Community health equity research & policy最新文献

{"title":"Shifting the Paradigm From Participant Mistrust to Researcher & Institutional Trustworthiness: A Qualitative Study of Researchers' Perspectives on Building Trustworthiness With Black Communities.","authors":"Cynterria Henderson, Taylor Scott, Bee Schinder, Erricka Hager, Felicia Savage Friedman, Elizabeth Miller, Maya I Ragavan","doi":"10.1177/0272684X221117710","DOIUrl":"10.1177/0272684X221117710","url":null,"abstract":"<p><strong>Introduction: </strong>Black communities are deeply underrepresented in research, due, in large part, to research mistrust. It is critical to shift the burden of trust building from communities to researchers and research institutions, which have perpetrated harm against Black communities for centuries. In this study, we examine researchers' perspectives on how to become trustworthy to Black-identifying participants and communities.</p><p><strong>Methods: </strong>We conducted semi-structured interviews with researchers affiliated with our institution's Clinical and Translational Science Institute. Participants were recruited through email and responded to the study team if they wished to participate. Interviews occurred through Zoom, took 60 minutes, and were audio recorded. We used an inductive thematic data analysis approach.</p><p><strong>Results: </strong>Sixteen researchers, who were affiliated with medicine, public health, psychology, education, and nursing, participated in this study. Participants agreed that researchers bear the responsibility for building trust and noted how critical it is to address the underrepresentation of Black participants in research through equitable recruitment and that researchers must be transparent and engage in reciprocal research practices. Community-partnered research was highlighted as a way to develop trustworthiness. Finally, participants noted that trustworthiness must also be built at the institutional level, rather than just by individual researchers.</p><p><strong>Discussion: </strong>To our knowledge, this is one of the first studies to examine researchers' perspectives on how to build their own trustworthiness, with a specific focus on trust-building with Black communities. Explicit training and resources are needed to build trustworthiness into academic centers.</p>","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":" ","pages":"127-136"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40372881","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":"Understanding the Public Health Role, Motivations, and Perceptions of Community Health Workers Deployed to Low-Income Housing in Richmond, Virginia.","authors":"Iyabo Obasanjo, Alison Scott, Monica Griffin, Amma Agyemang-Duah, Charlie Westhoff, Stephanie Toney, Patrice Shelton","doi":"10.1177/2752535X231154051","DOIUrl":"10.1177/2752535X231154051","url":null,"abstract":"<p><strong>Background: </strong>For the US health indicators to improve to the level of other developed countries, the use of Community Health Workers (CHWs) in vulnerable populations has been indicated as a possible long-term intervention. There are few models of long-term deployment of CHWs as part of the district level public health system in the US.</p><p><strong>Method: </strong>In this study we interviewed CHWs who served as neighborhood-integrated health district staff assigned to low-income housing in Richmond, Virginia for 10 years. Qualitative analyses of their taped and transcribed interviews resulted in 5 themes from the interviews. The themes were Activities, Satisfaction, Strengths, Facilitation/Resources and Challenges. We highlighted quotes from the CHWs interviews for themes and summarized the findings from each theme.</p><p><strong>Results: </strong>CHWs carried out a variety of activities daily and these were described. The CHWs were generally satisfied with their job because it enabled them to assist others. The strength of their communities was resilience, and the resources they needed more included physical resources, human resources, political support, and more comprehensive programming. Their client's challenges include transportation, mental health, and physical safety and the CHWs challenge to effectively carrying out their work with clients was trust by community members.</p><p><strong>Conclusion: </strong>The information garnered from the CHWs would be useful in designing CHW programs at other health districts.</p>","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":" ","pages":"219-227"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10586485","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":"\"Black Women Don't Always Put Our Healthcare First\": Facilitators and Barriers to Cervical Cancer Screening and Perceptions of Human Papillomavirus Self-Testing Among Church-Affiliated African American Women.","authors":"Kelsey Christensen, Alexandria G Bauer, Tacia Burgin, Joah Williams, Joan McDowd, Gary Sutkin, Kymberly Bennett, Carole Bowe Thompson, Jannette Y Berkley-Patton","doi":"10.1177/0272684X221115494","DOIUrl":"10.1177/0272684X221115494","url":null,"abstract":"<p><p><b>Background:</b> African American women are at greater risk for cervical cancer incidence and mortality than White women. Up to 90% of cervical cancers are caused by human papillomavirus (HPVs) infections. The National Institutes of Health (NIH) co-developed HPV self-test kits to increase access to screening, which may be critical for underserved populations. <b>Purpose/Research Design:</b> This mixed methods study used the Theory of Planned Behavior to examine attitudes, barriers, facilitators, and intentions related to receipt of cervical cancer screening and perceptions of HPV self-testing among church-affiliated African American women. Study Sample/Data Collection: Participants (<i>N</i> = 35) aged 25-53 participated in focus groups and completed a survey. <b>Results:</b> Seventy-four percent of participants reported receipt of cervical cancer screening in the past 3 years. Healthcare providers and the church were supportive referents of screening. Past trauma and prioritizing children's healthcare needs were screening barriers. Concerns about HPV self-testing included proper test administration and result accuracy. <b>Conclusions:</b> Strategies to mitigate these concerns (e.g., delivering HPV self-test kits to the health department) are discussed.</p>","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":" ","pages":"137-150"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40372884","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":"Contending With Precarity: Health and Multi-Sectoral Supports for Migrant Agricultural Workers in Southern Ontario.","authors":"C Susana Caxaj, Glynis George, Erika Borrelli, Linda Frost","doi":"10.1177/2752535X231221587","DOIUrl":"10.1177/2752535X231221587","url":null,"abstract":"<p><p>Research has long-documented how Canada's temporary foreign worker programs (TFWP) foster workers' precarity through their status as non-citizens and living and working conditions, ultimately, impacting their health. While studies point to limited supports and services for workers, their role in reinforcing or alleviating the precarious conditions that migrant agricultural workers experience remains largely unexplored. This paper draws on interviews with 35 service providers in three migrant-intensive regions in southwestern Ontario, to explore how service providers describe and construct support. We explore the barriers workers face in accessing services, challenges providers experience in supporting workers, and strategies employed to surmount these barriers. We argue that this multiregional analysis is important to illuminate how support shapes and is shaped by the larger structural context, namely common features of Canada's TFWP. A more comprehensive understanding of support moreover, provides direction for sustainable interventions that can promote the health and wellbeing of this population.</p>","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":" ","pages":"2752535X231221587"},"PeriodicalIF":0.0,"publicationDate":"2023-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11437694/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138813418","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":"Community Groups Co-Design Evidence-Based Docudramas to Communicate About Child Spacing in Bauchi State, Nigeria: A Qualitative Descriptive Study.","authors":"Umaira Ansari, Khalid Omer, Yagana Gidado, Muhd Chadi Baba, Adamu Ibrahim Gamawa, Lois Ezekiel Daniel, Neil Andersson, Anne Cockcroft","doi":"10.1177/2752535X231221594","DOIUrl":"10.1177/2752535X231221594","url":null,"abstract":"<p><p>In Bauchi State, northern Nigeria, communities recognise short birth interval (<i>kunika</i> in the Hausa language) as harmful, but family planning is a sensitive topic. This paper describes the development of a culturally safe way to communicate about <i>kunika</i> in a conservative Muslim setting. The objective was to co-design culturally safe communication material, based on local knowledge about short birth interval, to share with women and men in households.Six community co-design groups of women and six of men (total 96 participants) reviewed summaries of their previously created maps of perceived local causes of <i>kunika,</i> categorised as frequent sex, family dynamics and non-use of contraception. They advised how these causes could be discussed effectively and acceptably with women and their husbands in households and suggested storylines for three short video docudramas about the prevention of <i>kunika.</i> The research team created the docudramas with a local producer and fieldworkers piloted their use in households.The design groups advised that communication materials should focus on child spacing rather than on limitation of family size. Even sensitive issues could be covered. People would not change their sexual behaviour but could be advised to use contraceptives to prevent <i>kunika</i>. The groups approved the final videos and six focus groups of visited women and men reported they were acceptable and helpful. Community co-design of communication about <i>kunika</i> was feasible and led to videos about a sensitive topic that were acceptable to ordinary men and women in communities in Bauchi.