Health Promotion Practice最新文献

{"title":"Critical Anti-Racist Discourse Analysis Applied to Federally Qualified Health Center Policy.","authors":"Jennifer Jabson Tree, Judson Laughter, Sandra Wairimu, Khadijah Melvin, Eboni Winford","doi":"10.1177/15248399241308196","DOIUrl":"https://doi.org/10.1177/15248399241308196","url":null,"abstract":"<p><p>Federally Qualified Health Centers (FQHCs) seek to improve health equity for marginalized and historically disenfranchised communities. However, FQHC policies are not necessarily designed to be explicitly anti-racist. This can result in institutional racism shaping and influencing policy. FQHCs motivated to engage racism-conscious policy need anti-racism policy analyses. We applied one such method to an FQHC's operations manual: Critical, Anti-Racist, and Discourse Analysis (CARDA). Using CARDA, three themes were identified, describing pathways along which institutional racism might be reified: (a) procedures for actions were specified but no specific position was listed as responsible, (b) policies written in passive voice, and (c) absence of explicit delineation of workflow responsibilities. Dismantling institutional racism requires analyzing policies that have potential for unintended effects. Cultivating clear policies and procedures for addressing harm and naming positions responsible for implementation of policy and procedure builds accountability, trust, and relationships between institutions and communities.</p>","PeriodicalId":47956,"journal":{"name":"Health Promotion Practice","volume":" ","pages":"15248399241308196"},"PeriodicalIF":1.6,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Colorectal Cancer Messaging and Gaps in Knowledge Among Screening-Eligible Individuals.","authors":"Ginny E Kincaid, Carolyn Headley, Anna Jaffee, Bria Marlowe, Ally Moehring, Will A Murphy, Laura K Vercammen","doi":"10.1177/15248399241306409","DOIUrl":"https://doi.org/10.1177/15248399241306409","url":null,"abstract":"<p><p>Shifts in colorectal cancer (CRC) screening, including guidance from the United States Preventive Services Task Force lowering the recommended screening age from 50 to 45 years in 2021, may leave gaps in clinicians' understanding of related barriers and beliefs held by patients. This study uses the National Institute on Minority Health and Health Disparities Research Framework to analyze factors influencing CRC screening uptake among individuals aged 44-54 years and identifies how gaps in knowledge intersect with screening barriers, particularly as they relate to the health care system and sociocultural environment. In 2022, the Centers for Disease Control and Prevention's Division of Cancer Prevention and Control's Screen for Life campaign conducted 12 online focus groups to gather audience insights and test materials. Researchers conducted the focus groups in English and Spanish with individuals aged 44-54 years who had never had CRC and had never received a CRC screening. Focus groups gauged participants' knowledge, awareness, and behavior pertaining to CRC and CRC screening. Results show that participants often lacked knowledge about risk factors and screening modalities and appreciated emotionally resonant communication approaches that addressed gaps in knowledge using demystifying, destigmatizing language and representative imagery. Findings also indicate a need to help patients overcome barriers related to insurance coverage, treatment options, and discrimination. Results may guide the development of future health promotion efforts and empower health care providers to approach conversations with their patients with additional context regarding patients' needs.</p>","PeriodicalId":47956,"journal":{"name":"Health Promotion Practice","volume":" ","pages":"15248399241306409"},"PeriodicalIF":1.6,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential Use of Voice-Activated Personal Assistants in Diabetes Prevention and Management: An Exploratory Qualitative Study Using the Consolidated Framework for Implementation Research.","authors":"Sara Jacobs, Wendi Rotunda, Nikie Sarris Esquivel, Casey Horvitz, Valerie Ng, Adam Vincent, Laura Arena, John Feher, LaShonda Hulbert, Yvonne Mensa-Wilmot","doi":"10.1177/15248399241302051","DOIUrl":"https://doi.org/10.1177/15248399241302051","url":null,"abstract":"<p><strong>Background: </strong>Diabetes affects millions of people in the United States and poses significant health and economic challenges, but it can be prevented or managed through health behavior changes. Such changes might be aided by voice-activated personal assistants (VAPAs), which offer interactive and real-time assistance through features such as reminders, or obtaining health information. However, there are little data on interest and acceptability of integrating VAPAs into programs such as the National Diabetes Prevention Program (National DPP) or diabetes, self-management, education, and support (DSMES) services.</p><p><strong>Methods: </strong>We conducted individual and small-group semi-structured interviews of National DPP and DSMES staff and program participants. We used rapid-turnaround qualitative thematic analysis to identify emerging themes using an adapted version of the Consolidated Framework for Implementation Research (CFIR).