Community health equity research & policy最新文献

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Childbearing Women's Experiences of and Interactions With the Health System in Vietnam: A Critical Interpretive Synthesis. 越南育龄妇女对卫生系统的体验以及与卫生系统的互动:批判性解读综述》。
Community health equity research & policy Pub Date : 2024-08-27 DOI: 10.1177/2752535X241277678
Kimberly Lakin, Nguyen Thu Huong, Sumit Kane
{"title":"Childbearing Women's Experiences of and Interactions With the Health System in Vietnam: A Critical Interpretive Synthesis.","authors":"Kimberly Lakin, Nguyen Thu Huong, Sumit Kane","doi":"10.1177/2752535X241277678","DOIUrl":"https://doi.org/10.1177/2752535X241277678","url":null,"abstract":"<p><p>Scholars have long argued that the care experience is shaped by context, and by evolutions in this context. Using Vietnam as a case, we critically interrogate the literature on women's experiences with maternity care to unpack whether and if it engages with the major social, economic, and health system impacts of the Doi Moi reforms in Vietnam and with what consequences for equity. We conducted a critical interpretive synthesis of this literature in light of the social, economic, and health system transformations driven by the Doi Moi reforms. We offer three critiques: (1) an overwhelming focus on public maternity care provision in rural/mountainous regions of Vietnam, (2) a narrow focus on women's ethnic identity, and (3) a misplaced preoccupation with women's limited autonomy and agency. We argue that future research needs to consider the impact of Vietnam's shift towards market-oriented care provision, and the broader societal and health system changes impacting both rural and urban areas, as well as ethnic minority and Kinh majority populations.</p>","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":" ","pages":"2752535X241277678"},"PeriodicalIF":0.0,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142082745","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}
引用次数: 0
Health Equity in All Urban Policies: A Case Study of Richmond, California. 所有城市政策中的健康公平:加利福尼亚州里士满案例研究》。
Community health equity research & policy Pub Date : 2024-08-13 DOI: 10.1177/2752535X241273955
Jason Corburn, Shasa Curl, Gabino Arredondo
{"title":"Health Equity in All Urban Policies: A Case Study of Richmond, California.","authors":"Jason Corburn, Shasa Curl, Gabino Arredondo","doi":"10.1177/2752535X241273955","DOIUrl":"https://doi.org/10.1177/2752535X241273955","url":null,"abstract":"<p><p>Local governments working in partnership with communities can institutionalize practices that promote health equity. We offer a case study of how one city in the US is implementing Health in All Policies (HiAP) with the explicit aim of promoting health equity. We use participant observations, original document reviews and interviews to describe how Richmond, California, is building new partnerships, programs and practices with community-based organizations and within government itself as part of the implementation of its HiAP Ordinance. We also report on indicators that were identified by community and government stakeholders for tracking progress toward improving place-based determinants of population health. We find that the responsibility for implementing Richmond's HiAP Ordinance rests on a new institution within local government and this entity is building new partnerships, promoting innovative policies and augmenting practices toward greater health equity. We also reveal how city governments and community partners can collaboratively track progress toward health equity using locally gathered data.</p>","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":" ","pages":"2752535X241273955"},"PeriodicalIF":0.0,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141972347","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}
引用次数: 0
Setting the Priorities for LGBT+ Research and Intervention Effort in Malaysia Through Community Voices: A Brief Report. 通过社区的声音确定马来西亚 LGBT+ 研究和干预工作的优先事项:简要报告。
Community health equity research & policy Pub Date : 2024-08-09 DOI: 10.1177/2752535X241273831
Kyle Tan