</p>","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":" ","pages":"2752535X231221594"},"PeriodicalIF":0.0,"publicationDate":"2023-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11418317/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138813417","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":"Disparities in Lung Cancer Clinical Trial Discussion and Enrollment at a Safety Net Hospital.","authors":"Harshitha Dudipala, Laura Burns, Chinmay T Jani, Amr Radwan, Omar Al Omari, Mohini Patel, Seyda Kilic, Jenny Zhao, Kimberley Mak, Kei Suzuki, Umit Tapan","doi":"10.1177/2752535X231221394","DOIUrl":"https://doi.org/10.1177/2752535X231221394","url":null,"abstract":"<p><strong>Background: </strong>In the United States, less than 5% of all adult cancer patients enroll in clinical trials. Few studies explore participation in cancer clinical trials at safety net hospitals, which disproportionately care for minoritized, low-income, uninsured, and underinsured populations. Our study aims to investigate disparities in clinical trial discussions and enrollment among lung cancer patients at Boston Medical Center, the largest safety net hospital in New England.</p><p><strong>Methods: </strong>We included 1121 patients diagnosed with lung cancer between January 2015 and December 2020. Electronic Medical Records (EMR) were queried, and patients were categorized into three groups: (1) clinical trial discussed and the patient enrolled, (2) clinical trial discussed but the patient not enrolled, and (3) clinical trial not discussed. Sociodemographic variables such as age, gender, race, ethnicity, city, primary language, median household income, medical insurance type, and education level were also collected. Chi-squared,<i>t</i> test, and multivariate regression analysis was done using SPSS version 26.0.</p><p><strong>Results: </strong>Of the 1121 patients, clinical trials were discussed in 141 patients (12.6%), of which 22 (15.6%) were enrolled. Clinical trial discussions were conducted more with younger patients (68.19 vs 71.37, <i>p</i> = .001), but on multivariate analysis there was no significant difference (OR = 1.023; 95% CI 0.998-1.048; <i>p</i> = .068). There was no significant difference in clinical trial discussion or enrollment between the other sociodemographic factors.</p><p><strong>Conclusion: </strong>Additional study of barriers to cancer clinical trial discussion and enrollment at safety net institutions can serve as a prerequisite to ameliorating racial disparities observed on a national scale.</p>","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":" ","pages":"2752535X231221394"},"PeriodicalIF":0.0,"publicationDate":"2023-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138813419","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":"Caring in the Context of Systems: Service Provider Perspectives on the Mental Health Needs of Newcomer Young Men.","authors":"Mia Tulli-Shah, Carla Hilario, Bukola Salami, Josephine Pui-Hing Wong","doi":"10.1177/2752535X231217211","DOIUrl":"10.1177/2752535X231217211","url":null,"abstract":"<p><p>In this study, we applied an intersectional framework to explore service providers' perspectives on the mental health needs of newcomer young men. We conducted focus groups and interviews with 26 service providers in Edmonton, Calgary, and Vancouver, Canada. Findings show that service providers made sense of young men's mental health needs and service access in the context of systems. We identified three interconnected themes: newcomer young men's senses of self in relation to macro-systems, including racism and economic marginalization; settling well as a determinant of mental health; and systems capacities and interdependent resilience. While service providers are engaged in cross-sectoral work in support of newcomer young men's mental health, this work is not being sufficiently supported. Further work is needed around cross-sector capacity bridging and advocacy, as well as the tailoring of services to young men without the assumption and reinforcement of gender stereotypes.</p>","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":" ","pages":"2752535X231217211"},"PeriodicalIF":0.0,"publicationDate":"2023-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11416732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138296680","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":"Success and Challenges of Community Bicycle Advocacy Organizations in Reaching Underserved Populations.","authors":"Lucas D Elliott, Melissa Bopp","doi":"10.1177/2752535X231211418","DOIUrl":"10.1177/2752535X231211418","url":null,"abstract":"<p><strong>Introduction: </strong>Bicycling, as forms of recreation and travel, offers many positive physical and mental health benefits, though there are still many disparities in bicycling rates among underserved populations in the United States. Community bicycling advocacy organizations/coalitions promote and advocate for increased bicycling; however, have been shown to have a lack of organizational capacity for equitable programming to diverse populations (racial/ethnic minorities, women, low-income, LGBTQ+ communities, youth). The purpose of this study was to understand the current practices for providing underserved populations bicycling programming among advocacy organizations and to find major barriers and helpful tools for equitable programming.</p><p><strong>Methods: </strong>This was conducted in a volunteer sample of U.S. bicycle advocacy organizations. An interview (<i>n</i> = 23) assessed organizational function, successful programs, and barriers to reaching underserved populations.