</p><p><strong>Results: </strong>Nearly all program participants and staff had prior experience with VAPAs, but not in the context of these programs. Most program participants felt confident in their ability to use VAPAs but were concerned about their privacy and security. Program staff were optimistic about the feasibility of integrating VAPAs into existing programs given their ability to support healthy habit formation, but staff were less optimistic about using VAPAs to share health information. Program staff also felt that additional resources to support VAPA use would help ensure that VAPAs would not create an extra burden on staff and program participants.</p><p><strong>Implications: </strong>Integrating VAPAs as a resource to enhance mobile applications already in use shows potential to support health behavior change. Future research should include how this technology could be further optimized to enhance utility.</p>","PeriodicalId":47956,"journal":{"name":"Health Promotion Practice","volume":" ","pages":"15248399241302051"},"PeriodicalIF":1.6,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reframing the \"Migration Crisis\" as a Humanitarian and Public Health Emergency.","authors":"Isabel Latz, Mark Lusk","doi":"10.1177/15248399241303901","DOIUrl":"https://doi.org/10.1177/15248399241303901","url":null,"abstract":"<p><p>The current narrative of a \"migration crisis\" has so severely misdirected the understanding of the fundamental human safety, security, and health challenges that confront migrants, that we feel compelled to reframe the issue as a public health and humanitarian emergency. By looking at migrants as an economic threat or as an \"invasion\" that threatens the American way of life,\" it becomes difficult to view their humanity as vulnerable individuals who confront a host of challenges at the border, including abuse, dehumanization, and incarceration. The forced migration of thousands of individuals and families who flee their countries of origin to escape violence and insecurity to then be demonized and retraumatized at the border is a public health emergency. We propose a set of guiding principles for a more just and humane immigration reform, including the need to provide appropriate, trauma-informed care for migrants in detention, an expansion of access to alternatives to detention, especially for children, and the need for an alignment of immigration policy with national law and international human rights treaties.</p>","PeriodicalId":47956,"journal":{"name":"Health Promotion Practice","volume":" ","pages":"15248399241303901"},"PeriodicalIF":1.6,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of Community-Clinical Partnerships to Promote Cancer Screening: Lessons Learned From the National Breast and Cervical Cancer Early Detection Program.","authors":"Sujha Subramanian, Donatus U Ekwueme, Nathan Heffernan, Natalie Blackburn, Janice Tzeng, Amy DeGroff, Sun Hee Rim, Stephanie Melillo, Felicia Solomon, Karen Boone, Jacqueline W Miller","doi":"10.1177/15248399241303891","DOIUrl":"https://doi.org/10.1177/15248399241303891","url":null,"abstract":"<p><p>Community-clinical partnerships are an effective approach to connecting primary care with public health to increase disease prevention and screenings and reduce health inequities. We explore how the National Breast and Cervical Cancer Early Detection Program (NBCCEDP) award recipients and clinic teams are using community-clinical linkages to deliver services to populations who are without access to health care and identify barriers, facilitators, and lessons that can be used to improve program implementation. We used purposive sampling to select nine state recipients of the NBCCEDP and a clinic partner for each recipient. The data collection was implemented through a multimodal approach using questionnaires, semistructured interviews, and focus groups. Partnerships between award recipients and clinic teams enhanced planning as clinics were able to optimize the use of electronic medical records to identify women who were not up to date with screening. Partnerships with community organizations, hospital systems, and academic institutions were important to increase community outreach and access to services. These partnerships offered a source of client referrals, a forum to deliver in-person education, a platform for joint dissemination activities to reach a wider audience, collaborations to provide transportation, and coverage for clinical services not available at NBCCEDP participating clinics. In conclusion, partnerships between various organizations are important to enhance planning, increase outreach, and improve access to cancer screening. Internal organizational and external support is important to identify appropriate partners, and technical assistance and training may be beneficial to maintain and optimize community partnerships to address health disparities.