Community health equity research & policy最新文献

{"title":"Ethical Reflections on Integrating Artificial Intelligence in Care Practices.","authors":"Giulia Ricchezze, Luca Tomassini, Mauro Bacci","doi":"10.1177/2752535X251370928","DOIUrl":"10.1177/2752535X251370928","url":null,"abstract":"<p><p>BackgroundThe integration of artificial intelligence (AI) and robotics into disability care presents transformative opportunities while simultaneously raising pressing ethical concerns. Issues related to autonomy, human dignity, and equitable access require careful consideration, particularly as these technologies reshape the dynamics of care delivery and clinical relationships. PurposeDrawing on an interdisciplinary approach that synthesizes insights from bioethical literature, illustrative case studies, and expert perspectives from healthcare, law, and technology, this reflection examines the ethical landscape of AI-supported rehabilitation and assistance. Particular attention is given to risks such as algorithmic bias, over-reliance on automation, and the potential erosion of the human dimension in care. A biopsychosocial model serves as a guiding framework to analyze how technological systems intersect with the lived experiences of individuals with disabilities. Ethical tensions emerge around personalized care, transparency in decision-making, and the inclusivity of data and design processes.ConclusionsThe analysis emphasizes the need for governance models that embed ethical safeguards and promote fairness, while also encouraging participatory design involving patients, caregivers, and healthcare professionals. By situating technological developments within broader socio-political and clinical contexts, this reflection identifies pathways toward a more equitable and human-centered integration of AI. Recommendations include investment in inclusive datasets, the development of fairness-aware algorithms, and the establishment of regulatory mechanisms that align innovation with fundamental rights and principles of social justice in healthcare.</p>","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":" ","pages":"83-88"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980827","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":"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":"49-61"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13499906/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034894","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":"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":"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":"63-75"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","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":"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":"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":"11-21"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12686977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980770","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":"A Group-Based Participatory Approach to Examine Community Resilience and Trauma.","authors":"Rhonda BeLue, Keon Gilbert, Paula Southerland, Bryan Ho, Adolf Delgado, Adaobi Anakwe, Kemba Noel-London, Eboni Hooper-Boateng, Sara Mohamed, Erica Sosa","doi":"10.1177/2752535X251363925","DOIUrl":"10.1177/2752535X251363925","url":null,"abstract":"<p><p>BackgroundThe St Louis Resiliency in Communities After Stress and Trauma (ReCAST) project promoted community well-being in a designated Promise Zone over a 5-year period. The primary goals of the ReCAST project are: (1) to build a foundation to promote well-being, resiliency, and community healing through service integration; (2) to improve access to trauma-informed community behavioral health resources and youth peer support; and (3) to create community change through community and youth engagement, leadership development, improved governance, and capacity building.PurposeTo examine ReCAST stakeholder perceptions of resilience and trauma in their communities using Concept Mapping (CM), a participatory mixed methodology.ApproachCM is an integrated approach that supports the structured conceptualization of ideas and applies multidimensional scaling and hierarchical cluster analysis to bring together and organize the ideas of a group to capture the perspectives of multiple stakeholders.Results33 stakeholders participated in the ReCAST program. The resilience concept map yielded five clusters: (1) Community Relationships (positive and productive), (2) Religious Organizations/Spirituality, (3) Interaction with Diverse Communities, (4) People in power to create change, and (5) Community gatherings and organizations. The trauma cluster map identified the following clusters: (1) Substandard Education, (2) Traumatic events/community violence, (3) Racial Trauma, and (4) Physical Degradation of neighborhoods.DiscussionBased on CM results, participants identified the need for local political officials to make a coordinated effort to address issues expressed in both maps and funding of local organizations to address issues related to trauma and resilience, especially youth organizations.</p>","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":" ","pages":"89-99"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13499918/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144755250","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":"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":"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":"23-36"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13499923/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980759","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":"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":"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":"37-47"},"PeriodicalIF":2.