Community health equity research & policy最新文献

{"title":"<i>'We're More Prepared than Before</i>: Understanding the Strategies Used by a Non-governmental Organization During the COVID-19 Pandemic in Sub-Saharan Africa.","authors":"Satveer Dhillon, Isaac Luginaah, Susan J Elliott, Justine Nagawa, Ronah Agaba Niwagaba","doi":"10.1177/2752535X251317651","DOIUrl":"10.1177/2752535X251317651","url":null,"abstract":"<p><strong>Introduction: </strong>The COVID-19 pandemic had a negative impact on populations worldwide, particularly on older adults residing in low - and middle-income countries. Due to these negative impacts, non-governmental organizations (NGOs) provided extensive support, which affected their operations.</p><p><strong>Methods: </strong>Using the social resilience framework, the purpose of this study was to better understand what strategies NGOs used to support vulnerable populations and how they are building back stronger from the COVID-19 pandemic. In the fall of 2022, 26 (virtual) in-depth interviews were conducted with staff and volunteers from an NGO supporting older adults in Uganda.</p><p><strong>Results: </strong>Several key themes emerged including using existing resources to better support older adults and staff and the importance of having multiple sources of revenue to support organizational operations.</p><p><strong>Discussion: </strong>The key lessons learned by NGO staff and volunteers can be utilized to enact policy and practice change to help strengthen NGOs' social resilience. This would allow them to continue implementing innovative strategies to support vulnerable populations during times of crisis.</p>","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":" ","pages":"2752535X251317651"},"PeriodicalIF":0.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143071272","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":"Health-Related Social Needs Intervention for Adolescents and Young Adults With Type 2 Diabetes and Their Caregivers: An Exploratory Study Using Human-Centered Design.","authors":"Maya I Ragavan, Brianna Hewitt, Erin Mickievicz, Callie Laubacher, Caleb Harrison, Kristin N Ray, Abigail Carpenter, Lynne Williams, Bobbi Watts Geer, Arvin Garg, Mary Ellen Vajravelu","doi":"10.1177/2752535X251316990","DOIUrl":"https://doi.org/10.1177/2752535X251316990","url":null,"abstract":"<p><p>Youth-onset type 2 diabetes (T2D) is increasingly common and projected to impact over 200,000 adolescents and young adults by 2060. Youth with T2D frequently experience health-related social needs (HRSN) that increase their risk for poor outcomes. Using human-centered design methodology, we explored how best to address HRSN in pediatric endocrinology clinics. We conducted two parallel, six-session group meetings with youth (<i>n</i> = 4) and caregivers of youth (<i>n</i> = 6), as well as individual interviews with 12 pediatric endocrinology clinicians. An inductive thematic data analysis approach was used. Participants described that HRSN are pervasive for youth with T2D and are especially impactful after diagnosis. Participants thought that addressing HRSN in healthcare settings was important but emphasized that interventions need to be affirming and provide tangible, relevant resources. Engagement with community health workers trained around diabetes management is needed, as is structural change to disrupt health disparities. Future research and clinical transformation are discussed.</p>","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":" ","pages":"2752535X251316990"},"PeriodicalIF":0.0,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069780","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":"Liberal/Individualized Versus Materialist/Structuralist Approaches to Addressing Social and Health Inequalities: Education and Income as Social Determinants of Health.","authors":"Avery Ervin, Dennis Raphael","doi":"10.1177/2752535X251316086","DOIUrl":"10.1177/2752535X251316086","url":null,"abstract":"<p><p><b>Background:</b> While consensus exists that the sources of health inequalities are social inequalities brought on by the experience of qualitatively different living and working conditions, means of addressing these conditions continue to be the subject of dispute. Whether to emphasis education or income as a social determinant of health is one such example of differing views on the sources of these inequalities and the means of addressing them. These different emphases are often justified through the narrow examination of the magnitude of statistical relationships between educational attainment and income with health outcomes.<b>Purpose:</b> We offer a broader view, seeing these differing emphases as indicative of contrasting views of the nature of society and means of responding to these inequalities with emphasis on education representing a liberal reformist view of the issue while an emphasis on income representing a materialist structuralist view.