{"title":"Setting the Priorities for LGBT+ Research and Intervention Effort in Malaysia Through Community Voices: A Brief Report.","authors":"Kyle Tan","doi":"10.1177/2752535X241273831","DOIUrl":"https://doi.org/10.1177/2752535X241273831","url":null,"abstract":"<p><p>Internationally, there is a growing acceptance of gender and sexuality diversity and acknowledgment of LGBT + identities as health determinants. However, caution is warranted when applying research and intervention priorities from Global North countries to regions where LGBT + identities remain criminalized. In 2024, Malaysia maintains legal stances persecuting LGBT + individuals and shows no intent to address this human rights issue. This study offers an overview of pivotal issues identified by LGBT + communities in Malaysia that urgently require attention and resolution. Data were employed from a large-scale community-based survey: the KAMI Survey that recruited LGBT + participants in Malaysia in late 2023 and descriptive analyses were conducted on the responses of 637 participants (mean age = 27.75). Results revealed key issues deemed 'very important' to address by participants comprised HIV/AIDS, training for healthcare providers, police mistreatment, and discrimination, with more than 80% reporting each of these. When prompted to select a single issue for urgent resolution, three-fifths (61.0%) prioritized 'criminalizing laws affecting LGBT + individuals'. Echoing prolonged advocacy by local LGBT + community organizations, the author emphasizes the need for collective allyship across stakeholders to develop evidence-based practices and policies to address the concerns articulated in this paper.</p>","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":" ","pages":"2752535X241273831"},"PeriodicalIF":0.0,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141908517","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}
引用次数: 0
Impact of a Hospital-Based Food Pharmacy Program on Health Outcomes of Vulnerable Patients. 医院食品药房计划对弱势患者健康结果的影响。
Community health equity research & policy Pub Date : 2024-07-26 DOI: 10.1177/2752535X241269528
Lori A Bilello, Ross Jones, Nora Kassis, Chardaè Whitner, Ann-Marie Knight, Fern Webb
{"title":"Impact of a Hospital-Based Food Pharmacy Program on Health Outcomes of Vulnerable Patients.","authors":"Lori A Bilello, Ross Jones, Nora Kassis, Chardaè Whitner, Ann-Marie Knight, Fern Webb","doi":"10.1177/2752535X241269528","DOIUrl":"https://doi.org/10.1177/2752535X241269528","url":null,"abstract":"<p><p>Access to healthy foods, especially for those who are living with diabetes and hypertension, is crucial in managing these chronic diseases. This study evaluates the implementation of a food pharmacy and food prescription program at a safety-net hospital that serves vulnerable populations. Patients who screen as food insecure using the USDA adult food security survey receive a referral from the physician to the food pharmacy program where a dietician reviews their dietary requirements based on their chronic disease and develops a diet plan. Patients then receive fresh produce, meats and other products every 2 weeks that meets their nutritional needs from the food pharmacy. Biometric data from the patient's most recent clinic visit at the time of enrollment was collected as the baseline measures including blood pressure, weight, and HbA1c (if diabetic). Additionally, biometric information was collected from the patient's medical records from regularly scheduled clinic visits at 6 month intervals. A total of 266 patients were enrolled in the program during the 13-month period that was studied (121 patients with 6-month data and 68 patients with 12-month data). The statistical analysis showed a significant improvement in diastolic blood pressure at 12 months and in weight at both the 6 months and 12 months timeframes when comparing to baseline biometrics.</p>","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":" ","pages":"2752535X241269528"},"PeriodicalIF":0.0,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141768269","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}
引用次数: 0
Modifying Text Messages from a Faith-Based Physical Activity Intervention with Latino Adults in Response to the COVID-19 Pandemic. 针对 COVID-19 大流行,修改以信仰为基础的拉丁裔成人体育锻炼干预活动的短信。
Community health equity research & policy Pub Date : 2024-07-01 Epub Date: 2023-01-18 DOI: 10.1177/2752535X221150009
Margaret D Whitley, Lilian G Perez, Gabriela Castro, Anne Larson, Kathryn P Derose
{"title":"Modifying Text Messages from a Faith-Based Physical Activity Intervention with Latino Adults in Response to the COVID-19 Pandemic.","authors":"Margaret D Whitley, Lilian G Perez, Gabriela Castro, Anne Larson, Kathryn P Derose","doi":"10.1177/2752535X221150009","DOIUrl":"10.1177/2752535X221150009","url":null,"abstract":"<p><strong>Background: </strong>Text messages are useful for health promotion and can be modified during public health emergencies.</p><p><strong>Purpose: </strong>Describe how we developed and implemented a physical activity (PA) text messaging component within a faith-based intervention, modified the text message content in response to the COVID-19 pandemic and evaluated participants' perceptions of the modified text messages.