Community health equity research & policy最新文献

{"title":"Identifying CFIR Inner Setting Factors in the Implementation of a Salon-Based Intervention to Reduce Barriers and Improve Pre-Exposure Prophylaxis (PrEP) Uptake Among Black Women in US South.","authors":"Elizabeth Jeter, Cynthia Bacon, Ragan Johnson, Hannah Lane, Schenita D Randolph","doi":"10.1177/2752535X241305455","DOIUrl":"10.1177/2752535X241305455","url":null,"abstract":"<p><p>US Black women are disproportionally represented in new HIV diagnoses. PrEP is effective in HIV prevention, but Black women's uptake is low. The UPDOs salon-based intervention is effective in overcoming barriers to care but scaling implementation is needed. This mixed-method pilot study sought to understand how salon organizational factors may have influenced UPDOs implementation with a focus on organizational culture, team culture, relational connection, and communication within a Consolidated Framework for Implementation Research (CFIR) inner setting lens. Organizational culture and team culture were measured using the Organizational Culture Survey (OCS) and Team Psychological Safety Scale (TPS). Relational connection and communication were explored qualitatively using participant observations and semi-structured interviews. Findings were positive towards teamwork, morale, information flow, involvement, and supervision as well as reflected positive organizational environment that were supportive of developing knowledge and skills. Relational connection and communication created a trusting environment that facilitated implementation. Future research can benefit from examining organizational environment when scaling interventions to overcome HIV and PrEP inequities.</p>","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":" ","pages":"53-63"},"PeriodicalIF":1.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142735186","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":"\"It's Really About Those Social Determinants of Health that Drive It\": Addressing Food Insecurity in Rural Veterans.","authors":"Jacquelyn N Heuer, Sarah E Bradley, Bridget Hahm, Kristin Pettey, Karen Besterman-Dahan","doi":"10.1177/2752535X241292108","DOIUrl":"10.1177/2752535X241292108","url":null,"abstract":"<p><p>BackgroundThe Department of Veterans Affairs (VA) employs numerous strategies to address food insecurity among rural veterans. This manuscript discusses findings from a quality improvement project examining factors impacting food insecurity among rural veterans.MethodsQualitative interviews were conducted with VA expert informants (n = 30) who worked in national program offices addressing veteran food insecurity, site visit participants (n = 57) at three VA Medical Centers (VAMCs), and rural veterans who screened positive for food insecurity at the VAMC sites (n = 10). Interviews were analyzed with analysis matrices.ResultsCurrent VA programming includes a national food insecurity screening initiative and connecting veterans with local community resources. Veteran participants provided suggestions for addressing veteran food insecurity, including outreach and education. In addition, these interviews demonstrate that rural veteran food insecurity is intrinsically interwoven with other social determinants of health.ConclusionsAddressing rural veteran food insecurity must include strategies for understanding and supporting interconnected veteran needs.</p>","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":" ","pages":"65-77"},"PeriodicalIF":1.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142482298","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 Health Agents Dismantling Gender Norms in a Machismo Society.","authors":"Elizabeth M Allen, Michael J Van Skiba, Ariel Frisancho, Claudia Llanten, Cecilia Izarra","doi":"10.1177/2752535X241298832","DOIUrl":"10.1177/2752535X241298832","url":null,"abstract":"<p><p>BackgroundCommunity health agents (CHAs) play a crucial role in healthcare delivery and can also impact societal gender norms. This study aims to understand CHAs' perceptions of gender roles and norms to identify long-term strategies for women's empowerment.MethodsWe conducted 90-min focus group discussions (FGDs) among CHAs in Peru. FGDs illuminated women's perceptions of gender roles and how to empower women in communities.ResultsIn total, 53 CHAs participated across six FGDs. CHAs noted that women face significant barriers, are treated disrespectfully, and relegated to domestic roles. Ideal gender norms were described as having access to education, increasing voice, inclusion in decision-making, and independence. Changing gender norms requires that men, women, families, and communities support women's progress in society.ConclusionsCHAs are in a unique and powerful position to drive social change. Understanding CHAs perceptions can help develop effective strategies for women's empowerment.</p>","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":" ","pages":"31-39"},"PeriodicalIF":1.