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13499908/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980773","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":"Beyond individual deficit: A structural analysis of mental health access for Black immigrant youth of African descent in Canada.","authors":"Temitayo Sodunke, Nancy Ross, Penelope Poyah, Robert Gilbert, Jeff Karabanow","doi":"10.1177/2752535X261492025","DOIUrl":"https://doi.org/10.1177/2752535X261492025","url":null,"abstract":"<p><p>BackgroundBlack populations have deep ancestral ties to Canada, yet little research examines what shapes access to mental healthcare for Black immigrant youth of African descent (BIYAD), defined here as first-generation African-born Black young adults aged 18 to 34. Almost none of these studies examine how race, immigration status and young adulthood intersect to shape that access.PurposeTo argue that persistent underutilisation of mental health services by BIYAD is structurally produced rather than a failure of individual help-seeking or resilience, and to identify the structural drivers that clinic-centred models obscure by treating distress as personal deficit.Research DesignConceptual and critical policy analysis integrating Levesque and colleagues' multidimensional model of access with intersectionality theory. No empirical study was undertaken.Study SampleNot applicable. The analytic focus is BIYAD in Canada. No primary data were collected.Data Collection and/or AnalysisPeer-reviewed and grey literature on anti-Black racism, immigration and settlement, socio-economic position and Black mental health in Canada was assembled purposively and analysed against the five access dimensions and these intersecting axes.ResultsAccess narrows at every dimension: outreach that misses African-born communities and mistrust after racist encounters (approachability); stigma and few providers sharing language, faith or race (acceptability); thin Black-led provision and long waits (availability); precarious work and uninsured psychotherapy (affordability); and clinic-centred care that misreads spiritually grounded distress (appropriateness). These constraints compound rather than add. Framing resilience as the remedy recasts structural failure as personal attribute.ConclusionHealth equity for BIYAD requires structural and community-grounded reform rather than individual remediation: accountable anti-racism and cultural safety measures, culturally responsive community-based care, and sustained investment in Black-led services.</p>","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":" ","pages":"2752535X261492025"},"PeriodicalIF":2.2,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149076859","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":"Enhancing family caregiving through support from community health workers: A pathway towards a more integrated healthcare system.","authors":"Babatope Ayokunle Ogunjesa, Andiara Schwingel, Sunita Dodani","doi":"10.1177/2752535X261492031","DOIUrl":"https://doi.org/10.1177/2752535X261492031","url":null,"abstract":"<p><p>PurposeThis commentary examines the growing burden on family caregivers in the United States and argues for the strategic integration of community health workers (CHWs) into caregiver support models as a practical, equity-centered solution.Major FindingsFamily caregivers provide the majority of long-term care in the United States, but receive limited formal support despite escalating care demands and increasing complexity. As caregiving continues shifting into community and home settings, CHWs are uniquely positioned to address this gap through care navigation, coordination, education, and culturally responsive support. Emerging evidence and recent policy developments, including expanded Medicaid coverage and new Medicare reimbursement pathways, present concrete opportunities to integrate CHWs into family caregiver support frameworks, although early uptake of the new reimbursement codes remains limited and workforce capacity constraints must be addressed.ConclusionsIntegrating CHWs into family caregiver support models represents a practical, equity-centered approach to strengthening community-based care and improving health system resilience. Advancing this workforce integration, with attention to scalability, training, supervision, safety, gender equity, and sustainable reimbursement, could meaningfully expand caregiver capacity, reduce disparities, and support a more cohesive and responsive healthcare system.</p>","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":" ","pages":"2752535X261492031"},"PeriodicalIF":2.2,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009463","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":"Challenges of accessibility to healthcare services for persons with disabilities in Nigeria: A human-rights and SDG 3 analysis and evidence-based interventions.","authors":"Stephen Olabode Asaolu, Hilary Okagbue, Rauf Rauf, Tunde Masseyferguson Ojo, Chester Kalinda, Keshab Deuba, Kon Alier, Adedotun Esan, Sunday Atobatele","doi":"10.1177/2752535X261487473","DOIUrl":"https://doi.org/10.1177/2752535X261487473","url":null,"abstract":"<p><p>BackgroundPersons with disabilities (PWDs) face persistent barriers to healthcare access in Nigeria despite progressive legislation and policy commitments. These barriers undermine progress towards Universal Health Coverage (UHC) and Sustainable Development Goal 3 (SDG 3), and reflect ongoing violations of the right to health. Existing scholarship largely documents these barriers descriptively, with limited application of enforceable human-rights and health-systems frameworks.PurposeWe applied a normative policy and human-rights lens to examine healthcare inaccessibility for PWDs in Nigeria. Using the Availability, Accessibility, Acceptability, and Quality (AAAQ) framework, it identifies systemic failures, locates institutional responsibility, and proposes rights-based, contextually appropriate interventions.Research design and study sampleWe conducted a normative policy analysis and narrative synthesis of peer-reviewed literature, national laws and policies, and international normative instruments relevant to disability and health in Nigeria.Analysis and resultsBarriers to care span all AAAQ dimensions and are driven by chronic underinvestment in disability-responsive services, weak regulatory enforcement, fragmented federal-state governance, limited mainstreaming of disability within health planning, and persistent stigma. Exclusion is particularly severe for women with disabilities, rural PWDs, and conflict-affected populations. Priority interventions-including disability-inclusive primary healthcare infrastructure, health-worker training, accessible health information, inclusive community outreach, financial protection, and participatory governance-are mapped to specific AAAQ deficits and health-system building blocks.ConclusionHealthcare inaccessibility for PWDs in Nigeria is a structural and institutional problem requiring system-wide, rights-based reform. Embedding disability inclusion within core health-system functions and strengthening accountability for the Disability Act are essential to achieving UHC and realising the right to health.</p>","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":" ","pages":"2752535X261487473"},"PeriodicalIF":2.2,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148946380","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}