查看更多>>摘要：The capacity of cross-sector collaboration to create meaningful change across social-ecological levels has long been understood in public health. But the ability of cross-sector collaboration to achieve systemic change around the structural determinants of health remains complicated. In 2021, now more than ever, we understand the imperative of strengthening the capacity of collaborative efforts to address the myriad structural health crises facing our communities, from police violence and mass incarceration to Jim Crow laws and redlining, to urban renewal and environmental injustice. Our proposed collective healing framework brings together the collective impact model and radical healing framework to offer a blueprint for cross-sector collaboration that understands the practices of healing to be at the center of public health collaborations and public health practice at large. In this framework, public health practitioners and our collaborators are asked to prioritize relationship building, engage in critical self-reflection, to move beyond compromise, to address differences, to interrogate traditional metrics and approaches, to remake the collective table, and to build shared understanding through action.
Brandt, Carolyn M. A.Shire, Meriel A.Wilson, GinaIto, Kristin...
6页
查看更多>>摘要：Adolescents face a number of barriers to accessing high-quality, confidential sexual and reproductive health (SRH) services. Although federally qualified health centers (FQHCs), a type of community health center (CHC), are a critical source of health care for medically underserved adolescents, they often lack the capacity and resources to provide specialized SRH services to adolescents. In this article, we describe the development and implementation of an initiative aimed at improving an FQHC's capacity to provide high-quality confidential SRH services to adolescents. For this initiative, a team of clinical and quality improvement staff developed a set of six strategies to improve adolescent SRH services at an FQHC: (1) building community relationships and galvanizing internal organizational support to improve adolescent access to confidential SRH services, (2) developing a long-acting reversible contraception (LARC) program, (3) training clinic staff on SRH and adolescent health topics, (4) adapting the adolescent patient workflow to improve SRH service delivery during appointments, (5) updating and implementing a universal adolescent health assessment tool, and (6) developing billing and registration policies that allow adolescents to receive confidential SRH services. We identified several factors that we believe were key to the successful implementation of our approach in other CHC settings, including encouraging cross-sector collaboration and community focus, providing training as a tool to engage and empower staff as agents of change, involving interdisciplinary staff, piloting on a small scale, and establishing consistent meetings with a clinic champion and improvement team.
Zolezzi, MariaLopez, JulianaMitchell-Bennet, LisaPayne, Lisa Y....
5页
查看更多>>摘要：Despite evidence that chronic care management improves outcomes, a framework designed for low income, uninsured populations is still needed to improve health disparities and guide further replication. We describe the Innovative Care for Chronic Conditions framework implemented by a coalition of clinics and agencies to address chronic care management for Mexican Americans with Type 2 diabetes mellitus who have low income and primarily uninsured. The core elements of the framework are described by clinic, home and community settings with community health workers playing an essential role in the delivery of community-based services that address the social determinants of health. Promising results are described. This framework expands the understanding of chronic care management approaches and contributes to further replication of the framework in diverse settings.
Pollack Porter, Keshia M.Bridges Hamilton, Christina N.Umstattd Meyer, M. Renee
3页
查看更多>>摘要：Play streets involve the temporary closure of streets that for a specified time create a safe place for active play. Play streets have been implemented primarily in cities; it is unknown if they could be adapted and implemented in rural areas. To learn about implementation, core components of play streets and inform adaptation, we conducted systematic peer-reviewed and grey literature searches and interviews with a purposive sample of key informants. Data were analyzed by theme and used to inform implementation of play streets by four community organizations in low-income rural areas of Maryland, North Carolina, Oklahoma, and Texas from June to September 2017. Core elements of play streets in urban areas were present in rural settings-the content (e.g., activities offered), delivery of the intervention in partnership with community members and local organizations, and reoccurrence of play streets at a single location. There were three key adaptations relating to delivery and context to consider uniquely when implementing play streets in rural areas (1) using locations other than streets, (2) varying locations to account for geographic dispersion, and (3) maximizing participation and resources by coupling play streets with community events. Play streets can be successfully implemented in rural settings with these modifications, which support feasibility, reach, and access. Play streets in rural areas should include activities for active play that are age-appropriate and fun, without necessarily tailoring content for rural areas.
Pratte, Morgan A.Ogazi, ChiomaVozzolo, ChelseaWright, Donette...
3页
查看更多>>摘要：Women in underserved communities are disproportionately affected by chronic diseases such as cardiovascular disease and cancer. The Connecticut Early Detection and Prevention Program (CEDPP) has taken a streamlined approach to improve access to comprehensive preventive health services for minority women and those with incomes below the federal poverty threshold. The CEDPP has implemented Wellness Days to improve outreach in the community and offer opportunities for health assessments, screenings, and education around chronic disease prevention and management. CEDPP contractors coordinated 47 Wellness Days in 2019, reaching 2,509 women and successfully enrolling 107 (4.3%) in the CEDPP. While the majority of Wellness Day events offered health education to participants, only 10.6% offered mammograms and 6.4% offered Papanicolaou (Pap) tests onsite. Through ongoing evaluation efforts, the CEDPP and its contractors have identified opportunities to enhance the success of Wellness Days to connect women with essential preventive services. By expanding its reach, the CEDPP will have a more widespread impact on women's health across Connecticut.