</p>","PeriodicalId":47956,"journal":{"name":"Health Promotion Practice","volume":" ","pages":"15248399241303891"},"PeriodicalIF":1.6,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploratory Pilot Study Engages Community Health Workers to Test Drone-Based Package Delivery System for Personal Protective Equipment in High-Risk Appalachia Population.","authors":"Frances J Feltner, William Mace Baker, Beth Bowling, Bart Massey, Sydney Howard, Ellen J Hahn","doi":"10.1177/15248399241300577","DOIUrl":"10.1177/15248399241300577","url":null,"abstract":"<p><p>During the COVID-19 pandemic, high-risk clients' and caregivers' access to essential personal protective equipment (PPE) was limited especially in many remote areas of Appalachia. A multidisciplinary team of community and university partners explored how to coordinate the use of community health workers (CHWs) and drone technologies to increase access to PPE in rural and remote Appalachian regions. CHWs recruited 10 Homeplace clients in an exploratory study of drone-based package delivery of PPE to assess importance and effectiveness of PPE self-efficacy related to PPE use, use of PPE, and ease and acceptability of drone delivery (following delivery only). CHWs educated each participant via in-person and Zoom meetings on the reasons for using PPE and proper use of PPE using Centers for Disease Control and Prevention guidelines. Most participants found the drone delivery of PPE easy and 80% were extremely satisfied with the drone delivery process. The frequency of mask-wearing increased from 60% at baseline to 90% at follow-up. On average, participants rated all types of PPE as effective in preventing the spread of disease. Drone officials used the findings of this pilot study to develop a waiver application to the U.S. Federal Aviation Administration to request permission to fly beyond visual line of sight in remote areas. Aerial drone technology could be a cutting-edge approach to health promotion in remote areas. The study results provide the proof of concept to assist investigators in designing future projects to promote healthy homes by collecting air and water samples and testing novel interventions deploying drone technology in remote Appalachian regions.</p>","PeriodicalId":47956,"journal":{"name":"Health Promotion Practice","volume":" ","pages":"15248399241300577"},"PeriodicalIF":1.6,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Engaging With New Mexico's County and Tribal Health Councils: Practical Implications From a Co-created Online Resource to Enhance Academic and Community Collaboration Toward Health Initiatives.","authors":"Cynthia M Killough, Gerilyn Antonio, Robert L Rhyne, Valeria Alarcón, Sharon Finarelli, Nancy Pandhi","doi":"10.1177/15248399241302050","DOIUrl":"https://doi.org/10.1177/15248399241302050","url":null,"abstract":"<p><p>The Community-based Participatory Research (CBPR) model fosters equitable partnerships between communities and academic institutions to promote health equity. This model emphasizes shared control over all phases of the research process and recognizes the limited power and inequalities experienced by marginalized communities. At our institution, Community Engagement Liaison Specialists (CELS) build relationships with New Mexico communities, guided by CBPR principles. The CELS collaborate with county and Tribal Health Councils, addressing community mistrust toward health research and academic institutions and promoting projects of interest to both academic researchers and the community. To support these efforts, we developed a website called \"Ways to Engage with New Mexico's County & Tribal Health Councils,\" through a rigorous collaborative process involving university researchers, CELS, and the New Mexico Alliance of Health Councils. This resource provides historical context, lessons learned, and guidance for researchers who plan to engage with Health Councils. We offer implications for practice summarizing the lessons learned from the CELS work including collaboration on this website.</p>","PeriodicalId":47956,"journal":{"name":"Health Promotion Practice","volume":" ","pages":"15248399241302050"},"PeriodicalIF":1.6,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142865699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of Youth-Led Participatory Action Research to Examining Adolescent Sexual and Reproductive Health and Rights in Ontario: What Can We Learn?","authors":"Ashley Vandermorris, Jannah Wigle, Michelle Tam, Joelle Peresin, Siya Dalal, Ingrid Kwong, Morgan Little, Mia Polakovic, Stephanie Begun, Mohlil Imran, Andjela Kosevic, Ajwa Nayab, Madeline Ray, Heidi Byman, Journey Gammond, Stephanie Rathwell, Lilith Wall, Alene Toulany, Britt McKinnon, Hilary Brown, Megan E Harrison","doi":"10.1177/15248399241298836","DOIUrl":"https://doi.org/10.1177/15248399241298836","url":null,"abstract":"<p><p>Engaging adolescents and young people as partners in research is increasingly acknowledged as a vital strategy to ensure diverse voices are heard and to catalyze social change. This article, coauthored by adolescent and adult researchers, presents the methodological approach and outcomes of a youth-led participatory action research (YPAR) study in which three teams of youth researchers developed and implemented projects examining equity-related factors affecting adolescent sexual and reproductive health and rights (ASRHR) in Ontario, Canada. Teams of four assigned-female youth researchers aged 16-19 years were recruited from three priority regions through purposive sampling. Selected youth completed a paid 5-day virtual YPAR training. Each youth team, supported by adult research mentors, identified key ASRHR issues in their region and developed a related research question. Each team then determined their study's design, obtained institutional ethics