Advances in global health最新文献

{"title":"Participatory development of the <i>Shauriana</i> program to integrate sexual health and mental health support for young gay and bisexual men and other men who have sex with men in Kenya.","authors":"Laura Jadwin-Cakmak, Gary W Harper, Elijah Ochieng, K Rivet Amico, Teddy Aloo, Felix Okutah, Edwin Gumbe, Kennedy Olango, Duncan O Okall, Fredrick O Otieno, Wilson Odero, Susan M Graham","doi":"10.1525/agh.2025.2442813","DOIUrl":"https://doi.org/10.1525/agh.2025.2442813","url":null,"abstract":"<p><strong>Background: </strong>Gay and bisexual men and other men who have sex with men (GBMSM) are at elevated risk for HIV, especially in rights-constrained settings such as Kenya, where stigma and discrimination have impeded access to HIV prevention. This article describes the development and pilot run of a theory-based and culturally relevant peer-led program called <i>Shauriana</i> (\"we counsel each other\"), which combines health education and integrated Next Step Counseling (iNSC) to promote sexual and mental health and well-being.</p><p><strong>Methods: </strong><i>Shauriana</i> was developed using participatory methods in collaboration with GBMSM community members using the ADAPT-ITT framework and tested through a pilot run with 10 participants to refine and finalize program materials and procedures. The team monitored attendance and obtained participant feedback through quantitative evaluation and in-depth exit interviews that were thematically analyzed.</p><p><strong>Results: </strong>The majority of participants (90%) attended all four core sessions and completed study visits on time. All participants completed an exit interview, providing feedback on program content and format, challenges/barriers, recommendations, impact, and recommending <i>Shauriana</i> to others. We identified key elements for positive engagement with the program, including being peer-led, maintaining privacy and confidentiality, using iNSC to provide guidance while maintaining autonomy, and taking a holistic approach by focusing on mental health and issues affecting GBMSM's lives. We share modifications made in response to feedback and an overview of the final program sessions and structure.</p><p><strong>Conclusions: </strong>Pilot participants reported positive experiences engaging in <i>Shauriana</i>, and shared that the program was highly relevant to their lives. Refined intervention procedures and materials are being tested in a subsequent randomized controlled trial. Lessons learned throughout the participatory development process and confirmed in exit interviews center on the importance of community engagement, local GBMSM-leadership, and holistic, autonomy-supporting programming for young GBMSM in Kenya.</p><p><strong>Trial registration: </strong>Registered on ClinicalTrials.gov on September 16, 2020 (NCT04550221).</p>","PeriodicalId":520503,"journal":{"name":"Advances in global health","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12036828/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144050054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and determinants of physical activity behavior in a peri-urban population in Nepal: A secondary analysis of the Dhulikhel Heart Study.","authors":"Neha Balapal, Margaret Chi, Dinesh Timalsena, Lindy Reynolds, Niroj Bhandari, Archana Shrestha","doi":"10.1525/agh.2025.2476634","DOIUrl":"10.1525/agh.2025.2476634","url":null,"abstract":"<p><p>Physical inactivity is a well-known modifiable risk factor for the prevention and treatment of leading noncommunicable diseases. Secondary data analysis was performed using cross-sectional self-reported 2014 and 2023 data from the Dhulikhel Heart Study which assesses cardiovascular disease risk factors and outcomes in a peri-urban population of Nepal. Physical activity questions in the Dhulikhel Heart Study were assessed using the Global Physical Activity Questionnaire. Our analysis found that 82% of the study sample met the World Health Organization requirements for adequate physical activity and the average daily sedentary behavior was 34 min/day. However, there were high self-reported occupational physical activity and low leisure time physical activity rates among all demographic groups. However, there were high self-reported occupational physical activity and low leisure time physical activity rates among all demographic groups. The multivariable analysis found that age (OR = 1.26, 95% CI = 1.13-1.41), unemployment (OR = 2.22, 95% CI = 1.55-3.16), anxiety (OR = 3.33, 95% CI = 1.24-4.26), depression (OR = 1.71, 95% CI = 1.09-2.63), and comorbidity (OR = 2.62, 95% CI = 1.55-3.29) were all significantly associated with lower physical activity. Lack of formal education (OR = 0.51, 95% CI = 0.30-0.87), alcohol consumption (OR = 0.56, 95% CI = 0.33-0.97), central obesity (OR = 0.58, 95% CI = 0.36-0.92), and moderate and high perceived stress (OR = 0.19, 95% CI = 0.12-0.29) were significantly associated with medium and high physical activity. Therefore, the total self-reported physical activity in our study population is high, but still lower than findings from the national representative 2019 WHO STEPwise approach to surveillance Survey. Low leisure time physical activity is also a concern in our population, a finding consistent with other studies in South Asia. Future studies should examine factors related to leisure time physical activity and the effect of physical activity interventions on overall health in peri-urban populations in Nepal.</p>","PeriodicalId":520503,"journal":{"name":"Advances in global health","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13056369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147641215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}