Chalela, PatriciaMcAlister, Alfred L.Akopian, DavidMunoz, Edgar...
4页
查看更多>>摘要：Given how smart phones, internet services, and social media have shown great potential for assisting smoking cessation, we constructed a Facebook chat application based on our previous work with SMS texting services. This report summarizes findings from 2,364 Spanish-speaking young adults recruited through Facebook advertising in South Texas during the 2020 New Year holiday season. Among these service users, 926 (39%) were ready to make a quit attempt, and 26 (3.1%) of those users reported that they were tobacco free 1 month later. There were no responses to a chat question survey 72 days after the dates selected for quitting. Although more research with longer follow up is needed, these findings show that social media chat applications may be helpful for at least prompting quit attempts and short-term cessation among young adult Spanish-speaking smokers. There is no evidence of an impact on long-term cessation, and more research is clearly needed.
Boatman, Dannell D.Eason, SusanConn, Mary EllenKennedy-Rea, Stephenie K....
6页
查看更多>>摘要：Background. The human papillomavirus (HPV) vaccine is viewed as a critical tool to protect against six HPVrelated cancers. Vaccination is recommended from early adolescence through age 26 years. As young people have become increasingly involved in personal health-related decisions, there is a need to tailor HPV vaccine messaging and reach this priority population on social media and digital outlets. TikTok is a growing social media platform with approximately 70% of its users between the ages of 13 and 24 years. Purpose. The aim of this study was to understand HPV vaccine messaging and interactions on TikTok as a needed first step to identifying effective strategies to reach young people with important health messaging. Methods. Content analysis was performed on 170 top TikToks focused on the HPV vaccine. TikToks were assessed for content, classification type, and number of interactions. Results. Most TikToks were provaccine, while antivaccine TikToks had more user interactions. Cancer and prevention were the main content areas of the analyzed provaccine TikToks, while the side effects were the primary focus of antivaccine messages. Approximately 30% of all top TikToks analyzed were developed by health professionals. TikToks without an explicit vaccine opinion primarily described personal experiences and mentioned side effects most often. Implications. TikTok is a growing social media platform that can be used to reach young people and encourage HPV vaccine uptake. Health professionals need to consider the interest that users have in personal experiences and address antivaccine narratives related to side effects.
查看更多>>摘要：Background There is global concern regarding the public health impact of electronic cigarettes (ECs). ECs are commonly promoted as safer than conventional cigarettes (CCs), however there is limited knowledge of the long-term health effects. This scoping review examined the pulmonary health effects of ECs reported in the literature from 2009 to 2019. Method PubMed, CINAHL, and Science Direct databases were used. Search terms included "vaping, electronic nicotine delivery systems, electronic cigarettes, lung diseases, respiratory diseases, and pulmonary." Original research articles in English that used human subjects between January 1, 2009 and January 31, 2020 and reported pulmonary outcomes were included. Results Forty-five studies met the inclusion criteria. There were 14 (31.1%) randomized experimental, 7 (15.6%) nonrandomized experimental, 6 (13.3%) cohort, and 18 (40.0%) cross-sectional studies. Sixteen (35.6%) studies were conducted in the United States; the rest were conducted across 11 other countries. The total number of subjects was 1,465,292 and ages ranged from 12 to 99 years across studies. Eligible studies demonstrated an association between EC use and pulmonary symptoms, asthma and chronic obstructive pulmonary disease diagnosis and exacerbations. The degree of this association varied based on the use of additional tobacco products. EC use resulted in worse outcomes than nonsmoking, but resulted in improved outcomes when compared with CC use or dual use of CC and EC. Conclusion Evidence indicates that EC use, especially dual use, leads to negative pulmonary effects and adverse outcomes. Education on the potential risks and publishing of EC ingredients on labels could help improve public health safety communication and reduce EC use.
Kristjansson, Alfgeir L.Davis, Stephen M.Coffman, JessicaMills, Rosalina...
10页
查看更多>>摘要：The purpose of this study was to assess the feasibility of implementing the Icelandic model for Primary Substance Use Prevention (IPM) in rural Central Appalachia. Guided by the IPM's theoretical framework, 26 stakeholders from a single county in West Virginia were purposefully recruited during the spring of 2019 and divided into four focus groups. Interviews were recorded and transcribed verbatim and analyzed into themes based on IPM premises. Focus group material produced seven themes: Drug use overall, Drug treatment and other service needs, Poverty, Parenting/Caregiver practices, Transportation, Downtime/Leisure time activities, and Opportunities for solutions. General support was found for the potential of the IPM in the region. Preferably, the implementation of the model should coincide with attention to the adult population as drug use was reported to be plaguing the whole community. Treatment options were few and mostly far away. General poverty and lack of public transportation further stifled progress and potential for change. Organized leisure time activities and programs for youth were scarce and mostly seasonal. Suggested solutions for the adult community included workforce and skill training, coupled with increased opportunities for organized leisure activities for youth, and access to healthy role models via schools and faith-based organizations. We conclude that implementation of the IPM would be feasible to prevent substance use initiation and progression among youth in the rural Central Appalachia. We present several specific recommendations for policy and practice that address factors unique to this environment to initiate the IPM implementation development and suggest initial model application strategies.
NSTL
Sage