</p><p><strong>Results: </strong>Several themes emerged from the interviews. Participants stated that the lack of organizational leadership and member diversity, along with a lack of trust with underserved communities, presented major barriers to providing equitable programming. Partnering with other community organizations that place an emphasis on serving diverse populations was noted to have potential for increasing successful programming by allocating resources and connections.</p><p><strong>Conclusion: </strong>Although barriers exist for bicycle advocacy organizations when attempting to reach underserved and diverse populations, groups should focus on creating successful and diverse partnerships to increase the capacity for providing equitable programming.</p>","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":" ","pages":"2752535X231211418"},"PeriodicalIF":0.0,"publicationDate":"2023-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11418315/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71489629","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":"Adherence to Antiretroviral Medications Among People Living With HIV in the Era of COVID-19 in Central Ethiopia and Perceived Impact of the Pandemic.","authors":"Tariku Shimels,&nbsp;Rodas A Kassu,&nbsp;Gelila Bogale,&nbsp;Mahteme Bekele,&nbsp;Melsew Getnet,&nbsp;Abrham Getachew,&nbsp;Zewdneh Shewamene,&nbsp;Mebratu Abraha","doi":"10.1177/0272684X221094151","DOIUrl":"10.1177/0272684X221094151","url":null,"abstract":"<p><strong>Aim: </strong>This study assessed the level of adherence to antiretroviral drugs and the associated factors among clients who have a follow-up at public health facilities in central Ethiopia.</p><p><strong>Method: </strong>A multi-site cross-sectional study was conducted from August 1-30, 2020 at seven public health institutions. A systematic random sampling method was used to recruit 385 participants. Data was collected using a structured interviewer-administered questionnaire. Analysis was done using descriptive statistics, and binary logistic regression model. The OR with its 95% C.I was employed to present analytic outputs. Statistical significance for the multivariable model was considered at <i>p</i> ≤ 0.05.</p><p><strong>Results: </strong>Of the 371 participants, the majority were females (233, 62.8%), attended health centers (215, 58.0%), and were married (173, 46.6%). Eighty-nine (89, 24.0%) of the participants have at least one comorbidity. About 72 (19.0%) and 50 (13.5%) of the respondents stated that the COVID-19 has posed challenges on their follow-ups and availability of medications respectively. Nearly a half of the people living with HIV and comorbid T2DM or hypertension (29, 48.0%) reported that they had encountered an increase in the price of medications compared to the pre-COVID-19 times. About half of the respondents in the study setting have perfect adherence to antiretroviral therapy (ART) (200, 54.0%). Basic education (aOR = 3.02: 95% CI: 1.57-5.80), marriage (aOR = 2.27: 95% CI: 1.24-4.15), attendance to a health center (aOR = 0.59: 95% CI: 0.36-0.98) and sleep disturbance (aOR = 0.47: 95% CI: 0.26-0.84) showed a statistically significant association with adherence to ART.</p><p><strong>Conclusion: </strong>About half of the respondents in the study settings have perfect adherence to their ART medications. As multiple factors interplay in the success rate of adherence to ART, stakeholders should place and strengthen practices, such as active follow-up and tracing of cases, ensuring medication affordability (access and low pricing), and psycho-social support to patients.</p>","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":"44 1","pages":"99-107"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9364070/pdf/10.1177_0272684X221094151.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10346718","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":"Multi-Level Correlates of the Nutritional Status of Nigerian Women of Reproductive Age.","authors":"Nkiru N Ezeama,&nbsp;Nene Okunna,&nbsp;Chukwuemeka O Ezeama","doi":"10.1177/2752535X221126071","DOIUrl":"10.1177/2752535X221126071","url":null,"abstract":"<p><p>Poor nutrition compromises the capacity of women to perform their vital roles as mothers and productive workers in their families, communities and society. Using a conceptual framework developed by the United Nations Children's Fund, this study determines individual-, household- and community-level factors associated with the nutritional status of Nigerian women of reproductive age. A secondary analysis of pooled data from the Nigeria Demographic and Health Survey (NDHS) for 2003, 2008, 2013 and 2018 was conducted involving 82,734 non-pregnant women aged 15-49 years. Multinomial logistic regression was used to determine predictors of nutritional status. Study results show that a significant proportion of the women had poor nutritional status; the prevalence of underweight, overweight and obesity were 12.1%, 16.8% and 7.2% respectively. Statistically significant factors associated with poor nutritional status were found at all three levels, highlighting the need for effective multidimensional, multisectoral policy interventions to address the double burden of malnutrition among women in Nigeria.</p>","PeriodicalId":72648,"journal":{"name":"Community health equity research & policy","volume":"44 1","pages":"109-121"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10363183","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}