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607667","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":"Inadequate Indoor Air Quality and Household Overcrowding Predispose to Life-Threatening Pulmonary Infections: Call for Action.","authors":"Malvika Kaul, Israel Rubinstein","doi":"10.1177/2752535X251383183","DOIUrl":"https://doi.org/10.1177/2752535X251383183","url":null,"abstract":"<p><p>We propose that stakeholders should develop an economically sustainable, public health intervention to improve indoor air quality and to reduce overcrowding in households of underserved U.S. rural, urban and suburban residents exposed to life-threatening respiratory infections, such as caused by coronavirus disease 2019, influenza, and respiratory syncytial virus. We posit that a multifaceted community-based intervention in these households would improve social inequities, promote health justice, and reduce health care expenditure. However, this call for action would require an interdisciplinary, coordinated, and sustainable action plan devised by federal, state, county, and city government departments and agencies in close collaboration with and input from local community leaders, members, and residents.</p>","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":" ","pages":"2752535X251383183"},"PeriodicalIF":1.8,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139627","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":"Media Usage, Family Dynamics, Socio-Economic Factors and Geospatial Analysis of Mosquito Net Usage in Ghana: Insights From a Nationally Representative Study.","authors":"Crispin Rakibu Mbamba, Yohan Moon, Cheng Ren","doi":"10.1177/2752535X251383182","DOIUrl":"https://doi.org/10.1177/2752535X251383182","url":null,"abstract":"<p><p><b>Background:</b> Malaria prevention through mosquito net usage remains a critical public health challenge in Ghana, despite widespread distribution efforts. <b>Purpose:</b> This study examines how media exposure, family structures, and socio-economic conditions influence mosquito net utilization patterns across Ghana's diverse regions. <b>Reseaech design and study sample:</b> Drawing from the 2022 Demographic and Health Survey data of 9353 women aged 15-49, this research employs both logistic regression analysis and innovative geospatial techniques to uncover usage determinants. <b>Analysis and results:</b> Findings reveal a substantial gap between net ownership (80.6%) and actual usage (56.4%), with significant variations across demographic groups. The study identifies that participants with health cards had 51% higher odds of using nets (AOR = 1.51), while those from rural areas showed higher utilization rates compared to urban residents. Geospatial analysis exposed a concerning mismatch between healthcare facility distribution and malaria burden, particularly in Northern and Upper West regions, potentially hampering access to nets and educational resources. Family composition emerged as a key factor, with participants living with partners and those having children demonstrating significantly higher usage rates. Interestingly, while traditional media consumption (radio) positively correlated with net usage, internet use was associated with decreased utilization. The research also found that despite lower socioeconomic status households showing higher usage rates, education levels positively influenced utilization across all groups. <b>Conclusions:</b> These findings contribute to understanding the complex interplay between social determinants and healthcare infrastructure in shaping preventive health behaviors, suggesting the need for targeted interventions that consider both geographical accessibility and socio-cultural contexts in malaria prevention strategies.</p>","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":" ","pages":"2752535X251383182"},"PeriodicalIF":1.8,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132596","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":"Influences on Food Choices of Cambodian Women for Themselves and Their Families.","authors":"Janelle L Windus, Kerith Duncanson, Tracy L Burrows, Megan E Rollo, Clare E Collins","doi":"10.1177/2752535X251374278","DOIUrl":"https://doi.org/10.1177/2752535X251374278","url":null,"abstract":"<p><p>BackgroundThe nutritional status of Cambodian women and children remain poor despite implementation of dietary intake interventions. Cambodia-specific studies have explored how education influences nutrition and health behavior, but not factors influencing Cambodian women's food decision-making for themselves and their families.ObjectiveTo understand Cambodian women's food decision-making, particularly related to barriers and enablers of healthy eating for themselves and their families.MethodsQualitative descriptive methodology within an experiential paradigm involving four focus groups in rural and urban locations of Siem Reap province, Cambodia. Participants were Cambodian women aged from 18 years with at least one child under 5 years of