</p><p><strong>Research design and study sample: </strong>PA promotion text messages were delivered to predominately Spanish-speaking, churchgoing Latino adults (<i>n</i> = 284) in Los Angeles, California. In 2020, we modified the messages to disseminate COVID-19-related information and support and share virtual PA resources.</p><p><strong>Data collection and analysis: </strong>We analyzed quantitative and qualitative survey data to gauge participants' experiences with the text messages.</p><p><strong>Results: </strong>COVID-19 related text messages were a feasible, acceptable addition to a PA intervention for a sample of Latinos.</p><p><strong>Conclusions: </strong>Throughout the pandemic, the messages enabled continued communication and support for PA and protection from COVID-19 in a population at high-risk of health inequities.</p>","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":" ","pages":"399-407"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9852972/pdf/10.1177_2752535X221150009.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9463759","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}
引用次数: 0
Strengthening Health Literacy Through Structured Sessions for Non-Communicable Diseases in Low-Resource Settings: The Learning Nest Model. 在资源匮乏地区,通过非传染性疾病结构化课程加强健康知识普及:学习巢模式
Community health equity research & policy Pub Date : 2024-07-01 Epub Date: 2023-06-22 DOI: 10.1177/2752535X231184346
Maryvette Balcou-Debussche, Véronique La Hausse, Muriel Roddier, Claude Sokolowsky, Joëlle Rastami, Stéphane Besançon, Delphine Ballet, Jessica Caroupin, Sabeena Dowlut, Xavier Debussche
{"title":"Strengthening Health Literacy Through Structured Sessions for Non-Communicable Diseases in Low-Resource Settings: The Learning Nest Model.","authors":"Maryvette Balcou-Debussche, Véronique La Hausse, Muriel Roddier, Claude Sokolowsky, Joëlle Rastami, Stéphane Besançon, Delphine Ballet, Jessica Caroupin, Sabeena Dowlut, Xavier Debussche","doi":"10.1177/2752535X231184346","DOIUrl":"10.1177/2752535X231184346","url":null,"abstract":"<p><p>Health literate self-management education is at stake for the prevention and management of non-communicable diseases in low resources settings and countries. Here we describe the Learning Nest in Ordinary Context (NA-CO in French, <i>Nids d'Apprentissage en Contexte Ordinaire)</i> aiming at the structuring of health education programs at the micro- (education sessions) and the meso-levels (adapted to context). The Learning Nest model was designed based on a combination on health literacy principles and on studies conducted with vulnerable people with non-communicable diseases. Observation of NA-CO active-learning sessions found them to be operational and relevant as they center on access, understanding, and use of health information while integrating the ordinary context of learners. The Learning Nest packages (including several adapted thematic sessions, training of trainers and development in context) were shown to be feasible and realistic in diverse locations (Reunion, Mali, Mayotte, Mauritius, Burundi). Qualitative and intervention studies have documented the potential usefulness of the Learning Nest model for context- and setting-specific health literacy interventions.</p>","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":" ","pages":"409-418"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9671415","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}
引用次数: 0
Traditional Midwifery Contribution to Safe Birth in Cultural Safety: Narrative Evaluation of an Intervention in Guerrero, Mexico. 传统助产士对文化安全中的安全分娩的贡献:墨西哥格雷罗州干预措施的叙述性评估。
Community health equity research & policy Pub Date : 2024-07-01 Epub Date: 2022-10-03 DOI: 10.1177/0272684X221120481
Iván Sarmiento, Sergio Paredes-Solís, Abraham De Jesús-García, Nadia Maciel-Paulino, Alba Meneses-Rentería, Carolina Amaya, Anne Cockcroft, Neil Andersson
{"title":"Traditional Midwifery Contribution to Safe Birth in Cultural Safety: Narrative Evaluation of an Intervention in Guerrero, Mexico.","authors":"Iván Sarmiento, Sergio Paredes-Solís, Abraham De Jesús-García, Nadia Maciel-Paulino, Alba Meneses-Rentería, Carolina Amaya, Anne Cockcroft, Neil Andersson","doi":"10.1177/0272684X221120481","DOIUrl":"10.1177/0272684X221120481","url":null,"abstract":"<p><p>A 2017 randomised controlled trial in Guerrero State, Mexico, showed supporting Indigenous traditional midwives on their own terms improved traditional childbirths without inferior maternal health outcomes. This narrative evaluation complements the trial to document participant experience of safer birth in cultural safety, transformative dynamics and implementation issues of the intervention. Stories came from 26 traditional midwives, 28 apprentices, 12 intercultural brokers and 20 Indigenous women who experienced the intervention. Their accounts indicate the intervention revitalised traditional midwifery and consolidated local skills through traditional midwife apprentices and intercultural brokers to support safe birth. According to the stories, communities reintroduced traditional perinatal care and reported positive health impacts for mothers, children, and other adults, which contributed to early collaboration with official health services. Challenges included remuneration and disinterest of younger apprentices and brokers. The intervention seems to have improved interaction between traditional and Western services, setting the stage for further intercultural dialogue.