationship between health care use and access to health care services through insurance coverage. The paper analyzes how the Affordable Care Act (ACA) affected insurance coverage and access to health care services for obese and overweight individuals. A logistic regression was used on data from the Behavioral Risk Factor Surveillance System. Results: Results concluded that Georgia residents were less likely to have health insurance after the ACA was passed. Significant association between weight status and health care services through insurance coverage was not found. The results show that increased access to care including preventive services for obese and overweight post ACA is yet to be observed. Conclusions: Findings present a need for lawmakers to develop policy to promote insurance enrollment for Georgian residents. This is critical as the state sees an increase in overweight and obesity that are risk factor to many chronic disease conditions.
背景:肥胖在美国和乔治亚州的流行率持续增长。肥胖是许多慢性和可预防疾病的危险因素。因此,肥胖个体对医疗保健服务的需求高于非肥胖个体。此外,医疗保健系统可以在预防肥胖和其他由肥胖引起的疾病方面发挥作用。方法:本研究遵循医疗保健使用与通过保险获得医疗保健服务之间建立的正相关关系。本文分析了平价医疗法案(ACA)如何影响肥胖和超重个体的保险覆盖面和获得医疗保健服务的机会。对行为危险因素监测系统的数据进行逻辑回归分析。结果:结果表明,在ACA通过后,乔治亚州居民不太可能拥有健康保险。没有发现体重状况与通过保险范围提供的医疗保健服务之间存在显著关联。结果表明,增加获得保健,包括预防服务的肥胖和超重后ACA尚未观察到。结论:研究结果表明,立法者需要制定政策来促进格鲁吉亚居民的保险登记。这一点至关重要,因为该州认为超重和肥胖是许多慢性疾病的危险因素。
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引用次数: 0
Use of Complementary and Alternative Medicine Among People With Cardiovascular Diseases in Southeast Georgia 格鲁吉亚东南部心血管疾病患者补充和替代医学的使用
Pub Date : 2019-10-25 DOI: 10.20429/jgpha.2019.070203
C. Okoli, Stacy L Carswell, Sewuese Akuse, K. Sullivan
Background: Heart disease is a leading cause of death in the United States. Proper treatment of patients with cardiovascular disease is essential and can be challenged by non-disclosed use of complementary or alternative treatments. The objective of this study was to assess which demographics were associated with complementary and alternative medicine (CAM) use and if education affects the use of CAM. Methods: A cross-sectional survey was conducted among a stratified random sample of residents of Southeastern Georgia. Sampling was stratified by urban/rural residence in order to reach sufficient rural residents. Participants that indicated they had been diagnosed with hypertension or heart disease were included in this analysis. Participants also self-reported if they used CAM, their reasons for CAM use, frequency of CAM use, source of knowledge and level of satisfaction with CAM. Results: Among the 50 respondents with cardiovascular disease, 17 (34%) reported using CAM. The most commonly used type of CAM was vitamins and minerals (used by 26% or participants) followed by massage (19%) and relaxation/breathing (17%). CAM use was not associated with race, education, income, rural residence, smoking or quality of life, controlling for age and sex. Conclusions: Although there were no associations of socio-demographic characteristics and CAM use, this study highlights the prevalence of CAM use among individuals with heart disease and types of CAM frequently used. These findings should drive future, larger studies to further understand treatment decisions of rural patients with cardiovascular disease.
