Community health equity research & policy最新文献_第6页

Use of Subsidized Health Services by Artists in Canada: An Exploratory Study. 加拿大艺术家使用补贴医疗服务的情况：一项探索性研究。

Community health equity research & policy Pub Date : 2024-10-12 DOI: 10.1177/2752535X241290666

Sesinam de Youngster, Shelly-Anne Li

{"title":"Use of Subsidized Health Services by Artists in Canada: An Exploratory Study.","authors":"Sesinam de Youngster, Shelly-Anne Li","doi":"10.1177/2752535X241290666","DOIUrl":"10.1177/2752535X241290666","url":null,"abstract":"Introduction: Creative and performing artists are often confronted with precarious employment and insufficient healthcare coverage. A clinic in Canada that provides specialized healthcare to artists offers eligible artists subsidized health services. We aim to compare the use of health services, demographics and health conditions between subsidy artist recipients (SAs) and non-subsidy artists (NSAs).Methods: We accessed existing data from 265 SAs and 711 NSAs and applied descriptive and inferential statistics to address our research questions.Results: Musculoskeletal issues, stress, anxiety disorders, and depressive disorders are the most common health problems faced by SAs. Compared to NSAs, SAs were more likely to seek treatment for stress, but less likely to seek treatment for anxiety disorders, depressive disorders, chronic problems, and upper extremity problems.Discussion: Future research may investigate the enduring effects of subsidized health services on SAs' health outcomes. Sustained positive outcomes are crucial for maintaining an artist's career and well-being.","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":" ","pages":"2752535X241290666"},"PeriodicalIF":0.0,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142482299","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

Travel Burden to Cancer Screening and Treatment Facilities Among Washington Women: Data From an Integrated Healthcare Delivery System. 华盛顿妇女到癌症筛查和治疗机构的旅行负担:来自综合医疗保健服务系统的数据。

Community health equity research & policy Pub Date : 2024-10-01 Epub Date: 2023-11-17 DOI: 10.1177/2752535X231215881

Solmaz Amiri, Jeanne Robison, Chaya Pflugeisen, Pablo Monsivais, Ofer Amram

{"title":"Travel Burden to Cancer Screening and Treatment Facilities Among Washington Women: Data From an Integrated Healthcare Delivery System.","authors":"Solmaz Amiri, Jeanne Robison, Chaya Pflugeisen, Pablo Monsivais, Ofer Amram","doi":"10.1177/2752535X231215881","DOIUrl":"10.1177/2752535X231215881","url":null,"abstract":"Purpose: To characterize distance traveled for breast cancer screening and to sites of service for breast cancer treatment, among rural and urban women served by a Washington State healthcare network.Methods: Data for this study came from one of the largest not-for-profit integrated healthcare delivery systems in Washington State. Generalized linear mixed models with gamma log link function were used to examine the associations between travel distance and sociodemographic and contextual characteristics of patients.Results: Median travel distance for breast cancer screening facilities, hematologist/oncologists, radiation oncologists, or surgeons was 11, 19, 23, or 11 miles, respectively. Travel distance to breast cancer screening or referral facilities was longer in non-core metropolitan ZIP codes compared to metropolitan ZIP codes. AI/AN and Hispanic women travelled longer distances to reach referral facilities compared to other racial and ethnic groups.Conclusion: Disparities exist in travel distance to breast cancer screening and treatment. Further research is needed to describe sociodemographic and system level characteristics that contribute to such disparities and to discover novel approaches to alleviate this burden.","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":" ","pages":"13-21"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136400532","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

A Qualitative Exploration of Refugee Experiences of Access to a Dedicated Multi-Disciplinary Refugee Health Team in an Australian Context: Implication for Future Care. 在澳大利亚背景下，对难民获得专门的多学科难民医疗团队服务的经历进行定性探索：对未来护理的启示。

Community health equity research & policy Pub Date : 2024-09-19 DOI: 10.1177/2752535X241286250

Jennifer White, Ashley Young, Murray Webber, Joy Harrison, Amy Hiscox, Jessica Lush, Baeho Joo, Janessa Sherrin, Mattias Grasselli, Julie Byles