</p>","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":" ","pages":"377-389"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11143758/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40394262","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}
引用次数: 0
A Cross-Sectional Analysis of Community Perceptions of Flu and COVID-19 Vaccines at Turtle Creek Primary Care Center. Turtle Creek初级保健中心社区对流感和新冠肺炎疫苗认知的跨部门分析。
Community health equity research & policy Pub Date : 2024-07-01 Epub Date: 2023-10-14 DOI: 10.1177/2752535X231205665
Anjana Murali, Jorna Sojati, Marina Levochkina, Catherine Pressimone, Kobi Griffith, Erica Fan, Allie Dakroub
{"title":"A Cross-Sectional Analysis of Community Perceptions of Flu and COVID-19 Vaccines at Turtle Creek Primary Care Center.","authors":"Anjana Murali, Jorna Sojati, Marina Levochkina, Catherine Pressimone, Kobi Griffith, Erica Fan, Allie Dakroub","doi":"10.1177/2752535X231205665","DOIUrl":"10.1177/2752535X231205665","url":null,"abstract":"<p><strong>Background: </strong>Influenza (flu) and COVID-19 vaccination rates are subpar across the US, especially in racial and/or socioeconomic minority groups who are understudied in public health literature.</p><p><strong>Objective: </strong>The objective of this mixed-methods study was to elucidate attitudes of patients at the Turtle Creek Primary Care Center, a clinic that cares for ∼70% non-white patients, towards flu and COVID-19 vaccines, with the goal of establishing vaccine education gaps and increasing vaccine uptake in minority communities.</p><p><strong>Design/patients: </strong>This study was conducted as a cross-sectional analysis. Authors completed 123 patient phone surveys of patients cared for at the Turtle Creek clinic inquiring about flu and COVID-19 infection status and vaccination uptake (August 26-October 10, 2021).</p><p><strong>Approach/key results: </strong>We found that rates of vaccination were subpar in the Turtle Creek community, with only 54% having received the COVID-19 vaccine and only 44% receiving the flu vaccine regularly. There was a strong association between COVID-19 and flu vaccine acceptance and a notable correlation between vaccine acceptance and age. When assessing how vaccine acceptance was influenced by trusted sources of information, those who cited trusting \"medical professionals\" and \"word of mouth\" had higher odds of COVID-19 vaccine acceptance but those who cited trusting \"social media\" had decreased odds of acceptance. Finally, we uncovered 14 common factors for either vaccine acceptance or refusal that clustered into four overarching themes of trust, need, safety, and availability.</p><p><strong>Conclusion: </strong>These data highlight the necessity of improved vaccine education and reveal targetable populations and approaches for disseminating vaccine information.</p>","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":" ","pages":"439-451"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41221811","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}
引用次数: 0
Instituting Racial Equity: The Allegheny County Racial and Ethnic Approaches to Community Health Initiative. 实现种族平等:阿勒格尼县种族和民族社区健康倡议》(The Allegheny County Racial and Ethnic Approaches to Community Health Initiative)。
Community health equity research & policy Pub Date : 2024-07-01 Epub Date: 2022-10-20 DOI: 10.1177/2752535X221135301
Dara D Mendez, Stephanie N Christian, Andrea Casas, Samantha Scott, Hannah Hardy, Roderick Harris, Aja Wilkerson, Tiffany L Gary-Webb