<b>Research design and study sample:</b> We examine, the validity of this hypothesis through an analysis of content of five representative publications that consider educational attainment as a social determinant of health and five that do so for income.<b>Analysis and results:</b> We find that the emphasis on education as a social determinant of health focuses on the attributes of the individual and is generally accepting of the structures and processes of the existing economic and political order. In contrast, an emphasis on income - when placed within a materialist analysis - views existing systems as inequitably distributing income and other resources thereby requiring their reform or transformation.<b>Conclusion:</b> Considering evidence of deteriorating living and working conditions for many in Canada and elsewhere, we see the latter emphasis as more useful for understanding and addressing these disturbing developments.</p>","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":" ","pages":"2752535X251316086"},"PeriodicalIF":0.0,"publicationDate":"2025-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048722","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":"Community Views of Determinants of Men's Wellbeing in Guatemala: A Study Using Fuzzy Cognitive Mapping.","authors":"Katherine W Pizarro, Anne M Chomat, Diego P Quieju, Bernardo Y López, Iván Sarmiento, Nicholas LeBel, Chloe Mancini, Neil Andersson, Danielle Groleau, Anne Cockcroft","doi":"10.1177/2752535X241312378","DOIUrl":"https://doi.org/10.1177/2752535X241312378","url":null,"abstract":"<p><strong>Background: </strong>In post-conflict Guatemala, Indigenous men's psychological distress has been linked to violence exposure, disrupted social support systems, and structural inequities.</p><p><strong>Purpose: </strong>We aimed to document how communities themselves understand men's wellbeing and the factors that influence men's wellbeing.</p><p><strong>Research design and study sample: </strong>Fuzzy Cognitive Mapping with 20 stakeholder groups in Santiago Atitlán and Cuilco, Guatemala defined men's wellbeing in local terms and identified the influences community groups understood to promote and detract from men's wellbeing. Participants mapped pathways through which influences affected wellbeing and weighted their relative perceived strength.</p><p><strong>Analysis: </strong>The researchers used thematic analysis to summarise influences into 43 factors and used fuzzy transitive closure to calculate their net causal influence for each set of stakeholders. We compared perspectives of groups of adult men, adult women, and practitioners of Mayan medicine in Santiago Atitlán, with a primarily Indigenous population, to groups in Cuilco, with a primarily non-Indigenous population. We also compared perspectives across age groups in Santiago Atitlán.</p><p><strong>Results: </strong>Across regions, maps highlighted the importance of family and social relations, emotional distress, substance use and physical health for men's wellbeing. Basic resource insecurity and unemployment were top risk factors for men's wellbeing in maps from Cuilco but had both risk and protective influences on men's wellbeing in maps from Santiago Atitlán.</p><p><strong>Conclusions: </strong>Findings challenge the focus on scale-up of individual biomedical interventions as the best strategy to reduce the burden of emotional distress in Guatemala and raise questions about standard development approaches that emphasize income generation and educational attainment above cultural continuity and social harmony.</p>","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":" ","pages":"2752535X241312378"},"PeriodicalIF":0.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017336","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":"Community Engagement in the BE SAGE Project: Reducing COVID-19 in Hispanic and Low-Income Preschoolers via Testing and Open-Air Garden-Based Education.","authors":"Hector J Valdez, Michelle Santana, Sandra Genis, Edny Gonzalez, Joanna L Kramer, Rebecca E Lee","doi":"10.1177/2752535X241311172","DOIUrl":"https://doi.org/10.1177/2752535X241311172","url":null,"abstract":"<p><strong>Objective: </strong>Back to Early Care and Education Safely With Sustainability via Active Garden Education (BE SAGE) involved COVID-19 testing and a free garden-based physical activity and nutrition program at early care and education centers with primarily Hispanic/Latino enrollment. This article describes the project community engagement plan, process, and outcomes focusing on deliberate and intentional staffing, an extensive online presence, and focused outreach.