approval, and conducted data collection, analysis, and interpretation. Based on their findings, teams proposed potential solutions and communicated results to multiple stakeholders. Methodologically, the YPAR process amplified youth voices through a social justice-framed approach to examining ASRHR. Centering the perspectives, values, and experiences of youth positively impacted the youth researchers themselves, while yielding results that were relevant, meaningful, adolescent-responsive, and culturally informed. Results from the youth-led projects identified multiple barriers to accessing sexual and reproductive health services and products. Policy and practice implications encompassed concerns related to geographical accessibility, equity, service provider competence, and content of sexuality education curricula.</p>","PeriodicalId":47956,"journal":{"name":"Health Promotion Practice","volume":" ","pages":"15248399241298836"},"PeriodicalIF":1.6,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Caring for Patients Experiencing Incarceration: Development of an Online Learning Resource for Physicians in Training.","authors":"Heather M Barnett, Adeyinka A Adedipe, Juliet Meggs, Ingrid Cuthbert, Alieu Ann, Lindsey A McLeod, Lyndsey Booker, Radha Sacharan, Zoe Taylor, Jon Anscher, Lara B Strick","doi":"10.1177/15248399241302047","DOIUrl":"https://doi.org/10.1177/15248399241302047","url":null,"abstract":"<p><p>Many patients experiencing incarceration (PEI) in the United States (U.S.) have significant and complex medical conditions that require offsite consultation and hospitalization. Physicians in our academic medical system report that their education in caring for PEI is limited. We developed an online learning resource for physicians who care for PEI within our institution. Development included project planning, content development, iterative graphical design, feedback incorporation from key constituents, including individuals previously incarcerated, and module launch. The e-module was designed with a graphic user interface including video and case simulations. The curriculum includes background information on the U.S. carceral system, the basics of carceral health care, ethical considerations for community-based health care workers (introducing concepts of \"dual loyalty\" and examining patient privacy and autonomy for PEI), and policy and procedural considerations specific to our health care system. Future directions include disseminating the module to practicing physicians, advanced practice providers, and other allied health professionals (such as nursing, social work, and skilled therapists) and collecting feedback on user engagement. Institutions and groups wishing to improve care for this vulnerable patient population can implement training to address limitations in knowledge and confidence among staff and providers.</p>","PeriodicalId":47956,"journal":{"name":"Health Promotion Practice","volume":" ","pages":"15248399241302047"},"PeriodicalIF":1.6,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Daunting to Doable: Tools for Qualitative Evaluation of a Complex Public Health Intervention.","authors":"Celeste Nicholas, Tess D Weathers, Lisa K Staten","doi":"10.1177/15248399241298840","DOIUrl":"https://doi.org/10.1177/15248399241298840","url":null,"abstract":"<p><p>To address complex problems like health disparities, public health interventions have become increasingly ''complex''-engaging multisector partners and communities at multiple ecological levels. Complex interventions are intentionally flexible, making them challenging to evaluate with predetermined measures. While innovative evaluation methods tailored to complex interventions have been developed, there is a need for practical guidance to enhance capacity within public health. This article describes the qualitative FIND (Frame, Identify, Narrow, Do) evaluation process for a complex, community-engaged health equity intervention. Illustrative examples and take-away tools are provided. The FIND process is sensitive to complexity, involving ongoing data collection that helps guide implementation. The evaluator is embedded within the project team, facilitating frequent, direct interaction between the evaluator and those whose roles position them to hear or see happenings with the on-the-ground implementation in real time. The FIND process includes (a) developing a flexible framework for determining relevant processes and outcomes, (b) identifying important project events, (c) narrowing in on the most impactful events, and (d) making decisions informed by data. Using the FIND process, the project team learned about significant project events that would have been missed without a complexity-sensitive approach. Having the evaluator embedded within the project team, rather than as an independent entity, was crucial for understanding and utilizing on-the-ground developments in an evolving intervention. There is a need for more practical guidance to build capacity for evaluating complex public health interventions, including strategies for communicating with stakeholders about approaches that diverge from traditional scientific norms.</p>","PeriodicalId":47956,"journal":{"name":"Health Promotion Practice","volume":" ","pages":"15248399241298840"},"PeriodicalIF":1.6,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}