背景:心脏病是美国人死亡的主要原因。适当治疗心血管疾病患者是必不可少的,并且可能受到未公开使用补充或替代治疗的挑战。本研究的目的是评估哪些人口统计数据与补充和替代医学(CAM)的使用有关,以及教育是否会影响辅助和替代医学的使用。方法:采用横断面调查方法,对乔治亚州东南部的居民进行分层随机抽样。抽样按城乡居民进行分层,以覆盖足够的农村居民。表明自己被诊断患有高血压或心脏病的参与者也包括在这项分析中。参与者还自我报告了他们是否使用CAM,他们使用CAM的原因,使用CAM的频率,知识来源和对CAM的满意度。结果:在50名患有心血管疾病的受访者中,17名(34%)报告使用CAM。最常用的CAM类型是维生素和矿物质(26%或参与者使用),其次是按摩(19%)和放松/呼吸(17%)。CAM的使用与种族、教育、收入、农村居住、吸烟或生活质量无关,控制了年龄和性别。结论:虽然社会人口学特征与辅助辅助措施的使用没有关联,但本研究强调了辅助辅助措施在心脏病患者中的流行程度和经常使用的辅助辅助措施类型。这些发现将推动未来更大规模的研究,以进一步了解农村心血管疾病患者的治疗决策。
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引用次数: 2
Improving Housing Quality to Reduce Asthma Rates and Healthcare Costs in Athens-Clarke County, GA 改善住房质量,降低哮喘发病率和医疗费用在雅典-克拉克县,GA
Pub Date : 2019-10-25 DOI: 10.20429/jgpha.2019.070201
S. Harris, J. M. Johnston, M. Bowie, G. Adams
Background: Asthma is a chronic respiratory condition that often develops from controllable environmental factors, such as poor air quality. Our study examined the relationship between mold in the home, which compromises indoor air quality, and asthma prevalence in Athens-Clarke County (ACC), Georgia. Methods: Data from the Athens Wellbeing Project’s 2016 survey of 1,354 households in ACC was employed to examine indoor air quality and asthma prevalence in ACC. We provided descriptive statistics to examine asthma prevalence and asthma predictors, including the proportion of respondents reporting mold and pest problems, smoking prevalence, and the proportion of households reporting clinical obesity. We also examined demographic characteristics including race and ethnicity, educational attainment, home ownership status, and the percent of households in poverty at the 185% federal poverty line. We then employed a logistic regression analysis to assess the relationship between asthma and housing quality. Results: The descriptive statistics showed that seven percent of the ACC population, 17% of households, reported there was at least one individual in the home diagnosed with asthma and nine percent of the county population experienced mold problems in the home. Logistic regression analysis showed households that reported mold problems were 11% more likely to report at least one person in the household had been diagnosed with asthma. Educational attainment and obesity were also significantly associated with asthma, though not as predictive of asthma as mold. Conclusions: Strong statistical associations were found between indoor air quality and asthma prevalence in ACC. Improving housing quality by intervening on mold has the potential to reduce asthma rates, thereby increasing individual and community wellbeing. Our results have implications for the state of Georgia and the United States, as asthma prevalence is comparable throughout. This research adds to the body of literature focusing on the link between indoor air quality and asthma.
背景:哮喘是一种慢性呼吸道疾病,通常由可控的环境因素发展而来,如空气质量差。我们的研究调查了影响室内空气质量的家中霉菌与佐治亚州雅典克拉克县哮喘患病率之间的关系。方法:雅典健康项目2016年对ACC 1354户家庭的调查数据用于检查ACC的室内空气质量和哮喘患病率。我们提供了描述性统计数据来检查哮喘患病率和哮喘预测因素,包括报告霉菌和害虫问题、吸烟率、,以及报告临床肥胖的家庭比例。我们还研究了人口特征,包括种族和民族、教育程度、住房所有权状况,以及185%联邦贫困线下的贫困家庭百分比。然后,我们采用逻辑回归分析来评估哮喘与住房质量之间的关系。结果:描述性统计数据显示,7%的ACC人口,17%的家庭,报告家中至少有一人被诊断为哮喘,9%的县人口在家中出现霉菌问题。Logistic回归分析显示,报告霉菌问题的家庭报告至少有一人被诊断患有哮喘的可能性高出11%。教育程度和肥胖也与哮喘显著相关,尽管对哮喘的预测不如霉菌。结论:ACC的室内空气质量与哮喘患病率之间存在很强的统计相关性。通过干预霉菌来改善住房质量有可能降低哮喘发病率,从而提高个人和社区的幸福感。我们的研究结果对乔治亚州和美国有影响,因为哮喘的患病率在整个州都是可比的。这项研究补充了大量关注室内空气质量与哮喘之间联系的文献。
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引用次数: 0
Insights in Health Administration Education: Understanding the Role of Personality in Teamwork 健康管理教育的见解:了解个性在团队合作中的作用
Pub Date : 2019-10-25 DOI: 10.20429/jgpha.2019.070208
L. Clack, E. Droste
Background: Developing a health promotion program plan requires attention to the links between objectives, activities, and overall program goals. Instructors developed the “Connecting the Dots” worksheet to help students establish these linkages. Methods: The “Connecting the Dots” worksheet included six questions pertinent to the students’ health promotion program plans. The worksheet was given to the students in a flipped classroom setting. Evaluation of the effectiveness of the tool was based upon group presentations at the end of the semester. Results: Students developed more viable program plans that included stronger links between objectives and corresponding program activities. Conclusions: The “Connecting the Dots” worksheet is a promising tool for engaging public health students in the process of developing health promotion program plans.