</p><p><strong>Methods: </strong>BE SAGE purposefully hired bilingual (English/Spanish) and bicultural staff; developed and maintained a large bilingual online presence (website, newsletters, social media), and fostered community partnerships with community health workers (CHWs) and dedicated staff. Hiring records, online internet records, staff calendars, and field notes were coded and tabulated.</p><p><strong>Results: </strong>84% of the 13-member research team and all CHWs identified as Hispanic or Latino. Predominantly US users accessed the website (<i>N</i> = 3,108), 36.9% of received electronic newsletters were opened, and 1126 followed social media across four platforms. The Outreach Specialist fostered existing relationships and created new partnerships. With the help of CHWs, 562 research participants completed at least one COVID-19 test.</p><p><strong>Conclusions: </strong>By prioritizing representative staffing hires, expending substantial resources on an online presence, and establishing and nurturing our community partnerships, our BE SAGE community engagement approach helped to achieve study aims and create lasting community impact. Community engagement and partnerships to forward research requires ample funding and dedicated representative hiring polices to cultivate and maintain community relationships with asset-driven outcomes.</p><p><strong>Policy implications: </strong>Funding agencies must prioritize community engagement in research outcomes to ensure robust, meaningful scientific discovery and innovation.</p>","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":" ","pages":"2752535X241311172"},"PeriodicalIF":0.0,"publicationDate":"2025-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933871","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":"The Equity Impact of Universal Home Visits to Pregnant Women and Their Spouses in Bauchi State, Nigeria: Secondary Analysis From a Cluster Randomised Controlled Trial.","authors":"Anne Cockcroft, Loubna Belaid, Khalid Omer, Umaira Ansari, Amar Aziz, Yagana Gidado, Hadiza Mudi, Rilwanu Mohammed, Rakiya Sale, Neil Andersson","doi":"10.1177/2752535X241249893","DOIUrl":"10.1177/2752535X241249893","url":null,"abstract":"<p><strong>Background: </strong>Socio-economically disadvantaged women have poor maternal health outcomes. Maternal health interventions often fail to reach those who need them most and may exacerbate inequalities. In Bauchi State, Nigeria, a recent cluster randomised controlled trial (CRCT) showed an impressive impact on maternal health outcomes of universal home visits to pregnant women and their spouses. The home visitors shared evidence about local risk factors actionable by households themselves and the program included specific efforts to ensure all households in the intervention areas received visits.</p><p><strong>Purpose: </strong>To examine equity of the intervention implementation and its pro-equity impact.</p><p><strong>Research design and study sample: </strong>The overall study was a CRCT in a stepped wedge design, examining outcomes among 15,912 pregnant women.</p><p><strong>Analysis: </strong>We examined coverage of the home visits (three or more visits) and their impact on maternal health outcomes according to equity factors at community, household, and individual levels.</p><p><strong>Results: </strong>Disadvantaged pregnant women (living in rural communities, from the poorest households, and without education) were as likely as those less disadvantaged to receive three or more visits. Improvements in maternal knowledge of danger signs and spousal communication, and reductions in heavy work, pregnancy complications, and post-natal sepsis were significantly greater among disadvantaged women according to the same equity factors.</p><p><strong>Conclusions: </strong>The universal home visits had equitable coverage, reaching all pregnant women, including those who do not access facility-based services, and had an important pro-equity impact on maternal health.</p>","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":" ","pages":"141-151"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11577682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140875058","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":"Influences on COVID-19 vaccine Decision-Making: A Qualitative Study With Urban Indigenous and Rural Adults.","authors":"Jeffery Chaichana Peterson, Elizabeth Williams, Christian Goes-Ahead Lopez, Kelley Jansen, Alexandria N Albers, Sophia R Newcomer, James Caringi","doi":"10.1177/2752535X241273816","DOIUrl":"10.1177/2752535X241273816","url":null,"abstract":"<p><p>Despite the safety and effectiveness of the COVID-19 vaccine, public hesitancy about receiving vaccination remains strong among disproportionately affected populations in the United States. To design more locally and culturally appropriate strategies, research is needed to explore the qualitative characteristics of vaccine hesitancy in these populations. Thus, we conducted in-depth interviews with 19 Indigenous and 20 rural participants and utilized a grounded theory approach to identify factors associated with their COVID-19 vaccine decision making. Wariness regarding safety of vaccines, resignation over the quality of available health care, and a historical mistrust of government-led interventions influenced vaccine rejection for indigenous participants. Rural participants remained divided on the perceived threat and consequences of COVID-19 and the efficacy and safety of the vaccines. The influence of friends and family members impacted vaccine hesitancy, as did discussions with healthcare providers when discussions were perceived to be respectful, sensitive, and non-judgmental.