age, and primarily responsible for food provision in their family. Data was analyzed using reflexive thematic analysis.ResultsThe three main themes identified were: (1) access impacts food choice; (2) responsible, nurturing food provision role; and (3) dichotomous perceptions of food. Access to food strongly influenced Cambodian women's food choices, particularly cost and availability. Cambodian women were driven to fulfil their role and nurturing instincts to provide for their family within their capabilities and knowledge. They considered healthy food using a wide range of factors outside of nutrient values, including food texture, immediate body response, cultural food taboos and use of chemicals such as pesticides.ConclusionsTo optimize nutrient intakes, practical, culturally appropriate nutrition interventions that address food access and perceptions of Cambodian mothers regarding their nurturing food provision role are needed.</p>","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":" ","pages":"2752535X251374278"},"PeriodicalIF":1.8,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034894","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":"Using Participatory Methods to Develop the Prediabetes-Related Stress Scale (PRSS).","authors":"Deshira D Wallace, Tiffiany Portacio, Paris Wiechecki Vergara","doi":"10.1177/2752535X251372277","DOIUrl":"https://doi.org/10.1177/2752535X251372277","url":null,"abstract":"<p><p>BackgroundPrediabetes is a risk factor for type 2 diabetes. The transition from prediabetes to type 2 diabetes is inequitable, with Latinos reporting an increased risk than other groups. Stress can affect this transition; however, we have no means of measuring prediabetes-related stress.Research Design and Study SampleWe used group concept-mapping, a participatory mixed-methods approach to collect data from English- and Spanish-speaking Latino adults (18+ years old) living with prediabetes, or clinical providers, in the United States. Participants were invited to multiple activities. First, brainstorming around focal questions about the stress of prediabetes diagnosis and management. Second, individually sorting 86 brainstormed statements into like groups, and rating these statements based on perceived importance. Third, interpreting quantitative results. Post-concept mapping, we invited participants to complete cognitive interviews of the initial English and Spanish versions of the scale.ResultsForty participants engaged in one or more activities. Results from the sorting and rating activities resulted in 10 clusters that reflect how participants grouped the 86 statements. The clusters were shared with participants to support the interpretation of the data. Cognitive interviews revealed participant suggestions to improve comprehension of instructions, response options, and items. This iterative process resulted in a 29-item scale developed in English and Spanish.ConclusionWe centered participant experiences to create the first scale that focuses on the emotional health related to prediabetes diagnosis and management. This scale can support diabetes prevention research by measuring prediabetes-specific stress and support clinical interactions to inform tailored conversations between patients and providers.</p>","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":" ","pages":"2752535X251372277"},"PeriodicalIF":1.8,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980773","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":"Promoting Health Equity in an Era of Growing Contradictions Between Capital Accumulation and Social Reproduction in Capitalist Economies.","authors":"Dennis Raphael, Toba Bryant, Rozhin Amin","doi":"10.1177/2752535X251370927","DOIUrl":"https://doi.org/10.1177/2752535X251370927","url":null,"abstract":"<p><p><b>Background:</b> Despite a robust literature on the importance of promoting health equity, actual progress in doing so is flagging and this is especially the case in Anglo-Saxon liberal welfare states such as Canada, the USA, and the United Kingdom. <b>Purpose:</b> In this paper we place these developments within the context of the political economy concepts of capital accumulation -- or profit making -- and social reproduction -- or the ongoing functioning of society. <b>Research Design:</b> We carefully reviewed the current state of theorization and research into the political economy of health to identify the main themes and findings in this literature in relation to the polycrisis of living and working conditions in Canada, the USA, and United Kingdom.