{"title":"Instituting Racial Equity: The Allegheny County Racial and Ethnic Approaches to Community Health Initiative.","authors":"Dara D Mendez, Stephanie N Christian, Andrea Casas, Samantha Scott, Hannah Hardy, Roderick Harris, Aja Wilkerson, Tiffany L Gary-Webb","doi":"10.1177/2752535X221135301","DOIUrl":"10.1177/2752535X221135301","url":null,"abstract":"<p><strong>Introduction: </strong>In 2018, The Live Well Allegheny: Lifting Wellness for African Americans (LWA2) Initiative was developed to support six priority, Black communities in Allegheny County, Pennsylvania to address health equity in chronic disease. The LWA2 coalition members participated in ongoing anti-racism and racial equity sessions with a nationally recognized anti-racist facilitation team. The sessions included a 2-days experience in January 2020 along with follow up meetings throughout 2020.</p><p><strong>Methods: </strong>Surveys were administered to understand their perceptions related to anti-racism and oppression and subsequent actions as a result of the sessions. Additionally, we conducted nine in-depth interviews with organizational partners (January -May 2020) to evaluate the overall effectiveness of the coalition and inform future activities.</p><p><strong>Results: </strong>Ten participants completed the post session surveys. Seven out of 10 survey respondents felt they had a good understanding of how oppression (racism, sexism, capitalism) influenced their life and work. However, the majority indicated needing the tools to implement anti-racist strategies in their work. The in-depth interviews with organizational partners revealed that racial equity was of concern to all partners but there was variability in intentionality around racial equity as a core element of each organization's mission, goals and subsequent actions.</p><p><strong>Discussion: </strong>As a result of the interviews, coalition members developed a racial equity statement and theory of change for implementation in the coalition work and within individual organizations along with a plan for implementing an equity audit of the coalition. Coalitions of this kind should be intentional about implementing continuous strategies related to anti-racism for structural changes toward achieving racial equity in their overall work.</p>","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":" ","pages":"391-397"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40574834","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}
引用次数: 0
Activating Life Course Theory through a Whole System Prevention Framework to Address the Wicked Problem of Maternal and Infant Morbidity and Mortality. 通过全系统预防框架激活生命历程理论,解决母婴发病率和死亡率这一棘手问题。
Community health equity research & policy Pub Date : 2024-07-01 Epub Date: 2023-06-04 DOI: 10.1177/2752535X231170737
Lea Ayers LaFave, Naomi Clemmons, Milton Kotelchuck, Naima Morales Cozier, Ana Geltman, Dianne R Browne, Katie Kenyon
{"title":"Activating Life Course Theory through a Whole System Prevention Framework to Address the Wicked Problem of Maternal and Infant Morbidity and Mortality.","authors":"Lea Ayers LaFave, Naomi Clemmons, Milton Kotelchuck, Naima Morales Cozier, Ana Geltman, Dianne R Browne, Katie Kenyon","doi":"10.1177/2752535X231170737","DOIUrl":"10.1177/2752535X231170737","url":null,"abstract":"<p><strong>Background: </strong>Racial/ethnic disparities in maternal and infant morbidity and mortality (MIM&M) is a wicked problem that is reinforced and perpetuated by our system[s] of care. Life Course Theory (LCT) helps to explain drivers of health disparities, but its application is challenged. An upstream approach that promotes systemic change requires the implementation of an expanded prevention framework that includes primordial and quaternary prevention.</p><p><strong>Research design: </strong>We developed an innovative expanded Whole System Prevention Framework (WSPF) that incorporates LCT, prevention (including primordial and quaternary prevention) and systems thinking.</p><p><strong>Study sample: </strong>We implemented this new conceptual Framework with two Healthy Start community partnerships through training, service mapping, and strategic planning to address upstream drivers of MIM&M.</p><p><strong>Data collection and analysis: </strong>Service mapping revealed few Healthy Start upstream activities/services with the predominance being delivered downstream at the program (microsystem) level.</p><p><strong>Results: </strong>Service mapping provided a snapshot of the current service distribution of services across the systems. The preponderance were primary, secondary and tertiary prevention activities (75.5% and 65.6%) delivered at the program level (58.2% and 68%), revealing opportunities for upstream strategies to promote equity. The implementation process provided a new way to frame strategic planning and develop upstream strategies to promote health equity and reduce MIM&M.</p><p><strong>Conclusion: </strong>The Whole System Prevention Framework and its implementation methodology could be applied to address other wicked problems.</p>","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":" ","pages":"349-364"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11143759/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9754741","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}
引用次数: 0
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