</p>","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":" ","pages":"195-206"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141997008","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":"Centering Communities in Global Health: Using Human-Centered Design to Facilitate Collaboration and Intervention Development.","authors":"Sara E Baumann, Megan A Rabin, Bhimsen Devkota, Mary Hawk, Kajol Upadhyaya, Guna Raj Shrestha, Brigit Joseph, Jessica G Burke","doi":"10.1177/2752535X241264331","DOIUrl":"10.1177/2752535X241264331","url":null,"abstract":"<p><strong>Background: </strong>Utilizing iterative and collaborative tools, Human-centered Design (HCD) facilitates the creation of tailored solutions for multifaceted issues by fostering empathy and a deep understanding of human behaviors. This paper presents insights gleaned from employing HCD tools to center communities in global health intervention development.</p><p><strong>Purpose: </strong>The study team collaborated with community members in Dailekh, Nepal to co-design interventions to address harms associated with menstrual seclusion, known as <i>chhaupadi</i>.</p><p><strong>Research design and study sample: </strong>A Community Design Team, comprising 10 women representing various castes and ages convened for a four-day intervention co-design workshop in the community. A Community Validation Team, comprising 12 individuals from diverse occupational and caste backgrounds provided feedback on the interventions. Additionally, six village leaders participated in Key Informant Interviews to garner additional insights.</p><p><strong>Data collection: </strong>In the study's initial \"discovery\" phase, the Community Design Team employed HCD tools to generate a nuanced understanding of the context, stakeholders, and community experiences. Subsequently, in the second \"design\" phase, the Community Design Team crafted interventions to address harms associated with <i>chhaupadi</i>.</p><p><strong>Results: </strong>Invaluable lessons gained from this study underscore the necessity of crafting contextually suitable tools, checklists, and prompts for participants, allocating sufficient staff, time, and resources, and adapting to participants' literacy levels and engagement preferences, whether through group or individual activities.</p><p><strong>Conclusions: </strong>Reflecting on these insights, our experience suggests HCD offers promising tools to authentically and equitably involve participants with diverse backgrounds in articulating their own ideas for community-based solutions in Nepal. Health practitioners, researchers, and intervention development experts are encouraged to consider adopting HCD methodologies to prioritize community voices in devising solutions for complex health challenges.</p>","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":" ","pages":"167-185"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141753519","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":"\"How Fluent Do I Need to Be to Say I'm Fluent?\" Research Experiences of Communities that Speak Languages Other than English.","authors":"Kelsey Schweiberger, Olivia Migliori, Mayah Mbangah, Constanza Arena, Jenny Diaz, Sabrina Yowchyi Liu, Benoit Kihumbu, Benu Rijal, Aweys Mwaliya, Ximena Alejandra Castillo Smyntek, Henry Hoffman, Khara Timsina, Yesmina Salib, Joseph Amodei, Abby Jo Perez, Diego Chaves-Gnecco, Ken Ho, Kheir Mugwaneza, Jaime Sidani, Maya I Ragavan","doi":"10.1177/2752535X241238095","DOIUrl":"10.1177/2752535X241238095","url":null,"abstract":"<p><strong>Objective: </strong>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).</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":" ","pages":"111-125"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140133368","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":"\"How to Make it Out Alive\": A Strengths-Based Analysis of Latinas' Adolescent Sexual Health Experiences.","authors":"Jenn M Lilly, Maddox C Emerick, Derek Tice-Brown, Susan R Pace","doi":"10.1177/2752535X241260444","DOIUrl":"10.1177/2752535X241260444","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":" ","pages":"153-165"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141289015","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}