<b>Analysis:</b> We drew upon critical materialist political economy thought to show how the growing contradictions between profit making and societal functioning in capitalist economies - and this especially so in liberal welfare states -- threaten both the quality and equitable distribution of the living and working conditions that shape health - the social determinants of health - and the organization and delivery of health care. <b>Results:</b> While there is increasing application of political economy approaches to understanding the adverse effects of capitalism, almost all of these are limited to critiquing capitalism without envisioning a post-capitalist society. Various ways of addressing these contradictions are provided that include 1) redistribution, social spending by governments, and managing the market economy within existing economic and political structures; 2) movement towards social democratic or conservative models of governance common to the Nordic and Continental nations respectively; or 3) building a post-capitalist socialist future.<b>Conclusion:</b> While we offer three paths forward towards achieving health equity, we conclude that the last path, building a post-capitalist socialist future, offers the most useful means of promoting health equity in both the short and long-term.</p>","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":" ","pages":"2752535X251370927"},"PeriodicalIF":1.8,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980816","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":"An Integrated Methodological Approach to Address Immigrants' Complex Health Issues: Lessons From the CAN-HEAL Study.","authors":"Sarah Elshahat, Tina Moffat, Zena Shamli Oghli, Yasmine Belahlou, Yumnah Jafri, Salima Zabian, Sarah Ah Curtay","doi":"10.1177/2752535X251371127","DOIUrl":"https://doi.org/10.1177/2752535X251371127","url":null,"abstract":"<p><p>Community-based participatory research (CBPR) and integrated knowledge translation (IKT) are methodological approaches that emphasize the value of equitable partnerships between researchers and community partners. The main difference between these approaches is that CBPR is advocacy-centered and aims at addressing inequities by instigating systemic and policy changes, whilst IKT is application- and upstream solution-oriented especially within the context of health and social care improvement. Previous studies that have used a collaborative approach mainly focused on either CBPR or IKT to a lesser extent.The CAN-HEAL project employed an innovative methodological approach that integrates CBPR and IKT to address mental health needs among Arab immigrants and refugees in Ontario, Canada. Integral to this approach are three pillars: (1) establishment of a multi-level community partnership; (2) adherence to cultural sensitivity principles; and (3) commitment to social justice and application. The use of an CBPR-IKT approach led to numerous successes, including the co-development of a holistic upstream-downstream-based health promotion action plan to tackle inequities. This approach was associated with different challenges (e.g., limited resources), which were mitigated by employing certain enablers (e.g., assistance from community leaders). Based on lessons from this project, recommendations are made for governmental agencies and academic institutions to advance CBPR-IKT research to promote the sustainability and well-being of communities.</p>","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":" ","pages":"2752535X251371127"},"PeriodicalIF":1.8,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980759","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":"Factors Associated With Stigma and Depression Among People Living With HIV and Food Insecurity in the Dominican Republic.","authors":"Gabriela Armenta, Bing Han, Kartika Palar, Amarilis Then-Paulino, Glenn J Wagner, Kathryn P Derose","doi":"10.1177/2752535X251369101","DOIUrl":"https://doi.org/10.1177/2752535X251369101","url":null,"abstract":"<p><p>Food insecurity, depression, and HIV stigma adversely affect people with HIV and women face heightened vulnerability. Limited evidence exists regarding the factors associated with HIV internalized and experienced stigmas and depression for people with HIV and food insecurity in the Dominican Republic (DR). Using an HIV clinic-based sample of people with food insecurity in the DR (<i>n</i> = 115), we found that depressive symptoms and internalized and experienced stigmas were highly prevalent. A cross-sectional, multivariate linear regression analysis found that women, Haitians, and those with a detectable viral load had higher internalized stigma; those reporting intimate partner violence had higher internalized and experienced stigmas, while those reporting stronger social support had lower stigma scores for both types; finally, those with an undetectable viral load, better physical health, and better antiretroviral therapy adherence had reduced depression symptom severity. Targeting inequities related to gender, nationality and/or ethnicity, and HIV disease progression may mitigate internalized HIV stigma, and addressing the correlates of HIV stigmas and depression may improve HIV outcomes.</p>","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":" ","pages":"2752535X251369101"},"PeriodicalIF":1.8,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980770","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}