背景:制定健康促进计划需要注意目标、活动和总体计划目标之间的联系。教师开发了“串连点”工作表来帮助学生建立这些联系。方法:“串连点”工作表包含6个与学生健康促进计划相关的问题。工作表是在翻转课堂中发给学生的。评估该工具的有效性是基于学期结束时的小组报告。结果:学生们制定了更可行的项目计划,其中包括目标和相应的项目活动之间更强的联系。结论:“串连点”工作表是一个很有前途的工具,让公共卫生学生参与制定健康促进计划的过程。
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引用次数: 0
Examining the Characteristics of Physicians That Leave Georgia After Medical School Training 检验医学院毕业后离开乔治亚州的医生的特点
Pub Date : 2019-10-25 DOI: 10.20429/JGPHA.2019.070211
E. Akowuah, Fedelis Mutiso, Samuel T. Opoku, Bettye A Apenteng
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引用次数: 0
Experiences of Violence Among Female West African Asylum Seekers in Atlanta: a Qualitative Analysis 亚特兰大西非女性寻求庇护者的暴力经历:定性分析
Pub Date : 2019-10-25 DOI: 10.20429/jgpha.2019.070209
J. Curtis, Dabney P. Evans
Background: As the world faces the greatest number of displaced persons in history, it is urgent for countries offering refuge and asylum to understand the needs of these vulnerable populations. Asylum seekers face great uncertainty in the US legal system, and female asylum seekers often face additional challenges. The Atlanta Asylum Network (AAN) facilitates access to low or nocost physical, psychological and gynecological evaluations to enable a fair and complete judicial process. The purpose of this analysis is to assess the presence of various types of violence experienced by a population of female West African asylum seekers, and to make recommendations of how asylum policies can be applied more fairly. Methods: Qualitative analysis was conducted on 15 narrative affidavits from female West African clients of the AAN. These affidavits serve as a legal record of the persecution the asylum seeker faced in their home country. Based in grounded theory, the analysis consisted of data memoing, coding, and the development of thick descriptions. The analysis outcomes were reviewed to ensure they were grounded in the data, with special attention paid to outliers. Results: The key themes that emerged throughout analysis centered on experiences of structural violence and interpersonal violence, as well as significant examples of interaction between the two types. There were also clear differences between the experiences of two deductive subgroups: Gender-based and Gender-biased. Conclusions: In the US asylum process, cases of structural violence tend to be favored over cases of interpersonal violence. However, actual experiences show this is often a false dichotomy. For example, interpersonal violence can become structural when the government fails to protect the victim or punish the perpetrator. Asylum seekers should emphasize experiences of intersectional violence, and asylum law should be more consistently applied through acknowledgement of this complexity and codification in legal guidelines.
背景:由于世界面临着历史上最多的流离失所者,提供庇护和庇护的国家迫切需要了解这些弱势群体的需求。寻求庇护者在美国法律体系中面临很大的不确定性,女性寻求庇护者往往面临额外的挑战。亚特兰大庇护网络(AAN)促进获得低成本或免费的身体、心理和妇科评估,以实现公平和完整的司法程序。这项分析的目的是评估西非女性寻求庇护者所遭受的各种暴力行为,并就如何更公平地实施庇护政策提出建议。方法:对AAN的15名西非女性客户的叙述口述进行定性分析。这些宣誓书是寻求庇护者在其本国所面临迫害的法律记录。基于扎实的理论,分析包括数据记忆、编码和厚描述的发展。对分析结果进行了审查,以确保它们以数据为基础,并特别注意异常值。结果:整个分析中出现的关键主题集中在结构性暴力和人际暴力的经历上,以及这两种类型之间相互作用的重要例子。两个演绎亚组:基于性别和性别偏见的经验之间也有明显的差异。结论:在美国的庇护过程中,结构性暴力案件往往比人际暴力案件更受青睐。然而,实际经验表明,这往往是一种错误的二分法。例如,当政府未能保护受害者或惩罚犯罪者时,人际暴力就会变成结构性暴力。寻求庇护者应强调交叉暴力的经历,并应通过承认这种复杂性和在法律准则中编纂庇护法而更加一致地适用庇护法。
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引用次数: 0
期刊
Journal of the Georgia Public Health Association
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