{"title":"A Qualitative Exploration of Refugee Experiences of Access to a Dedicated Multi-Disciplinary Refugee Health Team in an Australian Context: Implication for Future Care.","authors":"Jennifer White, Ashley Young, Murray Webber, Joy Harrison, Amy Hiscox, Jessica Lush, Baeho Joo, Janessa Sherrin, Mattias Grasselli, Julie Byles","doi":"10.1177/2752535X241286250","DOIUrl":"https://doi.org/10.1177/2752535X241286250","url":null,"abstract":"Aims: Refugees experience physical and mental health issues that need attention following settlement in a new community. However, access to and utilisation of healthcare services is challenging. We aimed to explore the experience of refugee access to a dedicated multi-disciplinary refugee health team.Methods: An interpretative qualitative study. 17 qualitative interviews were conducted with Ezidi refugees who attended a newly established multi-disciplinary refugee health program in a regional town in NSW, Australia. Data were analysed using an inductive thematic approach.Results: Participants (n = 17) identified as Ezidi and were from Iraq. Parents were between 23 and 57 years of age and had 1-12 children per family. Most had been in Australia between 2 and 5 years. Four key themes were identified: (1) Identifying the extent of health needs following a long wait to migrate; (2) Health support across the life span: the benefit of access to a multi-disciplinary team; (3) Gaps in cultural competence - impacted by understanding and interpreter access; and (4) Ongoing health and lifestyle concerns - influenced by understanding and education.Conclusions: We identified the benefit of access to allied health for prompt diagnosis, treatment and management of conditions including congenital and developmental conditions, mental health and chronic diseases. Access to a dedicated team ensured early intervention for a broad range of health and social issues including early referral to services, close coordination and help to complete supporting paperwork and applications. Ongoing investments are needed to maintain this comprehensive and coordinated approach to care that is underpinned by a family centric approach.","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":" ","pages":"2752535X241286250"},"PeriodicalIF":0.0,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302406","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

The Women and Children of India's Red-Light Brothel Districts: An Exploratory Investigation of Vulnerability and Survival During a Global Pandemic. 印度红灯妓院区的妇女和儿童：对全球大流行病期间脆弱性和生存状况的探索性研究。

Community health equity research & policy Pub Date : 2024-09-12 DOI: 10.1177/2752535x241280226

Sharvari Karandikar,Rochelle L Dalla,Kaitlin Casassa

{"title":"The Women and Children of India's Red-Light Brothel Districts: An Exploratory Investigation of Vulnerability and Survival During a Global Pandemic.","authors":"Sharvari Karandikar,Rochelle L Dalla,Kaitlin Casassa","doi":"10.1177/2752535x241280226","DOIUrl":"https://doi.org/10.1177/2752535x241280226","url":null,"abstract":"Globally, women and children were disproportionately impacted by the COVID-19 pandemic. Vulnerable populations of women and children-including those who live in poverty, lack access to health care, have little informal support, and who face stigma and discrimination-were particularly susceptible to harm incurred by the pandemic. Using social determinants of health framework, this investigation sought to understand the lived experiences of women and children residing in an impoverished, resource-poor, urban brothel red-light brothel area district in India, at the outset of the pandemic and following the national lockdown(s). Four questions guided the investigation: (1) How did participants first hear about COVID-19 and what was learned regarding self-protective measures? (2) What daily life challenges were posed by the national lockdown? (3) To what extent were participants able to access or rely on informal supports support during the initial stages of the pandemic? and (4) What types of assistance, if any, did participants receive from non-governmental organizations (NGOs) or other (e.g., governmental) sources? This is one of only a handful of empirical investigations elevating the voices of children residing in urban brothel-based red-light districts. Findings pose significant implications for practice, policy, and continued research.","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":"5 1","pages":"2752535X241280226"},"PeriodicalIF":0.0,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142267280","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":"Background: Text messages are useful for health promotion and can be modified during public health emergencies.Purpose: 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.Research design and study sample: PA promotion text messages were delivered to predominately Spanish-speaking, churchgoing Latino adults (n = 284) in Los Angeles, California. In 2020, we modified the messages to disseminate COVID-19-related information and support and share virtual PA resources.Data collection and analysis: We analyzed quantitative and qualitative survey data to gauge participants' experiences with the text messages.Results: COVID-19 related text messages were a feasible, acceptable addition to a PA intervention for a sample of Latinos.Conclusions: 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.","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":"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, Nids d'Apprentissage en Contexte Ordinaire) 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.","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":"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.","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":"Background: 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.Objective: 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.Design/patients: 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).Approach/key results: 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.Conclusion: These data highlight the necessity of improved vaccine education and reveal targetable populations and approaches for disseminating vaccine information.","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":"Introduction: 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.Methods: 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.Results: 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.Discussion: 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.","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":"Background: 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.Research design: We developed an innovative expanded Whole System Prevention Framework (WSPF) that incorporates LCT, prevention (including primordial and quaternary prevention) and systems thinking.Study sample: 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.Data collection and analysis: Service mapping revealed few Healthy Start upstream activities/services with the predominance being delivered downstream at the program (microsystem) level.Results: 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.Conclusion: The Whole System Prevention Framework and its implementation methodology could be applied to address other wicked problems.","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