BMC Public Health最新文献

Background: Native Hawaiians and Pacific Islanders (NHPIs) have historically been erased from public health and research data due to smaller population size and mis-categorization. This became a bigger problem during the COVID-19 pandemic where NHPIs were disproportionately impacted, yet this was largely hidden because NHPI data were grouped with Asian Americans or aggregated into the Other category. This study assesses the impact of COVID-19 on the NHPI community as well as their willingness to participate in clinical trials.

Methods: This cross-sectional study took place between April 2021 and January 2022. Individuals in San Diego County who identified as NHPI were eligible to complete the survey on behalf of their households. The primary outcomes are willingness to get vaccinated and to participate in clinical trials as measured by Likert scales.

Results: Of the 130 households (representing 605 individuals) that responded to the survey, the majority were Samoan (53%) and Chamorro (30%) with an average household size of 4.6 individuals. Most (88%) households had one or more essential workers. The biggest COVID-19 challenges for respondents were paying for rent or food, caring for sick relatives, and dealing with lost jobs. Nearly half of households relied on support from community-based organizations, especially for meals/groceries, emotional/spiritual/mental health support and COVID-19 resources/vaccines. There was a stark contrast between willingness to get vaccinated (67% had gotten their second vaccine dose) and willingness to participate in a clinical trial (56% not at all likely to participate). This paralleled the difference in having a great deal of trust in COVID-19 information from doctors (69%) compared to researchers (37%).

Conclusions: This paper describes the gap between policy and practice, specifically a mismatch of available resources (for example, personal protective equipment and free COVID-19 tests from workplaces and the federal government) to those at disproportionate risk of exposure and severe outcomes during a pandemic. It also discusses the benefits of having local community-based organizations to help fill gaps in the public health system. Future research is needed to explore the reasons for lower levels of trust in researchers and less willingness to participate in clinical trials, which has implications for equity in research.

Background: In India, 40.2%, 23.1%, and 39.4% children below five years amongst the 104 million Scheduled Tribes (STs) are stunted, wasted, and underweight, respectively. Although optimal infant and young child feeding (IYCF) practices can substantially improve nutrition in early life, they are highly influenced by cultural beliefs, social exclusion, and sociodemography, notably in STs, necessitating culturally and contextually tailored interventions. This scoping review aimed to map the existing interventions designed to enhance IYCF among Indian STs.

Methods: Search was conducted on PubMed (NCBI), Embase (Elsevier), Web of Science (Clarivate), and CINAHL (EBSCO) using search strings built and modified using keywords such as 'India', 'tribe', and 'infant and young child feeding'. Google Scholar search and citation search were also conducted. The final search was conducted on 27 July 2024. Two-stage screening was conducted on Rayyan software, a screening tool.

Result: Out of 1387 results retrieved, 26 articles were included in this review. Citation search and grey literature provided 22 interventions. Overall, interventions varied from traditional face-to-face counselling to the use of audiovisual aids, such as videos and short films. They were delivered at various levels, including individual, interpersonal, organizational, and community. Mothers, fathers, grandmothers, and community members were targeted with holistic interventions that delivered key messages not only on IYCF in silos, but also on education, rights, marriage, reproductive health, maternal health, water, hygiene, sanitation, and agriculture. Interventions often focused on community participation, responsive interventions, and intersectoral convergence.

Conclusion: This review revealed that interventions aimed at improving IYCF among Indian STs predominantly employed a holistic approach, fostered community participation, leveraged existing local platforms and utilized linguistically tailored audiovisual aids. However, a few gaps persisted in active family involvement, motivation and incentivization of community members to serve as facilitators, and regular attendance of the target population during implementation. This highlights the need to focus on sustaining these interventions and scaling them.